NURT 3336 1st Edition Exam # 3 Study Guide Neurological Pathways Study Guide Study Guide - Neurological Diseases Nervous System- A complex collection of nerves and specialized cells known as neurons that transmit signals within the body- Essentially the body’s electrical wiring- Two divisions- Central Nervous System- Contains the brain, spinal cord, and associated nerves- Major function is to process sensory information after the appropriate responsive motor signal is generated- Peripheral Nervous system- Contains sensory neurons, Ganglia, and nerves that connect to oneanother and to the CNS- Major function is to conduct the transmission of impulses between the CNS and peripheral organsNeurological Disorder - Epilepsy - a condition characterized by recurrent seizures - defined as more than 2 unprovoked seizures - Epidemiology- > 3 million americans have Epilepsy - worldwide- 1% - 10% of this population will experience a seizure in their lifetime - Etiology - common causes - Head trauma, CNS infection/tumor, drug and alcohol abuse, and CVD (cerebrovascular disease) - No known defect - Pathophysiology - period of electrical discharge can range from few seconds to several minutes - duration > 5 min, heavy sedation medication required - important to know difference between seizures and epilepsy - seizures result from: - fever, metabolic/electrolyte abnormality (hypo-/hyperglycemia) - Clinical Manifestation- General Seizures - signs: staring, muscle jerking, twitching, head drops, falls and/or loss of consciousness - Absence - used to be called Petit-Mal- symptom: when a person stares without response - Tonic-clonic- used to be called Grand-Mal- mixture of symptoms- Partial Seizures - simple- involves entire brain- patient aware of surrounding and have recollection of what happened - complex - involves 1 section/lobe of brain- patient not aware of surrounding - blank stare have meaningless motion like climbing, drooling, and lip smacking Stroke & Aneurysm - defined as an interruption of brain function due to blockage/ interruption of blood flow to brain - considered as a cardiovascular accident (CVA)- Types - Ischemic Stroke - when an artery supplying blood to the brain is obstructed - Hemorrhagic Stroke - similar to aneurysm - when a brain vessel breaks in the brain Transient Ischemic Attacks (TIAs)● aka “mini-strokes” ● episode of ischemia where blood flow is quickly restored and symptoms resolve within 24 hours● HOWEVER if symptoms persist for more than 24 hours then it would go from a TIA into a CVARisk Factors Non-Modifiable ● Age, Gender, Ethnicity, and Genetic ● Age has the strongest association with stroke risk, doubling, for each decade after 55 years oldModifiable ● Presence of Hypertension, Cardiovascular Disease, Diabetes, Physical Activity, Obesity, Cigarette Smoking, Alcohol & Drug Use, Diet, and Oral Care● Cigarette Smoking DOUBLES the risk of Ischemic StrokeAneurysm ● the dilation and bulging of smooth muscle usually found at the points where cerebral arteries divide or split (bifurcation). ● if an Aneurysm that ruptures that becomes a Hemorrhagic Stroke. Risk Factors ● Cigarette Smoking and Alcohol IngestionEpidemiology of Strokes & Aneurysm ● 3rd leading cause of death in the United States ● Women and African-Americans are the most at risk in the USClinical Manifestation of Strokes & Aneurysm ● loss of vision or speech● paralysis of muscle weakness ● coma● changes in memoryParkinson’s Disease● first described in 1817 in James Parkinson’s publication, “Essay of the Shaking Palsy”● a neuromuscular, neurodegenerative disease caused by the loss of dopamine-producing cells in the substantia nigra portion of the brain- Epidemiology ● one of the most common neurological disorders, affecting approximately 1% of the United States and Canada over the age of 70● however, it is least present in Asian and African American populations● chances of Parkinson’s Disease increase with age and it is rarely diagnosed before the age of 40● more commonly diagnosed in men- Etiology ● genetics● environmental toxins● prions (protein malformations)● oxidative stress● imbalance of neurotransmitters● mitochondrial dysfunction● loss of dopamine-producing cells ● abnormal inflammatory response● improper response of dopamine within the brain● increased rate of cell death - Pathophysiology ● The neurons within the substantia nigraproduces the neurotransmitter dopamine.● A balance of dopamine and GABA(γ-aminobutyric acid) within the brain that usually would maintain slow, coordinated movements, muscle tone, and posture.● In parkinson’s disease, there is a progressive loss of dopamine. This causes an imbalance of neurotransmitters.● These issues can lead to a great number of symptoms.- Clinical Manifestation● resting tremor, shaking when people are at rest● rigidity in arms, legs, fingers, and toes● bradykinesia, slowed movement● akinesia, loss of movement ● postural instability● mask-like facial features ● shuffling gait, walking unsteady manner ● depression, anxiety, sleep disturbances, sensory abnormalities, pain, cognitive dysfunction Guillain-Barré - An acute peripheral nervous system disease characterized by progressive paralysis. - Etiology- An autoimmune response to an infectious trigger- of patients report a history of infection in the time before the onset of ⅔GBS - Pathophysiology- onset of GBS occurs either in a couple of hours or 3-4 weeks after the preceding infection- Some variants: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy (AMSAN), and Miller Fisher syndrome- Autoantibodies attack specific cells of the nervous system - Clinical Manifestation- Paralysis (can involve all limbs)- Severe Dysphagia and Respiratory Failure- 30% of patients require mechanical ventilationMultiple Sclerosis - A disease with a destruction of the myelin sheath and the formation of scar tissueresulting in the distortion of nerve impulses - Etiology - Unknown- Related to: Genetics, Autoimmune Factors, Infectious Factors, and Environmental Factors - Pathophysiology- Destruction of the myelin sheath (demyelination) occurs- Axons may be damaged as well- If both are damaged communication between the neurons can be reducedor lost - Clinical Manifestation- Numbness- Tingling- Uncoordination-