Term
degenerative disease of the CNS primarily affecting the white matter; damages the myelin sheath and eventually scars neuronal axons |
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Definition
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Term
t/f: multiple sclersis most common in women 20-50 years old |
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Definition
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Term
t/f: multiple sclerosis occurs most commonly in temperate climates |
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Definition
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Term
risk factors that may trigger the onset of multiple sclerosis |
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Definition
genetics and environment (viruses, trauma, and exposure to heavy metals) |
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Term
4 disease types of multiple sclerosis |
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Definition
relapsing-remitting, primary progressive, secondary progressive, and progressive relapsing |
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Term
relapsing/remitting disease |
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Definition
65% of cases relapse, develop over 1-2 weeks, resolve over 4-8 weeks, and return to baseline |
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Term
relapsing/progressive disease |
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Definition
15% of cases are similar to the relapsing/remitting form but with less recovery (the baseline is NOT returned to), and the individual is left with significant residual disability |
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Term
Chronic progressive disease |
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Definition
20% of cases are characterized by spinal cord and cerebellar dysfunction; symptoms of the spinal cord and cerebellum are the initial manifestations |
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Term
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Definition
used for individuals who have had no active clinical disease or any subjective deterioration in their condition during the last year |
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Term
t/f: MS etiology is unknown, but AIDs is suspected |
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Definition
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Term
demyelinating disease in which axonal myelin in the CNS is eroded, destroyed and replaced by scar tissue. it is caused by genetic and environmental factors which causes inflammation of venules in the CNS which disrupts the blood-brain barrier, allowing lymphocytes to enter the CNS tissue, the lymphocytes proliferate nd produce and antibody that attacks and damages myelin and causes the release of the inflammatory chemicals and edema. |
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Definition
(Acute Attack) Multiple Sclerosis |
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Term
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Definition
antibody produced by lymphocytes that cross the blood-brain barrier in MS that attacks and damages myelin and causes the release of inflammatory chemicals and edema |
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Term
t/f: as inflammation subsides, the myelin regenerates and manifestations of the disease (MS) subside |
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Definition
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Term
patches destroyed along the axon of myelin sheath |
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Definition
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Term
t/f: demyelination slows conduction of nerve impulses and sometimes results in total absence of transmission |
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Definition
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Term
t/f: demyelination requires more energy to conduct an impulses (200x more) |
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Definition
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Term
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Definition
Brain and Spinal cord (scarring) |
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Term
t/f: fatigue is a common symptom of MS |
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Definition
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Term
after repeated inflammatory attacks, myelin is irreparably damaged; segments of axons become totally demyelinated and may degenerate. |
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Definition
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Term
when astrocytes proliferate in damaged regions of CNS and form plaques that are scattered, appearing as gray or pinkish lesions |
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Definition
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Term
t/f: in an undamaged neuron, impulses travel down the axon by "leaping" from one node of Ranvier to the next, thus greatly increasing the speed of impulse transmission |
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Definition
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Term
what happens when a nerve impulse travels down an axon damaged by MS? |
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Definition
the impulses are significantly slowed and weakened as they cross the surface of demyelinated areas; they may be blocked entirely when axons degenerate. |
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Term
t/f: the weakening or interruption of the transmission of nerve impulses and plaque formation within the CNS cause the manifestations of MS, including extremity weakness, paresthesias, visual disturbances, bladder dysfunction, and vertigo |
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Definition
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Term
4 categories of S&S of MS |
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Definition
sensory, motor, cerebellar, and misc. |
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Term
numbness, burning, prickling, tingling, pain |
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Definition
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Term
decreased sense of temperature, depth, and vibration |
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Definition
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Term
Uncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style). It can also affect the limbs. |
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Definition
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Term
Nystagmus is a term to describe fast, uncontrollable movements of the eyes that may be: Side to side (horizontal nystagmus); Up and down (vertical nystagmus); Rotary (rotary or torsional nystagmus). Depending on the cause, these movements may be in both eyes or in just one eye |
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Definition
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Term
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Definition
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Term
the worsening of neurologic symptoms in multiple sclerosis (MS) and other neurological, demyelinating conditions when the body gets overheated from hot weather, exercise, fever, or saunas and hot tubs. It is possibly due to the effect of increased temperature on nerve conduction. With an increased body temperature, nerve impulses are either blocked or slowed down in a damaged nerve but once the body temperature is normalized, signs and symptoms may disappear or improve. |
