NEUROVASCULAR DISEASE

Question 1

Sympathetic S/sx

Answer 1

• All ↑
  -Except GIT & GUT ↓
  -All constrictor (Vasoconstrictor)
  -Except Bronchus & Pupil (Dilator)

Question 2

Beta-Adrenergic Blockers

Answer 2

-Parasympathetic S/sx
-Propanolol

Question 3

Anti-cholinergic

Answer 3

-Sympathetic s/sx
-Atropine SO4

Question 4

Cholinesterase

Answer 4

-Sympathetic s/sx
-Destroys Acetylcholine

Question 5

Anti-cholinesterase

Answer 5

-Parasympathetic s/sx
-Acetylcholine: P-N-M

Question 6

Adrenergic Blockers

Answer 6

-Parasympathetic S/sx

Question 7

-Loss of motor function in the “lower brainstem” and “anterior spinal cord”, due to hyperexcitability/ contraction of neurotransmitter.
-Glutamate

Answer 7

ALS (Amyotrophic Lateral Sclerosis)
AKA Low Gehrig’s Disease

Question 8

Predisposing factors ALS/LGD:

Answer 8

-Stress
-Autoimmune
-Smoking

Question 9

Pathognomonic Sign of ALS

Answer 9

ATROPHY OF THE TONGUE: 3D’s
-Dysarthria
-Drooling
-Dysphagia

Question 10

Manifestation ALS & LGD:

Answer 10

1. Atrophy of the tongue
   *Dysarthria: difficulty in articulation/ pronunciation
   *Drooling: Excessive salivation
   *Dysphagia: difficulty in swallowing
2. Muscle Weakness
   *Starts in hands
   ↓
   Shoulders
   ↓
   Respiratory muscles
   ↓
   Lower extremities
3. Respiratory Depression
   -Paralysis of respiratory muscle
   -Bradypnea & hypoventilation
4. Sclerosis: (+) Muscle Spasm

Question 11

PLAN OF CARE: ALS

Answer 11

DIET:
-Risk for aspirations 3D’s
-Small frequent meals

RESPIRATORY PARALYSIS:
-Mechanical Ventilator
-O2 Administration

PARALYSIS
-Wheelchair

Question 12

DOC FOR ALS

Answer 12

-Steroids (Prednisone)
-In case Muscle Spasm: Baclofen (Lioresal)

Question 13

What substance/food is being avoided in ALS patient?

Answer 13

-MSG (Monosodium Glutamate)

Question 14

-Hyperstimulation of sympathetic, due to “spinal cord injury above T6”.

Answer 14

Autonomic Dysreflexia

Question 15

Manifestation: Autonomic Dysreflexia

Answer 15

1) Hypertension
*severe headache: tension headache
*dizziness
*flushing
*blurring of vision

2) ↓ HR (Bradycardia)
-to decrease the pressure in the brain
-compensatory mechanism

3) ↓GIT: Constipation (fecal impaction)
↓GUT: Oliguria (↓ U.O.)

4) ↑Sweating
-Injury above T6
-Coldness (goose flesh/ goosebumps)

Question 16

HALLMARK SIGN/SYMPTOMS:
Hypertension + Bladder Distention

Answer 16

AUTONOMIC DYSREFLEXIA

***Palpate Bladder

Question 17

PLAN OF CARE FOR AUTONOMIC DYSREFLEXIA

Answer 17

HYPERTENSION
-Sitting/Upright/Head elevation

CONSTIPATION
-↑Fiber diet
-↑ fluid intake
-Laxatives
-Manual Extraction

BLADDER DISTENTION
-Catheterization

Question 18

DOC: Autonomic Dysreflexia

Answer 18

-Nitroprusside (Vasodilator)
-Beta-blockers

Question 19

HAPPY HORMONES

Answer 19

↑DOPAMINE
GABA
SEROTONIN

Question 20

HPN + BLADDER DISTENTION

Answer 20

-Palpate the bladder
-to confirm bladder is distended