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PCT NEURO


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[Front]


brainstem
[Back]


medulla, pons, midbrain

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PCT NEURO - Detalles

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Brainstem
Medulla, pons, midbrain
Diencephalons
Hypothalamus, thalamus
Divisions of the adults brain
Brainstem, cerebellum, diencephalons, cerebrum
Left hemishphere
Systematic, logical, interpretation or info, language mathematics abstraction and reasoning, and memory is stored in a language format
Right hemisphere
Dancing and gymnastics, visual spatial skills, memory is stored in auditory, visual and spatial modalities
Frofrontal lobe
Condition and memory, ability t concentrate and elaborate on thoughts, judgement and inhibition, personality and emotional traits
Frontal cortex- premotor cortex
Storage of motor patterns and voluntary activities, language is motor speech
Damage to frontal cortex
Inability to concentrate, impairment of memory, behaviour disorders, difficulty learning new info, lack of inhabitation, emotional liability, contralateral plegia, excessive motor aphasia
Dpariteal lobe
Processing of sensory input, sensory discrimination, body orientation, primary and secondary somatic area
Damage to parietal lobe
Inability to discriminate between sensory stimuli, inability to locate and recognize parts of the body, inability to recognize self, disorientation of environmental space, inability to write
Occipital lobe
Primary visual reception area, primary visual association area, allows for visual interpretation
Damage to the occipital lobe
Primary visual cortex, theres a loss of vision in opposite field, visual association cortex: loss of ability to recognize object seen in opposite field of vision
Temporal lobe
Auditory receptive area association areas, expressed behaviours, language: receptive speech, memory: info retrieval
Limbic system
Sex, rage, fear, emotions
Damage to the limbic system
Loss of sense of smell, agitation, loss of control and emotion, loss of recent memory
Basal ganglia
Subcortical grey matter nuclei, processing link between thalamus and motor cortex, imitation and direction of voluntary movements, balances postural reflexes, part of extrapyramidal system, regulation of automatic movement
CN III
Oculomotor, this controls pupil size, pressure eon this nerve will cause paralyzation and the pupil won't be reactive
CNX
Vagus, organ is the medulla, a bundle of nerves that supply SA and AV node, stomach, and GI tract, pressure on this nerve stimulates bradycardia
MReticular Activating system
Integrates info from all of the senses and from the cerebrum and determines the overall activity of the brain and ANS as well as patterns of behaviour during walking and sleeping
Ra meninges
Protective layer that surrounds and enfolds the entire CNS
Dura mater
Outer layer
Arachnoid layer
Middle layer
Pia mater
Inner layer
Cerebrospinal fluid
Clear, colourless fluid that circulates through the entire brain and spinal cord, there are few WBCs but NO RBCs
Cerebral blood flow
Oxygen and glue delivery are controlled by cerebral blood flow, PCO2 has the greatest effect on intracerebral vascular diameter
ICP symptoms
Headaches, nausea/vomitting, altered LOA/LOC, Cushing triad, pupil changes, posturing
Causes of ICP
Increase blood flow to the brain, blockage of blood flow to the brain, increase CSF production, blockage of CSF outflow, increase tissue mass, hear trauma, ruptured aneurysm, infection, cerebral edema, Shintos, severe hypertension
CNS disorders- structural
Tumour, degenerative disease's, intracranial hemorrhage, parses, trauma
CNS disorders- toxic-metabolic states
Anoxia, diabetic ketoacidosis, hepatic failure, hypoglycaemia, renal failure, thiamine deficiency, toxic pressure
PNS disorders
Any malfunction of damage to the peripheral nerves
PNS disorder- mononeuropathy
Localized condition due to trauma, compression or infection
PNS disorder- polyneuropathy
Demylentation or degeneration, Gillian barre leads to rapid muscle weakness, diabetes affects the distal nerves of the hands and feet
Conjugate gaze
Implied a structural lesion
Dysconjugate gaze
Implied a structural brain stem dysfunction
Nystagmus
Disorders of the brain that involve involuntary eye movements
Respiratory status
Cheyne stokes, kussmaul, central neurogenic hyperventilation, ataxic, apneustic
Geriatric population
More susceptible to systematic illness, changes that occur with ageing: pupil sluggishness, loss of body strength, muscle atrophy, altered sensation
Geriatric population- neuro
Headaches, LBP, weakness/dizziness, loss of balance (old man shuffle) Parkinson's, CVA
Stroke
Every delayed minute the average person loses 1.9 million brain cells, 13.8 billion synapses and 12kms of axonal fibres
Stroke
Injury or death to brain tissue
TPA
Used to bust clots in MI and has been shown to be effective in treating certain occlusive clots
Occlusive stroke
Cerebral artery blocked by a clot or foreign matter
Infarction
Death of tissue, there is further damages to nearby tissues due to edema
Embolic stroke
Sudden severe headaches, embolus carried to cerebral blood vessel from a remote site, usually clots arising from diseased vessels, atrial firbulation
Thrombotic stroke
S&S develop gradually, often occurs at night, blood clot gradually develops in and obstructs a cerebral blood vessel
Hemorrhagic stroke- intracranial
Within the brain, small blood vessels rupture due to hypertension, effects depend on location of blood vessels
Hemorrhagic stroke- subarachnoid
Developes from congenital blood vessel abnormalities or head trauma, aneurysms
Hemorrhagic stroke
Hemorrhage inside the brain tears and separates blood vessels, impaired drainage of CSF increases increased ICP, herniation of brain tissue occurs rapidly
