Term
| Acute pain classifications |
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Definition
Somatic: Pain with a cause; superficial, Sharp, well-localized, dull, aching
Visceral: Pain in internal organs, abdomen, skeleton, Poorly localized, associated with n/v, hypotension, restlessness, ~ shock
Referred: Present in an area removed or distant from point of origin |
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Term
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Definition
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Term
|
Definition
| A situation; state of existence |
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Term
|
Definition
| External agent or internal disease, injury or inflammation |
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Term
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Definition
| Unknown; if known, treatment is prolonged or ineffective |
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Term
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Definition
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Term
|
Definition
| May be sudden or develop insidiously |
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Term
|
Definition
Transient (up to 6 months); usually of short duration
Resolves with treatment and healing. |
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Term
|
Definition
| Prolonged (6 months to years) |
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Term
| acute pain identification |
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Definition
| Painful and nonpainful areas generally well identified |
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Term
| chronic pain identification |
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Definition
| Painful and nonpainful areas less easily differentiated; change in sensations becomes more difficult to evaluate |
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Term
| Acute pain clinical signs |
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Definition
Typical response pattern with more visible signs
Anxiety and emotional distress common |
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Term
| Chronic pain clinical signs |
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Definition
Response patterns vary; fewer overt signs (adaptation)
Can interfere with sleep, productivity and quality of life |
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Term
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Definition
| Significant (informs person something is wrong); protective |
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Term
| chronic pain significance |
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Definition
| Person looks for significance |
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Term
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Definition
| Self-limiting or readily corrected |
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Term
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Definition
| Continuous(persistent) or intermittent; intensity may vary or remain constant |
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Term
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Definition
| Suffering usually decreases over time |
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Term
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Definition
| Suffering usually increases over time |
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Term
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Definition
| Leads to actions to relieve pain |
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Term
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Definition
| Leads to actions to modify pain experience |
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Term
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Definition
| Likelihood of eventual complete relief |
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Term
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Definition
| Complete relief usually not possible |
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Term
| chronic pain physiologic adaptations |
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Definition
| Normal heart rate, BP, respiratory rate |
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Term
| Negative chronic pain physiologic responses |
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Definition
| Depression, difficulty sleeping, eating, preoccupation with pain, social-cultural influence |
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Term
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Definition
| Deviation of one eye while focusing on an object |
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Term
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Definition
| Reduced vision in affected eye |
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Term
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Definition
| Double vision, primary symptom of strabismus |
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Term
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Definition
Involuntary unilateral or bilateral rhythmic movement of the eyes
Caused by imbalanced reflex activity of inner ear etc. |
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Term
Temperature regulation in the elderly is compromised because: Elderly
blood c_________n is poor, structural/ functional s___ changes, decreased h__t-p____cing activities, decreased s____ring response, decreased meta___ic rate, decrease t____t and n____tion,
decreased p___pheral s___ation to h__t and c__d. |
|
Definition
Temperature regulation in the elderly is compromised because: Elderly
blood circulation is poor, structural/ functional skin changes, decreased heat-producing activities, decreased shivering response, decreased metabolic rate, decrease thirst and nutrition,
decreased peripheral sensation to heat and cold. |
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Term
| Intraocular pressure should be between __ to __ mm Hg. |
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Definition
| Intraocular pressure should be between 12 to 20 mm Hg. |
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Term
| Intraocular pressure over 20 mm Hg is __________. |
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Definition
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Term
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Definition
| Open angle, Angle closure, Congenital |
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Term
| Which type of glaucoma is the leading cause of blindness, has few preliminary symptoms, is inherited, and involves an obstruction of aqueous humor? |
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Definition
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Term
| Which type of glaucoma involves a displacement of iris toward cornea, and is characterized by acute pain and visual disturbances? |
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Definition
| Narrow or closed angle glaucoma |
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Term
| Which type of glaucoma is neither open or closed and is associated with other anomolies? |
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Definition
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Term
| Is the loss of vision reversible with Macular Degeneration? |
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Definition
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Term
| What are the risk factors for Macular Degeneration? |
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Definition
| Hypertension, cigarette smoking, and diabetes mellitus are risk factors for Macular Degeneration. |
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Term
| Onset of macular degeneration |
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Definition
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|
Term
| Types of macular degeneration |
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Definition
| atrophic or dry and neovascular or wet |
