Term
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Definition
~The part of the cerebral cortex in the brain where the nerve impulses originate voluntary muscle activity
~An area of the frontal lobe located in the dorsal precentral gyrus immediately anterior to the central sulcus |
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Term
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Definition
| ~The motor neuron and the group of muscle fibers it innervates in a muscle are called a motor unit, the basic unit of motor control. |
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Term
| Motor Unit and Spinal Cord |
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Definition
~The spinal cord contains the basic reflex circuitry for posture and movement
~The motor neurons supplying a motor unit are located in the ventral horn of the spinal cord and are called lower motor neurons. UMNs, which exert control over LMNs, project from the motor strip in the cerebral cortex to the ventral horn and are fully contained in the central nervous system (CNS) |
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Term
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Definition
~They can be checked at the wrists, elbows, knees, and ankles as a means of assessing the components of the stretch reflex at different spinal cord segments.
~Increased magnesium makes DTR's slow |
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Term
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Definition
~A reflex is a response between a stimulus and an elicited motor response.
~Two important types of spinal motor reflexes are the withdrawal reflex and myotatic reflex |
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Term
Withdrawal Reflex
(Spinal Reflex) |
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Definition
~The withdrawal reflex is stimulated by a damaging (nociceptive) stimulus and quickly moves the body part away from the offending stimulus, usually by flexing a limb part
~The withdrawal reflex is a powerful reflex, taking precedence over other reflexes associated with locomotion. Any of the major joints may be involved, depending on the site of afferent stimulation. All the joints of an extremity (e.g., finger, wrist, elbow, shoulder) typically are involved.
~This complex, polysynaptic reflex also shifts postural support to the opposite side of the body with a crossed extensor reflex and simultaneously alerts the forebrain to the offending stimulus event. The withdrawal reflex also can produce contraction of muscles other than the extremities. |
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Term
Myotatic Reflex
(Spinal Reflex) |
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Definition
~The myotatic or stretch reflex controls muscle tone and helps maintain posture.
~Specialized sensory nerve terminals in skeletal muscles and tendons relay information on muscle stretch and joint tension to the CNS. This information, which drives postural reflex mechanisms, also is relayed to the thalamus and the sensory cortex and is experienced as proprioception, the sense of body movement and position.
~Two types of sensory receptors—muscle spindle receptors and Golgi tendon organs.
~Muscle spindles are stretch receptors distributed throughout the belly of a muscle that transmit information about muscle length and rate of stretch. ~The Golgi tendon organs are found in muscle tendons and transmit information about muscle tension or force of contraction at the junction of the muscle and the tendon that attaches to bone. |
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Term
Guillain-Barre' Syndrome
(patho) |
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Definition
~Triggered by an autoimmune response, in which the body's immune system starts to destroy myelin sheath that surrounds axons or peripheral nerves, or the axons themselves.
~Prevents normal transmission of electrical impulses.
~Inflammation and degenerative changes in both the posterior (sensory) and anterior (motor) nerve roots, resulting in signs or sensory and motor losses at the same time.
~May also impair the autonomic nervous system. |
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Term
Guillain-Barre' Syndrome
(S/S) |
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Definition
~Ascending type: symmetrical muscle weakness; legs first and then arms and facial nerves within 24-72 hours.
~Descending type: muscle weakness in arms first, or in the arms and legs at the same time
~S/S of both:
~absent deep tendon reflexes; ~paraesthesia (tingling, prickling, or numbness of skin)sometimes before weakness, but vanishes quickly
~Diplegia (paralysis of like parts on either side of the body. Possibly with opthalmoplegia (paralysis or weakness of one or more of the six eyes muscles).
~Dysphagia (difficulty swallowing)
~Dysarthria (muscles used for speech are weak and you have trouble controlling them).
~Hypotonia (decreased muscle tone and strength, resulting in floppiness).
~Areflexia (absence of reflexes).
~ |
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Term
Guillain-Barre' Syndrome
(TX) |
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Definition
~Endotracheal intubation or tracheotomy, as indicated to clear secretions.
~Plasmapheresis (therapeutic plasma exchange).
~Continuous electrocardiogram monitoring.
~IV immunoglobulin
~Pain management, with anti-inflammatories and opioids.
~Rehabilitation. |
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Term
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Definition
~Habitually ingested irritants, such as hot peppers, alcohol.
~Drugs, such as aspirin, other NSAID's, cytotoxic agents, caffeine, corticosteroids, antimetabolites, phenylbutazone.
~Poisons, such as DDT, ammonia, mercury, carbon tetrachloride, corrosive substances.