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Definition
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Term
the barber chair phenomenon, is an electrical sensation that runs down the back and into the limbs. In many patients, it is elicited by bending the head forward. It can also be evoked when a practitioner pounds on the posterior cervical spine while the neck is flexed; this is caused by involvement of the posterior columns |
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Definition
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Term
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Definition
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Term
when you have difficulty saying words because of problems with the muscles that help you talk. |
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Definition
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Term
t/f: MS is difficult to diagnose because there is no definitive test |
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Definition
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Term
t/f: MS diagnosis made on clinical history, presentation of symptoms, and the elimination of other neurologic deficits |
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Definition
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Term
t/f: MS treatment is aimed at treating acute attacks, and decreasing the number of attacks and subsequent neurologic disabilities |
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Definition
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Term
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Definition
corticosteroids, interferon, and Imuran |
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Term
t/f: with parkinson's and ms, focus care on preventing injuries and complications. safety is a major concern with these patients. |
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Definition
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Term
t/f: in MS, there are meds available to cure disease |
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Definition
FALSE! NO CURE! meds only treat symptoms |
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Term
Immunomodulating Agents for MS |
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Definition
Interferon beta- 1a (Avonex; Rebif)- Glatiramer Copaxone) Interferon beta- 1b (Betaseron - Natalizumab- Tysabri) |
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Term
Immunosuppressive Agents for MS |
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Definition
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Term
Antiinflamatory Agents for MS |
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Definition
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Term
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Definition
baclofen (Lioresal); Dantrium; Valium |
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Term
Anticholinergics/Cholinergics for MS |
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Definition
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Term
plasma exchange procedure that removes the plasma component from whole blood. |
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Definition
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Term
what is the goal of plasmapheresis? |
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Definition
to remove inflammatory agents, such as T Lymphocytes |
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Term
t/f: plasmapheresis is very similar to hemodialysis because it is also accessed through an artery and vein where blood passes through a blood separater where the plasma is removed, and then cellular blood components are re-transfused using fresh-frozen plasma or albumin |
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Definition
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Term
how is foot drop relieved? |
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Definition
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Term
progressive, degenerative neurologic disease characterized by non-intention tremor, bradykinesia, muscle rigidity, and postural instability |
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Definition
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Term
t/f: Parkinson's is most common among males over 50 years old |
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Definition
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Term
t/f: Parkinson's is the 2nd most common neurodegenerative disorder |
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Definition
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Term
t/f: Parkinson's etiology is unknown |
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Definition
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Term
commonly occuring, slowly progressive, degenerative disorder caused by dopamine deficiency |
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Definition
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Term
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Definition
it carries messages to tell the body how and when to move |
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Term
t/f: shortage of dopamine causes movements to become more difficult |
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Definition
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Term
t/f: Secondary parkinsonism is similar to Parkinson's disease, but it is caused by certain medicines, a different nervous system disorder, or another illness. |
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Definition
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Term
what is the most distinct tremor of parkinsons? (non-intention tremor) |
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Definition
"pill-rolling" of thumb and forefinger |
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Term
t/f: stress and anxiety increase all tremors |
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Definition
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Term
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Definition
normal balance between excitatory and inhibitory neurotransmitters is disrupted; disorder of voluntary motor function occurs |
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Term
neurotransmitter involved in motor function |
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Definition
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Term
why is the dopamine level affected? |
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Definition
atrophy of neurons of the substantia nigra |
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Term
which neurons produce dopamine |
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Definition
neurons of the substantia nigra |
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Term
difficulty in initiating a movement, then moving very slowly (frozen in place) |
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Definition
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Term
involuntary, short, rapid, shuffling |
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Definition
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Term
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Definition
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Term
itchy rash, white scaley skin |
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Definition