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Term
| Symptoms of atrophic/dry macular degeneration: |
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Definition
| Limited night vision; difficulty reading |
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Term
| Symptoms of neovascular/wet macular degeneration: |
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Definition
| Leakage of blood or serum; retinal detachment; fibrovascular scarring; loss of photoreceptors |
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Term
|
Definition
Accommodation
Changes in thickness of the lens
Needed for clear vision
Presbyopia
Age related loss of accommodation; ocular lens becomes larger, firmer and less elastic |
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Term
|
Definition
Refraction – most common visual problems
Myopia – nearsighted
Hyperopia – farsighted
Astigmatism – unequal curvature of cornea |
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Term
|
Definition
Color blindness
Inherited trait; cannot distinguish between red and green
Affects males |
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Term
|
Definition
Conductive hearing loss
Impaired form outer to inner ear
Causes: impacted cerumen; foreign body, tumor
Clinical: diminished hearing and soft speaking voice |
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Term
| Sensorineural hearing loss |
|
Definition
Sensorineural hearing loss
Impairment of the organ of Corti or its central connections
Presbycusis
Most common form
Atrophy of the basal end of organ of Corti |
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Term
|
Definition
Otitis externa
Most common infection of outer ear
Pseudomonas, E. Coli, Staph
Occurs after prolonged exposure to moisture
Clinical
Swelling and clear purulent drainage; obstruction of ear canal |
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Term
|
Definition
Otitis media
Most common infection of children and infants
Strep, Haemophilus, Moraxella catarrhalis
Clinical
Pain, fever, irritability, inflamed tympanic membrane, fluid in middle ear |
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Term
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Definition
| Hyposmia – impaired sense of smell |
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Term
|
Definition
| Anosmia – complete loss of smell |
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Term
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Definition
Olfactory hallucinations
Smelling odors not present |
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Term
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Definition
| Parosmia – abnormal/ perverted sense of smell |
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Term
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Definition
| Hypogeusia: decreased taste sensation |
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Term
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Definition
| Ageusia - Absence of taste |
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Term
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Definition
| Parageusia - Substances possess an unpleasant flavor |
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Term
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Definition
– 15 point scale
Assesses level of consciousness
Three areas: eye opening; motor response; verbal response
Most critical clinical index of nervous system function |
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Term
| levels of altered consciousness |
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Definition
Confusion-Loss of ability to think rapidly and clearly; impaired judgment and decision making
Disorientation-Beginning loss of consciousness; disorientation to time followed by disorientation to place and impaired memory; lost last is recognition of self
Lethargy-Limited spontaneous movement or speech; easy arousal with normal speech or touch; may or may not be oriented to time, place, or person
Obtundation-Mild to moderate reduction in arousal (awakeness) with limited response to the environment; falls asleep unless stimulated verbally or tactilely; answers questions with minimum response
Stupor-A condition of deep sleep or unresponsiveness from which the person may be aroused or caused to open eyes only by vigorous and repeated stimulation; response is often withdrawal or grabbing at stimulus
Coma-No verbal response to the external environment or to any stimuli, noxious stimuli such as deep pain or suctioning do not yield motor movement
Light coma-Associated with purposeful movement on stimulation
Coma-Associated with nonpurposeful movement only on stimulation
Deep coma-Associated with unresponsiveness or no response to any stimulus |
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Term
| Why is the rate, rhythm and pattern of breathing important? |
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Definition
| Helps evaluate level of brain dysfunction and coma |
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Term
| The LOC is regulated by _______ _______ ______ in response to changes in ______ |
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Definition
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Term
| Cheyne-stokes breathing pattern is a ventilatory response to ____ and is characterized by _____ breaths and periods of _____ that grow _____. Also called the death ______. Caused by: |
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Definition
CO2, deep, apnea, longer, rattle
Bilateral dysfunction of the deep cerebral or diencephalic structures, seen with supratentorial injury and metabolically induced coma states |
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Term
| Why are pupillary changes important? |
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Definition
| The pupillary reflex is adjacent to the brain stem and is indicative of brain stem activity and dysfunction level. The pupil are also indicative of drug alterations. |
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Term
| Pupils: Dysfunction of the tectum of the midbrain looks like this: |
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Definition
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Term
| Pupils: A pontine dysfunction looks like this: |
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Definition
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Term
| Pupils: midbrain dysfunction looks like this: |
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Definition
| midposition and fixed pupils |
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Term
| pupils: dysfunction of the third cranial nerve looks like this: |
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Definition
| sluggish, dilated and fixed pupils |
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Term
| pupils: diencephalic dysfunction looks like this: |
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Definition
| small and reactive pupils |
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Term
| pupils: normal pupils look like this: |
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Definition
| small, reactive and REGULAR |
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Term
| Normal Oculocephalic Reflex Response (Dolls eyes Phenomenon test) |
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Definition
| eyes turn together (conjugate) to side opposite from turn of head. |
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Term
| Abnormal Oculocephalic Reflex Response (Dolls eyes Phenomenon test) |
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Definition
| eyes do not turn in conjugate manner (dysconjugate or asymmetric movement). |
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Term
| Absent Oculocephalic Reflex Response (Dolls eyes Phenomenon test) |
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Definition
| eyes do not turn as head position changes. |
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Term
| Normal Oculovestibular Reflex (Caloric Ice Water test) |
