Podcast
Questions and Answers
Which of the following best describes the role of the autonomic nervous system?
Which of the following best describes the role of the autonomic nervous system?
- Manages automatic functions like breathing and heart rate. (correct)
- Relays sensory information from the skin to the brain.
- Controls voluntary movements, such as walking and writing.
- Mediates conscious control over skeletal muscles.
How is Alzheimer's disease primarily characterized in terms of brain pathology?
How is Alzheimer's disease primarily characterized in terms of brain pathology?
- By the formation of amyloid plaques and neurofibrillary tangles. (correct)
- By a decrease in dopamine production.
- By demyelination of nerve fibers.
- By inflammation of the meninges.
In the context of neurological disorders, what is meant by 'dementia'?
In the context of neurological disorders, what is meant by 'dementia'?
- An umbrella term for loss of memory and cognitive abilities. (correct)
- A sudden, temporary state of confusion.
- A specific disease that causes memory loss.
- A rare genetic condition affecting motor skills.
How does Huntington's disease primarily affect movement?
How does Huntington's disease primarily affect movement?
If a patient exhibits bradykinesia and rigidity, which neurotransmitter deficiency is most likely the cause?
If a patient exhibits bradykinesia and rigidity, which neurotransmitter deficiency is most likely the cause?
What is the primary pathological process in multiple sclerosis (MS)?
What is the primary pathological process in multiple sclerosis (MS)?
Which of the following is a characteristic early symptom of Myasthenia Gravis (MG)?
Which of the following is a characteristic early symptom of Myasthenia Gravis (MG)?
What is the underlying mechanism of muscle weakness in Myasthenia Gravis?
What is the underlying mechanism of muscle weakness in Myasthenia Gravis?
Which condition is characterized by an ascending pattern of muscle weakness and areflexia?
Which condition is characterized by an ascending pattern of muscle weakness and areflexia?
What is a key diagnostic feature of Guillain-Barré Syndrome (GBS)?
What is a key diagnostic feature of Guillain-Barré Syndrome (GBS)?
Which of the following is a key characteristic of Amyotrophic Lateral Sclerosis (ALS)?
Which of the following is a key characteristic of Amyotrophic Lateral Sclerosis (ALS)?
What is the primary clinical manifestation of amyotrophic lateral sclerosis (ALS)?
What is the primary clinical manifestation of amyotrophic lateral sclerosis (ALS)?
What distinguishes episodic tension- type headaches (TTH) from chronic migraines?
What distinguishes episodic tension- type headaches (TTH) from chronic migraines?
What is the primary area of the nervous system affected by Parkinson's disease?
What is the primary area of the nervous system affected by Parkinson's disease?
Which statement best describes the nature of irreversible dementia?
Which statement best describes the nature of irreversible dementia?
What is the significance of Lewy bodies in the context of dementia and Parkinson's disease?
What is the significance of Lewy bodies in the context of dementia and Parkinson's disease?
In assessing a patient for headaches, why is it important to inquire about associated symptoms like nausea and vomiting?
In assessing a patient for headaches, why is it important to inquire about associated symptoms like nausea and vomiting?
What does Uhthoff's phenomenon, often seen in multiple sclerosis, refer to?
What does Uhthoff's phenomenon, often seen in multiple sclerosis, refer to?
A patient with Parkinson's disease is experiencing significant difficulty initiating movements. Which area of the brain is most likely affected, leading to this symptom?
A patient with Parkinson's disease is experiencing significant difficulty initiating movements. Which area of the brain is most likely affected, leading to this symptom?
A patient presents with a sudden onset of ascending muscle weakness accompanied by areflexia. What autoimmune disorder of the peripheral nervous system is most likely?
A patient presents with a sudden onset of ascending muscle weakness accompanied by areflexia. What autoimmune disorder of the peripheral nervous system is most likely?
In a patient with known Alzheimer's disease, what functional assessment findings would indicate progression from the early to moderate stage?
In a patient with known Alzheimer's disease, what functional assessment findings would indicate progression from the early to moderate stage?
What differentiates familial ALS from sporadic ALS?
What differentiates familial ALS from sporadic ALS?
What are some of the modifiable risk factors for dementia?
What are some of the modifiable risk factors for dementia?
Which diagnostic test is most useful in confirming the presence of MS plaques and monitoring disease progression?
Which diagnostic test is most useful in confirming the presence of MS plaques and monitoring disease progression?