~Physiological stress, such as surgery, head trauma, renal failure, hepatic failure, or respiratory failure. |
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Term
Acute and Chronic Gastritis
(Complications) |
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Definition
~Hemorrhage
~Shock
~Obstruction
~Perforation
~Peritonitis
~Gastric cancer |
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Term
Chronic Gastritis
(Causes) |
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Definition
~Helicobacter pylori infection
~Pernicious anemia
~Peptic ulcer disease
~Renal disease
~Diabetes mellitus |
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Term
Acute and Chronic Gastritis
(S/S) |
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Definition
~Epigastric discomfort
~Indigestion, cramping
~Anorexia
~Nausea, hematemesis, and vomiting
~Coffee-ground emesis or melena if GI bleeding is present
~Grimacing
~Restlessness
~Pallor
~Tachycardia
~Hypotension
~Abdominal distention, tenderness, and guarding
~Normoactive to hyperactive bowel sounds |
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Term
Peptic Ulcer Disease
(Causes) |
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Definition
~Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the esophagus, stomach or small intestine. The acid can create a painful open sore that may bleed.
~Helicobacter pylori bacteria
~Aspirin and other NSAID's
~Other medications such as bisphosphonates (Actonel, Fosamax, others) and potassium supplements. |
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Term
Peptic Ulcer Disease
(Complications) |
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Definition
~Periotonitis (inflammation of the lining)
~Internal bleeding
~Infection
~Scar tissue |
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Term
Peptic Ulcer Disease
(S/S) |
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Definition
~Burning pain that: Can be felt anywhere from your navel up to your breastbone; Be worse when your stomach is empty; Flare at night; Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication;
Disappear and then return for a few days or weeks
~Severe S/S: The vomiting of blood — which may appear red or black; Dark blood in stools or stools that are black or tarry; Nausea or vomiting;
Unexplained weight loss; Appetite changes |
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Term
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Definition
~Primary biliary cirrhosis (an autoimmune disease) and primary sclerosing cholangitis are caused by disorders of the small intrahepatic canaliculi and bile ducts.
~extrahepatic obstruction, which can be caused by conditions such as cholelithiasis, common duct strictures, or obstructing neoplasms, the effects begin with increased pressure in the large bile ducts. |
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Term
Cholestasis
(Complications) |
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Definition
~Jaundice from failure of breaking down bilirubin
~Diarrhea
~Organ failure can occur if sepsis develops
~Poor absorption of fat and fat-soluble vitamins
~Severe itching
~Weak bones (osteomalacia) due to having cholestasis for a very long time |
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Term
| Inflammatory Bowel Disease |
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Definition
~The term inflammatory bowel disease is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis.
~Both diseases produce inflammation of the bowel, both lack confirming evidence of a proven causative agent, both have a pattern of familial occurrence, and both can be accompanied by systemic manifestations.
~Crohn disease most commonly affects the distal small intestine and proximal colon, but can affect any area of the GI tract from the esophagus to the anus.
~Ulcerative colitis is confined to the colon and rectum. |
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Term
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Definition
~The precise cause of celiac disease isn't known.
~When the body's immune system overreacts to gluten in food, the immune reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat.
~Normally, villi resemble the deep pile of a plush carpet, on a microscopic scale.
~The damage resulting from celiac disease makes the inner surface of the small intestine appear more like a tile floor.
~As a result your body is unable to absorb nutrients necessary for health and growth. |
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Term
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Definition
~Although the classic signs are diarrhea and weight loss, most people with celiac disease experience few or no digestive signs or symptoms.
~In addition to digestive problems, other signs and symptoms of celiac disease include:
~Anemia, usually resulting from iron deficiency
~Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
~Itchy, blistery skin rash (dermatitis herpetiformis)
~Damage to dental enamel
~Headaches and fatigue
~Nervous system injury, including numbness and tingling in the feet and hands, and possible problems with balance
~Joint pain
~Reduced functioning of the spleen (hyposplenism)
~Acid reflux and heartburn |
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Term
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Definition
~A gluten-free diet is essential, and the only treatment for managing celiac disease. In addition to wheat, foods that contain gluten include:
~Barley
~Bulgur
~Durum
~Farina
~Graham flour
~Malt
~Rye
~Semolina
~Spelt (a form of wheat)
~Triticale |
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Term
Parkinson's Disease
(Patho) |
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Definition
| ~Is a degenerative process involving the dopaminergic neurons in the substantia nigra (area in basal ganglia that produces and stores the neurotransmitter dopamine). |
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Term
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Definition
~Muscle rigidity, akinesia (loss or impairment of the power of voluntary movement)and an insidious tremor beginning in the fingers (unilateral pill-rolling) that increases during stress or anxiety and decreases with purposeful movement and sleep
~Resistance to passive muscle stretching, which may be uniform (lead-pipe rigidity) or jerky (cogwheel rigidity)
~Akinesia causing difficulty walking (shuffling gait)
~Loss of posture control
~Drooling and excessive sweating
~Masklike facial expression
~Dysarthria (difficult or unclear articulation of speech)
~Dysphagia (difficulty swallowing)
~Decreased motility of GI and genitorurinary smooth muscle control
~Orthostatic hypotension
~Oily skin
~Progresses from down to up |
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Term
Multiple Sclerosis
(Patho) |
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Definition
~Activation of T lymphocytes against the myelin antigens, axons, and oligodendrocytes triggers an immunologic cascade.