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Definition
| eyes turn together (conjugate) to ear where pain is induced. |
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Term
| Abnormal Oculovestibular Reflex (Caloric Ice Water test) |
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Definition
| eyes do not turn in conjugate manner to ear where pain is induced (dysconjugate or asymmetric movement). |
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Term
| Absent Oculovestibular Reflex (Caloric Ice Water test) |
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Definition
| eyes do not turn to ear where pain is induced. |
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Term
| What are the two tests for Oculomotor Response? |
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Definition
| Dolls eyes phenomenon (Oculocephalic reflex response) and Caloric Ice Water Test (Oculovestibular reflex response) |
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Term
| What are the pathologic reflexes (4) and when should they disappear? |
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Definition
| They should disappear at 24 months and only reappear with brain dysfunction. They are the grasp reflex, the snout reflex, the palmomental reflex and the suck reflex. |
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Term
| What are the seven criteria for brain death? |
|
Definition
1 Completion of all appropriate and therapeutic procedures
2 Unresponsive coma (no motor or reflex movements)
3 No spontaneous respiration
4 No ocular responses to head turning or caloric stimulation; dilated, fixed pupils
5 Isoelectric (flat) EEG (electrocerebral silence)
6 Persistence of these signs for 30 minutes to 1 hour and for 6 hours after onset of coma and apnea
7 Confirming test indicating absence of cerebral circulation (optional) |
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Term
| Is recovery possible with brain death? |
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Definition
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Term
| Is there homeostasis with brain death? |
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Definition
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Term
| Is coma reversible with cerebral death? |
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Definition
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Term
| Is brain damage reversible with cerebral death? |
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Definition
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Term
| Is homeostasis intact with cerebral death? |
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Definition
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Term
| Brain death has occurred when there is no evidence of function above the __________—that is, in the cerebral hemispheres or brain stem—for an extended period. The abnormality of brain function must result from _____ or known ______ disease and must not be caused by a ______ drug, ______ poisoning, or ____thermia. An __________, or flat, ________________ (EEG) (electrocerebral silence) for _ to __ hours in a person who is not hypothermic and has not ingested depressant drugs indicates brain death. |
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Definition
| foramen magnum, structural, metabolic, depressant, alcohol, hypothermia, isoelectric, electroencephalogram, 6 to 12 |
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Term
| The three types of dysphagia |
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Definition
| Expressive, Receptive, and Transcortial |
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Term
Expressive dysphagia
Non______; cannot find _____
Difficulty _______ |
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Definition
Expressive
Nonfluent; cannot find words
Difficulty writing |
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Term
Receptive dysphagia
Fluent; __________ ____________words
Unable to monitor language for ____________
Speech may be _________________ |
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Definition
Receptive
Fluent; meaningless inappropriate words
Unable to monitor language for correctness
Speech may be incomprehensible |
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Term
Transcortical dysphagia
Echolalia – ______ another's words
Inability to ____ and _____
Impaired _________ |
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Definition
Transcortical dysphagia
Echolalia – repeat another's words
Inability to read and write
Impaired comprehension |
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Term
| Leading cause of severe cognitive dysfunction in older adults |
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Definition
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Term
| risk for AD increases with ________ |
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Definition
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Term
| AD has a diagnosis of ___________ |
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Definition
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Term
| what is the diagnostic criteria for AD? |
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Definition
| neurofibrillary tangles (and amyloid containing neuritic plaques) |
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Term
| What causes cortical atrophy in AD? |
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Definition
| Loss of neurons, particularly in the parietal and temporal lobes |
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Term
| What is another name for cortical atrophy? |
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Definition
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Term
| The loss of neurotransmitter stimulation by ____________ ______________ is thought to be responsible for AD. |
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Definition
| The loss of neurotransmitter stimulation by choline acetyltransferase is thought to be responsible for AD. |
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Term
| Where are neurofibrillary tangles? |
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Definition
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Term
| What causes a neurofibrillary tangle? |
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Definition
| Tau proteins in the neuron become distorted and twisted. |
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Term
| How long does stage 1 AD last and what are the symptoms? |
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Definition
| 2-4 years, memory loss, subtle personality changes, disorientation to time and place |
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Term
| What is another name for stage 2 AD and what are the symptoms and duration? |
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Definition
The confusion stage,
impaired cognition restlessness, agitation, wandering, SUNDOWNER'S SYNDROME, repetitive behavior,
lasts several years |
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Term
| What' another name for stage 3 AD and what are the symptoms and duration? |
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Definition
The terminal stage,
emaciation, inability to communicate, bowel and bladder incontinence, seizures,
lasts 1-2 years |
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Term
| Should you attempt to reorient a patient with AD? |
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Definition
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Term
| What is the first visible sign of Parkinson Disease? |
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Definition
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Term
| Parkinson disease is a ___________ disorder of the _____ ______. |
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Definition
| Parkinson disease is a degeneration disorder of the basal ganglia. |
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Term
| Parkinson disease is characterized by a progressive destruction of the ______________ pathway. |