Which of the following statements regarding headache classification is correct?
Which of the following statements regarding headache classification is correct?
What is thought to be the underlying issue in patients with Mysathenia Gravis relating to signals to the muscles?
What is thought to be the underlying issue in patients with Mysathenia Gravis relating to signals to the muscles?
Which cranial nerves are typically included in a Myasthenia Gravis evaluation?
Which cranial nerves are typically included in a Myasthenia Gravis evaluation?
Which statement is true in relation to Myasthenic Crisis?
Which statement is true in relation to Myasthenic Crisis?
What is a key consideration when providing medication for patients with GBS?
What is a key consideration when providing medication for patients with GBS?
What preceeding common issue could you see before presentation of GBS?
What preceeding common issue could you see before presentation of GBS?
If you assessed a patient with GBS and they have diplegia and dysphagia, where is the GBS affecting?
If you assessed a patient with GBS and they have diplegia and dysphagia, where is the GBS affecting?
A client that comes in with loss of dexterity and gait, and a decline in reflexes, what is a possible neurological condition?
A client that comes in with loss of dexterity and gait, and a decline in reflexes, what is a possible neurological condition?
What is the most common initial onset symptom when a patient begins having ALS type symptoms?
What is the most common initial onset symptom when a patient begins having ALS type symptoms?
What are some symptoms that do NOT fall under motor symptoms?
What are some symptoms that do NOT fall under motor symptoms?
What is critical in ensuring the accuracy of assessing for migraines?
What is critical in ensuring the accuracy of assessing for migraines?
Which of the following is an example of subjective data collected during the assessment of neurological conditions?
Which of the following is an example of subjective data collected during the assessment of neurological conditions?
Which modifiable lifestyle factor has the greatest impact on an Alzheimer’s prevention plan?
Which modifiable lifestyle factor has the greatest impact on an Alzheimer’s prevention plan?
A patient with known Parkinson’s Disease is assessed to be at a Stage 3 with movements classified as moderate along with balance. What does this translate to for the patient?
A patient with known Parkinson’s Disease is assessed to be at a Stage 3 with movements classified as moderate along with balance. What does this translate to for the patient?
A patient comes in stating that when they tilt their head down that they hear an electric shock sensation. Which of the following could this be?
A patient comes in stating that when they tilt their head down that they hear an electric shock sensation. Which of the following could this be?
What area is key for sensation perception, and information processing?
What area is key for sensation perception, and information processing?
What chemical messengar is lost in Alzheimers that plays an important role?
What chemical messengar is lost in Alzheimers that plays an important role?
If a patient comes in with trouble hearing, having low understanding of others, and have hearing loss from younger age, what issue could be the underlying issue that would be a modifiable risk factor to dementia?
If a patient comes in with trouble hearing, having low understanding of others, and have hearing loss from younger age, what issue could be the underlying issue that would be a modifiable risk factor to dementia?
During an Alzheimer's examination, why is it important to explain to the provider in charge what you hope to gain during the testing phase?
During an Alzheimer's examination, why is it important to explain to the provider in charge what you hope to gain during the testing phase?
Why is the distinction between 'forgetfulness' and 'dementia' clinically significant?
Why is the distinction between 'forgetfulness' and 'dementia' clinically significant?
How does the presence of Lewy bodies contribute to the pathology observed in Lewy Body Dementia?
How does the presence of Lewy bodies contribute to the pathology observed in Lewy Body Dementia?
How do genetic mutations contribute to the pathophysiology of Huntington's disease?
How do genetic mutations contribute to the pathophysiology of Huntington's disease?
What distinguishes reversible dementias from irreversible dementias in terms of their underlying causes and potential outcomes?
What distinguishes reversible dementias from irreversible dementias in terms of their underlying causes and potential outcomes?
What is the rationale behind monitoring for autonomic disturbances, such as cardiac arrhythmias and blood pressure instability, in patients with GBS?
What is the rationale behind monitoring for autonomic disturbances, such as cardiac arrhythmias and blood pressure instability, in patients with GBS?
How does the function of T cells relate to the pathophysiology of multiple sclerosis (MS)?
How does the function of T cells relate to the pathophysiology of multiple sclerosis (MS)?
What is the most important reason to have a 30 second neurological examination performed?
What is the most important reason to have a 30 second neurological examination performed?