Hemorrhage stroke- S&S
Motor, speech and sensory leading to unconsciousness, stertorous breathing (laboured snoring) eyes deviate away from side of body paralyzed
Hemorrhagic stroke
Not common, abrupt, during stress or exertion, may be associated with coke, asymptotic before rupture
Ischemic
Most common, usually d/t atherosclerosis or brain tumour, slow, may be associated with partial fib, valve disease, or contraceptives, history of angina or previous strokes
Transient ischemic attacks
Indicative of carotid artery disease, onset of TIA is usually abrupt,
Warning signs of stroke
Weakness, trouble speaking, vision problems, headache, dizziness
Left hemisphere damage
Expressive aphasia, receptive aphasia, global aphasia, R side weakness, reading, writing or math impairment, slow and cautious behaviour, defects in R visual field
Right hemisphere damage
Spatial perceptual deficits, L sided weakness or sensory loss, neglect of the affected side, distractible, impulsive behaviour, poor judgement, loss of flow of speech, defecets in L visual field
Thrombolytic therapy
TPA- tissue plasminogen activator
Peds stroke
Seizures, twitching or staring spells, extreme trouble staying awake or alert during the day or outside of normal sleeping time
Seizure
Temporary alteration in behaviour due to massive electrical discharge from on for more groups of neurons in the brain
Causes of seizures
Non compliance of drugs, meningitis, ICP, hypoglycaemia, EtOH withdraws, drug ingestion
Causes of seizures in pts >50
Cardiovascular disease, cerebrovascular disease, dysrhythmia or impending cardiac arrest, severe hypertension, brain neoplasms
Tonic
Increased muscle tone or tension
Clonic
Rhythmic jerking movements
Aura
Sensation preceding seizure, may be hours or seconds before seizures
Absence
Pets mal, 10-30 second loss of consciousness, may not response to normal treatment
Pseudoseizure
Usually stems from a psychological disorder, hysterical disorder, seizure often stops with saying "STOP IT", characterized with sharp and bizarre movements
Mpartial seizures
Chaotic movements, confined to a limited portion of the brain, only functions saved by the area will be dysfunctional, no loss of consciousness, begins as localized/clonic movements
Complex partial seizures
Characterized by an aura (smell, metallic taste, sounds), typically 2-3 mins in length, loss of contact with surroundings, confused, stagger, purposeless actions, unintelligent sounds
Status epilepticus
Two or more generalized seizures, they occur without a return of consciousness, usually caused by failure to take anticonvulsant meds
Anti seizure/antileptic drugs
Benzos, barbiturates, hydantoins, suxxinmides, depakote
Migraines
Throbbing pain, photosensitivity, nausea, sweats, usually unilateral, may be preceded by an aura, may last for extended periods to type
Cluster
One sided with nasal congestion, drooping eyelid, and irritated or watery eye, more frequent in men, usually concentrated around 1 eye, typically lasts 1-4 hours
Tension headache
Often when you wake up in the morning with mild pain and the pain gets worse as the day progresses, dull achey pain feels like pressure applied to the neck and head
Organic headache
Occurs due to rumours, infection, or other diseases of the brain, eye or other body system, headaches are associated with fever, confusion, nausea, vomitting, or rash
Neoplasm
Growth of a new tumour, they have ihhg mortality rates and can be classified as benign or malignant
Benign
Abnormal growth yet slow and grow in one location, cause pressure in confined spaces
Malignant
Grow quickly and spread to other sites within the body, infiltrates healthy tissue, likely to metastasize
Abscess
Collection of puss
Abscess- s&s
Leathery, hemiparesis, nuchal rigidity, headache, nausea, vomitting, seizures
Alzheimers
Most frequent cause of dementia, due to death and disappearance of nerve cells in the cerebral cortex, shuffling gait, stiffness of body muscles, progresses to aphasia, inability to think, speak and move
Muscular dystrophy
A group of genetic diseases characterized by progressive muscle weakness and degeneration of muscle fibres
Multiple sclerosis
Umpraedicitbale disease resulting from detonation of the myelin sheath leading to difficulty conducting nerve impulses, most victims are women, slow degeneration of sensory nerves but spares motor nerves
Dystonia
Groups of disorders characterized by muscle contractions that cause twisting repetitive movements, abnormal postures, or freezing during activity
Parkinsons
Rigidity or resistance to movement due to both opposing muscles activated at the same time, bradykinesia movement is slowed and sometimes lost, postural instability is impaired balance and coordination
Central pain syndrome
Result of CNS injury, intense steady burning pain
Bells palsy
One sided facial paralysis, unknown cause
Amyotrophic lateral sclerosis
Weakness, loss of motor control, dysphasia and cramping which will eventually lead to the diaphragm and respiratory problems, most its died within 3-5 years of being diagnosed, usually due to pulmonary infection
Myoclonus
Temporary, involuntary twitching of muscles, commonly witnessed in pts with MS, Parkinson's or alzhemers, may present as hiccups or muscle twitching
Spina bifida
Occurs in the firs month of prig, one of more fetal vertebra fail to close, potion of the spine is left unprotected
Polio
Inflammatory viral disease of the CNS tissue, can result in paralysis, characterized by fatigue, headache, fever, vomitting, pains in the hands and feet
Myasthenia Travis
Progressive muscle weakness and fatigue, autoimmune disease that sestroys the nicotinic receptors at the neuromuscular junction, muscles not stimulated as well so weakness occurs