Term
| Stroke: Clinic Manifestations : Cerebral cortex is involved |
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Definition
a. Aphasia –can’t speak
b. Apraxia-No purposeful movement
c. visual field change
d. Memory deficits
e. disorganized thinking; confusion |
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Term
| Stroke: Clinic Manifestation: cerebellum is involved |
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Definition
altered movement coordination (ataxia, no coordination)
c. vertigo and/or disequilibrium |
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Term
| Stroke Sequela: Motor Deficits |
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Definition
1. Initially characterized by flaccidity
2. Contralateral to the injury in the brain
3. Common problems in the lower extremity- foot drop
4. Spasticity starts at 6 weeks after the stroke
5. If spasticity is not evident within 3 months- function is not likely to return to the affected limb |
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Term
| Stroke Sequela: Sensory deficits |
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Definition
1. Occurs at the same location as the motor paralysis
2. Hemiattention/Neglect: Don’t realize that the affected body parts belong to them (limb susceptible to injury) |
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Term
| Stroke Sequela: Language deficits |
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Definition
1. Aphasia-can’t speak
2. Broca (aka verbal/motor/expressive aphasia)-understand what’s being said but can’t appropriately respond
3. Wernick)aka sensory or acoustic aphasia)-can’t understand what’s being said |
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Term
| Stroke Sequela: Cognitive Deficits |
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Definition
1. Vary according to the area of brain affected and the severity of injury.
2. Clinical Manifestations
a. Memory, ability to reason, judgement difficulties, concentration |
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Term
| Cerebral Aneurysm: Etiology |
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Definition
1. Weakness in a cerebral artery or vein causes a localized dilatation or ballooning of the vessel
2. More common in adults but may occur at any age
3. More common in women by a ratio of 2 to 1
4. Warning leaks may occur, manifested as severe headaches or still neck
a. can be genetics
b. can be caused by hypertension, cocaine use, and alcohol abuse
c. Circle of Willis -95% of cerebral aneurysms develop here (N, V, photo phobic) |
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Term
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Definition
bacterial or viral pathogens cross the blood brain barrier causing inflammation of the meninges surrounding the brain and spinal cord
A. Usually travels from blood stream, Exudate formation can mix in w/CSF risk for blocking drainage could increase ICP |
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Term
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Definition
1. Viral- Most common; often resolves without treatment
2. Bacterial
a. Contagious with high mortality rate
b. Prognosis dependent on supportive care
c. Complications more likely; cerebral edema, cranial nerve damage
d. CSF analysis-Common causes: Neisseria meningitiis, Streptococcus pneumoniae, Hameophilus influenzae
e.Vaccine |
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Term
| Signs of Meningeal Irritation |
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Definition
1. Nuchal rigidity-stiff neck
2. Brudzinski Sign-Drawing up knees when you flex your neck
3. Kernig’s Sign-flex hip when you straighten knee it causes
pain in leg or neck
4.CSF spinal tap-
a. low glucose count
b. increase bacterial count
c. cloudy exudate
D. Meningitis clinical manifestations
1. HA, fever, stiff neck, confusion |
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Term
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Definition
| inflammation of the brain tissue(usually viral) |
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Term
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Definition
1. Infectious process usually begins elsewhere in the body
2. same types of infectious agents that cause meningitis (usually viral)
3. West Nile virus, Herpes Virus |
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Term
| Encephaitis: Clinical Manifestations |
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Definition
Clinical Manifestations
1. HA, Malaise, Muscle pain, rash, (advancing age- risk factor) |
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Term
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Definition
| Uncontrolled electrical brain discharges cause alteration in normal brain function(flashing light, loud noises) |
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Term
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Definition
1. genetic
2. structural-abnormalities, some previous injury stroke, surgery, or illness causing structural, tumor, stroke, encephalitis, meningitis
3. Metabolic-nutritional-hypoxia, alcohol withdrawal, medication overdose, street drugs, fluid and electrolyte |
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Term
| Seizures: Clinical Manifestations |
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Definition
a. Partial (focal)-only a part of the brain affected
1. Simple partial-no impairment of consciousness, and limited to one part of the body
2. Complex Partial-impaired consciousness, and characterized by involuntary, repetitive movements
b. General-whole brain is affected
1. absence (petit mal)-only occur briefly Usually in children (staring episodes 15-30 sec.)
