1. Lou Gehrigs Disease
    • Amyotrophic Lateral Sclerosis: 40-60 years old more common in men in earlier ages but = after menopause
    • rapidly progressive & fatal (2-5 years, usually due to resp failure)
    • most common motor neuron disease in US
    • Muscle atrophy (weakness and wasting of muscles under voluntary control) resulting form motor neuron degeneration and sclerosis of corticospinal tract in the lateral column of the spinal cord
    • no accompanying sensory or cognitive changes
  2. amyotrophy
    without muscle nutrition or progressive muscle wasting/atrophy
  3. traumatic brain injury assessment
    • LOC
    • breathing pattern
    • PERRLA
    • eye position
    • skeletal muscle motor response
  4. Decorticate
    • Hemispheric damage above the midrain
    • toes pointed arms at chest
  5. Decerebrate
    • Severe damage to diencephalon or midbrain
    • toes pointed and arms at sides, wrists flexed
  6. symptoms of brain injury
    • depends on area of brain injured/extent of injury
    • highly variable
  7. types of brain injury
    • coup: impact against object
    • countercoup: impact within skull (head rebounds from wall)
    • focal: specific and grossly observable lesions
    • Diffuse: shaking effect, strains and distortions in the brain, seen with a microscope
  8. spinal cord injuries
    • Damage to motor neuron
    • much of injury due to cord ischemia
    • all have potential for: loss of voluntary control, flaccid paralysis, decreased muscle tone, muscle atrophy, absent or decreased reflexes
    • Long term loss depends on: level of injury, and extent of transection
  9. extents of spinal cord injuries
    • c2: ventilator dependent; quadriplegic
    • c4: move head, mouth, shoulders, diaphragm
    • c6: weak hands, drive with hand controls
    • t1: normal upper body; paraplegic
  10. Neuroplasticity
    brain has ability to reorganize after disease or injury
  11. Brain bleeds
    • Injury: sudden changes in motion can tear blood vessels because brain is floating in skull
    • can happen in response to aneurysm or artery bursting as last stage of chronic HTN
    • Bleeds shift and distort brain, may herniate brain tissue or compress vessels (leading to ischemia)
  12. Types of brain bleeds
    • within brain: hemorrhagic stroke: generally arterial aneurysms bursting
    • Epidural: between skull and dura: mostly arterial
    • Subdural: between the dura and the pia matter: mostly venous
    • Subarachnoid and intracerebral: between pia mater and the brain (into CSF) or brain tissue: venous or arterial
  13. symptoms of bleed
    • severe headache
    • change in LOC
    • glasgow coma scale: eye opening, verbal response, motor response
    • brain stem function: pupillary response, corneal reflex
  14. phases of seizures
    • tonic: arms up, heels pushing back up, neck down
    • clonic: legs bent, arms straight down, neck back
  15. seizures
    • caused by sudden changes in the membrane potential of neurons
    • seizure thresholds are lower in some due to more permeable plasma membrane: hyperthermia, hypoxia, hypoglycemia, hyponatremia, repeated sensory information, emotional/physical stress, fatigue, lack of sleep
  16. Stroke
    • 20 % hemorrhagic: 50% mortality
    • 80% ischemic: emobolic, thrombotic, treatment <3 hrs with fibrinolytic crucial
    • 1/3 die 1/3 sig deficit 1/3 functional recovery
  17. signs of stroke
    • numbness or weakness on one side of body
    • confusion, trouble speaking or understanding
    • visual disturbances
    • dizziness, trouble walking
    • severe headache (hemorrhagic stroke)
  18. cerebral blood flow
    • basilar/vertebral: feeds cerebellum and brain stem: lack of flow affects gait, speech, swallowing, vision
    • anterior cerebral: feeds frontal lobes: lack of flow causes contralateral motor sensory loss, impaired cognition, incontinence, aphasia
    • Middle cerebral: middle of brain: lack of flow causes contralateral motor/sensory loss, aphasia, altered consciousness, neglect syndrome, most fatal
    • Posterior cerebral: occipital and temporal: lack of flow causes vision and memory loss
  19. Right hemisphere affected
    • spatial perceptual abilities
    • judgment (loss of judgment with no awareness)
    • Memory (short term memory loss)
    • Mood (indifference, impulsive)
  20. Left hemisphere affected
    • altered speech and understanding of it (aphasia)
    • patient has slow cautious behavior style
    • patient has difficulty learning new information
    • patient has depression
  21. infections altering neuro function
    • meningitis: Infection in subarachnoid space, often bacterial, recovery depends on prompts treatment, headache, fever, stiff neck
    • Encephalitis: inflammation of the brain, often viral, difficult to diagnose
    • Brain abscess: mostly bacterial, necrotizing, infections from neighboring structures (teeth, sinuses, ears) or penetrating wounds
  22. delirium vs dementia
    • delirium: abrupt onset, typically physiologic cause, typically reversible IF treated, fluctuating course, Altered LOC's
    • Dementia: progressive failure of cerebral functions, irreversible confused states, decline in intellectual ability
  23. 3 consistent neuropathological hallmarks alzeimers
    • amyloid-rich senile plaques
    • neurofibrillary tangles
    • neuronal degeneration
  24. Parkinsons Disease
    • motor system disorder: result of the loss of dopamin-producing brain cells (people over 50)
    • there are no test for PD
    • 4 primary symptoms of PD are: tremor, rigidity, bradykinesia (slowness of movement), postural instability
    • other symptoms: deppression, difficuly swallowing chewing speaking, urinary/bowel problems, skin problems, sleep disruptions
    • difficulty walking talking or completing simple tasks
  25. treatment PD
    • levadopa & carbidopa: delay conversion of levodopa into dopamin until it reaches brain because levodopa is needed to make dopamine to replenish the brains supply
    • other drugs that mimin dopamine
    • antiviral: amantadine reduces symptoms
    • Surgery: Deep brain stimulation: electrodes implaned into brain and connected to pulse programmer, Pallidotomy: Part of the brain called globus pallidus is overactive so is destroyed by creating a scar which relieves movement symptoms/stiffness
  26. multiple sclerosis
    • degeneration of previoiusly normal myelin with relative preservation of axons (degeneration of myelin with inflammatory edema occurs)
    • age 20-40 (peak 30) 1 male: 2 Female
    • May occur when a previous viral insult to the nervous system has occurred in a genetically susceptible individual
    • cd4 crosses blood brain barrier and becomes autoreactive to myelin
    • Symptoms: paresthesias(numbness tingling), Weakness, strange sensation of tightness banding ithching constriction, imbalance ataxia, visual changes
Card Set
Neurological Disorders