A&P Neurology Flashcards

bacterial meningitis
Terms Definitions
neur/o
nerve
-phasia
speechdysphasia-bad speech
Degenerative Myelopathy--prog
poor
Diagnosis: Hydrocephalus: Communicating Hydrocephalus
Diagnosis: Hydrocephalus: Communicating Hydrocephalus
 
source
brs pathology p.364
Hyperalgesia—increased pain sensation
(blank)
Tiagabine
Gabitril

GABA reuptake inhibitor
Epilepsy
Right Hemisphere
Spatial Ability
Face Recognition
Visual Imagery
Music Recognition & Appreciation
cerebr/o
braincerebritis, inflimation of brain
Cranial Nerve XII—Hypoglossal Nerve
(blank)
Neoplastic PNS
Nerve Sheath Tumor
Dendrites
Receive information from previous neuron
Prevalence of essential tremors increases with what?
Age
Diagnosis: Hydrocephalus: Hydrocephalus ex vacuo
Diagnosis: Hydrocephalus: Hydrocephalus ex vacuo
 
source
brs pathology p.363
remarkable, strange
märklig [²m'är:klig] märkligt märkliga
Movement of involuntary nature:
Basal ganglia
Cranial Nerves IX and X—Glossopharyngeal and Vagus Nerves
(blank)
Dysautonomia--def
idiopathic, widespread degeneration of the autonomic nervous system.
Immune-mediated PNS
Acute idiopathic polyradiculoneuritis (coonhound paralysis) and Acquired myasthenia gravis
Parentese
(universal style of infant-directed speech) exaggerates phoneme separation, helping infants to learn their native language.
Cranial Nerve I
Olfactory Nerve


Most rostral cranial nerve
Special sensory: smell
Meningitis
A pt presents with fever, nausea/vomitting, headache and a petechial rash, what would you suspect?
Name the stroke:..Contralateral Homonymous Hemianopsia (usually upper quadrant)..MILD CONTRAlateral weakness and sensory loss...COLOR anomia.(post. aspect of Corpus Callosum)...Memory Loss.(severe is bilateral blood flow loss)
PCA.(posterior cerebral artery)
lethargy
client opens eyes, answers question, then falls back to sleep.
any surgery involving the nervous system
neurosurgery
Midbrain
contains many motor neurons and tracts
Compression--tx
Conservative management - indicated in animals w/ mild neuro. deficits and stable, minimally displaced fractures/lux. or in cases where sx is not an option for the owner. 4-6 wks of cage rest. External support w/ splint
Botulism--def
Intoxication w/ neurotoxin produced by Clostridium botulinum. 8 types of ag bot. toxin = A, B, Ca, Cb, D, E, F, G. Dogs = by C. Large animals = by B, C, or D.
Concussion--prog
similar to that given for intervertebral disc d'se although dogs w. absent deep pain perception rarely recover after trauma.
Concussion--tx
Manage life threatening inj. (shock, card., lungs, abd. head). Immobilize patient to prevent further displacement of any unstable spinal injuries (ambl. animals in small cage, nonambl. strapped to a board.) Medical tx Methylprednisilone sodium succinate (Solu Medrol or Solu-Delta-Cortef) prednisolone s.s. ASAP w/in 6 hours of injury, 2 hrs. later hit w/ another dose or CRI, treat for 34-48 hours, benefit vs. risk (GI hem.) Other glucocorticoids such as dex. are NOT NOT NOT indicated. DMSO and other med. txs have been supported but not really evaluated.
Tick Paralysis--def
rapidly progressing paralysis caused by several species of ticks
Dysthymia
Low-grade depression lasting 2 years of more.
Carbidopa
prevents the peripheral conversion of L-dopa to dopamine and thus reduces the incidence of peripheral dopaminergic side effects (nausea, vomiting, hypertension).
Temporal Lobe
Auditory, emotions, learning, sense of smell
 
