McCance Chapter 18 Disorders of the CNS, PNS and NMJ

Borrelia burgdorferi

Bacterial spirochete C—> Lyme d/z transmitted by ticks

Amyotrophic lateral sclerosis (ALS)

Degeneration U/L motor N. in cerebral cortex, brainstem, & spinal cord characterized by progressive muscle weakness leading to respiratory failure & death (2 to 5 years from symptom onset).

Person has normal intellectual & sensory function until death

Arteriovenous malformation

Arteries feed directly into veins through a vascular tangle of vessels

Autonomic hyperreflexia (dysreflexia)

afferent stimuli C→ intense sympathetic discharge in spinal cord above major splachnic outflow. symptoms:

hypertension, bradycardia, sweating of the forehead, severe headache, and piloerection on distention of the bladder and rectum.

Cavernous angiomas

Sinusoidal collections of blood vessels w/o interspersed brain tissue

Cerebellar astrocytoma

Brain tumor C→ symp. on the same side as the tumor including head tilt, limb ataxia, and nystagmus.

in R or L cerebellar hemisphere

Cerebral infarction

Area of the brain loses blood supply b/c of vascular occlusion

Chronic paroxysmal hemicrania

Cluster-type headache occurs w/

-high frequency (4 to 12/day)

-low duration (20-120 minutes)

Classic cerebral concussion

Diffuse brain injury w/ cerebral disconnection from the brainstem reticular activating system

phenomenon of physiologic, neurologic dysfunction w/o substantial anatomic disruption.

immd. loss of consciousness for less than 6 hours with retro/anterograde amnesia.

Cluster headache

Headache charact. by unilateral severe pain over the eye & forehead that lasts 30 minutes to 2 hours,

several attacks per day can occur over a period of days followed by long periods of remission

Contrecoup

Brain injury resulting from the brain hitting the inside of the skull on the side opposite the site of blunt force trauma.

Contusion

Bruise produced by bleeding into skin or underlying tissues from an insult that did NOT break the skin but did rupture blood vessels.

Coup

Brain injury that occurs on the same side of a blunt force to the head;

it results from the rapid acceleration and then deceleration of the brain as it hits the inside of the skull.

Injury directly b/w point of impact.

Diffuse brain injury

Brain injury C→ stretching & shearing forces of neuronal axons (injury)

(_____ axonal)

Embolic stroke

blockage of cerebral vessels C→ stroke

Encephalitis

Inflammation of the brain usually caused by a virus.

Ependymoma

Intracranial tumor commonly found in children

- typically arises from the inner lining of the 4th ventricle & spinal canal.

Extradural Hematoma

Hemorrhage usually from an artery a/w skull fracture post-head injury

Extramedullary tumors

Tumor originating from tissues outside the spinal cord including the meninges, epidura tissue or vertebral structures

Fasciculation

Involuntary muscular twitching

Fusiform aneurysm (giant aneurysm)

Large aneurysm that stretches to affect the entire circumference of the arterial wall.

Guillain-Barré syndrome

bacterial/viral infection trig.→

Acute, inflam., autoim. →

demyelination of neurons resulting in atrophy & denervation (PNS) of muscle w/ numbness, pain, parasthesis or weakness

Hemorrhagic stroke (intracranial hemorrhage)

Hypertension or ruptured aneurysms C→

bleeding in brain, typically inc. intracranial pressure & may lead to death.

Intramedullary tumors

Tumor originating w/n neural tissue

Lacunar stroke

occlusion (microinfarct) of a small branch of larger blood vessel a/w:

smoking, diabetes and hypertension

C→ stroke

Lyme d/z

Tick-borne spirochete bacterial (Borrelia burgdorferi) infection

lyme d/z

characterized by a rash in area of the bite, headache, neck stiffness, chills, fever, myalgia, arthralgia, malaise, fatigue, and possible development of arthritis in large joints.

Meningioma

A slow-growing, often encapsulated mass of cells derived from arachnoid tissue in the dural membrane that is usually benign but inc intracranial pressure.

Meningitis

Inflammation of the membranes covering the brain & spinal cord a/w bacteria/viruses/parasites infection or toxins

Metastasis

Spread of cancer to other parts of the body

Migraine

Headache that usually begins in the temporal region unilaterally after vascular changes of cranial arteries

C→irritability, nausea, vomiting, constipation or diarrhea, and photophobia.

Mild concussion

Tempr. axonal disturbances w/o the loss of consciousness in response to a violent blow, jarring, shaking, or other closed head injury.

Multiple sclerosis

Chronic, autoimmune, demyelinating disease of the CNS that C→ inflammation, axonal degeneration & scarring of myelin sheaths.

Myasthenia gravis

autoimmune response in which antibodies to acetylcholine receptors impair neuromuscular transmission.

Neuromuscular disorder caused by an

Mycotic aneurysm

Aneurysm that is caused by bacterial or fungal growth in the vessel wall or infection of a arteriosclerotic aneurysm.

Myelopathy

Degeneration of the spinal cord

Neurofibroma or schwannoma

Benign nerve sheath tumor in the PNS

Neurogenic shock

Sudden loss of the SNS signals to smooth muscle in vessel walls, c→

vasodilation, hypotension, bradycardia and hypothermia

Neuropathy

Degeneration of nervous system

Capillary telangiectasis

Dilated capillaries with interspersed brain tissue deep in the brain

Oligodendroglioma

Benign nerve sheath tumor in the CNS

Radiculitis

Inflam. of spinal nerve root

Saccular aneurysm (berry aneurysm)

congenital anomalies or degeneration C→ slowly progressing aneurysm that affects only a portion of circumference of arterial wall

Spinal shock

A complete loss of reflex f/x in skeletal muscles, bladder, bowel, sexual function & autonomic control b/w the level of lesion

Stenosis

Narrowing or stricture of a passage or vessel

Spondylolisthesis

Stress factor allowing the vertebra to slide forward in relation to the vertebra b/w

Spondylolysis

Degenerative process of the vertebral column & a/w soft tissue

Subdural hematoma

rupture of veins → Collection of blood b/w the inner surface of the dura mater & surface of the brain

Tension headache

emotional strain or overwork focuses occipital region and can be continuous for months C→ headache

Thrombotic stroke (cerebral thrombosis)

Arterial occlusions in vessels supplying the brain or intracranial vessels caused by atherosclerosis or inflammation.

Transient ischemic attack

Tempr. neurologic dysfunction, symptoms last less than 1 hr,

no evidence of infarction

Venous angioma

Primitive embryologic veins in a radial pattern feedng a central vein