Chapter 34 Neurology

absence seizure

type of generalized seizure with sudden onset, characterized by a brief loss of awareness and rapid recovery

afferent

carrying impulses toward the central nervous system

Alzheimer’s disease

progressive, degenerative brain disorder, resulting in impaired memory, thinking, and behavior; the most common cause of dementia

amyotrophic lateral sclerosis (ALS)

progressive degeneration of the motor neurons that control voluntary movement, resulting in weakness, loss of motor control, difficulty speaking, and cramping. Also called Lou Gehrig’s disease

arachnoid membrane

the middle membrane of the meninges

aura

subjective sensation that may precede a seizure

autonomic nervous system

part of the nervous system controlling involuntary bodily functions

Bell’s palsy

one-sided facial paralysis with an unknown cause characterized by the inability to close the eye, pain, tearing of the eyes, drooling, hypersensitivity to sound, and impairment of taste

brain abscess

collection of pus localized in an area of the brain

brainstem

part of the brain connecting the cerebral hemispheres with the spinal cord. It consists of the mesencephalon (midbrain), pons, and medulla oblongata

cauda equina syndrome

condition caused when nerve roots at the lower end of the spinal cord are compressed, interrupting sensation, movement, and function in the lower body

central nervous system (CNS)

brain and spinal cord

central neurogenic hyperventilation

rapid, deep, often noisy respirations caused by a lesion in the central nervous system; can lead to respiratory fatigue, coma, and death

central pain syndrome

condition resulting from damage to the brain, brainstem, or spinal cord characterized by intense, steady pain described as burning, aching, tingling, or a “pins and needles” sensation

cerebellum

portion of the brain located dorsally to the pons and medulla oblongata that plays an important role in fine motor movement, posture, equilibrium, and muscle tone

cerebrospinal fluid

fluid surrounding and bathing the brain and spinal cord

cerebrum

largest part of the brain, consisting of two hemispheres separated by a deep longitudinal fissure

clonic phase

portion of a seizure characterized by alternating contraction and relaxation of muscles

coma

state of unconsciousness from which the patient cannot be aroused

complex focal seizure

type of focal seizure usually originating in the temporal lobe characterized by an aura and focal findings such as alterations in mood or the inability, for a short time, to respond to questions or directions

cranial nerves

twelve pairs of nerves that extend from the lower surface of the brain

Creutzfeldt-Jakob disease (CJD)

rare form of brain damage that leads to a rapid decrease in mental function and movement characterized by dementia, ataxia, hallucinations, jerking, and general decline

Cushing’s triad

collective change in vital signs (increased blood pressure, decreased pulse rate, and irregular respirations) associated with increasing intracranial pressure

decerebrate posturing

sustained contraction of extensor muscles of the extremities resulting from a lesion in the brainstem. The patient presents with stiff and extended extremities and retracted head

decorticate posturing

characteristic posture associated with a lesion at or above the upper brainstem. The patient presents with the arms flexed, fists clenched, and legs extended

degenerative neurologic disorders

collection of diseases that selectively affect one or more functional systems of the central nervous system

dermatome

topographical region of the body surface innervated by one nerve root

diencephalon

portion of the brain lying beneath the cerebrum and above the brainstem. It contains the thalamus, hypothalamus, and limbic system.

dura mater

outermost layer of the meninges

dystonias

disorder characterized by muscle contractions that cause twisting and repetitive movements, abnormal postures, or freezing in the middle of an action

efferent

carrying impulses away from the brain or spinal cord to the periphery

emergent large vessel occlusion (ELVO)

a type of stroke that occurs when one of the large arteries supplying a big portion of the brain becomes blocked

focal seizure

type of seizure that is located in just one area of the brain

generalized seizure

a seizure that involves both hemispheres of the brain rather than starting and staying in one localized area

Guillain-Barré syndrome

a serious autoimmune disorder in which the body’s immune system mistakenly attacks the peripheral nerves, causing nerve inflammation and demyelination

homonymous hemianopsia

loss of half of the visual field in both eyes

Huntington’s disease

disorder caused by a genetic defect and characterized by rigidity, slow movements, tremor, behavioral changes, unusual movements, and dementia

