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ch 44 the spinal cord/brain
ch 44 spinal cord/ brain
102
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11/01/2013

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Term
migrain headache what is it and how is it felt
Definition
cronic episodic disorder
pain that is unilateral and worsens with movement
Term
who is affected more with migranes
Definition
women and they tend to be familial, those with anxiety and depression are more predisposed
Term
what cranial nerve is associated with migranes
Definition
trimengeminal
Term
what is the patho behind a migrane
Definition
blood vessles overreact with a decrease in verebral blood flow then arteries dialate and relese prostagladins
Term
what are some trigger zonesfor migranes
Definition
caffiene red wine stress and msg
Term
aura
Definition
a sensation that may be felt before a migrane
Term
atypical migranes what are the5 stages
Definition
prodrom0 food craving
aura- flashing lights dilopia
headaches phase- lasts hours or days
termination- headache decreses
postdrome phse-fatigued and irratable
Term
whats the difference between a migrane without an aura and atypical migrane
Definition
migraine the pain is unilateral, photophobia and pohnophobia
\atypical is like a brain stroke and can last for more then 72 hours or days
Term
what are the three r is migraines
Definition
recognize symptoms
respond and see health care provider
reliev pain
Term
when is aborative therapy used with migraines
Definition
during the aura phase of a migrain
Term
what are mild migraines releived by
Definition
nsaids tylenol or abenol and nsaids like ibuprofen
Term
what are mild migraines releived by
Definition
nsaids tylenol or abenol and nsaids like ibuprofen
Term
rebound headache
Definition
medication overuse headache where another one occurs after drug relieves it
Term
triptan preperations what do these work on and what arteries
Definition
releive headaches associated with seretonin receptors on the cranial areteries, basilar arteries and blood vessles
Term
what are three triptan preperations
Definition
zomig
replex
imitrex
Term
what blocking agents are used with migrianes
Definition
calcium channel blockers and beta blockers
Term
topamx is an antiepileptic drug used for migranes in low doses what have been reported with this drug
Definition
suicides
Term
what is the pain described as in a pt with an unliateral headache
Definition
xcrutiating
broing or
nonthrobbing
Term
cluster headaches when do these develope and why do these develope
Definition
20 and 50 years old from overinlarged hypothalamus
Term
cluster headaches when do these develope and why do these develope
Definition
20 and 50 years old from overinlarged hypothalamus
Term
why are cluster headaches named this
Definition
because they occur around the same time about 4 to 12 weeks followed by remission for 9 m,ths toa year
Term
what is the pt behavior during a cluster headache
Definition
walks paces or sits
Term
what is the onset of pain during a cluster headache
Definition
during relaxation napping or rapid eye movement
Term
6 things that occur with a cluster headache
Definition
ipsilateral\
rhionorrhea
ptosis
eyelid edema
sweating
misosi
Term
what can you teach a pt during a cluster headache
Definition
wear sunglasses face away from windows
'o2
good sleep wake cycle
Term
seizure
Definition
abnormal sudden excesive uncontrolled electrical discharge of neurons in the brain
Term
epilepsy
Definition
chronic disorder that has repeated seizures from imbalance of neurotransmitters especially gamma aminobutyric
Term
what are the 6 types of gernealzied siezures
Definition
tonic clonic
absence
myoclonic
atonic
patial
complete partial
simple partial
Term
tonic clonic seizure
Definition
tonic is the stiffening phase and clonic is the jerking or extremieits
Term
abscence seizures who is it common in and what happens
Definition
common in children
breif loc with blank staring lip smacking
Term
myoclonic seizure
Definition
brief jerking may be both sides or just one side
Term
atonic seizure
Definition
sudden loss of muscel tone lasts for a few seconds and is followed by confusion
Term
partial seizures (focal or local )
Definition
begins in one part of the hemisphere most are adults
Term
complex partial seizures
Definition
loc for 1 to 3 minutes with automiscs and the pt is unaware of the enviorment and may wander then after the seizure the pt may be confused
