Ms final hard topics
Terms in this set (9)
amyotrophic lateral sclerosis (ALS)
a degenerative disease of the central nervous system causing loss of muscle control
Too much glutamate (motor nerve to
motor nerve NT) damages only MOTOR neurons.
Muscle spasticity → weak → paralysis
Hallmark sympt Excess saliva production.
Ultamatly will require vent support and will prob die from resp infection
a chronic progressive nervous disorder involving inflammatory destruction of myelin sheath around certain nerve fibers
- ocular (diplopia, nystagmus)
- cerebrum (sensory/motor impairment, cognitive decline late ssx)
Characterized by exacerbation and remission. Exacerbation may be precipitated by stress.
The inability to control the range of a movement and the force of muscular activity (eg hard to stop movement, knock cup over)
Chronic neuromuscular autoimmune dz with decreased ACh receptor number, function, and or amount
of ACh released at neuromuscular junction. Impaired neuro-muscular function.
- descending weakness
- weakness that worsens with exertion and improves with rest
- Oral and facial involvement (asp risk, face may look like snarl, ptosis and diplopia)
Dx with Tensilon Test (+ is pt has improved strength to cholinesterase inhibitor given IV
- corticosteroids and immunosuppressants to manage inflammation
- anti cholinesterase
DDX Myasthenic crisis (undermed) and Cholinergic crisis (overmed) with Tensilon Test
Anticholinergic Medication used to manage cholinergic crisis
Autoimmune (humoral and cell mediated) segmental demyelination of nervous system, usually precipitated by GI or resp virus a few weeks prior to onsite. This causes impaired conduction of nerve impulses (ascending weakness and sensory loss -> severe pain and parasthesia)
May also trigger autonomic dysreflexia (vagal deficit impairing parasympathetic stimulation resulting in labile BP and HR).
- Morphine or baclofen to manage pain
- Always prepared to intubate/trach. Goal is to do planned, but keep tray at bedside
EMERGENT - involves uncontrolled activation of autonomic neurons resulting in extreme HTN and may lead to hemorrhagic stroke if not addressed. HOB UP. Remove stimuli frequently impaction or full bladder. HTN MEDS
loss of substantia nigra (dopamine producing/storage region) causing a deficit of DA (smooths muscle contractions) and impairment of extrapyramidal tracts and subsequent loss of movement coordination. Basal ganglia produce Ach (excitatory) which is fine.
Onset is usually mild and unilateral but progresses bilaterally.
- resting tremors
- pill rolling
- shuffle gait
- difficulty swallowing
- mask face
- Levodopa (dopamine agonist) ideally give before pt prev dose starts to wear off and mobility becomes issue. AF: Confusion, AVH, night terrors -> drug holiday
- MOAI B Selegine
Progressive fatal degeneration of the brain from buildup of plaque and tangles that ultimately results in dementia.
Risk factors: smoking, HTN DM old AA
Early: anxious forgetful resistant to change
Middle: loss of independence and behavior change
Late: major behavior change, paranoia rage (goal is to keep safe an don't worry about orientation)