Term
|
Definition
| nociceptors > terminate in the dorsal horn of cord>ascend via the lateral spinothalamic tract |
|
|
Term
|
Definition
| interpretationof signals by limbic reticular formation, thalamus, hypothalamus, medulla and cortex |
|
|
Term
|
Definition
| modulation of pain sensation (reticular formation, midbrain, substantia gelatinosa) from CNS back to dorsal horm of spinal cord |
|
|
Term
|
Definition
| processing of potentially harmful stimuli through the CNS |
|
|
Term
|
Definition
| free nerve endings in afferent PNS that selectively respond to different types of stimuli |
|
|
Term
|
Definition
myelinated, rapid transmission, sharp, localized pain
lateral neospinothalmic tract--> lateral thalamus --> somatosensory cortex |
|
|
Term
|
Definition
small and unmyelinated, slower transmission, diffuse, burning, aching pain,
paleothalamic tract, medial thalamus, brainstem, reticular formation, hypothalamus |
|
|
Term
|
Definition
| triggered by mechanisms like tissue injury (release of prostalandins, bradykinins) and chronic inflammatory lesions (lymphokines) |
|
|
Term
| excitatory neuromodulators |
|
Definition
| include substance P, histamine, glutamate, and calcitonin gene-related peptide, somatostatin. lead to increased responsiveness and reduced threshold of nociceptors that cause them to fire with increased frequency, resulting hyperalgesia (increased sensitivity) and allodynia (perception of innocous stimuli) They enhance the pain experience |
|
|
Term
|
Definition
| GABA, endorphins, glycine, 5 hydroxtrytamine, norepinephrine, and endogenous opiods. Some excite the PNS but inhibit the CNS. Help to modulate pain downward |
|
|
Term
| Gate Control Theory of Pain |
|
Definition
| pain tranmission is modulated by a balance of impulses conducted to the spinal cord, where cells in the substantia gelatinosa function as a gate that regulates the pain tranmission to higher centers in teh CNS. Nociceptive transmission on tehse fibers "open" the spinal gate and increase perception of pain. non-nonciceptive transmissions serve to "close the gat" decrease pain perception. |
|
|
Term
|
Definition
| interpretation of learned behavior to pain influenced by culture, gender, etc (cerebrral) |
|
|
Term
|
Definition
| conditioned avoidance, emotional responses (reticular, limbic, brain system) |
|
|
Term
|
Definition
| process information about strength, intensity, temporal and spatial aspects of pain (afferent nerves, SC, brainstem, higher) gives us information just about intensity and location |
|
|
Term
|
Definition
| visible, known cause, signs of pain with anxiety and emotional distress, self-limiting with likelihood of complete relief, duration up to 6 months. is relieved when chemical mediators that stimulate pain receptors are diaphoresis, and dilated pupils, anxiety. Arises from somatic, visceral, or referred pain |
|
|
Term
|
Definition
| unknown or unresponsive to treatment, sudden of insidious onset, prolonged months to years, fewer overt signs, can interfere with sleep, daily activities, suffering increases over time, complete relief unlikely. Adaptation for HR and BP |
|
|
Term
|
Definition
| unknown or unresponsive to treatment, sudden of insidious onset, prolonged months to years, fewer overt signs, can interfere with sleep, daily activities, suffering increases over time, complete relief unlikely. Adaptation for HR and BP |
|
|
Term
|
Definition
problem of aqueous humor flow
left is normal-flow to posterior to anterior channel, fluid is free to drain through canal of schlemm at outer edge of te iris (constant process) causes increasing peripheral vision loss
problem when flow is obstructed, and there's not the chance for the aqueous fluid to be reabsorbed
pressure
pressure builds (12-20) |
|
|
Term
|
Definition
| females, african americans over 40, mexican Americans over 60, againg, familial tendencies. characterized by outflow obstrction of aqueous humor and trabecular meshwork or canal of Schlemm even though there's adequate space for drainage; often inherited disease and is a leading cause of blindness with few preliminary symptoms. can lead to blindness if left untreated |
|
|
Term
|
Definition
only about 10% of cases; displacement of iris against the cornea obstruting outflow of aqueous humor from teh anterior chamber > IOP