While assessing a patient recently diagnosed with Parkinson's Disease, what would the nurse assess for?
While assessing a patient recently diagnosed with Parkinson's Disease, what would the nurse assess for?
How is muscle weakness experienced in Myasthenia Gravis (MG) typically different from other types of muscle weakness caused by neurological disorders?
How is muscle weakness experienced in Myasthenia Gravis (MG) typically different from other types of muscle weakness caused by neurological disorders?
Why is early administration of IVIg or plasma exchange critical in patients with Guillain-Barré Syndrome (GBS)?
Why is early administration of IVIg or plasma exchange critical in patients with Guillain-Barré Syndrome (GBS)?
What role does the APOE4 allele play in the pathogenesis of Alzheimer's disease?
What role does the APOE4 allele play in the pathogenesis of Alzheimer's disease?
What is the primary reason for assessing bulbar and axial weakness in patients during neurological examinations?
What is the primary reason for assessing bulbar and axial weakness in patients during neurological examinations?
How do 'red flags' in a headache assessment guide further diagnostic evaluation?
How do 'red flags' in a headache assessment guide further diagnostic evaluation?
How does early-life education impact the manifestation of dementia later in life according to reports?
How does early-life education impact the manifestation of dementia later in life according to reports?
What is the clinical significance of identifying antecedent factors, such as recent infections or vaccinations, in patients diagnosed with Guillain-Barré Syndrome (GBS)?
What is the clinical significance of identifying antecedent factors, such as recent infections or vaccinations, in patients diagnosed with Guillain-Barré Syndrome (GBS)?
What is the relevance of assessing symmetry and progression in patients with a diagnosis of GBS?
What is the relevance of assessing symmetry and progression in patients with a diagnosis of GBS?
How does the assessment for myasthenia gravis affect treatment?
How does the assessment for myasthenia gravis affect treatment?
In the assessment of patients with multiple sclerosis (MS), what is the significance of Uhthoff's phenomenon?
In the assessment of patients with multiple sclerosis (MS), what is the significance of Uhthoff's phenomenon?
What are the important factors to consider when performing an evaluation for patient who comes in with potential Alzheimers?
What are the important factors to consider when performing an evaluation for patient who comes in with potential Alzheimers?
What are some key factors in helping patients during a dignified diagnosis?
What are some key factors in helping patients during a dignified diagnosis?
In the context of neurological assessments, what is the primary distinction between 'signs' and 'symptoms'?
In the context of neurological assessments, what is the primary distinction between 'signs' and 'symptoms'?
How might the assessment of motor and sensory functions aid in differentiating between multiple sclerosis and amyotrophic lateral sclerosis?
How might the assessment of motor and sensory functions aid in differentiating between multiple sclerosis and amyotrophic lateral sclerosis?
Why is it so important to test for the various cranial nerves during assessment?
Why is it so important to test for the various cranial nerves during assessment?
What implications does the potential for 'molecular mimicry' in Guillain-Barré Syndrome have in terms of understanding disease triggers?
What implications does the potential for 'molecular mimicry' in Guillain-Barré Syndrome have in terms of understanding disease triggers?
Which neurotransmitter is most significantly affected in Alzheimer's disease and what cognitive functions are subsequently impaired?
Which neurotransmitter is most significantly affected in Alzheimer's disease and what cognitive functions are subsequently impaired?
How does the dual involvement of upper and lower motor neurons manifest clinically in patients with Amyotrophic Lateral Sclerosis (ALS)?
How does the dual involvement of upper and lower motor neurons manifest clinically in patients with Amyotrophic Lateral Sclerosis (ALS)?
What is the usual first sign of Amyotrophic Lateral Sclerosis?
What is the usual first sign of Amyotrophic Lateral Sclerosis?
During a physical examination for headaches, which of the following is the priority?
During a physical examination for headaches, which of the following is the priority?
During assessment, what is the most important reason to use tools to tests cognitive function?
During assessment, what is the most important reason to use tools to tests cognitive function?
If you are assessing a patient that you think has Alzheimers, what information from the patient or family is important?
If you are assessing a patient that you think has Alzheimers, what information from the patient or family is important?
In managing headaches, what is the first thing that you should be assessing during your assessment?
In managing headaches, what is the first thing that you should be assessing during your assessment?
As far as modifiable risk factors go, what has had the greatest impact on reducing Alzheimer's?