Primary Auditory: Detection of sound quality
Auditory Association: Processes auditory imformation
A common term for various conditions of head and neck dystonia.
Torticollis
Disease of the nervous system w/ disturbance in the fxn of a nerve or group of nerves.
Neuropathy
Autonomic
What type of symptoms would someone have if they experienced vomitting, sweating, piloerection and pupil dilation during a seizure?
Name the stroke:..Bilateral extremity motor and sensory loss..quadraplegia in severe cases..crossed motor and sensory findings..eg:.Right Face and Left Arm..Horners syndrome..cerebellar signs..stupor and coma..pharyngeal weakness, jaw weakness, DEAFNESS
Brain Stem Stroke
occipital
influences the ability to read with understanding primary visual receptor center
Axon has what?
Action potential (nerve impulse) begins near the axon hillock, travels along the length of the axon towards the synaptic terminalArival activats the synaps
PNS
peripheral nervous system 12 pairs of cranial nerves, and 31 spinal nerves
a diagnostic sign for meningitits marked by the person's inability to extend the leg completely when the thigh is flexed upon the abdomen and the person is sitting or lying down
Kernig's sign
the uppermost part of the brain stem
midbrain
Nystagmus
is a backandforth oscillation of the eyes. Endpoint nystagmus, a few beats of horizontal nystagmus at extreme lateral gaze, occurs normally. Assess any other nystagmus carefully, noting:
Vertebral infections--prog
depends on ability to identify causative organism. Guarded for dogs with marked spinal cord compression.
Concussion--def
result of dynamic forces applied to the spinal cord. usu. assoc. w/ disruption of the spine
Acute idiopathic polyradiculoneuritis (coonhound paralysis)--path
inflammation, demyelination, and varying degrees of axon degeneration in the ventral nerve roots and peripheral nn.
Bacterial Meningitis--def
Meningitis = inflammation of the meninges
Extradural--def
primary tumors of the vertebrae - (osteogenic sarcoma, fibrosarcoma, hemanigiosarcoma, multiple myeloma); lymphoma; metastatic
Compression--cs
Signs of other injuries may be present. neuro. deficits depend on location and severity of the lesion. Focal hyperesthesia is expected in acute inj.
Hansen type II
fibrous degeneration, older dogs, chronic protrusions
Botulism--path
Usu. Due to ingestion of preformed toxin, often in carrion that has contaminated the feed. Also present in decaying vegetation (rotting hay or silgae).
Tellegen's model (3 things)
Positive affectivity, negative affectivity, and constraint.
Absence seizures
Seizures that occur in developmentally normal children, Childhood absence Epilepsy (CAE) or Juvenile Absence Epilepsy (JAE).
Treatment of RLS
Levodopa and dopaminergic agents, Pramipexole and ropinirole, and iron replacement. AEDs are second line (gabapentin and carbamazepine). If ineffective try benzos or opiates.
contra-coup injury
brain focal contusion brusing area not the same as impact area
Drugs of abuse all activate the reward system of the brain via increasing _______ transmission.
Dopamine
Receptive Aphasia
A sensory problem where written or spoken words are not properly understood?
Staging
Autonomic extent of a tumor, how big it is and where it is located.
To test cranial nerve 1, the nurse would assess the client's ability to ?
smell
HOW MANY PAIRS OF NERVE FIBERS EXIT THE SPINAL CORD?
THIRTY-ONE
resting membrane potential
net negative charge of a neuron.
2 processes cause arenchymal change with stroke
1) ischemia
2) hemorrhage
thin outer layer of nerve tissue, known as gray matter, that covers the surface of the cerebrum
cerebral cortex
Sensory function
Superficial pain and light touch, arms and legs, Vibration, arms and legs
What's in the gray matter?
neuronal cell bodies--contains everything for reflexes--on the inside
Block vertebrae
partial or complete fusion of two adjacent vertebrae--no clinical significance--can predispose cranial and caudal disc spaces to excessive stresses predisposing them to extrusion
Feline Hypokalemic Polymyopathy--def
metabolic myopathy due to chronic depletion of total body potassium. Combination of low dietary intake of potassium and increased urinary potassium loss over a period of months may lead to depletion of body stores
Tick Paralysis--Prog
good and recovery occurs w/in 1-2 days. Exception is in Australia w/ intoxication due to Ixodes holocyclus. A hyperimmune serum is available for tx. Prog = guarded as death from resp. paralysis may occur despite tx.
Dermoid Sinus
invagination of skin over the spine extending partially or completely to the dura; failure of separation of the neural groove from the epidermis
Kyurenic acid
Product of metabolism of tryptophan. Has neuroactive activity.
Two types of learning
Associative (with pairing) and non-associative (no pairing: Habituation, Sensitization, Observational learning (modeling))
Leaky K+ Channels
Potassium (K+) can cross membrane with ease
Dopamine depletion results in ____ and dopamine excess results in _____.
Parkinsonism. Chorea.
What is the peak age of onset of ALS?
50-70s
Motor Cortex
Which part of the brain deals with conscious movements of muscles, fine motor control of movement of different body parts (face, mouth, hands, etc.)?
seizures
What would you be worried about with a patient with a subarachnoid hematoma?
Generalized Seizures
What type of seizure starts deep in the brain and then spreads to all areas of the brain?
Arachnoid mater
Which layer of the dura do Meningiomas arise from?
Normal reflex responses are indicated by what numbers?
1+, 2+, or 3+
Action potentials
opening and closing of gated Na+ and K+ channels in response to a gated potential
Risk factors for CVA
older adult= doubles q.year after 55
male sex
history of TIA
hypertension
smoking
HX of cardiovascular disease
diabetes mellitus
African American
A lesion that involves loss of pain and temp on the R of the body and dilation of the pupil with the L eye down and turned outward. There is also ptosis of the eyelid. Where is the lesion located?
L midbrain
rigidity of the neck; the neck is resistent to flexion. the condition is seen in patients with meningitis
nuchal rigidity
Upper motor neurons
Complex of all the descending motor fibers that can influence or modify the lower motor neurons, Located completely within the CNS
Compression--prog
not based on RDX, but rather on neuro status.
Fibrocartilagenous Embolism (FCE)-prog
dogs w/ intact pain perception often have substantial improvement w/in 2 wks. Prog. Is poor for dogs w/ absent pain perception.
X-linked Muscular Dystrophy of Dogs and Cats--incidence
Golden retrievers, rottweilers, samoyeds, irish terriers and DSH cats.
Aortic Thromboembolism (Saddle Thrombus)--def
Obstruction at the distal aortic trifurcation, usu. Caused by a cardiogenic embolism. Much less common sites of emobolization include the brachial and intracranial arteries.
What are the spinal cord segments?
Cervical: C1-C5; Cervicothoracic: C6-T2; Thoracolumbar: T3-L3; Lumbosacral: L4-S3
Delusional disorder age of onset
30-50 (is unrelated to schizophrenia)
Transitional treatment for cluster headache
Prednisone, ergotamine tartrate, DHE 45, occipital nerve block
Lab findings for CJD
Lumbar function has cellular proteins 14-3-3 (reflecting brain tissue destruction), triphasic sharp waves on EEG, high signal changes bilaterally in putamen and caudate head., pulvinar and dorsomedial nucleus hyperintensities give “hockey stick” appearanc
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What med. is used to tx alcohol abuse and help reduce relapse?
Naltrexone (Revia)
Clinical findings in brain abscess in frontal lobe?
Drowsiness, inattentiveness, disturbed judgement, grasp/suck reflex
CN 3 - oculomotor
Which cranial nerve deals with pupil size?
Complex partial seizures
What type of seizures begin as simple partial seizures and progress to impairment of consciousness?
With regard to a Subarachnoid Bleed what beside the bleed itself can cause damage?
The VASOSPASMS...Secondary Vasospasms can commonly cause additional deterioration and these symptoms occure more slowly.
What is the definition of a TIA?
·"Silent" stroke·precedes other strokes·Reversible Ischemic Neurologic Deficit (RIND)·Transient focal dysfunction d/t brief interruption of blood flow, e.g., spasms·TIA and RIND differ in duration
WHAT IS THE CEREBRUM?
THE LARGEST PART OF THE BRAIN, CONSISTING OF TWO HEMISPHERES. THE CEREBRUM IS THE SEAT OF CONSCIOUSNESS AND THE CENTER OF THE HIGHER MENTAL FUNCTIONS SUCH AS MEMORY, LEARNING, REASONING, JUDGEMENT, INTELLIGENCE AND THE EMOTIONS.
Glossopharyngeal
cranial nerve IX