sudden onset of severe eye pain, nausea, red steamy eye blurred vision |
|
|
Term
|
Definition
vision blurs; gradual opacification of the lens of the eye due to degeneration of lens protein
most commonly associated with aging
we replace lenses with artificial ones |
|
|
Term
|
Definition
sometimes brought on by trauma
can happen spontaneously too with age
internal wall begins to detach from teh back of the eye
may be due to a tear in the retina, fluid gets behind the lining and begins to buckle
will see a floater- curtain effect, flashing of light
risks include extreme myopia (light rays are focused in front of the retina when a person is focused on a distant object), diabetic retinopathy, sickle cell disease |
|
|
Term
| Risks for retinal detatchment |
|
Definition
| over age 40, males more than females, whites more than AA, individuals with significant myopia, family history of retinal detachment, hx of cataract surgery, eye injury. |
|
|
Term
| clinical findings of retinal detachment |
|
Definition
| floaters, flashes, curtain effect, potential for vision loss |
|
|
Term
| age related macular degeneration |
|
Definition
severe and irreversible loss of vision
begins centrally
risk from :hypertension, cigarette smoking, diabetes mellitus, family history, over age 60
atrophic (dry) or neovascular (wet) |
|
|
Term
| conductive hearing disorders |
|
Definition
outer and middle ear up to the tympanic membrane
conduction of sound. caused by impacted ceruen, otitis media, eustachian tube dysfunction- hearing loss is loudness |
|
|
Term
| sensorineural hearing loss |
|
Definition
| alteration in inner ear processing of sound due to impairment of organ of corti/connections. caused by congenital or hereditary factors, aging (presbycusis), ototoxic agents, maternal rubella. clinical findings are tinnitus, hearing loss for high frequency sounds |
|
|
Term
| alterations in neurologic functioning causes |
|
Definition
| infection, vascular problems, neoplasms (tumors), trauma, congenital problems, degenerative, polygenic, metabolic |
|
|
Term
| Neurologic Function bedside checks |
|
Definition
LOC
Motor responses
eye responses
vital signs |
|
|
Term
|
Definition
| ability to be present cognitively in an environement, wakefullness mediated by reticular activating system. assessed by orientation to time, place, person and self |
|
|
Term
|
Definition
| condition of deep sleep or unresponsiveness from which person may be aroused or caused to open eyes only by vigorous and repeated stimulation; responses is often withdrawal or grabbing at stimulus |
|
|
Term
|
Definition
| blink threat intact, normall doll's eye (vestibuloocular reflex), pupils equal, reflexes and motor movement symmetric |
|
|
Term
|
Definition
| blink threat asymmetric, gaze paresis, pupils asymmetric, reflexes and motor movement asymmetric |
|
|
Term
| Rancho Los Amigos Cognitive Scale |
|
Definition
well known in rehab to measure cognitive imporovement in individuals, especially with TBIs
higher stage=better |
|
|
Term
| non purposeful motor responses |
|
Definition
defensive
rudamintary response: shrug of shoulders to pain
posturing: decorticate or decerebrate response |
|
|
Term
|
Definition
|
|
Term
|
Definition
pronate all 4 extremeties
more serious injury
hands by butt, flexed out |
|
|
Term
| abnormal reflexive responses |
|
Definition
| sucking, snout reflex, babinski, yawning and hiccoughs, vomiting, nucchal rigidity |
|
|
Term
| what does asymmetric dilation of a pupil indicate? |
|
Definition
| intracranial pressure increase |
|
|
Term
|
Definition
difference between systolic and diastolic pressure
sign that intracranial pressure is beginning to rise |
|
|
Term
|
Definition
alternating periods of tachypnea (creascendo-decrescendo) p
increased paCo2-tachypnea-decrease pCo2-apnea-increase again
people very ill and in terminal stages
not necessarily associated with neuro damage but its the most common cause of it |
|
|
Term
|
Definition
Sudden, disorderly discharge firing of neurons associated with sudden, transient alteration in brain function
potential causes: cerebral lesions, biochemical disorders, cerebral trauma |
|
|
Term
|
Definition
Condition with no underlying
correctable cause hallmarked
by recurring seizure activity |
|
|
Term
| precipitating factors of seizures |
|
Definition
