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chapter 13 PHCC
diseases of the nervous system
| Question | Answer |
|---|---|
| meningitis is an | acute inflammation of the arachnoid membrane and the pia mater |
| the meninges are the | protective membranes surrounding the brain and spinal cord |
| meningitis is an infectious disease that affects | children and young adults |
| the infection of organisms of meningitis can reach the meninges from the | middle ear, upper respiratory tract, frontal sinuses, or carried in the blood from other infected sites |
| symptoms of meningitis | pyrexia; chills; N+V; rash; severe cephlagia(increased ICP-intracranial pressure); stiff neck |
| meningitis pyrexia can cause | delirium, convulsions, and coma |
| meningitis diagnosis is made through a | spinal puncture(LP)AKA"spinal tap" |
| meningitis crebral spinal fluid (CSF) will contain | protein, leukocytes, and the infecting organism |
| meningitis Tx includes | antibiotic therapy for bacterial infections; antipyretics (tylenol) for fever control; IV therapy for dehydration |
| meningitis without treatment may cause permanent brain damage resulting in | blindness, deafness, paralysis, mental retardation, hydrocephalus, and death |
| encephalitis is an inflammation of the brain and meninges usually caused by a | viral infection transmitted by mosquitoes |
| encephalitis signs and symptoms range from mild to severe and may include | cephalgia; pyrexia; cerebral dysfunction; seizures; paralysis |
| encephalitis Dx is made by | lumbar puncture |
| encephalitis Tx includes | controlling pyrexia and ICP; maintain fluid and electrolyte balance; careful monitoring of respiratory and kidney function |
| rabies is an inflammatory disease of the | brain and spinal cord |
| rabies is transmitted through | bites and scratches of rabid animals |
| animals that commonly contract rabies are | dogs; cats; wolves; raccoons; skunks; foxes; bats; humans |
| the onset of symptoms of rabies usually appear | 3 weeks to 3 months after exposure |
| signs and symptoms of rabies include | pyrexia; generalized pain; mental derangement; rage; convulsions; paralysis; hydrophobia; aphagia;a production of a profuse sticky frothy saliva |
| rabies-once visible symptoms develop mortality rate is almost | 100% |
| rabies Tx includes | 3 subQ antirabies inections over 3 weeks |
| animals infected with rabies exhibit a change in temperament such as | wild animals may act tame; the tameness is followed by a furious stage where the animal bites everything; in the final stage there is foaming at the mouth and death |
| shingles is an acute and chronic sensory neuritis caused buy the latency effect of | varicella (chicken pox) |
| shingles AKA | herpes zoster |
| signs and symptoms of shingles include | a painful unilateral vesicular(blisters)rash; pruritus; scarring |
| an outbreak of shingles commonly lasts | 2-4 weeks |
| shingles most commonly occure in people over the age of | 50 |
| an immunization recommended for people over 60 who have had chickenpox is called | zostavax |
| shingles Tx includes | antiviral therapy(zorivax); analgesics(vicodan); antipruritics(calydryl); SAID (prednisone)(steroid) |
| shingles are cured by | nothing |
| contracting chicken pox(varicella) during youth will | increase the chance of developing shingles later in life |
| the activation of the dormant varicella virus is associated with | a compromised immune system; poorly controlled stress |
| reye's syndrome is an encephalopathy(disease of the brain)associated with the combination of | children; viral infections; and the use of ASA |
| reye's syndrome causes an increased | intracranial pressure(ICP) |
| signs and symptoms of reye's syndrome include | persistrent vomiting; rash; letargy; confustion; seizures; coma |
| reye's syndrome Tx includes | controlling cerebral swelling; lowering ICP with the use of steroids(SAID) (Decadroin) |
| with proper Tx the recovery rate from reye's syndrome is | 85 to 90% |
| tetanus is an acute infection of motor neurons caused by the | tetanus bacillus that lives in the intestines of animals and humans |
| tetanus is found in | fecal material |
| the tetanus bacillus persists as spores indefinitely in the | soil |
| wounds most susceptible to tetanus are | ragged, lacerated tissue contaminated with fecal material |
| tetanus produces a powerful toxin that circulates to the | nerves |
| tetanus affected nerves cause the muscles to become rigid with | painful spasms and convulsions |
| with tetanus the first muscles to be affected are located in the jaw, hence the name | "lockjaw" (the muscles cannot relax and the mouth is tightly closed) |
| with tetanus the neck can become stiff and there is | dysphagia |
| if tetanus causes the muscles of ventilation to be affected | asphyxiation can ocur |
| tetanus has an incubation period of | one to three weeks and the toxin travels slowly |
| tetanus Tx includes | debridement of the wound(cleansing, removal of necrosed tissue, and removal of foreign bodies(FB) |
