Human Body Nervous System Pathology and Diagnostic Tests

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simpson.kass
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205857
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Human Body Nervous System Pathology and Diagnostic Tests
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2013-03-08 09:11:07
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Human Body Iowa Central Community College
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Human Body Nervous System Pathology
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  1. Description of cerebral palsy
    (Also, is it progressive or non-progressive?)
    permanent, non-progressive disorder affecting major motor control areas of brain leading to paralysis
  2. Most common type of cerebral palsy
    spastic
  3. Etiology of cerebral palsy
    brain trauma before, during, or shortly after birth caused by injury or infection
  4. Signs and symptoms of Cerebral palsy
    • can affect both arms and legs or an arm and leg on one side of the body
    • *muscles and joint contractures (arms tucked in toward side, knees crossed or touching)
    • *abnormal gait
    • *difficulty with precise small motor skills
    • *below average intelligence
    • *drooling
    • *problems with speech, hearing, vision
    • *seizures
  5. Dx of cerebral palsy
    MRI, CT
  6. Tx of cerebral palsy
    orthopedic devices, PT, OT, visual and hearing aids, muscle relaxants, anticonvulsants
  7. Prognosis for pts with cerebral palsy
    usually a normal life expectancy (depending od severity)
  8. The Dick and Rick Hoyt video dealt with what disease?
    cerebral palsy
  9. Lou Gehrig's disease is AKA:
    Amyotrophic Lateral Sclerosis (ALS)
  10. Lou Gehrig died in what year of ALS?
    1941
  11. Etiology of ALS
    idiopathic; rarely genetic
  12. Signs and symptoms of ALS
    (Can it worsen?)
    • subtle initially with no effect on involuntary muscles or intellect (IT WILL WORSEN)
    • *weakness in hands, arms, legs, muscles of speech, swallowing and breathing
    • *clumsiness
    • *twitching and cramping (hands and feet)
    • *slurred speech
    • *difficulty breathing
  13. Dx of ALS
    (Also, what age and sex is it most common with?)
    • More common in men, middle-age onset
    • *neuromuscular exam (shows weakness, atrophy, stiffness, abnormally rapid knee jerk reflex, non sensory abnormalities
    • *EMG
    • *Nerve Conduction Velocity shows slow speed of nerve conduction and decreased muscle action potentials
  14. Tx of ALS
    • No cure
    • *antiglutimate/neuroprotective medication riluzole (Rilutek) to slow progresson
    • *skeletal muscle relaxants to relieve spasticity
    • *eventual need of respirator
  15. Is ALS terminal or no?
    Yes, terminal (3-5 years after onset)
  16. Diagnostic tests: EEG
    What does it stand for and what does it do?
    • Electroencephalography (EEG)
    • *records electrical activity in cerebral cortex
    • *electrodes placed on head to record activity, amplify it, and produce brain waves
    • *Dx of sleep disorders, tumors, epilepsy, brain death
  17. Diagnostic tests: (EMG)
    What does it stand for and what does it do?
    • Electromyography (EMG)
    • *measures electrical signals in muscle at rest and during contraction to assess nerve damage
    • (needle electrode in muscle to record muscle's action potential)
  18. Diagnostic tests: NCV
    What does it stand for and what does it do?
    It is often done with what other test?
    • Nerve Conduction Velocity (NCV)
    • * Measures how fast an impulse travels through a nerve (nerve is stimulated and electrodes record nerve's action potential)
    • *Often done with an EMG
  19. Diagnostic tests: lumbar puncture
    Between what two vertebrae?
    What is it also known as?
    Name different reasons why they would use it.
    • *between 3rd and 4th vertebrae
    • *AKA spinal tap
    • *reasons: to get a sample of CSF, relieve pressure of accumulating CSF, inject radiopaque dye for x-ray, instill meds (epidural)
  20. Diagnostic tests: MRI
    What does it stand for?