| hypoglycemia, lack of sleep, stress, fever, withdrawal from certain drugs, blinking, flashing lights, certain sounds or odors, pre/post menses |
|
|
Term
% increase in O2 consumption during seizure activity
may result in
Grand Mal may lead to |
|
Definition
60%
brain injury
respiratory arrest |
|
|
Term
|
Definition
begin locally, no complete loss of consciousness (simple, complex)
locally: an arm, hand, twitching of the eye
almost never see complete loss of consciouness |
|
|
Term
| grand mal seizures (tonic-clonic) |
|
Definition
| involves both hemispheres, associated with LOC, tonic-clonic activity, often go into deep sleep when seizure ends, loss of bladder control post-ictally |
|
|
Term
|
Definition
| usually in children, short dazed epidsodes, eye blinking |
|
|
Term
|
Definition
| prolonged seizure activity or rapidly repitious seizure activity, medial emergency, may lead to respiratory arrest, loosen anything tight, roll them on their side, pay attention to about how long seizure lasts, movement of eyes in a certain direction |
|
|
Term
|
Definition
infants 6mo-2yrs
15-19yo
elderly
inner city, low SES
males 2-3x>females |
|
|
Term
|
Definition
falls 28%
MVA 20%
Struck by...19% |
|
|
Term
|
Definition
low velocity impact
hairlie fracture
doesn't indicate brain tissue injury |
|
|
Term
|
Definition
in 3 out of every 4 TBIs secondary to MVAs
happens when people don't wear seatbelts |
|
|
Term
| depressed skull fractures |
|
Definition
| due to high velocity injury and usually requires elevation |
|
|
Term
|
Definition
| clear CSF leaking out the ear |
|
|
Term
|
Definition
CSF leaking out the nose
test with a diabetic glucose test strip |
|
|
Term
|
Definition
racoon eyes
halo ring
battle sign |
|
|
Term
|
Definition
bruising of brain tissue; frontal and temporal lobes are particularly vulnerable
associated with coma and some degree of lasting disability |
|
|
Term
|
Definition
arterial bleed between skull and dura mater
90% of time person have a concurrent skull fx
usually in temporal area
rapid bleed, surgical emergency
arterial bleed- really rapid |
|
|
Term
|
Definition
venous bleed below the dura mater
slow accumulation over 48 hours-2 weeks
expanding mass that displaces brain tissue
top part of cerebral areas usually 10-20% of TBI |
|
|
Term
|
Definition
bleeding in brain tissue
associated with contusions/missile injuries
typically frontal-temporal areas
2-3%
delayed may appear 2-10 days after head injury |
|
|
Term
|
Definition
shearing and stretching of axons due to violent movement of head and rotation of the brain within the skull.
degree is associated with length of coma and extent of diability
axons twist and tear |
|
|
Term
| chronic traumatic encephalopathy |
|
Definition
| characterized by extensive progressive atrophy of areas throughout the brain brought on by mulitple concussions over a period of time |
|
|
Term
| chronic traumatic encephalopathy |
|
Definition
| characterized by extensive progressive atrophy of areas throughout the brain brought on by mulitple concussions over a period of time |
|
|
Term
|
Definition
|
|
Term
|
Definition
| not being able to form memories after injury |
|
|
Term
|
Definition
| 30-40% stay in reduced stats of consciouness for prolonged periods of time (3-4 months) and the longer they stay in reduced states of consciouness the less likely they are to make a significant improvement in functional abilities |
|
|
Term
| minimally conscious state |
|
Definition
open eyes but they can’t focus, can’t track, will go back into coma and come out again
Families get very excited when they open their eyes- be careful not to discourage sense of hope but don’t let them think that something is happening that is not |
|
|
Term
|
Definition
| do not respond to anything, do not open eyes, may have some movement, may get a shrug or a pull away from noxious stimulus, don’t respond to sound |
|
|
Term
|
Definition
brain 80%
blood 10%
CSF 10%
only place for anything to move is through foramen magnum |
|
|
Term
|
Definition
exerted by CSF in ventricles
5-15 mmHg |
|
|
Term
|
Definition
| amount of blood in cranial vault at any given time |
|
|
Term
|
Definition
|
|
Term
| cerebral perfusion pressure |
|
Definition
pressure necessary to perfuse brain
normal 60-100mmHg |
|
|
Term
CPP=MAP-ICP
danger of increased ICP |
|
Definition
Cerebral blood flow=mean arterial pressure - intracranial pressure
