n305 neuro disorders

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buckwild
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181816
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n305 neuro disorders
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2012-11-05 11:14:33
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n305 neuro disorders
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n305 neuro disorders
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  1. what week of gestation does the brain begin development?
    • 2nd week
    • starts as tube
  2. Kernig's sign, Brudzinski's sign - implications of what?
    • usually meningitis
    • sometimes IVH 
  3. decorticate posturing
    • flexion of upper extrem, extension of lower extrem
    • implies injury to cerebral hemisphere
  4. decerebrate posturing
    • extension of all extremities
    • indicates more damage to brain, brainstem
    • progression of damage from decorticate posturing
  5. CSF normals? indications?
    • fluid should be clear, colorless
    • should NOT have WBCs
    • meningitis, possible shunt infection, etc
  6. CSF protein/glucose levels?
    • glucose should not be low
    • protein should not be high
    • (think of pacman - eats up glucose).
  7. most seizures are caused by what?
    • disorders that originate outside the brain
    • F/E imbalances
    • high fever
    • infection
    • hypoxia
    • toxins
  8. partial focal seizures?
    • starts in one hemisphere
    • usually one-sided manifestations
    • can become generalized
  9. generalized seizure
    both hemispheres of brain
  10. simple partial seizure vs complex partial?
    • simple: remain in one hemisphere
    • no impairment of LOC
    • motor symptoms/hallucinations

    • complex: starts in one hemis but spreads to both
    • may have LOC
  11. absence seizures (petite mal)
    • kid becomes "out of it" - but no LOC
    • sudden, quick onset. last 5-10 sec
    • can have ~100 a day
    • onset around 5 years, outgrows by school age
  12. myoclonic seizures
    short muscle contractions
  13. tonic-clonic (grand mal)
    • violent, total body seizure
    • rhythmic jerking
  14. atonic seizure
    • drop and fall attack
    • wear helmet
  15. akinetic seizure
    • suddetn brief loss of muscle tone/posture
    • temporary LOC
  16. status epilepticus
    • continuous seizures without interruption
    • *emergency
    • risk of cardiac/respiratory arrest, brain damage
    • consciousness not regained
    • last more than 30 min
  17. febrile seizures
    • **rapid rise of temperature
    • not necessarily how high the fever goes.
    • one seizure per fever
  18. nursing implications for seizures
    • primary concern: safety. remove objects, equipment, etc
    • document findings of seizures
  19. anencephaly
    • absence of entire brain
    • brain stem or cerebellum may be present
  20. encephalocele
    meningeal/cerebral tissue protruding in sac through skull defect
  21. spina bifida
    • defective closure of verterbral column
    • directly related to what spinal column it begins at
  22. occulta
    spinal "dimple"
  23. meningocele vs myelomeningocele
    • myelo contains spinal cord.
    • meningocele is only meninges
  24. associated conditions/complications with spina bifida
    • hydrocephalus
    • chiari malformation
    • UTIs
    • bowel obstructions
    • hip subluxation
  25. communicating vs non-communicating hydrocephalus?
    • communicating: excess production of CSF
    • noncommunicating: obstruction
  26. VP shunt
    ventriculoperitoneum shunt.  drains CSF to extra-cranial compartment, usually peritoneum
  27. major complication of VP shunts?
    infections
  28. manifestations of meningitis?
    • fever, chills
    • HA
    • changed LOC
    • photophobia
    • nuchal rigidity
    • +Kernig's sign (pain when lifting leg to 90degrees)
    • +Brudzinski sign (lift head, knees automatically also lift)
    • petechial rash
    • septic shock
  29. spinal tap will reveal what for meningitis?
    cloudy CSF, increased WBCs
  30. most common permanent disability in childhood?
    cerebral palsy
  31. *nonprogressive* disorder of motor function
    cerebral palsy
  32. spastic CP
    hypertonicity, posturing, impaired motor skills, drooling
  33. dyskinetic CP
    abnormal involuntary motion, athetosis
  34. ataxic CP
    poor coordination, balance, control of upper extremities, wide gait
  35. main goal of therapy for CP children?
    potentiate muscle function
  36. red flags for CP
    • not sitting by 8 months
    • hypotonia, hypertonia
    • one-sided function (crawling)/asymmetry (hemiplegia)
    • persistent toe-walking

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