~Recruitment of inflammatory cells and local release of lymphokines and cytokines results in injury to the myelin and underlying axon.
~Axon damage and nerve fiber loss occur in patches throughout the CNS.
~Damaged myelin can't conduct normally, and the partial loss or dispersion of the action potential causes neurologic dysfunction. |
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Term
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Definition
~Optic neuritis, diplopia (double vision), opthalmoplegia, blurred vision, and nystagmus (repetitive uncontrolled movement of the eyes)
~Sensory impairment, such as burning, pins and needles, and electrical sensations
~Fatigue (most debilitating symptom)
~Weakness, paralysis ranging from monoplegia (restricted to one limb or region of the body) to quadraplegia (all limbs and torso), spasticity, hyperreflexia (overactive reflexes), intention tremor and ataxia (loss of full control of body movements).
~Incontinence, frequency, urgency, and frequent UTI's.
~Involuntary evacuation or constipation
~Poorly articulated or scanning speech (syllables separated by pauses)
~Dysphagia (difficulty swallowing) |
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Term
Acute Spinal Cord Injury
(Patho) |
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Definition
~The pathophysiology of acute SCI can be divided into two types—primary and secondary.
~The primary neurologic injury occurs at the time of mechanical injury and is irreversible.
~Secondary injuries follow the primary injury and promote the spread of injury. |
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Term
Acute Spinal Cord Injury
(Spinal Shock) |
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Definition
~Sudden, complete transection of the spinal cord results in complete loss of motor, sensory, reflex, and autonomic function below the level of injury. The immediate response to SCI is often referred to as spinal shock.
~It is characterized by flaccid paralysis with loss of tendon reflexes below the level of injury, absence of somatic and visceral sensations below the level of injury, and loss of bowel and bladder function. Loss of systemic sympathetic vasomotor tone may result in vasodilation, increased venous capacity, and hypotension. These manifestations occur regardless of whether the level of the lesion eventually will produce spastic (UMN) or flaccid (LMN) paralysis. |
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Term
Acute Spinal Cord Injury
(S/S) |
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Definition
~Spinal shock can last hours, days, or weeks
~Muscle spasm and back pain that worsens with movement:
In cervical FX, pain may cause point tenderness
In dorsal and lumbar FXs, pain may radiate to other body areas such as legs
~Mild paraesthesia to quadriplegia and shock, if the injury damages the spinal cord |
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Term
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Definition
| ~Tetraplegia, sometimes referred to as quadriplegia, is the impairment or loss of motor or sensory function (or both) after damage to neural structures in the cervical segments of the spinal cord. It results in impairment of function in the arms, trunk, legs, and pelvic organs. |
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Term
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Definition
| ~Paraplegia refers to impairment or loss of motor or sensory function (or both) in the thoracic, lumbar, or sacral segments of the spinal cord from damage of neural elements in the spinal canal. With paraplegia, arm functioning is spared, but depending on the level of injury, functioning of the trunk, legs, and pelvic organs may be impaired. Paraplegia includes conus medullaris and cauda equina injuries. |
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Term
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Definition
~C1-C8
~C1: Head and neck
~C2: Head and neck
~C3: Diaphragm
~C4: Upper body muscles (eg, deltoids, biceps)
~C5: Wrist extensors
~C6: Wrist extensors
~C7: Triceps
~C8: Hands |
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Term
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Definition
~T1-T12
~T1-12 power the muscles that lie between the ribs (intercostal muscles). These also help you breathe by drawing the rib cage outwards and upwards, pulling the lungs in the same direction. The lungs expand, helping them fill with air.
~The diaphragm and the intercostal muscles are your major breathing muscles.
~Your lower thoracic spinal nerves T6-12 provide power to your abdominal muscles. These muscles help you cough and expel matter from your air passages. Abdominal muscles are also important in balance and posture. |
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Term
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Definition
~L1-L5
~L2 powers muscles that bend or flex your hip joint.
~L3 powers your quadriceps muscle so your leg straightens at the knee.
