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Mind and Body > Neurological disorders > Flashcards

Neurological disorders Flashcards

1
Q

What is aquired brain injury?

(Drake et al 2015)

A

traumatic and other causes of brain injury such as stroke.

this is distinct from degenerative disorders of the brain which tend to be progressive.

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2
Q

What are the causes of traumatic brain injuries?

(Drake et al 2015)

A
  • trauma to the head
  • e.g. traffic accidents, assaults, falls
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3
Q

What is a mild brain injury?

A
  • brief period of unconsciousness
  • recovery is likley to be good and fast
  • GCS 13-15
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4
Q

What is a moderate brain injury?

A
  • loss of consciousness 15mins-6 hours
  • recovery is often good however could have some residual disability
  • GCS 9-12
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5
Q

What is a severe brain injury?

A
  • unconsciousness over 6 hours
  • very limited recovery
  • GCS less than 9
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6
Q

What is a primary brain injury?

(Drake et al 2015)

A
  • a closed head injury, no break of skin or wound
  • head is rocked back and forth with brain following movement
  • results in the nerve fibres twisting, stretching, and tearing
  • most common type of injury
  • Often happens as a result of rapid acceleration or deceleration e.g. car hitting a wall.
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7
Q

What is a diffuse brain injury?

(Drake et al 2015)

A
  • a mild injury that produces damage widespread in the brain
  • the front of the skull has sharp, bony, ridges where the brain collides, causing more damage.
  • arteries and veins in the brain can be damaged causing blood to leak.
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8
Q

What happens in crushing injuries?

(Drake et al 2015)

A
  • the head is caught between two hard objects
  • the least common type of injury.
  • often the damage is the base of the skull and nerves of the brain stem rather than the brain itself.
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9
Q

What is an anoxic brain injury?

(Drake et al 2015)

A

When the brain becomes starved of oxygen

  • this makes damage from primary injuries worse
  • may happen from choking, blood blocking airways, position someone is lying blocking their airway
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10
Q

What is a secondary brain injury?

(Drake et al 2015)

A
  • takes place anytime after primary brain injury, may be days or weeks after
  • due to bleeding, bruising, or swelling in the brain because blood clots have developed
  • the skull cannot expand due to the fluids leading into the brain causing it to swell
  • this means the brain is sqeezed against the skull, damaging it and limiting circulation
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11
Q

How are blood clots formed in the brain and what is their impact?

(Drake et al 2015)

A
  • blood leaks from damaged veins and arteries and pools into a clot
  • they can press on surrounding brain tissue which can damage it, and they also raise pressure in the brain.
  • can occur in the brain itself or the space between the brain and the skull
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12
Q

What are the most visible signs of brain injury?

(Drake et al 2015)

A
  • coma
  • loss of power in the arms and legs
  • speech impairment
  • traumatic brain injury causes numerous ‘hidden disabilities’ in that it results in changes to personality, thinking and memory.
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13
Q

How do you reduce the risk of head injury?

(Drake et al 2015)

A
  • ensure home is free of trip hazards
  • childproof home
  • use right safety equipment for work
  • wear helmets
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14
Q

What is a stroke?

(Drake et al 2015)

A

an interruption of blood supply to area of brain, depriving it of oxygen and nutrients causing the cells to die

  • two types, either a clot or a bleed
  • ischemic stroke is the most common type, occuring when a blood clot prevents blood flow to the brain, accounts for 87% of strokes
  • haemorrhagic stroke is when a blood vessel in the brain leaks or ruptures, causing the brain to swell and put pressure on brain cells, damaging them. can occur in the brain itself or in the subarachnoid space in the arteries
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15
Q

Give some statistics about stroke in the UK.

(Drake et al 2015)

A
  • in 2019, 8% of all deaths in the UK were due to stroke
  • there were 718,222 iindiviuals living with stroke in 2019
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16
Q

How is blood supplied to the brain?

(Drake et al 2015)

A
  • comes from arterial circle at base of skull, made of the internal catotid and cerebral arteries
  • the brainstem and cerebellum get their blood supply from branches off the basilar artery
  • the cerbrum and cerbeal cortex get thier blood supply from the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA)
17
Q

How are ischaemic strokes treated?

(Drake et al 2015)

A
  • use of fibrinolytic drugs to break down the blood clot
  • removal of the blood clot via a catheter based procedure requiring specialist resources
18
Q

How are haemorrhagic strokes treated?

(Drake et al 2015)

A
  • catheter based approaches, packing the aneurism
  • surgical based approaches to clip the aneurism
19
Q

What is BEFAST?

A
  • stokes have different effects depending on the area of the brain however these are common signs

B- balance

E- eyes- blurry, double vision or loss of vision

F- facial drooping - or numbness

A- arm weakness

S-speech difficulty, slurred words, unable to speak

T- time to call 999

Early diagnosis and intervention lead to better outcomes

20
Q

What mechanisms can cause neurodegeneration?

(Sience/AAAS, 2019)

A
  • autophagy- breaks down and destruction of old, damaged or abnomal proteins
  • oxidative stress- imbalance free radicals and antopxidants in the body causing damage
  • apoptosis-programmed cell death
  • necrosis- cell death
21
Q

What is autophagy?