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Term
cardinal signs of parkinsons disease |
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Definition
1. resting tremors and shaking 2. muscle rigidity and stiffness 3. bradykinesia 4. postural instability |
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Term
how is parkinson's disease diagnosed? |
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Definition
complete health assessment, medical history, and complete neurologic examination |
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Term
t/f: parkinson's disease cannot be cured or arrested but symptoms can be controlled with drug therapy |
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Definition
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Term
drugs used to decrease akinesia in parkinson's patients |
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Definition
Levodopa, dopamine agonists, anticholinergic drugs, antihistamines, and amantadine |
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Term
t/f: parkinson's drugs are not initiated until the symptoms become incapacitating because of the side effects and a decreased responsiveness after 5 years |
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Definition
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Term
t/f: treatment with levodopa does not prevent the progressive changes that are typicl of Parkinson's disease |
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Definition
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Term
eyes become fixed with a lateral and upward gaze |
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Definition
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Term
t/f: there is no test for Parkinson's disease |
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Definition
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Term
t/f: PD pharm. goal is to control symptoms to greatest extent possible |
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Definition
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Term
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Definition
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Term
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Definition
apomorphine; bromocriptine; parmipexole; ropinirole; rotigotine transdermal system |
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Term
monoamine oxidase B inhibitors for PD |
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Definition
selegiline/deprenyl; rasagiline |
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Term
catecholOmethyltransferase inhibitors for PD |
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Definition
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Term
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Definition
trihexyphenidyl; benztropine, ethopropazine |
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Term
glutamate antagonist for PD |
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Definition
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Term
surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain; In select brain regions it has provided therapeutic benefits for otherwise-treatment-resistant movement and affective disorders such as Parkinson's disease, essential tremor, dystonia, and chronic pain |
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Definition
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Term
recent development; locates affected area(s) in the brain and destroys involved tissue |
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Definition
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Term
destroys small amount of tissue in thalamus with needle; used to decrease tremors and rigidity |
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Definition
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Term
adrenal medullary grafted to basal ganglia |
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Definition
autologous adrenal medullary transplant |
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Term
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Definition
difficulty with motor control of the mouth |
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Term
agnosia ataxia aphraxia aphasia |
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Definition
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Term
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Definition
shakes at rest but usually stop when reaching for something Parkinsons |
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Term
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Definition
fine at rest but shakes when reaching for something; MS |
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Term
Famous people with Parkinson's |
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Definition
Hitler, Michael Fox, Muhammed Ali |
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Term
(PARKINSONS or HUNTINGTONS) Increase in acetecholine, decrease in dopamine |
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Definition
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Term
(PARKINSONS or HUNTINGTONS) Decrease in acetecholine, increase in dopamine |
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Definition
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Term
why do parkinson's patients have night mares? |
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Definition
anti-dyskinetics produce nightmares and hallucinations |
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Term
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Definition
crosses blood brain barrier and converts to dopamine |
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Term
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Definition
protects dopamine and holds it in |
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Term
carbidopa and levodopa mixed together |
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Definition
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Term
|
Definition
a substance that fully activates the neuronal receptor that it attaches to |
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Term
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Definition
a substance that attaches to a receptor but does not activate it or if it displaces an agonist at that receptor it seemingly deactivates it thereby reversing the effect of the agonist |
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Term
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Definition
a separation of the circulating blood from the brain extracellular fluid (BECF) in the central nervous system |
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Term
progressive, degenerative, inherited neurologic disease characterized by increasing dementia and chorea; single-gene autosomal-dominant inherited disease that affects the neurons of the basal ganglia |
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Definition
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Term
jerky, rapid, involuntary movements; dancing or writhin of the limbs or facial muscles |
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Definition
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Term
why is huntinginton's also known as "Huntington's Chorea? |
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Definition
because chorea is the most common presenting symptom of huntingtons |
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Term
t/f: huntingtons has a cure |