reduced perfusion or cause herniation |
|
|
Term
|
Definition
| traumatic insult to spinal cord resulting in various sensory, motor, autonomic dysfunction depending on level of injury and type |
|
|
Term
|
Definition
Vehicular 41.3%
Falls 27.3% |
|
|
Term
|
Definition
|
|
Term
| spinal cord extends from? |
|
Definition
|
|
Term
|
Definition
sensory information
dorsal half of cord |
|
|
Term
|
Definition
| distributes motor info; located on ventral half of cord; |
|
|
Term
| mixed somatic spinal nerves |
|
Definition
31 pairs
have dorsal and ventral parts
fuse together to form spinal nerve |
|
|
Term
|
Definition
| help determine at what level an injury has occured and what function they will lose for muscles |
|
|
Term
|
Definition
skin or sensory innervation
important when you consider at what level an injury has occured and what function they will lose |
|
|
Term
| Most common areas for spinal cord injury |
|
Definition
| C1-2, C 4-7, T10-L-1; most mobile |
|
|
Term
|
Definition
| head flexed too far forward, stopped by chest |
|
|
Term
|
Definition
worse
tend to almost always be complete injuries
nothing to stop angle from widening |
|
|
Term
|
Definition
| usually from diving too shallow |
|
|
Term
|
Definition
| torque types of injuries, tearing muscle tissue and twisting spinal cord |
|
|
Term
|
Definition
loss of movement on one side and loss of sensation on the other side
more likely to occur with compression injury
outer part injured, middle part not |
|
|
Term
|
Definition
loss of movement and sensation in upper part of the body with incomplete loss of lower part of the body
hard to hold body up |
|
|
Term
| common associated problems with SPI |
|
Definition
| spinal shock, autonomic dysrefelxia (t6 and above level injuries), pain/spasticity, orthostatic hypertension, bradycardia, deep vein thrombosis, blower/bladder dysfunction, pressure ulcers |
|
|
Term
|
Definition
inflammation of spinal cord
flaccid paralysis below levl of injury
areflexia
absence of sensation
loss of bowel and bladder control
low blood pressure,
lasts 7-20 days |
|
|
Term
| autonomic dysreflexia (hyperreflexia) |
|
Definition
T6 and above injuries
begins with noxious stimulus which mobes up cord until it reaches the level of injury where it's blocked.
causes extreme elevation of BP, and mottle skin below the level of injury. Causes bradycardia, flushed skin, stuffy nose, severe headache, and diaphoresis |
|
|
Term
|
Definition
Syndrome characterized by gradual to
rapid non-convulsive onset of neurological deficits that are associated with a specific vascular area of more than 24 hrs. duration. |
|
|
Term
|
Definition
50% of all neuro problems
usually in patients over 65
familial tendency
males
southern black population with hypertension
heredity
age
gender
race
family history
hypertension
DM
atherosclerosis
atrial fib
hyperlipidemia
lipoprotein A
obesity
hyperhomocysteniemia
smoking
ETOH
inactivity |
|
|
Term
|
Definition
ischemic stroke that forms in direct acess to brain
carotid system
gradual occlusion
TIA "little strokes" w/ double vision, loss extremity, resolves
sleep |
|
|
Term
|
Definition
ischemic; breaks off from something else and travels to brain
plug lumen or shatter
second stroke usually follows
younger patients
awake and active
rapid onset
cardiac problems like A-fib; rapid resolution |
|
|
Term
|
Definition
spontaneous hemorrhage associated with arterial rupture
hypertension
headache/vomiting
LOC
poor prognosis with large amounts of blood |
|
|
Term
|
Definition
aneurysms
Arteriovenous malformations
blood escapes to CSF
severe headache
n/v
nucchal rigidity
over 50% mortality |
|
|
Term
|
Definition
small vessel disease
misdiagnosed as parkinsons |
|
|
Term
| genetic predispositions for aneurysms |
|
Definition
|
|
Term
|
Definition
visual field loss
still crosses
optic nerve defects
can vary in terms of vision loss
change around their room so they can see |
|
|
Term
|
Definition
broca's
word production
halting speech
comp intact
circumlocuting
frustrating |
|
|
Term
|
Definition
wernicke's
comp problem
fluent production of meaningless language
draw pictures |
|
|
Term
| Stroke on Left side of brain causes |
|
Definition
expressive or receptive aphasia
global aphasia
intellectual impairment
slow and cautious behavior
defects in right visual fields |
