Neuro

• Infection of arachnoid and pia mater
• Droplet precaution
• SS: nucal rigidity
• Brudzinski sign: flex neck-they will flex knee/hip
• Kernig sign:  bent knee=px
• fever
• photophobia
• h/a
• confusion

• Rash=bacterial (strep, neisseria haemophilus, listeria)
• N/V= viral

• Testing: CT, MRI, blood culture, lupbar puncture (CSF)
• Tx: antibiotics (vancomyicin)

OPEN (90% of cases): visual changes, Haloos, blurry, peripheral loss, px

CLOSED: sever Px, dilated/nonreactive pupils, N/V, blurry, rainbows

TX:  B Blockers, B antagonists (-onidine), Carbonic anhydrase inhibitors (don't give w/ sulfa all), prostaglandins (lataanoprast), sx, elevate head, cholinergics; pilocarpine drops (green cap)

• Progressive neurodegenerative disorder of CNS
• Degeneration of Basal Ganglia-> dopamine loss, inc. acetylcholine

• SS: *tremors
• *muscle rigidity
• *slow movement-shuffling steps
• postural instability
• pill rolling
• autonomic issues: orthostatics, constipation, swallowing, freq urination

Diagnostics: see if they respond to meds

• Tx: anticholinergics-cogentin (benztropine)
• dopaminergics- carbidopa

*monitor weight; diff eating.  burn calories walking around

Inflammation of the brain-typically a viral infection that only causes minor flu

Primary: virus or other agent (vector or amoeba) directly infects brain

• Secondary: Reaction to infection somewhere else due to faulty immune system response.
• 2-3 weeks after initial infection

• Tx; antival (acyclovir)
• Control ICP
• Phentoin (anticonvulsant)

• progressive destruction of nerve cells: Amytrophic
• No nourishment to muscles

SS: Diff w/ daily activities, balance, speech, weakness, swallowing, cramps, twitching

diagnosis: muscle tissue biopsy

Life span: 2-4 years

Oh Oh Oh to touch a Female's vagina gives very special hormones

• 1. Olfactory 1 nose
• 2. Optic 2 eyes -vision
• 3. Occulomotor-wolverine claws - eyes up/in
• 4. Trochlear- opposite of 3 eyes down/in
• 5. Trigeminal- face slap  face, cheek, jaw
• 6. Abducens- check out "sixy" abs- eyes side to side
• 7. Facial- facial expressions, taste
• 8. vestibulocochlear- headphones- hearing
• 9. glossopharyngeal- cat w/ 9 lives.  lick, taste
• X. vagus- X-rated.  swallow, HR, BP
• 11. Spinal accessory- shoulder shrug
• 12. Hypoglossal- under tongue, tongue movement

Left- Christian- numbers, logic, speaking, listen

Right: emotion, intuition, imagination

• FRONTAL: Cognitive function
• PARIETAL- (CROWN)- Sensory info, spacial sense, language
• OCCIPITAL-(rear, low)- vision
• TEMPORAL (sides) hearing, learning, feelings, hypocampus
• CEREBELLUM- (bottom) balance, coordination
• BRAIN STEM- basic, autonomic functions

• Ground-up weakness/paralysis (ascending)
• Highest risk: resp dysfunction

• Tx: plasmaphoresis, immunoglobin therapy
• * most recover

• Autoimmune disorder of PNS
• thymus gland produces antibodies that fight muscle receptor sites for acetylcholine (nerves, muscles don't communicate)

SS: Ptosis (droopy eyelid) dryness, weak

TX: cholinesterase inhibitors (pyridostagmine) ↑acetylcholine

• corticodsteroids, immunosuppressants
• Break up tasks throughout the day, avoid overehertion

overmedication: cholinergic crisis (SLUDGE)

• CLUSTER: stabbing, rhinitis, lacrimation
• 30-90 minutes
• can occur for weeks, months, then disappear
• males
• also associated with mental illness, ETOH

TENSION (stress): feels like a band squeezing the head

• MIGRAINES: one side of the head
• nausea
• photophobia, sound sensitive
• hours-days
• females (hormonal changes)
• aura may be present: visual/sensory numbness/tingling

• AAA: ss: ab pulsation/bruit (xyphoid to umb)
• ache radiating to back, groin
• Rupture-sever px w/ N/V

• Thoracic: Most common site of dissection
• SS: dyspnea
• sudden loss of peripheral pulses
• sudden tearing chest px

Dissection: Tear of inner vessel wall; blood flows betw. layers

• most common form of dementia
• gradual

• ss: Think A
• anomia- inability to remember names of things
• apraXia- unable to Xecute function (uses shoe as phone)
• Agnosia: unable to recognize stuff
• Amnesia
• Aphasia

Diagnosis: rule out others

• tx: cholinesterase inhibitors
• saftey
• NMDA inhibitors
• Nutrition

sundowning: evening=crazy. keep them busy

Conductive:  interference w/ air conduction

• Sensorineural: nerve impairment
• Presbycusis=most common

• affects 1/3 of the world
• granuloma usually envelops bacteria-prevents growth

• ss: fatigue, weight loss
• night sweats
• hematosis
• nausea
• low-grade fever

• Tx: 4 drug combo for 9-12 months
• Rimampin, Isoniazid, Pyrazinamide, Ethambutol

• Complete- Total loss of neuro below injury
• Incomplete- some nervous function in tact below injury

Tetra/quadraplegia: total loss of function in all limbs, trunk, pelvic organs

Paraplegia:  Still have function in arms

AUTONOMIC DYSREFLEXIA: (t5-t6) neg stimuli>sympathetic response; ↑BP, urine retention, H/A.  can be caused by sheet wrinkles, etc.