Patho test 3

sensorineural hearing loss is due to

something is wrong with middle or inner ear or auditory nerves

keratitis

inflammation of the cornea, often caused by HSV

begins superficially, may go deeper

eye pain, redness, photophobia, feeling of foreign body in eye

aphasia

loss of ability to understand or express speech, caused by brain damage

expressive aphasia

the individual can understand words, but can not respond back with speech, Broca’s area is affected

receptive aphasia

unable to comprehend speech, Wernicke’s area is affected

ischemic stroke

caused by a thrombus or embolus that lodges in a cerebral artery and blocks blood flow to the brain tissue

cerebral infarction

the death of brain cells

hemorrhagic stroke

caused by rupture and hemorrhage of a cerebral artery, leading to compression and toxicity of brain cells and loss of cerebral blood flow

TIA

“mini-stroke” a disruption of cerebral circulation with neurological deficits that are reversible and last for less than 24 hours

Neurological deficits

brain cell death leads to loss of function

carotid stenosis

arteriosclerosis (plaque build up) of the carotid artery (a common cause of ischemic stroke)

lacunar infarcts

small areas in the brain that endure ischemia from occluded tiny blood vessels

subarachnoid hemorrhage

a specific type of cerebral hemorrhage occurs when an arterial branch in the subarachnoid space ruptures

anoxic encephalopathy

causes decreased levels of consciousness

cushing’s triad (hemorrhagic stroke)

irregular respiratory rate, bradycardia, and hypertension(widen pulse pressure)

What is the olfactory nerve?

number one of the cranial nerves, it is sensory, and its function is smell

what is the optic nerve?

number 2 of the cranial nerves, it is sensory, and its function is vision

what is the oculomotor nerve?

number 3 of the cranial nerves, it is motor and its function is extra-ocular movements and pupil response

what is the trochlear nerve?

number 4 of the cranial nerves, it is motor and its function is extra-ocular movement

what is the trigeminal nerve?

number 5 of the cranial nerves, it is mixed and its function is facial sensations, chewing

what is the abducens nerve?

number 6 of the cranial nerves, it is motor and its function is extra-ocular movements

what is the facial nerve?

number 7 of the cranial nerves, it is mixed and its function is facial expressions and taste over 2/3 of the tongue

what is the auditory/ vestibulocochlear nerve?

number 8 of the cranial nerves, it is sensory and its function is hearing and equilibrium

what is the glossopharyngeal nerve?

number 9 of the cranial nerves, it is mixed and its function is elevation of pharynx in swallowing and taste of 1/3 of tongue

what is the vagus nerve?

number 10 of the cranial nerves, it is mixed and its function is gag reflex and parasympathetic control of body

what is the accessory nerve?

number 11 of the cranial nerves, it is motor and its function is turn the head and shrug

what is the hypoglossal nerve?

number 12 of the cranial nerves, it is motor and its function is tongue movement

motor nuerons _____

descend

sensory nuerons _____

ascend

damage on the right side of the brain will present injury on what side of the body

left side of the body

what is the midbrain responsible for ?

auditory and visible responses, motor movement

what is the pons responsible for?

arousal and sleep

what is the medulla oblongata responsible for?

HR, respiratory function

what is the circle of willis?

base of the brain, most common site for aneurysms

if the patient is having loss of consciousness than we know they are having a ______ stroke

hemorrhagic

what stroke can be caused by atrial fibrillation?

ischemic

what stroke can be caused by hypertension?

hemorrhagic stroke

what can happen if the hemorrhage is large?

hematoma and clot form because blood gets stationary in skull

what does FAST stand for?

F: facial drop

A: arm weakness

S: speech difficulty

T: time to call 911

what is the traditional diagnosis for epilepsy?

2 unprovoked seizures at least 24 hrs apart

focal seizure

located within 1 cerebral hemisphere

generalized seizure

involve both hemispheres

clonic movement

sustained rhythmical jerking

atonic movement

limbness

myoclonus movement

muscle twitching

nonmotor symptoms of seizure

starting spells with no movement, just staring off into space

what is an aura?

sensation people get before a seizure

what is the ictal period

time when the seizure is occurring

what is the post ictal period

after the seizure is complete

what is the interictal period

if multiple seizures occur in short time, this is the time between seizures

after seizure has ended, place patient on their ______ side

left

primary headaches characteristics

* arise independently of any other medical illness or traumatic cause
* ex) tension type, migraine

Secondary headaches characteristics

* caused by another primary condition
* ex)head injury, tumors, vascular problems

what is the tension type headache?