| Multiple Sclerosis(MS) is an idiopathic, autoimmune, chronic, progressive, degenerative, disease of the | CNS (central nervous system) |
| the most common form of MS is called | relapsing-remitting |
| MS signs and symptoms | loss of balance; poor coordination(ataxia); tingling and numbness in extremities; shaking tremor; |
| status epilepticus | life threatening persistent epileptic seizure lasting more than thirty minutes |
| migrane triggers | stress; food preservatives; weather changes; menstruation; skipping meals; fatigue; alterations in normal sleep patterns |
| Tx for MS includes | Betaseron(interferon) to decrease the severity of symptoms and slow the progression |
| the risk factor for MS increases with a | high fat diet and growing up in a cold climate |
| Amyotrophic Lateral Sclerosis(ALS) is AKA | Lou Gehrig's disease |
| ALS commonly occurs during the | 50's and 60's |
| ALS is slightly more common in | men |
| ALS is diagnosed with an | electromyogram(EMG) |
| Parkinson's Disease(PD) is an idiopathic and gradual progressive degeneration of the neurons that control | body movement and coordination |
| prople afflicted with PD produce insufficient amounts of a neurotransmitter in the brain called | dopamine |
| PD is more common in caucasion men and the average age is | 50 |
| signs and symptoms of PD | tremor(pill rolling); rigid muscles and myalagia; loss of reflexes; masklike facial expressions; shuffling gait; bradykinsea; stooped posture; |
| PD Tx includes | antiparkinsons medications(sinemet); physical therapy; tandem bike riding |
| alzheimers disease (AD) is a | progressive degenerative genetic brain disease causing dementia |
| dementia is a | loss of mental skills affecting daily life |
| signs and symptoms of PD include | dysphagia, choking, and drooling; monotone speech; incontinence; constipation; loss of libido(ED); clinical depression |
| asking the same question over and over again; repeating the same story, word for word; forgetting how to cook, or how to make repairs, or how to play cards, activities that were once taken for granted | warning signs of AD |
| sundowning | when AD becomes more severe after dusk |
| AD can cause | depression, irritability, aggressiveness, and delusions |
| eventually a person with AD will need | complete care |
| familial AD accounts for | 10% of all cases |
| AD is usually diagnosed after age 65 and every five years afterwards the incidence | doubles |
| the duration of AD can be | 2 to 20 years |
| AD affects more | women(one in four), than men(one in six) |
| increased risk of AD is associated with | obesity, hypertensiion, and DM |
| research indicates that the risk of AD is lowered by | keeping the mind active |
| AD is diagnosed when other conditions are | ruled out |
| warning signs of AD | losing one's ability to pay bills or balance a checkbook; getting lost in familiar surroundings, or misplacing household objects; neglecting to bathe, wearing the same clothes over and over, (not bathing, not changing clothes) |
| a common medication used to treat AD is | aricept |
| epilepsy is an abnormal electrical activity that spreads over the cerebrum and can manifest itself as a | seizure |
| epilepsy can be caused by | brain tumor; brain damage; alcohol or drug abuse; uremia |
| grand mal, petit mal associated with | epilepsy |
| LOC; tongue biting; hypersalvation; incontinence; tonic-clonic movements | grand mal seizure |
| tonic-clonic movements are | rapid contraction and relaxation of the muscles |
| muscular twitching around the mouth and eyes; absentmindness; the head may sway rhymically | petit mal seizures signs |
| a warning sign or symptom of an impending petit-mal seizure is called an | aura |
| postical state | confused and lethargic state of mind five to thirty minutes after a grand mal seizure |
| Dx of epilepsy is made by using an | electroencephlogram(EEG) |
| MS signs and symptoms | progressive fatigue and muscular weakness; dysphasia; bladder dysfunction(enuresis); blurred vision and diplopia; Nystagmus(involuntary, rapid, movement of the eyeballs) |
| epilepsy Tx | antiseizure medications (Dilantin) |
| spina bifida is a congenital neural tube defect(NTD) where | one or more vertebrae fail to fuse |
| spina bifida can be accompanied by one or more of the following | hydrocephalus; cleft lip and/or palate; club foot; strabismus(esotropia)(wandering eye, cross-eyed) |
| how many types of spina bifida | four |
| spina bifida occulta can cause | incorrect posture; inability to walk; incontinence; a tuft of hair over the vertebral defect |
| spina bifida occulta can be corrected by | surgery |
| meningocele | meninges protruding through the opening of a vertebral defect |
| menengeceles can be corrected by | surgery |
| meningomyelocele characterized by | meninges and spinal cord protruding through the opening in the vertebral defect |
| meningomyelocele can cause | mental retardation, failure to develop, and paralysis |
| myelocele characterized by | a disorganized spinal cord that is exposed |
| myelocele is usually | fatal |
| spina bifida prophylactic Tx includes | three month pregravida folic acid supplements of 400mcg/day |