Term
what type of the brain is involved in a complex partial seizure
Definition
temporal lobe
Term
simple partial lseizure
Definition
the pt remains consius thru the episode
aura before the siezure or de ja vu
Term
primary or idopathic epilepsy is not associated with brain leasions what is the cause of this development
Definition
family and genetics
Term
secondary seizures
Definition
from underlying brains lesion tumor or trauma
Term
what are some examples of howsecondary seizures occur
Definition
metabolit disoder
acohol withdrawl
stroke
high fever
heart disease
Term
what are some thing to teach a pt who is on antieliptic druigs 3
Definition
that it can build up sensitivity to them
warfin should not be given with dilantin
some citiris fruits can interfer with the metabolism and raise the blood level which can cause toxicity
Term
what should be done during a simple partial seizure
Definition
document the time it lasted. redirect pt away from activity that could cause injury
Term
what should be done with a pt during a tonic colonic seizure, what about when they turn blue
Definition
turn the pt on their side, cyanosis may be present but will go away shortely after the episode
Term
status elipticus
Definition
medical emergency it is a seizure that lasts longer then 5 minutes or repeated over 30 minutes
Term
what are some cuases of status elipticus
Definition
withdraw from antielptic drugs
infections
withdraw
trauma
Term
what is the worst case scenario in apt with status elipticus
Definition
brain damge
Term
what are 2 drugs of choice for a pt with status elipticus
Definition
iv push lorazapam \
diazepam rectal gel
Term
what is done after the initial treatment of status elipticus what is given to prevent more from occuring
Definition
phenytoin ( dilantin)
Term
vagal stimulation who has this how is it done
Definition
used for those with seizures who are not candidates for surgery
has an electrode places to the left vagus nerve- it is activated when a pt holds a magnet over the place during an aura
Term
how can a pt know for sure that their vagus nerve has been stimulated
Definition
they have a voice change
Term
meningitis
Definition
inflamatory of the menides that surround the brain and spinal cord
Term
what is the difference between bacterial menigits and viral
Definition
viral is self limiting and bacterial is life threatening
Term
what are some predispostions that may cause menigitis
Definition
otits
pneumonia
sinutis
sickle cell anemia
Term
why would a basilar fracute lead to menigits
Definition
from direct communication of cerebral spinal fluid with the enviroment
Term
viral menigitis what is the common cause
Definition
aseptic from measels mump herpes and herpes zoster
Term
the formation of exudate and viral menignits
Definition
exudate with viral does not occur and no organisms are in the csf
Term
what are the s/s of viral menigitis 4
Definition
photophobia
respiratory infections
muscle aches
n/v
Term
cryptococcus neoformans
Definition
menigits that is fungal and attakcs the cns of those with aids
Term
meningococcal menitits what does it attack and is it deadyly or contagious
Definition
can die within 24 hours
affects the menigis, subarachnoid brain tissue
very contagiou
Term
when does meningoccoal menigits occur
Definition
winter with pper respiratory from strep
Term
where does meningococcal occur
Definition
occurs in outbreaks in dorms and areas of high population
Term
3 normal finding with menigitis
Definition
nuchal rigidity
positive kernigs
bruddzinskis
Term
difference between bacterial and viral in appearnce of the csf
Definition
bacterial is cloudy and viral is clear
Term
bacterial menigits
wbc
protein
gluclose
csf pressure
Definition
increased
increased
decreased
elevated
Term
viral menigitis
wbc
protein
gluclose
csf pressure
Definition
increased
increased
normal
varies
Term
what should be given before a lumbar puncute is done with menigits
Definition
braod spectrum
Term
what assesment of the cranial nerve is done for those with menigitis
Definition
nerves III
IV
VII
VIII
the 6th is very improtant (inabilty to close the eyes laterally) becuase it may determine that there is hydrocephalus
Term
what preventitive treatment shold those with exposure to menigits have
Definition
rifadin
cipro
rocephin
Term
encepohalitis
Definition
inflammation of the brain tissue and the meniges