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Definition
| Parkinson disease is characterized by a progressive destruction of the nigrostriatal pathway. (gray matter) |
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Term
| Parkinson disease is characterized by a decrease in the concentration of ________. |
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Definition
| Parkinson disease is characterized by a decrease in the concentration of dopamine. |
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Term
| Cardinal manifestations of PD include _______ (rhythmic altenation flexion and contraction), _______ (resistance to movement throughout full ROM), ___wheel motions (most evident during _______ joint movement), _____kinesia, ____ rolling, uncontrolled __________ caused by ANS, salivation, ___________ gait, _____ steps, _________ posture. Dementia occurs __% of the time with PD patients. |
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Definition
| Cardinal manifestations of PD include tremors (rhythmic altenation flexion and contraction), rigidity (resistance to movement throughout full ROM), cogwheel motions (most evident during passive joint movement), bradykinesia, pill rolling, uncontrolled sweating caused by ANS, salivation, shuffling gait, short steps, stooped posture. Dementia occurs 20% of the time with PD patients. |
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Term
|
Definition
| weakness on one side of the body (left or right) |
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Term
|
Definition
| Paralysis on one side of the body (left or right) |
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Term
|
Definition
| paralysis of both upper or lower extremities |
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Term
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Definition
| paralysis of both lower extremities |
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Term
|
Definition
| paralysis of all four extremities |
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Term
Increased intracranial pressure (ICP)
Normal: _ to __ mm Hg
Causes
_____ growth, _____, excess ___, h_______ge, brain a______m
Clinical
Subtle and t______t; episodic con______n, ____lessness, _____iness, slight p_________ and b_______g changes
Decreased levels of a________, ________ pulse pressure, b__________dia, pupils small and s____ish
Cerebral hypoxia and a_______s
Prolonged effect
Brain h_______tion, d_____ |
|
Definition
Increased intracranial pressure (ICP)
Normal: 5 to 15 mm Hg
Causes
Tumor growth, edema, excess CSF, hemorrhage, brain aneurysm
Clinical
Subtle and transient; episodic confusion, restlessness, drowsiness, slight pupillary and breathing changes
Decreased levels of arousal, widened pulse pressure, bradycardia, pupils small and sluggish
Cerebral hypoxia and acidosis
Prolonged effect
Brain herniation, death |
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Term
| Which cerebral edema is the most important clinically? |
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Definition
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Term
| What causes vasogenic edema? |
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Definition
| increased permeability of capillary endothelium after injury |
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Term
| What are the 4 types of cerebral edema? |
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Definition
| ischemic, vasogenic, cytotoxic, and interstitial |
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Term
| Ischemic cerebral edema is actually what two types of cerebral edema? |
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Definition
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Term
| What type of seizure am I? Seizure activity that occurs without loss of consciousness. Seizure activity that begins and usually is limited to one part of the left or right hemisphere. |
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Definition
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Term
| What type of seizure am I? Seizure activity that occurs with impairment of consciousness. Seizure activity that begins and usually is limited to one part of the left or right hemisphere. |
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Definition
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Term
| What type of seizure am I? Partial onset evolving to generalized tonic-clonic seizures. |
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Definition
| Partial seizure: Secondary Generalized |
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Term
| What type of seizure am I? Brief loss of consciousness with minimal or no loss of muscle tone; may experience 20 or more episodes a day lasting approximately 5-10 seconds each; may have minor movement, such as lip smacking, twitching of eyelids. |
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Definition
| Generalized seizure: Absence |
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Term
| What type of seizure am I? Sudden, brief contractures of a muscle or group of muscles. |
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Definition
| Generalized seizure: Myoclonic |
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Term
| What type of seizure am I? Alternating contraction and relaxation of muscles. |
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Definition
| Generalized seizure: Clonic |
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Term
| What type of seizure am I? Musculature stiffens, then intense jerking as trunk and extremities undergo rhythmic contraction and relaxation. |
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Definition
| Generalized seizure: Tonic-Clonic |
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Term
| What type of seizure am I? Sudden, momentary loss of muscle tone; drop attacks, likelihood of injury. |
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Definition
| Generalized seizure: Atonic |
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Term
| Seizure terminology: A partial seizure experienced as a peculiar sensation preceding the onset of generalized seizure that may take the form of gustatory, visual, or auditory experience or a feeling of dizziness, numbness, or just “a funny feeling”. |
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Definition
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Term
| Seizure terminology: Early clinical manifestations, such as malaise, headache, or a sense of depression, that may occur hours to a few days before the onset of a seizure. |
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Definition
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Term
| Seizure terminology: A state of muscle contraction in which there is excessive muscle tone. |
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Definition
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Term
| Seizure terminology: A state of alternating contraction and relaxation of muscles. |
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Definition
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|
Term
| Seizure terminology: The time period immediately following the cessation of seizure activity. |
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Definition
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Term
| Agnosia is a defect of pattern re_____tion—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in A_________ D________. |
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Definition
| Agnosia is a defect of pattern recognition—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in Alzheimer's Disease. |
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Term
| What are the disorders of expression? |
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Definition
| hypermimesis, hypomimesis, dyspraxia, apraxia |
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Term
|
Definition
Hypermimesis:
Pathologic laughter (R hemisphere injury) and Pathologic crying (L hemisphere injury) |
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Term
|
Definition