| hydrocephalus is an abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of | cerebral spinal fluid (CSF) |
| hydrocephalus causes the brain to be compressed resulting in | mental retardation; failure to grow normally; prominent forehead; bulging eyes; frighrtened expression; veins of the scalp are prominate |
| hydrocephalus Tx includes | surgical placement of a shunt to relieve the intracranial pressure (ICP) |
| MS signs and symptoms | blindness; cognitive dysfunction; decreased libido and ED; clinical depression (MDD) |
| Cerebral Palsy(CP) is a non-progressive brain damage resulting in mental and/or motor retardation before the age of | three |
| gestational rubella infection; drugs and/or ETOH during gestation; hypoxia in utero; erythroblastosis (Rh neg mom,Rh pos Pop) | causes of cerebral palsy |
| CP can also be | idiopathic |
| a cerebral vascular accident (CVA) is also known as a | stroke |
| a CVA is brain damage commonly resulting from | cerebral aneurysyms; cerebral infarctions |
| the main causes of CVA are | atherosclerosis; chronic hypertension |
| increased risk of CVA has been linked to a deficiency of | vitamin C and folate(folic acid) |
| CVAs usually occur after the age of | 55 |
| CVA risk is | one in five for women over 55 and one in six for men over 55 |
| african-americans are _________ as likely to have a CVA than caucasions | twice |
| signs and symptoms of CVA | dysphasia; blurred vision; ataxia; vertigo; N+V; hemiparesis; hemiplegia; LOC; FAST(facial drooping,arm weakness,speech difficulties,time) |
| CVA Tx includes | thrombolytic therapy(Activase)is effective within the first three hours of the onset of symptoms if caused by an emboli |
| once brain tissue necroses, it will not | regenerate |
| antihypertensives(tenormin); anticoagulants (coumadin) | Tx for CVA |
| CVA rehab entails | teaching non-damaged parts of the brain to perform the duties of the necrosed brain tissue |
| CVA kills ________ americans each year | 170,000 |
| AKA little stroke or mini-stroke | transient ischemic attack (TIA) |
| TIA characterized by | ischemic brain tissue caused by a reduced flow of blood to the brain |
| causes of TIAs include | atherosclerosis; microemboli formation |
| signs and symptoms of a TIA are the same as a | CVA except they last an average of 15 minutes |
| TIA Tx includes | prophylactic anticoagulant therapy (ASA, plavix, coumadin) |
| cerebral concussion is a transient brain disorder resulting from a | violent blow to the head |
| signs and symptoms of a cerebral concussion include | LOC, amnesia about the accident, nausea, vertigo, cephalgia |
| cerebral concussion signs and symptoms should resolve within | 24 hours |
| cerebral concussion patients should have neurological checks(NVA) performed every | two hours |
| cerebral concussion "neuro checks" include | LOC status and orientation; PEARRLA(Pupils Equal, Round, Reactive to Light and Accomodation); gait check |
| Cerebral Contusion | violent blow to head where the neurological deficits last more than 24 hours |
| intracranial hemorrhages causing increased ICP; coma; permanent brain damage | complications associated with a cerebral contusion |
| intracranial hemorrhages include | epidural hemorrhage; subdural hemorrhage; subarachnoid hemorrhage |
| intracranial hemorrhage Tx includes | surgery to seal off the bleeding vessel(s) and remove blood |
| primary malignant tumors of the brain are called | gliomas |
| most malignancies of the brain | metastasize from other sites |
| brain tumors signs and symptoms | severe cephalagia(bending); personality changes; loss of memory; diplopia; blindness; dysphasia; ataxia; seizures; coma |
| benign brain tumors can be removed | surgically |
| malignant brain tumors are | inoperable |
| malignancies of the brain are usually treated with | chemotherapy and radiation therapy |
| a migraine is a | severe cephaligia |
| migraines are accompanied by | nausea, vomiting, and photophobia |
| migraines are caused by | constriction and dilation of cerebral arteries and the release of serotonin and prostaglandins |
| migraine triggers may be | inherited |
| migraines occur more often in | women(70%) |
| 60-70% of migraines are associated with hormonal fluctuations that occur during the | menstrual cycle |
| migraines commonly last | four hours to three days |
| motrin; aleve; excedrin; inderal; calan | migraine medications |
| cerebral angiography | process of recording the vessels of the cerebrum |
| CT or CAT | computerized (axial) tomography |
| process of recording the spinal cord | myelography |
| MRI | magnetic resonance imaging |
| PET | positron emission tomography |
| listeria is a | bacterium |
| menactra | an immunization against meningococcal infection |
| spinal bifida occulta | one or more verterbrae fail to fuse |
| meningocele | meniges protruding through the opening of the vertebral defect |
| meningomyelocele | meninges and spinal cord protruding through the opening in the vertebral defect |
| myelocele | a disorganized spinal cord that is exposed |
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