Week 2 - Nervous System

general effects of neurological dysfunction

Local (focal) effects, Supratentorial and infratentorial lesions, Left and right hemispheres, Level of consciousness, Motor dysfunction, Sensory deficits, Visual loss: hemianopia, Language disorders, Seizures, Increased intracranial pressure

damage to left hemisphere

loss of logical thinking ability, analytic skills, other intellectual abilities, communication

damage to right hemisphere

impairs appreciation of music and art, behavioral problems, spatial orientation and recognition of relationships, self-care deficits

sensory deficits

somatosensory cortex in parietal lobe receives and maps out dermatomes, evaluating spinal cord lesion, special senses, pain, touch, temperature and position

optic chiasm damage

vision in both eyes lost if chiasm if completely destroyed, partial loss depends on fibers that are damaged

optic tract of occipital lobe damage

loss of visual field on the side opposite to that of the damage

seizures

spontaneous excessive discharge of neurons in the brain, manifested with an aura, continued can be life threatening

cerebral palsy

group of disorders marked by some degree of motor impairment, caused by genetic mutations, abnormal fetus formation, infection, brain damage in perinatal period, altered brain tissue, hypoxia or ischemia is major cause

ICP (Increased intracranial pressure)

increased fluid causing pressure, lack of blood flow can happen, ischemia and eventually infarction of brain tissue, decreased level of consciousness, reduced breathing rate, common in many neurological problems

herniation

mass, blood clot or tumor, pushes on brain tissue and displaces it, causes death

contusion

bruising of brain tissue, rupture of small blood vessels and edema

hematomas

bleeding between the dura and skull

basilar fractures

CSF leaks through ears or nose, when forehead hits windshield, dark discoloration of eyes, cranial nerve damage

contrecoup injury

area of the brain contralateral to the site of direct damage gets injured from a bounce off

tetraplegia

paralysis of all 4 limbs

paraplegia

paralysis of lower part of trunk and legs

autonomic dysreflexia

massive sympathetic reflex response that cannot be controlled by the brain, sensory stimulus triggers a massive sympathetic reflex response that can’t be controlled, sudden increased blood pressure, severe headache and visual impairment

herniated disc

protrusion of nucleus pulposus, sensory, motor or autonomic function may be impaired, a tear in the capsule may occur suddenly, S and S depend on location and extent (pain at site, numbness or tingling in limbs, heavy feeling in limbs, pain with bending and twisting, mm spasms)

MS

immune system produces antibodies that attack oligodendrocytes, producing plagues in the white matter of the CNS, weakness, lack of coordination, impaired vision, impair sensation, slurred speech, difficult to diagnose from how symptoms occur and disappear

ALS

marked by degeneration of upper and lower motor neurons, progressive muscle wasting of skeletal muscles, intellect persists pa

parkinson’s

progressive degenerative disorder, dysfunction of motor system, imbalance between excitation and inhibition, resting tremors, rigidity, posture instability, altered gait

supratentorial lesion

occur in the cerebral hemispheres above the tentorium cerebeli, lead to specific dysfunction in a discrete area

infratentorial lesions

located in the brain stem or below the tentorium, may affect many motor or sensory fibers, widespread impairment, respiratory and circulatory function impaired and level of consciousness

decreased level of consciousness or responsiveness

early changes with acute brain disorders

levels of reduced consciousness may lead to

confusion, disorientation, memory loss, unresponsiveness to verbal stimuli, difficulty in arousal, loss of consciousness or coma

vegetative state

loss of awareness and mental abilities, result of diffuse brain damage, brain stem function continues, appearance of a sleep-wake cycle, person is unresponsive to external stimuli

locked-in syndrome

individual is aware and capable of thinking, but it paralyzed and cannot communicate

criteria for brain death

cessation of brain function (cortex and brain stem dysfunction, flat or inactive EEG), absence of brain stem reflexes or response, absence of spontaneous respirations when the ventilator is removed, irreversible brain damage is confirmed

spina bifida

group of neural tube defects

spinal bifida occulta

spinous processes do not fuse, dimple or a tuft of hair may be present over site, sensory and motor function impaired below the level of herniation

meningocele

transillumination confirms absence of nerve tissue, herniation of the meninges occurs through a defect, meninges and CSF form a sac on the surface

myelomeningocele

most serious form of spina bifida, herniation of the spinal cord and nerves, along with meninges and CSF

damage to the upper motor neurons

interference with voluntary movements, weakness or paralysis on contralateral side of body

damage to the lower motor neurons

weakness or paralysis on same side of the body at and below level of spinal cord damage

aphasia

inability to comprehend or express language

dysarthria

motor dysfunction affecting mm of speech

expressive or motor aphasia

impaired ability to speak of write fluently or appropriately (broca’s)

receptive or sensory aphasia

inability to read or understand the spoken word (wernicke’s area)

alexia

impaired reading ability a