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Definition
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Term
why does dopamine increase in huntingtons? |
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Definition
Gamma-aminobutyric acid (GABA) is decreased and acetylcholine is decreased, which results in an excess of dopamine |
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Term
autosomal dominant disorder means |
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Definition
if you have the gene, you have the disorder |
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Term
excess of dopamine contributes to these s&s of huntingtons |
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Definition
severe depression, memory loss with decreased ability to concetrate, emotional lability, impulsiveness, mood swings, dementia, disorientation, confusion |
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Term
t/f: in huntingtons, motor signs worsen with environmental stimuli and emotional stress |
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Definition
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Term
t/f: in huntingtons, motor signs usually are absent when sleeping |
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Definition
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Term
t/f: in huntingtons, death is usually caused by aspiration pneumonia or another infection |
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Definition
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Term
how to diagnose huntingtons |
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Definition
genetic testing (chromosome 4) |
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Term
pharmacology for huntingtons |
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Definition
antipsychotics; block dopamine; antidepressants |
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Term
huntingtons: t/f: death usually occurs within a year after being diagnosed |
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Definition
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Term
early symptoms of huntingtons: |
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Definition
mood swings, depression, irritbility, trouble driving, learning new things, remembering facts or making decisions; abnormal movement and pregressive dysfunction of intellectual and thought processes |
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Term
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Definition
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Term
a heightened state of well-being |
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Definition
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Term
t/f: each child of an HD parent has a 50% chance of inheriting the HD gene. Anyone who inherits the gene will eventually develop the disease |
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Definition
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Term
t/f: dopamine agonist drugs cn help control the movement disorder of HD |
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Definition
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Term
progressive, degenerative neurologic disease characterized by weakness and wasting of involved muscles WITHOUT sensory or cognitive changes; disease of the upper and lower motor neurons; leads to respiratory failure; has two names |
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Definition
Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig's Disease |
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Term
what differentiates Lou Gehrig's (ALS) from other motor neuron disorders? |
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Definition
1. involvement of both the upper and lower motor neurons 2. the degeneration is not accompanied by inflammation |
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Term
t/f: lou gehrig's disease slightly higher possibility in men |
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Definition
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Term
most common motor neuron disease |
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Definition
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Term
|
Definition
without muscle nutrition; progressive muscle wasting |
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Term
lateral sclerosis refers to: |
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Definition
the scarring that takes place in the lateral column of the spinal cord, which is the upper motor neuron component of the ALS lou gehrigs syndrome |
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Term
defined as overactive or overresponsive reflexes. Examples of this can include twitching or spastic tendencies, which are indicative of upper motor neuron disease as well as the lessening or loss of control ordinarily exerted by higher brain centers of lower neural pathways (disinhibition) |
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Definition
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Term
involuntary contraction or twitching of muscle fibers |
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Definition
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Term
|
Definition
muscle spasticity, hyperreflexia, faciculations, tongue atrophy, dysarthria, fatigue, urinary and bowel dysfunctions |
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Term
t/f: in ALS Lou Gehrig's Disease, intellectual ability, sensory function, vision, and hearing are all affected |
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Definition
FALSE! NONE ARE AFFECTED! |
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Term
T/F: cpk (creatinine phosphokinase) may be elevated in ALS |
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Definition
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Term
|
Definition
antiglutamate that slows deterioration in ALS |
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Term
t/f: Lou Gehrigs patients are at risk for aspiration and pneumonia |
|
Definition
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Term
chronic, progressive neuromuscular disorder characterized by fatigue and severe weakness of the skeletal muscles; experiences remissions and exacerbations |
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Definition
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|
Term
t/f: MG occurs more in women than in men |
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Definition
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Term
|
Definition
antibodies destroy/block neuromuscular junction receptor sites, resulting in decrease in number of acetylcholine receptors; also structural changes that result in diminished acetylcholine uptake; results in Decrease in muscle's ability to contract; (weakness and rapid fatigue) |
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Term
why do MG patients have to have thymectomys? |
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Definition
the thymus gland never disappears when they mature and becomes a tumor which is believed to be source of the auto-antigens |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
t/f: MG symptoms increase with repeated activity and improve with rest, so its best to do things in the morning before the fatigue sets in |
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Definition
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Term
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Definition