|
|
Term
| stroke on left side of brain can cause |
|
Definition
spactial perceptua deficit
denial and dficits of syndrome
distractable
impulsive
poor judgment
deficit in left visual field |
|
|
Term
|
Definition
Chronic, degenerative
disorder characterized by
profound, progressive
cognitive loss affecting:
Activities of Daily Living (ADL)
Behavior and Personality
Cognition |
|
|
Term
|
Definition
before age 65
3 genes on 21
genetic contributions clear
autosomal dominant |
|
|
Term
|
Definition
after 65
90% of cases
not understood
multifactorial disorder
APOE allele on CH19 |
|
|
Term
|
Definition
|
|
Term
|
Definition
transports lipids among CNS cells to uphold lipid homeostasis, repairing injured neuron, maintaining synaptic connections, scavenging toxins
APOE 4 has biggest effect out of 2,3 and 4 |
|
|
Term
| decreased risk for alzheimer's |
|
Definition
adequate folic acid intake
low sat fat consumption
high fruit/veggie
use of statins
light to mod ATOH consumption
education
cognitive engagement
physical activity |
|
|
Term
| Multiple Sclerosis and risks |
|
Definition
disorder in which myelin shealth is destroyed
remissions and exacerbations
chronic or progressive
onset 20-40
female
geographic away from equator
caucasian
started with virus-genetic susceptibility
destroys myelin sheath |
|
|
Term
| MS initial and worsening manifestations |
|
Definition
paresthesias, weakness, visual disturbances, urinary incontinence
increased body temp/serum calcium concentration |
|
|
Term
|
Definition
Degenerative disease of the basal ganglia involving dopaminergic neurons.
Associated with loss of dopamine and dopaminergic neurons |
|
|
Term
| Parkinson's risk factors and etiology |
|
Definition
40
males
genetic viral or environmental toxins |
|
|
Term
|
Definition
known cause
infection, trauma, drug intox, toxins |
|
|
Term
| Parkinson's pathophysiology |
|
Definition
degeneration of cells in substantia nigra
dopaminergic inhibitory cells cause cholinergic cells to become excessively active
help move smoothly |
|
|
Term
| Cardinal signs of parkinsons |
|
Definition
tremor, rigidity, bradykinesia, postural instability
dysarthia
dysphagia |
|
|
Term
| congenital problems and risk factors |
|
Definition
75% of fetal deaths and 40% of deaths in first year related to CNS malformations
most neural tube defects from no prenatal vitamins
maternal blood glucose
hereditary factors
anticonvulsant drug
maternal hyperthermia |
|
|
Term
|
Definition
vetebral arch fails to close
meninges or meninges and cord exposed to external environment |
|
|
Term
|
Definition
10-25% of births
80% are in lumbar
clincal findings: dimpling, hair growth, angioma, subcutaneous cyst
gait disturbances and sphincter problems |
|
|
Term
| Spina bifida cystica meningocele |
|
Definition
sac cyst
meninges and CSF protruding through vertebral defect
gait or bladder problems
often accompanied by hydrocephalus |
|
|
Term
| cystic fibrosis myelomeningocele |
|
Definition
sacklike cyst with meninges, SCF, cord, and spinal nerves
flaccid paralysis
loss of sensation
hydrocephalus
bowel and bladder dysfunction |
|
|
Term
|
Definition
increased CSF due to more production, block in flow, or problem in reabsorption by arachnoid villi
aqueduct stenosis |
|
|
Term
|
Definition
Acute, chronic, static
or progressive brain
disorders occurring
during gestation, the
birthing process, or
during childhood growth
and development |
|
|
Term
|
Definition
Encephalopathy consists of a group of non- progressive syndromes causing motor dysfunction in early infancy.
Common crippling disorder of childhood |
|
|
Term
| etiology of cerebral palsy |
|
Definition
prenatal: external or internal
perinatal: anoxia, infection trauma
postnatal: infection, metabolic disorder, trauma, toxin, vascular abnormalities |
|
|
Term
|
Definition
incresed muscle tone, rigidity, hyperactive DTR, scoliosis
65-70% |
|
|
Term
|
Definition
| gait disturbances, instability 5% |
|
|
Term
|
Definition
disturbances of fine motor movt. and purposeful movement; jerky, uncontrolled
accompanied by seizure disorders, intellectual impairment, visual impairment (20-25%) |
|
|
Term
|
Definition
defect amino acid metabolism
can't convert phenylaline to tryosine
deficiency of phenylalanine hydroxylase
abnormal CNS development
mental retardation
hyperactivity
seizures |
|
|