sensory and motor
(s) sensory fibers for taste on the posterior third of the tongue and sensory fibers of the pharynx that result in the gag reflex when stimulated.
(m)provides secretory fibers to the parotid salivary glands: promotes swallowing movements.
Diff dx problems w/ GBS-
-distinguish GBS from acute spinal cord ds marked by sensorimotor paralysis
-acute lesion of cord where DTR in intially lost
-early transient urinary retention
-cervical myelopathy
a deep groove in the middle of the cerebrum that divides the cerebrum into the right and left hemispheres
longitudinal fissure
Degenerative Lumbosacral stenosis-path
degneration of (Type II) of the L7-S1 IV disc; disc protrusion compressing the cauda equina; collapse of the disc space leading to narrowing of the intervertebral foramen and nerve root compression; thickening and infolding of the interacrcurate ligament compressing the cauda equina
Sciatic Nerve Injury--CS
hock and digits cannot flex or extend and weight is supported on the dorsal surface of the foot with the hock excessively flexed. Anesthesia may be present below the stifle except for the medial aspect (femoral n.). Injury to tibial n. causes inability to extend the hock or flex the digits and reduced sensation over the plantar surface of the foot. Damage to peroneal n. = inability to flex the hock or extend the digits and decreased sensation over the crdor. surface of the foot, hock and stifle.
7 psychiatric conditions that increase risk of suicide
Depression, substance abuse, anorexia nervosa, schizophrenia, borderline personality disorder, and panic disorder.
What are the functional divisions of the nervous system?
Voluntary (somatic) and Autonomic
4 surgeries to relieve cluster headaches
Sensory trigeminal pathway procedures (Radiofrequency or glycerol rhizotomy, Gamma knife, radiosurgery, trigeminal root section), autonomic (parasymp.) pathway procedures, hypothalamic stimulation, or occipital nerve stimulation (deep brain).
Group Ib therapy for acute migraines
Substantial empirical evidence of clinical benefit in restricted populations. Aspirin. (Excedrin) Aspirin, acetaminophen plus caffeine.
Which has a better prognosis, the relapsing or progressive form of MS?
Relapsing has a better prognosis
Hydrocephalus
 
