Studied by 88 people
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
Note 
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