most common type of primary headache, bilateral pain

what is the migraine headache?

throbbing period headaches that worsen with movement, most common in young women

what is trigeminal autonomic cephalgia?

excruciating one sided headache, most common in male 25-50 years. Signs are blood shot eyes, tearing of eyes, clear fluid coming out of nose, eyelid edema

what is a sinus headache?

caused by a sinus infection, fever and discharge from nose, pain worsens when patient leans over

brain tumor headache

dull and constant, worse pain on the side of with the tumor, pain starts locally then becomes generalized

sign of brain tumor headache

change in prior headache patterns, headache worsens with change of body positioning

what is parkinson’s disease?

progressive loss of Dopamine-producing cells in the substania nigra

what is the pathophysiology of parkinson’s disease?

acetylcholine stimulates muscle movement while dopamine has an inhibitory affect. In parkinson’s there is a dopamine depletion causing uncontrolled acetylcholine leading in muscle tremors.

what is the classic triad for parkinson’s?

* bradykinesia
* resting tremor (“pill rolling”)
* muscle rigidity

what does TRAP stand for?

T: tremor at rest

R: Rigidity

A: Alkinesia

P: postural/ gait instability

what is ALS (Lou Gehrig’s Disease)?

progressive loss of UMN and LMN, sensory neurons and cognitive function intact but no motor.

what is multiple sclerosis?

demyelinating disorder, characterized by remissions and exacerbation. During remission the myelin heals. Both sensory and motor neurons affected

what is progressive multiple sclerosis?

where no remission occurs

characteristics of huntington’s disease

appears between ages 30 to 50 with progression for 10 to 20 years. Gene mutation on chromosome 4 disrupts the protein huntingtin

what are common clinical manifestations of Huntington’s?

Dyskinesia (difficult movement), chorea(dancelike movements), athetosis(twisting and writhing), depression, slowed though process

What is guillian- Barre syndrome?

occurs after infection, acute inflammatory demylination, recovery is steady over weeks and months, weakness varies from mild to complete paralysis

What is myasthenia Gravis?

Autoimmune disease, attack of actylecoline receptors

____% of patient with myasthenia gravis have thymus gland hyperplasia (increase in cell growth)

70

myastenia gravis is present in two ways:

ocular form and general form

myasthenia gravis manifestations

repetitive notions, true muscle fatigue

what is normal intracranial pressure?

5-15 mm Hg

alertness

highest level of conciousness

lethargy

individual sleepy but can be aroused easily

obtunded or stuporous

difficult to arouse state, with little or no interaction with environment

coma

lowest level of consciousness, no interaction with environment

coup-contrecoup injury:

brain strikes one side of skull, rebounds, and strikes the other side

T or F: if there is a disruption in the blood flow to the brain then ICP can be altered

true

vasogenic cerebral edema is a

shearing stress

cytotoxic cerebral edema

reduced oxygen

decreased ICP can happen from

hypertonic IV, respiratory alkalosis, craniectomy, low BP

apnea

not breathing

transtentorial (uncal) herniation:

temporal lobe (uncus) forced through the tentorial notch compressing brain tissue

duration of unconsciousness assessment assesses for what

how long were they knocked out

the glasgow coma scale

lowest GCS: 3

Highest GCS: 15

\*\*The lowest the scale the worse the outcome

decorticate coma posturing

flexed arms, clenched fists, rigid legs. indicates corticospinal tract damage

decerebrate coma posturing

arms held straight outward with toes pointed downward. indicates upper brainstem damage

what is the norm for deep tendon reflex scale

2+

diffuse axonal injury

one of the most common TBI widespread damage to brain tissue, widespread damage to brain tissue. Diffuse swelling on neuronal axons.

concussion

traumatic force causes disruption in brain

simple concussion

* resolved without complication
* may take up to 10 days
* less likely to have less of consciousness

complex concussion

* symptoms may persist for longer
* longer loss of consciousness (greater than 1 min)

\

retrograde amnesia

before

antegrade amnesia

after

what is post concussion syndrome?

symptoms that last longer than 3 weeks

cerebral contusion characteristics

* bruise of brain tissue
* scattered areas of bleeding on brain surface
* cerebral edema around contusion within 48 to 72 hours

Cerebral contusion signs and symptoms

* severe headache
* dizziness
* vomiting
* INCREASED SIZE OF ONE PUPIL ( tells us what side the damage is on)

a contusion is a medical emergency when there is

decreased HR, decreased respiration, hypertension, can not be awakened