 
*Will have demetia like symptoms
What will develop in the brain after a stroke if the CSF circulation is not working correctly?
Cell count: mostly lymphocytes
Glucose: <2/3
What are the common CSF readings for mycobacterial meningitis:Cell count? Glucose?
the cranial nerve examination provides information concerning?
the transmission of motor and sensory messages primarily to the head and neck.
WHAT IS A TOXIC METABOLIC STATE?
INVOLVE EITHER THE PRESENCE OF CIRCULATING TOXINS OR METABOLITES OR THE LACK OF METABOLIC SUBSTRATES (O2, GLUCOSE, THIAMINE). THESE STATES PRODUCE DIFFUSE DEPRESSION OF BOTH SIDES OF THE CEREBRUM WITH OR WITHOUT DEPRESSION OF THE BRINSTEM.
When is a neuro-check useful?
in an emergency or when frequent assessments are needed during the acute phase of illness, or when a client has already had a complete neurological test.
Feline Hypokalemic Polymyopathy--dx
Serum K+ <3.5 mEq/L . CK increased 500-10000 IU/L. Creatinine increased (2.5-5 mg/dL), mild to moderate metabolic acidosis. USPG may be low and excretion of K+ is increased.
5 DSM-IV exclusion criteria for schizophrenia
Major depressive disorder, bipolar I disorder, schizoaffective disorder, general medical causes, or drug intoxications.
Alzheimers pathology begins in the...
Entorhinal cortex and spreads to the hippocampus.
Name 5 poor prognostic factors for GBS.
1)Older age 2)Rapid onset (
A Subarachnoid hemorrhage
If you are doing a lumbar tap and all of 4 of the tubes of CSF you pull out are full of blood what can be diagnosed?
If a client scores less than a 7 on the Glasgow Coma Scale the client is considered to be ?
in a coma
HOW LONG IS THE SPINAL CORD?
17-18 INCHES LONG IN THE AVERAGE ADULT. STARTS AT THE FORAMEN MAGNUM AND ENDS NEAR THE LEVEL OF THE FIRST LUMBAR VERTEBRA.
Cranial nerve VII
Facial