2. Atypical absence- autoclonic jerks, repeat over and over automotions lipsmacking
3.Myoclonic-brief single or multiple jerks of 1 or more muscle groups
4. Atonic-Drop attack head injury complete sudden loss of muscle tone
5. Clonic-alternating periods of involuntary contractions and relaxations
6. Tonic-(grand mal)-sudden loss consciousness followed
7. Generalized clonic-tonic- Resp stop, eyes open, mouth open, may lose bowel or bladder control, 15 sec. end of seizure marked by inspiration posticidel state, person regains consciousness, confused, no memory, physically exhausted and sleeps for hours |
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Term
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Definition
Epilepsy: a group of syndromes characterized by recurring seizures
1. Underlying condition that affects how electrical energy behaves in the brain
B. Etiology: Idiopathic or related to another condition
1.Seizures are a symptom of epilepsy BUT having a single seizure does not |
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Term
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Definition
1. Refers to a life-threatening condition in which the brain is in a state of persistent seizure
2. Defined as one continuous unremitting seizure lasting longer than 30 minutes necessarily mean a person has epilepsy.(lack of O2) |
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Term
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Definition
– Dementia-causing illnesses, Parkinson, alcoholism, Huntington’s, crutchfield’s
– Vascular (CVA)
– More common in geriatric population(50% over 95 yo, 10% over 65yo) |
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Term
| Dementia: Clinical manifestations |
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Definition
1.Insidious-onset comes on slow
2. agnosia-effected person unaware of cognitive limitations
3. anxiety, judgement, problem solving, communication, ADL,s, bladder problems, aspiration pneumonia, accident(usually Die from), recent memory lost, agitation |
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Term
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Definition
Chronic, progressive form of dementia
– Usually occurs after age 65 but can occur as early as age 40 |
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Term
| Alzheimer’s Disease: Etiology |
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Definition
theories(4x at risk for Alz. w/direct relation affected)
– Abnormal protein processing destroys cells
– Genetic coding causes neuronal death
– Previous head injury
– Depression |
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Term
| Alzheimer’s Disease: Pathogenesis and Clinical Manifestations |
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Definition
B. Pathogenesis-Plaques, pathological changes and neuronal tangles occur in the brain
Loss of neurons and synapses in the cerebral cortex result in atrophy of affected regions
Decrease in number of functioning neurons accounts for decline in cognition, memory and thought
C. Clinical Manifestations-same as dementia decrease ability to function |
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Term
| Parkinson's Disease: Etiology and Risk Factors |
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Definition
Progressively debilitating disease that affects motor function, and deficiency of dopamine
A. Etiology
– Primary: Idiopathic
– Secondary: Linked to other causes
B. Risk Factors
-Boxing injury, infection, trauma, and genetics, drug toxcity
-70 to 80% of neurons damaged before diagnosis |
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Term
| Parkinson's Disease: Pathogenesis and Clinical Manifestations |
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Definition
C. Pathogenesis-Neurons degenerate and become deficient in production and storage of dopamine. As dopamine decreases, acetylcholine is no longer inhibited and the imbalance of this neurotransmitter is responsible for the symptoms of Parkinson’s
D. Clinical Manifestation(classic Triad)-Fall Risk
1.Akinesia/Bradykinesia(first difficulty then slow inability to initiate movement
2.Tremors-“pill rolling”, arms, head, hand-(usually start with one hand at rest)
3.Rigidity-smooth, stiff movements, and resistance to passive ROM
a. swallowing is also affected |
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Term
| Multiple Sclerosis: Etiology and Pathogenesis |
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Definition
Autoimmune disorder of the CNS where myelin and nerve axons in the brain and spinal cord are destroyed
A. Pathogenesis-Loss of myelin sheath results in inability to effectively conduct nerve impulses. Plaque formation in the CNS also affects conduction of nerve impulses, and Inflammation occurs around plaque and in normal tissue, and Multiple Sclerosis refers to the scars (scleroses-plaques or lesions) that form in the brain and spinal cord as a result of demyelination(age 20-40)
. B. Etiology: Unknown, Exposure to a virus or environmental toxin in genetically predisposed individuals is suspected, and Exacerbations can be triggered by a variety of factors(genetics) |
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Term
| Types of Multiple Sclerosis |
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Definition
C. Types – MS
1.Relapsing-remitting: neurological exacerbations with full or partial recovery (most common)
2.Primary progressive: sudden loss of neurological function with functional impairment; no remission follows
3.Secondary progressive: starts as relapsing-remitting and changes to primary progressive
4.Progressive relapsing: progressive from the start duration of disease usually 30 year except from start |
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Term
| Clinical Manifestations of Multiple Sclerosis |
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Definition
Clinical Manifestation
1. Depend on location
a. visual-decrease acuity, blurred, double, eye pain,
b. Weakness-extremely fatigue
c. Motor-parasthesia, trouble with coordination
d. Neuro- behavior disorders, memory, cognitive disfunction |
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Term
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Definition
Autoimmune disorder involving acute destruction of the myelin sheath
A. Etiology-Exact cause unknown,
B. Risk Factors-Viral infection, immunizations, febrile illness, injury, surgery
C. Pathogenesis
-Trigger initiates immune response
-Formed antibodies cause destruction of myelin in PNS
-Nerve impulses are slowed or stopped and muscles lose nerve innervation
-Remyelinization occurs over a period of a few months to a few years
D. Clinical Manifestation
A. Ascending weakness or paralysis in the legs that spreads to the upper limbs and the face Greatest concern? (Breathing)
B. Symptoms usually peak 12-14 days after onset. 80% make full recovery within a few months to a year |
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Term
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Definition
Compression or blunt trauma causes contusion, penetration, or transection of neural tissue
-One can have spine injury without spinal cord injury
-The level of cord involved determines the consequences of spinal cord injury
A. Etiology-Trauma; primarily MVAs and violence, followed by falls and recreational accidents(horseback riding, diving)
B. Major mechanisms of SCI
1.Flexion Injury-head flying forward
2. Hyperextension injury-Hitting chin on dash board or desk
3. Compression Injury-diving(falling) straight on head
C. Spinal Cord Injuries
1. Complete Injury- No function below the level of injury, and Less than 5% of people with "complete" spinal cord injury recover locomotion.
2. Incomplete Injury- Retains some sensation or movement below the level of the injury. Over 95% of people with "incomplete" spinal cord injury recover some locomotor ability
3. Cervical Injury-
a. C1-2: total tetraplegia and respiratory paralysis
b. C2-3 varying degrees of tetraplegia
4. Thoracic Injury- Injuries at the thoracic level and below result in varying degrees of paraplegia
5. Lumbar and Sacral Injury- Decreased control of legs/hips, elimination systems |
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