| Hypomimesis: Manifests as aprosody (loss of emotional language) |
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Term
|
Definition
Dyspraxias/apraxias:
Inability to perform purposeful or skilled motor acts. Absence of paralysis, sensory loss, abnormal posture and tone, abnormal involuntary movement, incoordination, or inattentiveness. |
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Term
| Three types of hyperkinesia |
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Definition
| Dyskinesias, Paroxysmal dyskinesias, Tardive dyskinesia |
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Term
|
Definition
| Dyskinesias: Abnormal involuntary movements |
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Term
|
Definition
| Paroxysmal dyskinesias: Abnormal involuntary movements (spasms/tremors) |
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Term
|
Definition
| Tardive dyskinesia: Involuntary movement of face, trunk, extremities. Usually caused by side effect of prolonged phenothiazine drug therapy. |
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Term
|
Definition
| Guillain-Barre syndrome - an idiopathic, peripheral polyneuritis that occurs 1 to 3 weeks after a mild episode of fever associated with a viral infection or with immunization. Symmetric pain and weakness affect the extremities, and paralysis may develop. The neuritis may spread to the trunk and face. Symptoms vary in intensity from mild to severe enough to require critical nursing care, including ventilator assistance. Treatment consists of supportive care and IV high doses of immunoglobulins. Recovery depends on the extent of neuritis and may take weeks to many months. |
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Term
| Most frequently occurring neuro disorder |
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Definition
|
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Term
| Leading cause of disability in U.S. (paresis and paralysis) |
|
Definition
|
|
Term
|
Definition
Arterial HTN,
Diabetes,
Lipoprotein-a presence (testable),
Polycythemia and Thrombocythemia (>600,000) which thickens blood,
Smoking which constricts vessels, Impaired cardiac function – quivering atrium, Non-rheumatic atrial fibrillation |
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Term
| Classifications of strokes according to patho (4) |
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Definition
| Global hypoperfusion (shock) (death can follow quickly), Ischemia: Thrombotic or Embolic (blood clot or air or other bubble, not DVT) comes from carotid artery or heart, Hemorrhage |
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Term
| Ischemic Stroke: Thrombotic is common with what two disease processes? |
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Definition
| artherosclerosis and inflammatory disease (arthritis) (damage to arterial walls) |
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Term
| Ischemic Stroke: Thrombotic is a thrombus where? |
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Definition
|
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Term
| 3rd most common cause of CVA |
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Definition
|
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Term
| Fragments that break from thrombus (air, fat, tumors) formed outside the brain in the heart, aorta, and carotid |
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Definition
|
|
Term
| Risk factors for Ischemic Stoke: Embolic (5) |
|
Definition
Atrial fibrillation,
endocarditis,
MI,
Rheumatic heart disease,
valvular prostheses |
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Term
| Risk factors for Hemorrhagic stroke (5) |
|
Definition
anticoagulation disorders,
bleeding into tumor,
HTN,
ruptured aneurysms,
vascular malformation, |
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|
Term
| CVA signs and symptoms - 16 |
|
Definition
agnosia (decreased sensory interpretation),
aphasia (cva left hemisphere),
apraxia (decreased learned movements),
decreased cough and swallow reflex,
emotional lability (uncontrolled crying and crisis state),
Headache,
hemiparesis or hemiplegia,
hypertension,
hyperthermia,
incontinence,
mental changes (confusion, memory impairment, disorientation),
perceptual defects (cva right hemisphere),
resp problems (decreased neuro muscle control),
seizures,
visual changes (Homonymous hemianopsia or Horner's syndrome: half blindness),
vomiting, |
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|
Term
| focal neurologic signs and symptoms (4) |
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Definition
language disorder,
paralysis,
reflex changes
sensory loss, |
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Term
| TIA signs and symptoms (6) |
|
Definition
confusion,
dysarthria,
syncope,
temporary vision changes,
transient hemiparesis,
vertigo, |
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|
Term
| Stroke that has lesions less than 1 cm in size, pure motor and sensory deficits, associated with smoking, DM, and HTN |
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Definition
|
|
Term
| two main bacterias responsible for bacterial meningitis |
|
Definition
| Neisseria meningitidis and Streptococcus pneumoniae |
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|
Term
| infected areas in bacterial meningitis |
|
Definition
| pia mater and arachnoid, the subarachnoid space, the ventricular system, and the CSF |
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|
Term
| signs and symptoms of bacterial meningitis (9) |
|
Definition
Fever, tachycardia, chills, petechial rash,
Throbbing HA, photophobia, nuchal rigidity (covering of brain is inflammed – extremely painful to put chin to chest),
decreased LOC, cranial nerve palsies, focal deficits, |
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|
Term
| viral meningitis point of infection |
|
Definition
| meninges only - membranes which envelops the central nervous system, dura mater, arachnoid mater, pia mater. |
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|
Term
| contagion in viral meningitis |
|
Definition
| enteroviral viruses,mumps, herpes simplex I |
|
|
Term
| symptoms of viral meningitis(3) |
|
Definition
| mild generalized headache, photophobia, neck stiffness |
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|
Term
| contagions of fungal meningitis |
|
Definition
| cryptococcosis, aspergillosis |
|
|
Term
| Does fungal meningitis develop quickly? |
|
Definition
| No, slow, chronic, and insiduous |
|
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Term
| fungal meningitis symptom |
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Definition
|
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Term
|
Definition
| bacterial, fungal, viral, parasitic, toxic |
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Term
| Multiple sclerosis: destruction of the _______ ___________ ________ |
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Definition
|
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Term
| MS spares the __________ nervous system |
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Definition
|
|
Term
| MS: onset of __ to __ years |
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Definition
|
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Term
|
Definition
|
|
Term
| leading cause of neuro disability in EARLY adulthood |
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Definition
|
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Term
| Are MS sufferers always symptomatic? |
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Definition
| No, exacerbations and remissions occur. |
|
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Term
| What are the MS manifestations dependant on? |
|
Definition
| Location and extent of lesion |
|
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Term
| Common symptoms of MS (19, only about 5-6 categories, though) |
|
Definition
Optic nerve, optic neuritis (cloudiness), diplopia, blurred vision, nystagmus, tinnitus, decreased hearing, urinary retention, spastic bladder, constipation, dysarthria(speech)/dysphagia(swallowing), muscle strength, gait/coordination, balance, muscle spasticity, ataxia, acute paresthesias, leads to paralysis, |