sensory and motor
(s) contains sensory fibers for taste on the anterior two thirds of tongue and stimulates secretions from salivary glands and tears from the lacrimal gland
(m)supplies the facial muscles and affects facial expressions=smiling, frowning, closing eyes
Thoracolumbar disk signs in order
1. pain 2. kyphosis 3. paraparesis 4. paraplegia 5. descending-ascending myelomalacia
Differentials for a paraparetic cat:
1. saddle thrombus 2. spinal tumor 3. spinal lymphoma 4. FIP 5. other infectious causes of myelitis such as toxoplasmosis
4 elevated enzymes in someone with anorexia nervosa
SGOT, LDG, alkaline phosphatase and amylase.
4 symptoms of large fiber neuropathy
Loss of vibration and joint position sense,
weakness,
denervation with fasciculations, and
loss of deep tendon reflexes.
What is the etiology of normal pressure hydrocephalus?
Impaired absorption of CSF (SAH, or acute/chronic meningitis)
Describe a MCA stroke that involves the upper division and spares the diencephalon...
Weakness and Sensory loss is MOST pronounced in the FACE and UPPER extremities.
What is the synaptic cleft?
is the space between the pre and post synaptic neuron
How is a complete neurological exam performed?
from the level of higher cerebral integration to the level of lower level of reflex activity.
What is the pathway when you check the patellar reflex?
tap the patellar ligament-->stretches the mm spindles of the quadriceps mm-->sensory fibers ascend via the femoral nerve and dorsal roots to synapse on LMN located in L4-6-->motor fibers exit via the ventral roots and are carried by the femoral nerve to the quadriceps
What is the receptive region
The area of the dendrites of a neuron that recieves stimulus via neurotransmitters.
MC organisms to cause nosocomial meningitis? If ventricular shunt placement?
Klebsiella or E. coli (gram -). S. aureus.
Ringing in the ears or hearing loss could indicate??
a dysfunction of cranial nerve VIII (acoustic).
Reduction in what CSF protein is found in RLS?
Ferritin (even though serum iron is normal)
Uncal herniation is life threatening. What is it?
Cause by a shift of one or both areas of the temporal lobe, known as the uncus. This shift creates pressure on the 3rd cranial nerve and result in dilated and nonreactive pupil, ptosis, and a reapid < LOC.
Name the 4 clinical findings required for El Escorial criteria.
1)LMN in at least 2 limbs 2)UMN in at least 1 region 3)EMG finding of fibrillation potentials for evidence of LMN involvement 4)Exclusion of ddx by electro, neuroimaging, and lab
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