Module 10 Part 1
What cranial Nerve is responsible for Pupil contriction?
Autonomic (You have no control over)
When finger is moving around the eye what cranial nerves are you testing for?
CN6 and CN4
What should happen to both eyes when light is only shined in one eye?
Both pupils should contract
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
What CN allows light in?
What CN reacts to light?
Allows light in: CN2
Reacts to light: CN3
What is Reticular Formation?
Network of nerve fibers
Reticular Activating System (RAS)
-Responds to all stimuli except smell
- Regulates Wakefullness & Attention
- Control autonomic nervous system= Cardovascular, respiratory & Reflex
Coma: What is it?
*State of altered arousal characterized by unresponsiveness, from which pt cannot be aroused & absence of voluntary movement*
-Bilateral cerbral hemisphere involvement or RAS dysfunction
- Structural (focal damage): tumor, abscess, hemorrhage, hematoma, concussion
- Non-Structural/metabolic factors(diffused damage): DKA(Respiratory rate high), hepatic encephalopathy, hypercalcemia, hypercapnia
Coma: Clinical Dx
Glasgow Coma Scale
Mechanism or injury= order CT/ MRI
Acute Confusion vs. Dementia
Dementia gets worse over time
~Not nl part of aging
-Progressive failure of cerebral functions
- Confusion, memory loss
-Loss of reason & judgement
R/O all other physical/ mental causes
Alzheimer's Disease: What is it?
*Progressive destruction of the brain*
Alzheimer's Disease: Causes
-Chromosome 21: Early Onset Familial AD (FAD)
-Chromosome 19: Genetic Late Onset AD
- Usually non-hereditary late onset 70-90%
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
Alzheimer's Disease: Tx
- Ach inhibitor (not cure)
Alzheimer's Disease: Prevention
Healthy aging, intelectual stimulation, social activity
Alzheimer's Disease: Testing
-Mental status exam
-R/O other causes
- Brain tissue shrinks
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
Huntington's Disease: Degeneration of what nerve cells?
- Decrease GABA neurons
- Decrease Dopamine receptors
Huntington's Disease: Genetics
Autosomal Dominant (Short arm chromosome 4)
Huntington's Disease: S/s
-Chorea (athetosis): Spasmotic involuntary movement
- Dementia: Attention deficites
-Problems w/: Speech, balance, swallowing
- Genetically passed down
What is affcted first in Huntingtons Disease:
Basal Ganglia: Starting and stopping of movement
Which mental disease presents Earliest?
** ON EXAM**
Huntington's Disease: Testing
- Increase CAB gene = increase risk for Huntington's
- Genetic testing
Urinary Tract Infection(UTI): Causes
- Pyelonephritis (From ureters to kidneys)
- increase in females, DM
Urinary Tract Infection(UTI): S/s
-Dysuria, frequency, urgency, fever, flank pain, N/V
Urinary Tract Infection(UTI): Testing
Hypoglycemia: What is it?
Low blood glucose level
Hepatic Failure: Test
-Increase NH3 toxin