DYSARTHRIA, DYSPHAGIA, PTOSIS, DIPLOPIA, NASAL SOUND TO VOICE, AND WEAK NECK MUSCLES |
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Term
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Definition
sudden exacerbation of motor weakness; often due to under medication, missed doses, or developing infection; insufficiency of acetylcholine ; life threatening |
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Term
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Definition
tachycardia, tachypnea, severe respiratory distress, dyspagia, restlessness, impaired speech, anxiety |
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Term
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Definition
result of over-dosage of medication; excess of acetylcholine |
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Term
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Definition
gi symptoms, severe muscle weakness, vertigo, respiratory distress |
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Term
how are myasthenic and cholinergic crisises differentiated? |
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Definition
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Term
|
Definition
edrophonium chloride is given IV and individual is observed for muscle tone improvement. |
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Term
t/f: in tensilon test, muscle improvement is myasthenic crisis |
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Definition
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|
Term
t/f: in tensilon test, if there is no improvement in muscle tone, test is negative and crisis is cholinergic |
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Definition
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Term
|
Definition
because S&S are very similar |
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Term
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Definition
1. anticholinesterases: allow acetylchoine to concentrate at receptor sites: Mestinon- most common, prolongs contraction of muscles 2. corticosteroids- suppress antibodies that block Ach-R (Prednisone) 3. Immunosuppressants: used when other meds fail to reduce symptoms |
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Term
the complete exchange of plasma |
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Definition
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|
Term
acute inflammatory demyelinating disorder of the PNS; progressive, usually with rapid muscle weakness and paralysis; one of the most common PNS disorders; usually occurs after a viral respiratory or GI infection |
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Definition
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|
Term
t/f: GBS rehabilitation time varies from 6 months to 2 years |
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Definition
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|
Term
t/f: GBS usually ascending |
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Definition
|
|
Term
|
Definition
muscle weakness starts in legs and works its way up to arms and trunk |
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|
Term
|
Definition
muscle weakness starts in the arms and works its way down to the legs |
|
|
Term
|
Definition
the symptoms begin in the patient's head. The illness affects eye muscles and balance first. It then slowly moves down the body to the neck, arms and other areas. |
|
|
Term
acute panautonomic neuropathy |
|
Definition
affects ALL the nerves, CNS and PNS |
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|
Term
t/f: GBS initially in lower extremeties, then to upper extremeties, torso, and cranial nerves |
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Definition
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|
Term
|
Definition
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|
Term
what do you do to GBS patients who can't close their eyes? |
|
Definition
Eye Drops Eye creams Tape Eyes shut |
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Term
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Definition
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|
Term
t/f: 85% of GBS patients recover completely |
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Definition
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|
Term
chronic disease of the trigeminal cranial nerve that causes severe facial pain |
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Definition
trigeminal neuralgia (tic douloureux) |
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|
Term
contributing factors to trigeminal neuralgia |
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Definition
- irritation from flu - trauma or infection of teeth or jaw - pressure on nerve by aneurysm - tumor - arteriosclerotic changes of artery near nerve |
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Term
t/f: Tic douloureux can be characterized by brief repetitive episodes of sudden severe facial pain that may occur as often as hundreds of times per day to as infrequently as a few times a year |
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Definition
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|
Term
how is the trigeminal neuralgia pain described? |
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Definition
stabbing or lightning-like pain |
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|
Term
t/f: trigeminal neuralgia can be irritated by eating, light touch, talking, swallowing, brushing teeth, shaving, etc. |
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Definition
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|
Term
|
Definition
surgical severing of a nerve root |
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Term
|
Definition
closed procedure where needle goes through cheek into foramen ovale at the base of the brain to partially destroy trigeminal nerve |
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Term
|
Definition
total severing of nerve root |
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Term
disorder of the facial nerve; characterized by unilateral paralysis of facial muscles; the eye does not close and the forehead does not wrinkle; impairs taste; individual cannot smile, whistle or grimace; paralyzed side is masklike and sags with constant tearing of the eye and possible drooling |
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Definition
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|
Term
t/f: bells palsy has a relationship to herpes simplex virus |
|
Definition
true (uh oh Jenny ;) LOL) |
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|
Term
t/f: decompression of facial nerve cures bell's palsy |
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Definition
FALSE! no evidence that doing so is of value |
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|
Term
viral infection of CNS transmitted by infected saliva that enters through open wound; frequently causes death; virus carried by wild and domestic animals |
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Definition
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|
Term
pathophysiology of rabies |
|
Definition
spreds from wound to local muscle cells and then invades peripherl nerves; eventually travels to CNS |
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|
Term
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Definition
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|
Term
|
Definition
site is painful; exhebits various paresthesias, anxiety, irritability, depression |
