UWF NUR 3125 Patho - Module 4 Recap

movement pathway

Brain - UMN - LMN - NMJ - Muscle contraction

motor unit

one motor neuron and all the muscle fibers it innervates

neuron death

leads to denervation atrophy (muscle wasting)

UMN lesions

hyperreflexia, spastic, minimal atrophy (Ex. Stroke)

LMN lesions

hyporeflexia, flaccid, marked atrophy (ex. Guillain-barre syndrome)

Myasthenia Gravis

(NMJ disorder) antibodies destroy acetylcholine receptors → weaknessthat improves with rest

Parkinson's Disease

(basal ganglia disorder) decreased dopamine → resting tremor, slow movement(bradykinesia), rigidity

intention tremor

(cerebellar) rhythmic, involuntary shaking that becomes more pronounced as a person attempts to perform a purposeful, targeted movement

ataxia

(cerebellar) lack of muscle coordination

dysmetria

(cerebellar) overshoot movements; The inability to control the range of a movement and the force of muscular activity.

Peripheral neuropathy

numbness, burning pain

Radiculopathy

(nerve root compression): pain follows a dermatomal pattern

spinal cord injury effects

paralysis, respiratory compromise, unstable blood pressure,bladder/bowel dysfunction

Ischemia

reduced blood flow

Excitatory amino acid injury:

excess glutamate damages neurons

Cerebral edema

fluid accumulation (vasogenic or cytotoxic)

Increased Intracranial Pressure (ICP)

risk of brain herniation

Normal ICP

0-15 millimeters of mercury (mmHg)

Early Signs of Increased ICP

Headache• Vomiting without nausea• Decreased level of consciousness (earliest change)

Late Signs of increased ICP - Cushing's Triad

Increased systolic blood pressure• Decreased heart rate (bradycardia)• Irregular respirations

communicating hydrocephalus

impaired cerebrospinal fluid (CSF) absorption

non-communicating hydrocephalus

CSF flow obstruction

epidural hematoma

arterial bleed leading to rapid decline

subdural hematoma

venous bleed leading to slower symotoms

concussion

transient loss of consciousness and memory issues

Ischemic stroke:

blocked vessel (most common

hemorrhagic stroke

ruptured vessel

stroke risks

hypertension, atrial fibrillation, smoking, diabetes

Stroke Assessment

BEFAST - balance, eyes, face, arms, speech, time

Meningitis

Fever, headache, stiff neck (nuchal rigidity)• Positive Kernig and Brudzinski signs• Place on droplet precautions immediately

Encephalitis

Infection of brain tissue → altered mental status

Partial seziure

one brain region

Generalized seziures

both hemispheres

Status epilepticus:

prolonged seizure → emergency

Priority during seizure

protect airway, turn on side, do not restrain

Strain

injury to tendon

sprain

injury to ligament

dislocation

bones displaced from joint

loose bodies

fragments floating in joint space

fracture cause

sudden injury, stress, pathologic

greenstick fracture

one in which the bone is bent and only partially broken

comminuted fracture

fracture in which the bone is splintered or crushed

5 stages of bone healing

hematoma formation, cellular proliferation, callus formation, ossification, remodeling

fractures delayed healing

Infection• Poor blood flow• Malnutrition• Smoking• Corticosteroid use

compartment syndrome

involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles

compartment syndrome symptoms

Hallmark: severe pain not relieved by opioid medications• Medical emergency → contact provider immediately• Do not elevate or apply ice (ATI emphasis)

rickets

Vitamin D deficiency in children

osteomalacia

disease marked by softening of the bone caused by calcium and vitamin D deficiency

osteomyelitis

infection of the bone; requires weeks of IV antibiotics

benign bone tumor

Osteochondroma

metastatic bone disease

most common bone cancer in adults

Growth plate injury

leads to risk of permanent limb shortening

internal/external toeing

A walking pattern where the feet point inward (intoeing) or outward (out-toeing), often due to rotational differences in the hips, legs, or feet.

Tibial Torsion

A twisting of the tibia (shinbone) that causes the feet to turn inward or outward during walking.

Femoral Torsion

An inward or outward twisting of the femur (thighbone) that affects hip rotation and foot alignment.

Bowlegs (Genu Varum)

A leg alignment where the knees stay apart when the ankles are together, creating a bowed appearance

Knock-Knees (Genu Valgum)

A leg alignment where the knees touch or angle inward while the ankles remain apart.

diagnostic test for developmental dysplasia of the hip

Signs:• Asymmetrical thigh folds• Limited abductionDiagnostic test: Ortolani maneuver

clubfoot

A congenital condition in which a baby’s foot is twisted inward and downward due to abnormal positioning of the bones, muscles, and tendons. corrected with serial casting

Postural scoliosis

corrects with bending

Structural scoliosis

does NOT correct

scoliosis symptoms

uneven shoulders and hips, rib hump

Osteopenia

reduced bone mass

osteoporosis definition

fragile bones

osteoporosis risk factors and prevention

Risk factors: aging, inactivity, low calcium/vitamin D• Prevention: weight-bearing exercise and adequate nutrition

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome

Persistent fatigue lasting at least six months.

Vitiligo

absence of melanin

Albinism

congenital lack of melanin production

Melasma

hyperpigmentation

Mongolian spots

congenital bluish patches in infants

tinea

fungal infections

impetigo

bacterial infection of honey-colored crusts; keep child home until treated

ecthyma

bacterial infection of deep and ulcerative form

cellulitis

bacterial deep skin infection

HPV

warts

HSV

herpes 1 and 2

herpes zoster

shingles, viral; painful vesicles along a dermatome; treat with antiviral meds within 72 hours

rosacea

chronic inflammation with vascular instability

Psoriasis

A chronic inflammatory skin condition marked by well-defined, silvery, scaly plaques on the skin.

Pityriasis rosea

A self-limiting rash that begins with a "herald patch" followed by multiple oval, scaly lesions in a Christmas-tree pattern.

Lichen planus

An autoimmune skin disorder characterized by flat-topped, purple, itchy papules often with fine white lines (Wickham striae).

Scabies

An intensely itchy skin infestation caused by mites that burrow into the skin, creating linear tracks.

Pediculosis (lice)

Infestation of the scalp, body, or pubic area by lice that live on hair or clothing and feed on blood.

Tick-borne illnesses (Lyme disease, RMSF):

Infections transmitted by tick bites that can cause systemic symptoms such as rash, fever, and joint or neurologic complications.

pressure injuries

repositon every 2 hours, keep heels off bed, do not massage red areas

malignant melanoma

most aggressive

basal cell carcinoma

most common

squamous cell carcinoma

second most common

Superficial spreading melanoma:

The most common melanoma, growing horizontally across the skin surface before invading deeper layers.

Nodular melanoma

A fast-growing, aggressive melanoma that forms a raised, dome-shaped nodule and invades early.

Lentigo maligna melanoma:

A slow-growing melanoma that begins as a flat, mottled patch on sun-damaged skin, usually in older adults

Acral lentiginous melanoma:

A melanoma that appears on the palms, soles, or under the nails, more common in people with darker skin tones.