(Sience/AAAS, 2019)

A

normal housekeeping in cells, elimating waste and protecting against variations in nurtient availability

if disrupted toxic substances can accumulate, disruping cell function and causing harm

22
Q

What is oxidative stress?

(Sience/AAAS, 2019)

A

when there is an inbalance btween the production of free radicals and the body’s ability to neutralize them with antioxidants.

free radicals are products of metabolic processes and are highly reactive molecules containing oxygen and can cause damage to the body

when there’s an excess of free radicals or a deficiency of antioxidants, oxidative stress can occur as the body cant neutralise them

23
Q

What is apoptosis?

(Sience/AAAS, 2019)

A
  • programmed cell death
  • cells undergo a series of controlled biochemical changes that ultimately lead to their self-destruction.
  • apoptosis is a controlled process that does not trigger inflammation or damage surrounding tissues, unlike other forms of cell death.
24
Q

What is necrosis?

(Sience/AAAS, 2019)

A

a form of cell death that occurs as a result of injury, infection, or disease.

  • Unlike apoptosis, which is a programmed and controlled process of cell death, necrosis is typically unplanned and unregulated.
25
Q

What is Parkinson’s disease?

(Sience/AAAS, 2019)

A
  • loss of dopaminergic cells in the basal ganglia of the brain
  • leads to a reduction in dopamine casuing tremor, bradykinesia (slowness of movement and rigidity), leading to reduced movements, changes in personality and behaviour, and cognitive impairment
  • prevalnce increases with age
  • 6.1 million with Parkinson’s worldwide
26
Q

What is Huntington’s disease?

(Sience/AAAS, 2019)

A
  • inherited progressive neurodegnerative disorder
  • characterised by chorea (irregular, involuntray movements), psychiatric problems, behavioural changes, cognitive decline, and dementia
  • autosomal dominant disorder on chromosome 4, each child of an affected person has a 50% change of inheriting the full mutation
  • no cure, slowly progressing disorder with average survival of 10-20 years
27
Q

What is motoneuron disease?

(Sience/AAAS, 2019)

A
  • affects the nerve cells responsible for controlling voluntary muscle movements (motor neurons).
  • the motor neurons gradually degenerate and die, leading to muscle weakness, atrophy (shrinkage), and eventually paralysis.
  • leads to difficulty with activities such as walking, speaking, swallowing, and breathing. MND can also affect other aspects of motor function, including fine motor skills and coordination.
28
Q

What is Prion disease?

(Sience/AAAS, 2019)

A
  • rare, progressive neurodegenerative disorder where abnormal, infectious protiens called prions build up in the brain causing microscopic holes to form in brain tissue
  • Prions also induce normal proteins to adopt the misfolding, leading to a chain reaction
  • this accumulation of Prions leads to brain degeneration and disrupted function
  • fatal with no effective treatment to stop progression
  • management primarily involves supportive care to alleviate symptoms and ensure patient comfort.
29
Q

What is dementia?

(Sience/AAAS, 2019)

A
  • most common neurodegentive disease
  • affects primarily cells in cerebral cortex and reduces function
  • accumulation of toxic fragments, damaging synapses, forming plaques and causing cell death
  • symptoms include forgetfulness,
    language deterioration,
    mood changes and impaired judgement
  • types include alzheimers, vascular, Lewy body, dementia, fronto temporal dementia
30
Q

What are some things healthcare professionals can do to increase good outcomes after a stroke?

A
  • early stroke consultatnt assessment
  • CT scan within 24 hours
  • early nurse and therpaist assessment
  • early swallow and nutrion assessment
  • early iv fluids and aspirin
31
Q

How does stroke change BG?

A
  • increased BG levels can lead to strokeand there is acute hyperglycaemia at time on infarct
  • should monitor on admission
  • worse BG outcomes after stroke
32
Q

How can nurses prevent risk of aspiration?

A
  • postion the pateint upright- at head of bed, at least 30 degrees
  • set up suction at bedside
  • remain nil by mouth until dysphagia screening completed
33
Q

Why do nurses need to monitor temperature?

A
  • fever could have critical effect in first 24hrs after stroke
  • 37.5 - treat aggressively physical and pharmacologically and prevent shivering
  • goal is to reduce the fever
34
Q

What are essential nursing interventions in acute stroke care?

A
  • positioning: seated upright
  • GCS
  • BM
  • BP: treat if BP >180/100
  • sats <95%
  • temp
  • swallowing screening
  • hydration and nutrition

care in first 24 hours is crucial to limit the brain damage and prenumbra area (the area affected by the stroke)

35
Q

What is goal adjustment?

(Scobbie et al, 2020).

A
  • long term health conditons can liumit acheivement of goals, sometimes it is necessary to adjust these goals to make them more attainable.
  • Goal adjustment is a complex process influenced by various factors, e.g. illness severity, symptom management, social support, and coping strategies.
  • may do this by revealuating, modifying, letting go of, or setting new goals
  • highlights the importance of understanding and supporting goal adjustment in healthcare settings to enhance patient-centered care and improve outcomes for individuals with long-term conditions.
36
Q

List some references for neurological disorders.

A
  • (Drake et al 2015)
  • (Sience/AAAS, 2019)
  • (Scobbie et al, 2020

Mind and Body (21 decks)

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