    Magnetic resonance imaging
  21. Pathology: Paralysis description
    loss of motor and sensory function when communication with brain is altered
  22. paralysis etiology
    spinal cord, brain, or nerve injury
  23. paralysis types (based on disability) 3
    • Quadriplegia: all four extremities and trunk
    • Paraplegia: lower extremities
    • Hemiplegia: one side/half of body
  24. Dx of paralysis
    neurological assessment, MRI, CT, myelography
  25. Pathology: herniated disk (description)
    inner material (nucleus pulposus) of intervertebral disk protrudes outward towards spinal cord compressing nerves
  26. herniated disk AKA
    slipped disk, ruptured disk
  27. herniated disk etiology
    spinal trauma, strain (lifting), intervertebral joint degeneration
  28. What is the most common location for a herniated disk?
    lumbar region
  29. Herniated disk signs and symptoms
    vary by location; back pain worsened by movements (coughing, sneezing, bending, etc.), numbness, weakness, sciatica
  30. Dx of herniated disk
    spinal x-ray, MRI, CT, myelography
  31. Tx of herniated disk
    rest, PT, analgesics, NSAIDS, muscle relaxants, steroid injections, surgery (if severe)
  32. Pathology: Peripheral Neuritis (description)
    degeneration of nerves
  33. Peripheral neuritis AKA
    multiple neuritis, polyneuritis, or peripheral neuropathy
  34. Etiology of of peripheral neuritis
    • Nerve damage caused by:
    • *Trauma
    • *Infection (bacterial or viral)
    • *Metabolic disease
    • *Toxins (lead, arsenic, etc.)
    • *Vitamin deficiency, especially B12
    • *Autoimmune disease (Lupus, RA, Guillain-Barre Syndrome)
  35. Signs and symptoms of Peripheral neuritis
    pain, numbness, tingling, loss of sensation, muscular weakness; possible loss of autonomic functions (BP, heart rate, digestion, bladder function)
  36. Dx of peripheral neuritis
    NCV and EMG
  37. Tx of peripheral neuritis
    supportive; elimination of causative factors if possible
  38. Pathology: Herpes Zoster (description)
    What is it AKA?
    viral infection along course of nerve that causes painful rash (SHINGLES)
  39. Etiology of Shingles (Herpes Zoster)
    reactivation of varicella-zoster virus (chickenpox) which lies dormant in nerves until immune system is compromised
  40. Shingles are common in what age group?
    Elderly
  41. Signs and symptoms of Shingles (herpes zoster)
    What type of rash is it?
    unilateral pain, tingling, or burning followed by eruption of vesicular rash (spine around to anterior abdomen or chest)
  42. Dx of Shingles (herpes zoster)
    clinical
  43. Tx of Shingles (herpes zoster)
    antivirals (acyclovir--Zovirax, famciclovir--Famvir, valacyclovir--Valtrex)
  44. Prognosis of Shingles (herpes zoster)
    usually lasts a few weeks, but pain can linger indefinitely after rash is gone
  45. Pathology: Bell's Palsy (description)
    inflammation or compression of seventh cranial nerve (facial) that causes paralysis of muscles on one side of face
  46. Etiology of Bell's Palsy
    may be viral (Herpes Simples, Epstein-Barr)
  47. Signs and symptoms of Bell's Palsy
    facial weakness, drooping of mouth, drooling, diminished sense of taste, pain in jaw or behind or in front of ear, excessive tearing, Bell's Palsy Phenomenon (eyes roll upward when person attempts to close them)
  48. Dx of Bell's Palsy
    clinical (rule out CVA--cerebrovascular accident--Stroke)
  49. Tx of Bell's Palsy
    antivirals, analgesics, corticosteroids, temporary eye patch
  50. Prognosis for Bell's Palsy
    good with spontaneous remission occurring within eight weeks
  51. Pathology: Guillain-Barre Syndrome (description)
    acute, rapidly progressing disorder of the immune system (attacks myelin on peripheral nerves)
  52. Etiology of guillain-barre syndrome
    often follows viral infection or immunization; can also affect young
  53. Signs and symptoms of Guillain-Barre Syndrome
    sudden onset of bilateral muscle weakness, numbness, and tingling that begins in legs and ascends to upper body and arms, loss of deep tendon reflexes, paralysis; may progress to affect respiratory muscles
  54. Dx of Guillain-Barre Syndrome
    clinical, NCV studies, EMG, CSF analysis that will show increased protein
  55. Tx of Guillain-Barre Syndrome
    plasmapheresis (removes harmful plasma components), high-dose immunoglobulin meds, mechanical ventilation
  56. Prognosis of Guillain-Barre Syndrome
    most recover, but may have residual weakness indefinitely; can be fatal
  57. Pathology: Spina bifida

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