Term
what is the difference between menigits and encephalitis
Definition
it does not cause exudate
Term
what occurs in the white matter because of encephalitis
Definition
demylination whcih can lead to hemorrhage and cell death
Term
arbovirus how is it transmitted
Definition
mosquito or tick- west nile
Term
west nile virus is usually mild and asymotomatic but what can be serious wht are the s/s
Definition
headache
tremors
loss of vision
Term
what are some enterovirusse associated with encephalitis
Definition
herpes 1
herpes zoster
mumps
Term
what should be taught to thsoe to prptect fomr encephalitis
Definition
mosquito nets
take acyclovir for herpes
use deet
Term
parkinsons what is it and what are the 4 signs
Definition
affects the motor abiltiy with four symptoms
slow movement no movement and posture unstability
Term
what occurs pathologically with parkinsons
Definition
basal gnaglia are stimulated and the muscle tone in the body is inhibited and movements are refined
Term
what are the 2 major nerotransmitters to affect those with parkinsons
Definition
dopamine and acetylcholine
Term
where is dopmaine produced
Definition
substanitia nigra and in the adrenal glands and it is transmitted to the basal gangila
Term
where is dopmaine produced
Definition
substanitia nigra and in the adrenal glands and it is transmitted to the basal gangila
Term
where is dopmaine produced
Definition
substanitia nigra and in the adrenal glands and it is transmitted to the basal gangila
Term
where is dopmaine produced
Definition
substanitia nigra and in the adrenal glands and it is transmitted to the basal gangila
Term
where is the ach produced and secreted
Definition
produced and secreted by the basil ganglia and in the nerve endings of the body
Term
what does ach do what does dopamine do
Definition
ach exites messages and dopamine inhibits excitable neurons to allow control over voluntary movement
Term
what can widespread loss of substatia nigra do to the brian and what will this cause for the person
Definition
decrease the amount of dopamine in the brain which then the person loses ability to refine their movements
Term
what happens with ach in the brain in those with parkinsons
Definition
the ach levels remain active which creates an imbalance of excitable neurons to inhibitory ones
Term
s/s parkinsons in the beginning
Definition
tremors inthe upper extremities that increase with stress
Term
cogwheel
Definition
rythmic interruptions of movment
Term
plastic
Definition
mildly restricitve movement
Term
lead pipe
Definition
total resistance to movement
Term
what is the posture of those with parkinsons
Definition
stopped
Term
why do those with parkinsons have a masklike face and what are the problems associated with this
Definition
caused by the rigidity of the facial muscles- can lead to swallowing difficulites
Term
what are some emotional changes with parkinsons
Definition
depresison
'irritable
fear and insecurity
Term
what are some other issue in those with parkisons
Definition
bowel and bladder problems
very soft voice and voice changes
Term
what will the csf show in those with parkinsons
Definition
decreasedd dopamine
Term
whatr drugs will be given to those with parkinsons and how do these work
Definition
dopamine agonsits which stimulate the dopanmine recpetors in the brain
Term
almost all pt with parkinsons are on sinemet what are these
Definition
combo of levodopa and carbidopa
Term
catechol o methyltranferases what are these and when are they used
Definition
enzymes that inactivate dopamine to prolong the activity of levadopa used for those with parkinsons
Term
maois are taken often in those with parkinsons what should be avoided
Definition
cheese aged and smoked foods and sausage
wine and beer
Term
drug holiday when is it used and what is it
Definition
used in thsoe with parkinsons where the pt recieves no drugs because a drug tolerance was reached and the drugs do not last
Term
can the uap feed a pt with parkinsons
Definition
yes but they have to be taught to prevent aspiration
Term
sterotactic pallodotomy
Definition
buur hole is made and then an electrode is placed to reduce tremors and rigidity the probe then creates scar tissue to destroy tissue
Term
deep brain stimulation
Definition
used whend rgus no longer work a thin electrode is placed into the thalamus to interfere with tremor cells
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