Korsakoff’s psychosis

a brain disorder that develops in the setting of chronic alcoholism with thiamine deficiency

medulla oblongata

lower portion of the brainstem, connecting the pons and the spinal cord. It contains major centers for control of respiratory, cardiac, and vasomotor activity

meninges

the three membranes protecting the brain and spinal cord

mesencephalon

portion of the brain connecting the pons and cerebellum with the cerebral hemispheres, controls eye movement and motor coordination

multiple sclerosis (MS)

autoimmune disease that involves inflammation of certain nerve cells followed by demyelination

muscular dystrophy (MD)

group of hereditary, genetic diseases characterized by progressive muscle weakness and degeneration of the skeletal or voluntary muscle fibers

myoclonus

temporary, involuntary twitching or spasm of a muscle or group of muscles

neoplasm

tumor

neuron

nerve cell

neurotransmitter

substance that is released from the axon terminal of a presynaptic neuron on excitation and that travels across the synaptic cleft to either excite or inhibit the target cell

parasympathetic nervous system

the ‘rest and digest’ system

Parkinson’s disease

chronic and progressive motor system disorder characterized by tremor, rigidity, bradykinesia, and postural instability

peripheral nervous system (PNS)

the nervous system outside the CNS

peripheral neuropathy

malfunction or damage of the peripheral nerves

pia mater

the innermost layer of the meninges

Pick’s disease

permanent form of dementia similar to Alzheimer’s disease but affecting only certain areas of the brain; characterized by incorrect behavior in social settings and difficulty with decision making, complex tasks, and language

poliomyelitis (polio)

infectious, inflammatory viral disease of the central nervous system that sometimes results in permanent paralysis

pons

process of tissue responsible for the communication interchange between the cerebellum, the cerebrum, the midbrain, and the spinal cord

reticular activating system (RAS)

network of nerve cells in the brainstem responsible for consciousness

seizure

temporary alteration in behavior due to the massive electrical discharge of one or more groups of neurons in the brain

simple focal seizure

type of focal seizure that affects a small part of the brain and can cause twitching or a change in sensation, such as a strange taste or smell

somatic nervous system

PNS division that controls conscious movement

spina bifida (SB)

neural defect that results from the failure of one or more of the fetal vertebrae to close properly during the first month of pregnancy, exposing the spinal cord and its meninges

status epilepticus

series of two or more generalized motor seizures without any intervening periods of consciousness

stroke

neurologic deficit caused by interruption of cerebral blood flow and oxygenation from either ischemic or hemorrhagic lesions to a portion of the brain

sympathetic nervous system

division of the autonomic nervous system that prepares the body for stressful situations

syncope

fainting; transient loss of consciousness due to inadequate flow of blood to the brain with rapid recovery of consciousness on becoming supine

tonic phase

stage of a seizure characterized by tension or contraction of muscles

tonic–clonic seizure

type of generalized seizure characterized by rapid loss of consciousness and motor coordination, muscle spasms, and jerking motions

transient ischemic attack (TIA)

reversible, temporary interruption of blood flow to the brain

Wernicke’s syndrome

condition characterized by loss of memory and disorientation, associated with chronic alcohol intake and a diet deficient in thiamine

What’s the dosage for diazepam in a seizure?

5-10mg IV

What’s the dosage for midazolam in a seizure?

10mg IM

What’s the dosage for lorazepam in a seizure?

0.1mg/kg IV

What are the characteristics of Parkinson’s?

tremor, rigidity, bradykinesia, postural instability

Vertebral Spondyolysis

the degeneration of the vertebrae

Reflex impulses come from the _____

Spinal cord

The parasympathetic system uses what neurotransmitter?

Acetylcholine

The sympathetic nervous system uses what neurotransmitter?

Norepinephrine

How many cervical vertebrae?

7

How many thoracic vertebrae?

12

How many lumbar vertebrae?

5

How many sacral vertebrae?

5

How many coccygeal vertebrae?

4

The carotid system and vertebrobasilar system join together where?

The Circle of Willis

How many nerve fiber pairs exit the spinal cord?

31

How many cranial nerve pairs are there? (Add them in here at some point)

12