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Term
| Myasthenia Gravis: autoimmune disorder caused by antibodies against ________ receptors, which affect the ________ junction |
|
Definition
| acetylcholine, neuromuscular |
|
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Term
| symptoms of Myastenia Gravis |
|
Definition
Progressive muscle fatigue,
drooping head,
diploplia of eyes,
affects muscles of mouth and throat,
comes without warning, causing difficulty swallowing , HIGH-PITCHED VOICE, and decreased energy that improves with rest. The body literally attacks itself. |
|
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Term
| Autonomic Dysreflexia Patho |
|
Definition
•Sensory receptors below level of cord lesion are stimulated
• The intact nervous system then responds with arteriolar spasm increasing blood pressure
• Baroreceptors in cerebral, carotid sinus, and aorta stimulate PNS (r/t HTN)
• Heart rate decreases, but visceral and peripheral vessels do not dilate r/t blocked impulses |
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Term
| Herniation of an intervertebral disk |
|
Definition
| Herniation of an intervertebral disk is a protrusion of part of the nucleus pulposus through a tear in the posterior rim of the annulus fibrosus (the fibrous capsule enclosing the gelatinous center of the disk). Rupture of an intervertebral disk usually is caused by trauma, degenerative disk disease, or both. Most commonly affected are the lumbosacral disks—that is, L5-S1 and L4-L5. Disk herniation occasionally occurs in the cervical area, usually at C5-C6 and C6-C7. A herniated disk in the lumbosacral area is associated with pain that radiates along the sciatic nerve course over the buttock and into the hamstring to the sole of the foot. The pain increases with straight leg raising. Other clinical manifestations include limited range of motion of the lumbar spine. Diagnosis of a herniated intervertebral disk is made through the history and physical examination, spinal x-ray films, electromyelography, CT scan, MRI, myelography, diskography, and nerve conduction studies. |
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Term
|
Definition
| Mild concussion: Temporary axonal disturbance affecting attention and memory. Consciousness not lost. |
|
|
Term
| Classical cerebral concussion |
|
Definition
| Classical cerebral concussion: Physiologic neurologic dysfunction without substantial anatomic disruption; Immediate loss of consciousness lasting < 6 hours. |
|
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Term
|
Definition
| Diffuse axonal injury (1/3 of injuries, 30%): Prolonged traumatic coma longer than 6 hours. |
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Term
| Warning signs after a head trauma (first 24 hours) are: |
|
Definition
| Warning signs after a head trauma (first 24 hours) are: Changes in LOC, increased drowsiness, difficult to arouse; seizures; bleeding or water drainage from nose or ears; pupils slow to react or unequal; blurred vision; loss of sensation to any extremity (depending on where lesion is); slurred speech; vomiting. |
|
|
Term
| At what point will a spinal cord injury cause quadriplegia? |
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Definition
|
|
Term
| Bone healing steps in order (5): |
|
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down. |
|
|
Term
Bone Healing
A: _______ at broken ends of the bone with subsequent ________ formation.
B: ____________ of hematoma into fibrous _______. (inflammatory)
C: Invasion of osteo______, lengthening of ________ strands, and deposition of _______.
D: ______ formation; new bone is built up as osteo_______ destroy ____ bone.
E: __________ is accomplished as excess ______ is reabsorbed and __________ bone is laid down. |
|
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down. |
|
|
Term
|
Definition
| incomplete or partial dislocation of a joint, partial loss of opposing bone surface |
|
|
Term
Delayed union
Union that does not occur for _ to _ months after injury (or _ to __) |
|
Definition
Delayed union
Union that does not occur for 8 to 9 months after injury (6-12) |
|
|
Term
Malunion
Healing of bone with incorrect _________ ________ |
|
Definition
Malunion
Healing of bone with incorrect anatomic position |
|
|
Term
Nonunion
Failure of bone ends to ____ __________ |
|
Definition
Nonunion
Failure of bone ends to grow together |
|
|
Term
Dislocation
Temporary ____________ of one or more bones in a _____ with entire loss of _______ |
|
Definition
Dislocation
Temporary displacement of one or more bones in a joint with entire loss of contact |
|
|
Term
| When is dislocation most prevalent (age)? |
|
Definition
|
|
Term
| Dislocation is associated with what other alteration in MS function? |
|
Definition
|
|
Term
| What complication is possible with dislocation? |
|
Definition
| Disruption of circulation leading to ischemia and permanent disability. |
|
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Term
|
Definition
| Tear in tendon (ties muscle to bone), associated with sports injuries |
|
|
Term
|
Definition
| Tear in ligament (ties bone to cartilage) |
|
|
Term
|
Definition
| Complete separation from tendon or ligament from the bone |
|
|
Term
| Signs and symptoms of strains, sprains, and avulsions: |
|
Definition
Pain, soft tissue swelling, change ligament or tendon contour, dislocation or subluxation of bone,
decreased mobility, instability, weakness |
|
|
Term
|
Definition
| inflammation of the tendon (like achilles tendonitis) |
|
|
Term
epicondylitis - Inflammation of t_____ where it attaches to a b___ at its o___in
(H_____s, r____s, u___, k___) |
|
Definition
epicondylitis - Inflammation of tendon where it attaches to a bone at its origin
(Humerus, radius, ulna, knee) |
|
|
Term
|
Definition
Inflammation of small sac that lines synovial membranes. Localized; tenderness, pain with activity. Common sites are: * Prepatellar bursitis, "housemaid's knee",
* Trochanteric bursitis giving hip pain,
* Olecranon bursitis characterised by pain and swelling in the elbow, and
* Subacromial bursitis, which gives shoulder pain. |
|
|
Term
| osteoporosis affects __% of people age __ and older |
|
Definition
|
|
Term
| In osteoporosis the _________ cycle is disrupted, which means that ___ bone is reabsorbed ________ than ___ bone is formed. |
|
Definition
| In osteoporosis the modeling cycle is disrupted, which means that old bone is reabsorbed faster than new bone is formed. |
|
|
Term
| Genetic risk factors for osteoporosis include: |
|
Definition
Family history of osteoporosis
White race
Increased age
Female sex |
|
|
Term
| T/F: Even though age is a risk factor for osteoporosis it is not a disease of aging. |
|
Definition
|
|
Term
| Hormonal and metabolic risk factors for osteoporosis include: |
|
Definition
Early menopause (natural or surgical)
Late menarche
Nulliparity (never pregnant)
Obesity (increased pressure on bone tissue)
Hypogonadism
Cushing syndrome
Weight below healthy range
Acidosis |
|
|
Term
| Anthropometric risk factors for osteoporosis include: |
|
Definition
Small stature
Fair or pale skinned
Thin build |
|
|
Term
| Diet risk factors for osteoporosis include: |
|
Definition
Low dietary calcium and vitamin D
Low endogenous magnesium
Excessive protein
Excessive sodium intake
High caffeine intake – high metabolism, increased excretion
Anorexia
Malabsorption |
|
|
Term
| Lifestyle risk factors for osteoporosis include: |
|
Definition
Sedentary
Smoker
Alcohol consumption (excessive) |
|
|
Term
| Concurrent risk factors for osteoporosis include: |
|
Definition
| Hyperparathyroidism - pulls the calcium out of the bone |
|
|
Term
| Illness and trauma risk factors for osteoporosis include: R____ insufficiency, h___calciuria (extra calcium becomes uremic frost), ____________ arthritis, S______ c___ injury, S_________ lupus. |
|
Definition
Illness and trauma risk factors for osteoporosis include: Renal insufficiency, hypocalciuria (extra calcium becomes uremic frost), Rheumatoid arthritis, Spinal cord injury, Systemic lupus.