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|
Term
|
Definition
periods of excitement and quiet; hydrophobia; thick mucus; convulsions, muscle spasms, periods of apnea, death can occur in 7 days (The Ring? SEVEN DAYS) |
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|
Term
disorder of the nervous system caused by a neurotoxin from clostridium tetni; anaerobic bacillus lives in the soil; spres enter body through open wound, germinate, and produce the tetanospasmin toxin |
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Definition
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|
Term
|
Definition
stiffness, dysphagi, profuse perspiration, hyperreflexia, jaw/neck/facial muscle spasms, tonic seizures |
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|
Term
|
Definition
|
|
Term
what toxin produces botulism? |
|
Definition
clostridium botulinum; found in soil; most cases from eating improperly canned or cooked foods |
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|
Term
pathophysiology of botulism |
|
Definition
toxins absorbed by GI tract and bind to nerve tissues; block release of acetylcholine from nerve endings |
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|
Term
complication of previous infection by poliomyelitis virus; increased in women; |
|
Definition
|
|
Term
pathophysiology of post-polio syndrome |
|
Definition
virus destroys some of the motor cells of the anterior horn of the spinal cord; mild to severe flaccid paralysis and atrophy; signs emerge years after initial infection; seen in those who had a severe case of polio with hospitalization |
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|
Term
a cluster of symptoms localized near the jaw; can be caused by degenerative arthritis of mandibular joint, teeth malocclusion, bruxism, dislocation of jaw during ET; occurs when the meniscus, cartilaginous disk, between condyle and temporal bone dislaced; results in s&S |
|
Definition
Temporomandibular Disorder (TMD) (TMJ) |
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|
Term
|
Definition
jaw pain, HA, tinnitus, ear pain, clicking of jaw, may even lock periodically |
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|
Term
neurologic disorder characterized by persistent tics |
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Definition
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|
Term
sudden involuntary movements and vocalizations |
|
Definition
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|
Term
t/f: no two tourettes patients are the same |
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Definition
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|
Term
t/f: tourretes does not impair intelligence |
|
Definition
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|
Term
neurological disorder characterized by paresthesias or dysethesias of legs |
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Definition
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|
Term
t/f: in RLS, leg pain eases with motion of legs nd is more noticeable at rest |
|
Definition
|
|
Term
comes from the Greek words meaning "not-normal" and "sensation" (abnormal sensation)It is defined as an unpleasant, abnormal sense of touch. It often presents as pain but may also present as an inappropriate, but not discomforting, sensation. It is caused by lesions of the nervous system, peripheral or central, and it involves sensations, whether spontaneous or evoked, such as burning, wetness, itching, electric shock, and pins and needles |
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Definition
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|
Term
the excessive grinding of the teeth and/or excessive clenching of the jaw |
|
Definition
|
|
Term
any disease of the nerves |
|
Definition
|
|
Term
any syndrome causing muscle weakness, paresthesias, impaired reflexes, and autonomic symptoms in the hands and feet |
|
Definition
peripheral neuropathy (polyneuritis, polyneuropathy) |
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|
Term
t/f: diabetes mellitus is the most common cause of metabolic neuropathy |
|
Definition
|
|
Term
t/f: alcoholism is the most common nutrition related neuropathy |
|
Definition
|
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Term
group of genetic disorders that affects the cell growth of neural tissues; has two names and two types; can very from skin spots to tumors, scoliosis, seizures, gliomas, neuromas, htn, and mental retardation |
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Definition
neurofibromatosis (von recklinghausen's disease) |
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Term
type one neurofibromatosis |
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Definition
skin spots, non/malignant neurofibromas, scoliosis, seizures, gliomas, neuromas, htn, and mental retardation; no cure |
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Term
type two neurofibromatosis |
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Definition
intracranial and spinal tumors; 8th cranial nerve is especilly susceptible; palliative care |
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Term
t/f: glossopharyngeal neuralgia is similar to trigeminal neuralgia but is more rare |
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Definition
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Term
difference between glossopharyngeal and trigeminal neuralgia |
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Definition
glossopharyngeal orginates in throat and cn affect ear; trigeminal is facial pain. |
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Term
intense, sudden, and repeating pain |
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Definition
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Term
syndrome caused by continuous signaling of the end regions of peripheral nerve fibers that activate muscle fibers; causes muscle stiffness, continuous twitching/vibrating of muscles, cramping, increased sweating, and delayed muscle relaxation; has three names |
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Definition
Isaac's syndrome (neuromyotonia, continuous muscle fiber activity syndrome) |
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Term
t/f: symptoms of Isaac's syndrome cn occur even during sleep or when under general anesthesia |
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Definition
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Term
t/f: when confusion, hallucinations, and insomnia are associated with Isaac's syndrome, the condition is known as Marfan's syndrome |
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Definition
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Term
progressive loss of cognitive and intellectual functions without impairment of perception or consciusness |
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Definition
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Term
the onset of delirium during the evening or night with disappearance of delirium during the day |
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Definition
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Term
chronic neurologic disorder that involves progressive and selective degeneration of neurons in the cerebral cortex and certain subcortical structures; most common in women; loses ability to perform ADLs, impairment of short/long term memory, aphasic, apraxic, complete loss of cognitive function and emotional response |
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Definition
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