Module 10 Part 1

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Altered Mental States
updated 2 years ago by mkeobounna
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1

What cranial Nerve is responsible for Pupil contriction?

CN 3

Autonomic (You have no control over)

2

When finger is moving around the eye what cranial nerves are you testing for?

CN6 and CN4

3

What should happen to both eyes when light is only shined in one eye?

Both pupils should contract

4

When finginger is moved towards and away face what happens to the pupils?

Looking at object near face pupils should constrict

Looking at object away from face pupils sould dilate

5

What CN allows light in?

What CN reacts to light?

Allows light in: CN2

Reacts to light: CN3

6

What is Reticular Formation?

Network of nerve fibers

7

Reticular Activating System (RAS)

-Responds to all stimuli except smell

- Regulates Wakefullness & Attention

- Control autonomic nervous system= Cardovascular, respiratory & Reflex

8

Coma: What is it?

*State of altered arousal characterized by unresponsiveness, from which pt cannot be aroused & absence of voluntary movement*

9

Coma: Mechanism

-Bilateral cerbral hemisphere involvement or RAS dysfunction

10

Coma: Cause

- Structural (focal damage): tumor, abscess, hemorrhage, hematoma, concussion

- Non-Structural/metabolic factors(diffused damage): DKA(Respiratory rate high), hepatic encephalopathy, hypercalcemia, hypercapnia

11

Coma: Clinical Dx

Glasgow Coma Scale

Mechanism or injury= order CT/ MRI

12

Acute Confusion vs. Dementia

**ON EXAM**

Dementia gets worse over time

13

Dementia: Causes

-Alzheimers

-Hunteringtons

~Not nl part of aging

14

Dementia: S/s

-Progressive failure of cerebral functions

- Confusion, memory loss

-Loss of reason & judgement

15

Dementia: Testing

CT/ MRI

R/O all other physical/ mental causes

16

Alzheimer's Disease: What is it?

*Progressive destruction of the brain*

17

Alzheimer's Disease: Causes

-Chromosome 21: Early Onset Familial AD (FAD)

-Chromosome 19: Genetic Late Onset AD

- Usually non-hereditary late onset 70-90%

18

Alzheimer's Disease: S/s

-Neuretic Plaques(MC cerebral cortex & hippocampus): Amyloid plaques(toxic amyloid beta protein), Neurofibrillary tangles(tau protein)

- Problem: Memory, judgement, behavior, reasoning,

- Decrease Ach level

19

Alzheimer's Disease: Tx

- Ach inhibitor (not cure)

20

Alzheimer's Disease: Prevention

Healthy aging, intelectual stimulation, social activity

21

Alzheimer's Disease: Testing

-Mental status exam

-CT/MRI

-R/O other causes

- Brain tissue shrinks

22

Huntington's Disease: What is it?

*Rare degenarative hyperkinetic movement disorder*

-progressive degeneration of nerve cells;

-Decrease GABA Neurons w/in basal ganglia

-Decrease Dopamine receptors in basal ganglia

23

Huntington's Disease: Degeneration of what nerve cells?

- Decrease GABA neurons

- Decrease Dopamine receptors

24

Huntington's Disease: Genetics

Autosomal Dominant (Short arm chromosome 4)

25

Huntington's Disease: S/s

-Chorea (athetosis): Spasmotic involuntary movement

- Dementia: Attention deficites

-Problems w/: Speech, balance, swallowing

- Genetically passed down

26

What is affcted first in Huntingtons Disease:

Basal Ganglia: Starting and stopping of movement

27

Which mental disease presents Earliest?

** ON EXAM**

Huntington's Disease

28

Huntington's Disease: Testing

- Increase CAB gene = increase risk for Huntington's

- CT/MRI

- Genetic testing

29

Urinary Tract Infection(UTI): Causes

- E.coli

- Pyelonephritis (From ureters to kidneys)

- increase in females, DM

30

Urinary Tract Infection(UTI): S/s

-Dysuria, frequency, urgency, fever, flank pain, N/V

-Hematura, Leukocytosis

31

Urinary Tract Infection(UTI): Testing

- UA

-Urine culture

32

Hypoglycemia: What is it?

Low blood glucose level

33

Hepatic Failure: Test

-Increase NH3 toxin