Systemic lupus |
|
|
Term
| Liver diseases as risks for osteoporosis: |
|
Definition
| Marrow disease (myeloma, mastocytosis, thalassemia) |
|
|
Term
| WHO=______ Health ____________, BMD=____ ____ Density. |
|
Definition
| WHO=World Health Organization, BMD=Bone Mass Density. |
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|
Term
| The WHO defines bones density as normal if it is greater that ___ mg/cm2, ostepenia if between ___ and ___ mg/cm2, and osteoporosis if less than ___ mg/cm2. |
|
Definition
| The WHO defines bones density as normal if it is greater that 833 mg/cm2, ostepenia if between 833 and 648 mg/cm2, and osteoporosis if less than 648 mg/cm2. |
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|
Term
| Osteoporosis is a impairment of the structural integrity of ___________ bone. |
|
Definition
| Osteoporosis is a impairment of the structural integrity of trabecular bone. |
|
|
Term
| Common s/s of osteoporosis |
|
Definition
| Pain, bone deformity, kyphosis, fractures (distal radius, ribs, vertebrae, neck of femur) |
|
|
Term
| Complications of osteoporosis include: |
|
Definition
| fat or pulmonary embolism, pneumonia, hemorrhage, shock |
|
|
Term
| Osteomylelitis is a ____________ bone disease caused by ________, ______, _________, and _______. |
|
Definition
| Osteomylelitis is a infectious bone disease caused by bacteria, fungi, parasites, and viruses. |
|
|
Term
| What are 3 contributors to osteomyelitis? |
|
Definition
| Multiple microscopic channels in bone tissue, microcirculation vulnerable to damage, limited capacity to replace bone destroyed by infection. |
|
|
Term
| What are the two types of osteomyelitis? |
|
Definition
| Exogenous (open fractures, penetrating wounds, surgery) and endogenous osteomyelitis (staph through cutaneous, sinus, ear, dental or other primary infection sources) |
|
|
Term
| Clinical manifestations of osteomyelitis vary with ___, ________, ________, and ______ of infection. |
|
Definition
| Clinical manifestations of osteomyelitis vary with age, location, organism, and length of infection. |
|
|
Term
| Acute osteomyelitis infections involve the _____________ response. |
|
Definition
| Acute osteomyelitis infections involve the inflammatory response. |
|
|
Term
| With chronic osteomyelitis, symptoms are _____, including _____, malaise, ________, weight ____, and ____. |
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Definition
| With chronic osteomyelitis, symptoms are vague, including fever, malaise, anorexia, weight loss, and pain. |
|
|
Term
Osteoarthritis is a ____________ disease with loss of _________ cartilage in ________ joints. It occurs > age __. ________ are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as _______.
Pathologic characteristics are erosion of _________ cartilage, _________ of bone underneath cartilage, formation of bone _____ (osteo______). |
|
Definition
Osteoarthritis is a degenerative disease with loss of articular cartilage in synovial joints. It occurs > age 40. Athletes are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as trauma.
Pathologic characteristics are erosion of articular cartilage, sclerosis of bone underneath cartilage, formation of bone spurs (osteophytes). |
|
|
Term
| Commonly affected joints by osteoarthritis: |
|
Definition
| Hand, wrist, neck, hip, knees, ankles, feet |
|
|
Term
| T/F Aging is an important associated factor in osteoarthritis. |
|
Definition
|
|
Term
| Clinical s/s of osteoarthritis include nothing (asymptomatic), ____ in one or more joints, especially _____ ________ joints, pain at _____, and pares______. |
|
Definition
| Clinical s/s of osteoarthritis include nothing (asymptomatic), pain in one or more joints, especially weight bearing joints, pain at night, and paresthesia. |
|
|
Term
| Risk factors for osteoarthritis include: |
|
Definition
| Risk factors for osteoarthritis include trauma, sprains, strains, joints dislocations, etc. Also long term mechanical stress caused by athletics, ballet dancing, or repetitive physical tasks. Inflammation of the joint structures is a risk factor. Joint instability from damage to supporting structures is a risk factor. Diabetic neuropathy is a risk factor. Other risk factors include Congenital or acquired skeletal deformities, hematologic or endocrine disorders including hemophilia and hyperparathyroidism, and the use of certain drugs like colchicine, indmethacin and steroids (stimulates collagen digesting enzymes in the synovial membrane). |
|
|
Term
| ___________ Arthritis is a systemic autoimmune disease. |
|
Definition
| Rheumatoid Arthritis is a systemic autoimmune disease. |
|
|
Term
| Rheumatoid Arthritis is characterized by a chronic inflammation of __________ tissue (primarily joints). |
|
Definition
| Rheumatoid Arthritis is characterized by a chronic inflammation of connective tissue (primarily joints). |
|
|
Term
| The cause of rheumatoid arthritis is _______, however it is believed to be genetic with ____________, _________, and ______________ factors. |
|
Definition
| The cause of rheumatoid arthritis is unknown, however it is believed to be genetic with environmental, hormonal, and reproductive factors. |
|
|
Term
| In rheumatoid arthritis the ___________ become activated, degrading surface layers of _________ cartilage. _________ also cause chondrocytes to attack cartilage. ________ digests nearby cartilage. |
|
Definition
| In rheumatoid arthritis the neutrophils become activated, degrading surface layers of articular cartilage. Cytokines also cause chondrocytes to attack cartilage. Synovium digests nearby cartilage. |
|
|
Term
Paget disease is a state of __creased metabolic activity with abnormal and excessive bone __________ (resorption & formation). The accelerated remodeling e_____es and s____ns affected bones.