~L4 powers muscles around your ankle, allowing your ankle to bend and draw the foot back towards your head (dorsi-flexion). |
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Term
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Definition
~S1-S5
~S1 powers muscles around your ankle, allowing it to bend and your foot and toes to point downwards (plantar flexion)
S2-S4 powers external sphincter muscles of your anal canal and urethra. |
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Term
Autonomic Dysreflexia or Hyperflexia
(Patho) |
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Definition
~Whiplash
~Autonomic dysreflexia, also known as autonomic hyperreflexia, represents an acute episode of exaggerated sympathetic reflex responses that occur in people with injuries at T6 and above, in which CNS control of spinal reflexes is lost
~It does not occur until spinal shock has resolved and autonomic reflexes return, most often within the first 6 months after injury. It is most unpredictable during the first year after injury, but can occur throughout the person’s lifetime. |
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Term
Autonomic Dysreflexia or Hyperflexia
(S/S) |
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Definition
~anxiety and apprehension
~irregular or racing heartbeat
~nasal congestion
~high blood pressure, with systolic readings often over 200mm Hg
~pounding headache
~flushing of the skin
~profuse sweating, particularly on the forehead
~lightheadedness, dizziness, or confusion
~dilated pupils |
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Term
Brain Injury
(changes in manifestations) |
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Definition
~Is manifested by changes in the level of consciousness and alterations in cognitive, motor, and sensory function.
~Focal brain injury causes focal neurologic deficits that may, or may not, alter consciousness.
~Global brain injury nearly always results in altered levels of consciousness, ranging from inattention to stupor or coma.
~Severe injury that seriously compromises brain function may result in brain death. |
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Term
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Definition
~The cerebral hemispheres are the most susceptible to damage, and the most frequent sign of brain dysfunction is an altered level of consciousness and change in behavior. ~
As the brain structures in the diencephalon, midbrain, pons, and medulla are sequentially affected, additional signs related to pupillary and eye movement reflexes, motor function, and respiration become evident. ~
Hemodynamic and respiratory instability are the last signs to occur because their regulatory centers are located low in the medulla. |
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Term
Brain Injury
(Glasgow Coma Scale) |
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Definition
~THE GLASGOW COMA SCALE
~Eye Opening (E)
Spontaneous=4
To speech=3
To painful stimuli=2
No response=1
~Motor Response (M)
Obeys commands=6
Localizes pain=5
Normal flexion (withdrawal)=4
Abnormal flexion (decorticate)=3
Extension (decerebrate)=2
No response=1
~Verbal Response (V)
Oriented=5
Confused conversation=4
Inappropriate words=3
Incomprehensible sound=2
No response=1 |
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Term
| Increased Intracranial Pressure (ICP) |
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Definition
| ~The cranial cavity contains blood (approximately 10%), brain tissue (approximately 80%), and CSF (approximately 10%) in the rigid confines of a nonexpandable skull.2 Each of these three volumes contributes to the ICP, which normally is maintained within a range of 0 to 15 mm Hg when measured in the lateral ventricles. |
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Term
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Definition
~Early S/S: decreased alertness to drowsy LOC; small pupils and sluggish reaction to light; hemiparesis (weakness on 1 side of the body); no change in vitals; headache and slurred speech
~Late S/S: Stupor or coma LOC; large pupils nonreactive to light; hemiplegia (paralysis on 1 side of the body); increased blood pressure, widened pulse pressure, bradycardia, abnormal respiratory pattern; vomiting |
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Term
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Definition
| ~Cerebral edema, or brain swelling, occurs with an increase in water and sodium content causing an increase in brain volume.18 There are two types of brain edema: vasogenic and cytotoxic |
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Term
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Definition
~Vasogenic edema occurs with conditions that impair the function of the blood–brain barrier and allow transfer of water and protein from the vascular into the interstitial space. ~It occurs in conditions such as tumors, prolonged ischemia, hemorrhage, brain injury, and infectious processes (e.g., meningitis).
~Vasogenic edema occurs primarily in the white matter of the brain, possibly because the white matter is more compliant than the gray matter. ~Vasogenic edema can displace a cerebral hemisphere and can be responsible for various types of herniation.
~The functional manifestations of vasogenic edema include focal neurologic deficits, disturbances in consciousness, and severe intracranial hypertension. |
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Term
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Definition
~Cytotoxic edema involves an increase in intracellular fluid.
~It can result from hypoosmotic states such as water intoxication or severe ischemia that impair the function of the sodium–potassium membrane pump. ~Ischemia also results in the inadequate removal of anaerobic metabolic end products such as lactic acid, producing extracellular acidosis.
~If blood flow is reduced to low levels for extended periods or to extremely low levels for a few minutes, cellular edema can cause the cell membrane to rupture, allowing the escape of intracellular contents into the surrounding extracellular fluid. This leads to damage of neighboring cells.
~The altered osmotic conditions result in water entry and cell swelling. ~Major changes in cerebral function, such as stupor and coma, occur with cytotoxic edema. The edema associated with ischemia may be severe enough to produce cerebral infarction with necrosis of brain tissue. |
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