HTHS 1120 Module 4 Meningitis

meningitis

infection of the meninges, the tissues covering brain and spinal cord

types of meningitis

Viral and bacterial (more severe with possible long term complications)

transmission of meningitis

respiratory and throat secretions (coughing, kissing, sharing objects like a glass or cigarette)

Who is most at risk for contracting meningitis?

Children under 5, especially those under age 1, also teenagers and young adults

symptoms of meningitis

High fever, headache, vomiting, body aches progressing to neck stiffness, lethargy, severe headache and convulsions

short and long term complications of meningitis

10% of patients with Meningococcal meningitis will die within 24-48 hours of the onset of symptoms. Of the survivors, 10-20% will have neurological complications such as paralysis, deafness, seizure disorders, mental problems. Other individuals may lose limbs.

Which CBC and spinal fluid parameters are indicative of bacterial meningitis?

WBC is elevated in the CBC. Spinal Fluid: Elevated WBC, protein. Glucose is decreased. Cells and bacteria present in spinal fluid

Why are steroids used to treat patients with meningitis?

reduce inflammation and swelling around the brain, reducing the chance of seizures

What procedure has greatly reduced the incidence of bacterial meningitis?

Vaccination

How long must infectious airborne precautions be maintained after the start of antibiotics?

24 hours

cause of petechial rash in meningitis

Hemorrhage

CT scan

x-ray beams from many different angles are used to create cross-sectional images of the patient's body assembled into a three-dimensional picture.

Why would a physician request a CT scan over an X-ray?

Organs, bones, and tissues can be displayed in great detail in a three-dimensional picture in a CAT scan., while an x-ray is one dimension

Why would an X-ray be ordered over a CT scan?

x-ray picture is all that is needed, more inexpensive

dura mater

superficial layer, composed of dense, irregular connective tissue

arachnoid mater

middle layer, resembles a spider's web of collagen and elastic fibers

Pia Mater

deepest layer, thin transparent connective tissue that adheres to the surface of the spinal cord and brain, supplies oxygen and nutrients to the spinal cord

epidural space

between dura and wall of vertebral canal, composed of fat and connective tissue for protection

subdural space

between dura mater and arachnoid mater, thin layer containing interstitial fluid

subarachnoid space

between arachnoid and pia mater, contains CSF for shock absorption and suspension system for spinal cord and brain

CSF

clear, colorless, liquid that protects the brain and spinal cord from chemical and physical injuries

where is CSF produced?

choroid plexuses

what is the function of CSF?

carries oxygen, glucose, and other needed chemicals from the blood to neurons and neuroglia

How does CSF flow?

lateral ventricles, interventricular foramen, third ventricle, cerebral aqueduct, fourth ventricle, central canal, subarachnoid space, superior sagittal sinus

blood-cerebrospinal fluid barrier

permits certain substances to enter CSF but excludes others, protecting the brain and spinal cord from potentially harmful blood-borne substances

mechanical protection

shock-absorbing to protect brain and spinal cord from hitting walls of cranial cavity and vertebral canal

chemical protection

optimal chemical environment for accurate neuronal signaling, slight changes in CSF can disrupt production of action and postsynaptic potentials

circulation

allows exchange of nutrients and waste products between the blood and nervous system

How does CSF contribute to homeostasis

mechanical and chemical protection, circulation

Name the layers of the meninges from superficial to deep.

dura, arachnoid, and pia mater

Most common causative agent of meningitis in teens

Neisseria meningitis (meningococcal meningitis)

septicemia

bacteria in the blood

normal constituents of CSF

anions, cations, glucose, and WBCs

common meningitis vaccines

Hib, pneumococcal, meningococcal

effect of steroid drugs on acute meningitis

Reduced intracranial pressure

ER nurse

admit patient and administer medications

epidemiologist

notifying school or institutional authorities as to the risks posed by a communicable disease

Medical Laboratory Scientist

responsible for running the tests to detect bacterial meningitis

neurologist

most skills and training to assess the neurological effects of a patient recovering from meningitis

Physician

performs the lumbar puncture

radiology technician

perform an x-ray of the patient's brain assessing the pressure

What is one of the first signs of Disseminated Intravascular Coagulation (DIC)?

Petechial Rash

How can microorganisms gain access to spinal fluid and the meninges

selective permeability through endothelial cells; active transport across border

how powerful is the meningococcal endotoxin?

100 to 10,000x more than other types of bacteria

how do bacterial organisms gain access to the CNS

colonize the nasopharynx, spread to the blood, and make their way to meninges.

WBC

elevated due to the body's response against the bacterial infection

meningitis will present what glucose and proteins CSF levels?

decreased glucose, elevated protein

What would you expect to see in the gram stain?

gram neg diplococcoid bacteria

What happened to intracranial pressure (ICP)?

slightly elevated

why is glucose decreased?

bacterial utilize the CSF glucose

why is the protein increased?

increased cellular matter present