Most commonly affected bones include the v________, s___l, s_c___, st_____, p____s, f___r. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often a______matic, as_______cal skull; A__ (_______ ______ ______), d_____ia; s______ d______ (d/t pressure on brain)
Impaired m____/m_____ function, d___ness, atrophy _____ nerve, ____ache is common. |
|
Definition
Paget disease is a state of increased metabolic activity with abnormal and excessive bone remodeling (resorption & formation). The accelerated remodeling enlarges and softens affected bones.
Most commonly affected bones include the vertebrae, skull, sacrum, sternum, pelvis, femur. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often asymptomatic, asymmetrical skull; AMS (altered mental status), dementia; sensory deficit (d/t pressure on brain)
Impaired motor/muscle function, deafness, atrophy optic nerve, headache is common. |
|
|
Term
Gout is an ___________ response in relation to ____ acid production or excretion. The result is _____uric____
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in _________ tissue. Clinical s/s are joint and organ involvement including acute joint p___ or “_____ ar______s” and r____ stones. M______ium u____ crystals deposit in subcutaneous tissue as well and are called T____ (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to p______ metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process. |
|
Definition
Gout is an inflammatory response in relation to uric acid production or excretion. The result is hyperuricemia
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in connective tissue. Clinical s/s are joint and organ involvement including acute joint pain or “Gouty arthritis” and renal stones. Monosodium urate crystals deposit in subcutaneous tissue as well and are called Tophi (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to purine metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process. |
|
|
Term
| What is the most common site of gouty arthritis? |
|
Definition
|
|
Term
| Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the _________. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in Mc_____ disease (muscle myophosphorylase deficiency) and m_______t _____thermia. The contracture is usually temporary if the underlying pathology is reversed. |
|
Definition
| Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the sarcolemma. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in McArdle disease (muscle myophosphorylase deficiency) and malignant hyperthermia. The contracture is usually temporary if the underlying pathology is reversed. |
|
|
Term
| A pathologic contracture is a permanent muscle shortening caused by muscle s____ or w___ness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as m________ d________ (see p. 1079) and C______ _______ ______ (C__) injury. Contractures also may develop secondary to ____ tissue contraction in the flexor tissues of a joint, for example, contracture of b___ed tissues in the antecubital area of the forearm leading to a flexion contracture. |
|
Definition
| A pathologic contracture is a permanent muscle shortening caused by muscle spasm or weakness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as muscular dystrophy (see p. 1079) and central nervous system (CNS) injury. Contractures also may develop secondary to scar tissue contraction in the flexor tissues of a joint, for example, contracture of burned tissues in the antecubital area of the forearm leading to a flexion contracture. |
|
|
Term
| The term disuse atrophy describes the p_____logic reduction in normal size of muscle fibers after prolonged inactivity from b__ ____, t_____ (c___ing), or l___l n____ damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of _% per day. |
|
Definition
| The term disuse atrophy describes the pathologic reduction in normal size of muscle fibers after prolonged inactivity from bed rest, trauma (casting), or local nerve damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of 3% per day. |
|
|
Term
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and t____r points. Increased sensitivity to touch (i.e., tender points), the __sence of systemic or localized inflammation, and the presence of f______e and non_______tive sleep are common. Because the symptoms are v___e, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: F__like v___l illness, Chronic f______e s______e, H__ infection, L___ disease, Physical tr____, Persistent s____s, Chronic s___p disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are _ pairs (__ total) of tender points for diagnostic classification of fibromyalgia. People describe the pain as b_____g or g___ing. F___gue is profound. There is a strong association (50%) between fibromyalgia, R_______d phenomenon, and irritable b___l syndrome. |
|
Definition
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and tender points. Increased sensitivity to touch (i.e., tender points), the absence of systemic or localized inflammation, and the presence of fatigue and nonrestorative sleep are common. Because the symptoms are vague, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: Flulike viral illness, Chronic fatigue syndrome, Human immunodeficiency virus (HIV) infection, Lyme disease, Physical trauma, Persistent stress, Chronic sleep disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are 9 pairs (18) of tender points for diagnostic classification of fibromyalgia. People describe the pain as burning or gnawing. Fatigue is profound. There is a strong association (50%) between fibromyalgia, Raynaud phenomenon, and irritable bowel syndrome. |
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