As far as modifiable risk factors go, what has had the greatest impact on reducing Alzheimer's?
In regards to patients with Parkinson's stages, what stages typically still allow patients to function on average?
In regards to patients with Parkinson's stages, what stages typically still allow patients to function on average?
What is the overall goal for assessing the cranial nerves?
What is the overall goal for assessing the cranial nerves?
If a patient were to come in with suspected tremors related to parkinsonism, what is important to know if one is to assess the tremor for accuracy?
If a patient were to come in with suspected tremors related to parkinsonism, what is important to know if one is to assess the tremor for accuracy?
A patient has new onset uncontrolled movement classified as dance-like, which term could you use to define this assessment?
A patient has new onset uncontrolled movement classified as dance-like, which term could you use to define this assessment?
Which of these symptoms is least likely to be considered part of non-motor issues related to Parkinsons?
Which of these symptoms is least likely to be considered part of non-motor issues related to Parkinsons?
What is the primary method by which Lewy bodies cause neuronal dysfunction in Lewy Body Dementia and Parkinson's Disease?
What is the primary method by which Lewy bodies cause neuronal dysfunction in Lewy Body Dementia and Parkinson's Disease?
How do you describe the effect the Amyloid plaques and neurofibrillary tangles have on neuron function in Alzheimer's Disease?
How do you describe the effect the Amyloid plaques and neurofibrillary tangles have on neuron function in Alzheimer's Disease?
A patient reports experiencing significant changes in behavior, including increased impulsivity and emotional flatness. Imaging reveals atrophy primarily in the frontal and temporal lobes. Which type of dementia is most consistent with these findings?
A patient reports experiencing significant changes in behavior, including increased impulsivity and emotional flatness. Imaging reveals atrophy primarily in the frontal and temporal lobes. Which type of dementia is most consistent with these findings?
In assessing a patient with suspected Parkinson's disease, what differentiates resting tremors from other types of tremors?
In assessing a patient with suspected Parkinson's disease, what differentiates resting tremors from other types of tremors?
What is the significance of identifying antecedent events, such as recent infections or vaccinations, in the diagnostic workup for Guillain-Barré Syndrome (GBS)?
What is the significance of identifying antecedent events, such as recent infections or vaccinations, in the diagnostic workup for Guillain-Barré Syndrome (GBS)?
What pathological process primarily underlies the motor deficits seen in Amyotrophic Lateral Sclerosis (ALS)?
What pathological process primarily underlies the motor deficits seen in Amyotrophic Lateral Sclerosis (ALS)?
Which assessment finding would be most indicative of Bulbar Palsy and helps differentiate it from Spinal ALS?
Which assessment finding would be most indicative of Bulbar Palsy and helps differentiate it from Spinal ALS?
Which key element in assessing for headaches will help differentiate headaches from neurological conditions?
Which key element in assessing for headaches will help differentiate headaches from neurological conditions?
What distinguishes Myasthenia Gravis (MG) from other conditions, such as stroke or ALS, that also cause muscle weakness?
What distinguishes Myasthenia Gravis (MG) from other conditions, such as stroke or ALS, that also cause muscle weakness?
A patient is being evaluated for cognitive decline. Which of the following subjective data points would be most relevant in differentiating between normal age-related memory changes and early-stage dementia?
A patient is being evaluated for cognitive decline. Which of the following subjective data points would be most relevant in differentiating between normal age-related memory changes and early-stage dementia?
Flashcards
What does the CNS include?
What does the CNS include?
The central nervous system (CNS) includes the brain and spinal cord.
What does the PNS include?
What does the PNS include?
The peripheral nervous system (PNS) consists of the nerves that reach every part of the body.
Somatic Nervous System Function
Somatic Nervous System Function
The somatic nervous system controls voluntary movement and sensation in the skin, muscles, and joints.
Autonomic Nervous System Function
Autonomic Nervous System Function
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Sympathetic Nervous System
Sympathetic Nervous System
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Parasympathetic Nervous System
Parasympathetic Nervous System
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Frontal Lobe Function
Frontal Lobe Function
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Temporal Lobe Function
Temporal Lobe Function
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Alzheimer's disease
Alzheimer's disease
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Dementia
Dementia
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Motor Neuron Involvement in ALS
Motor Neuron Involvement in ALS
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Neurotransmitter Affected in Alzheimer's
Neurotransmitter Affected in Alzheimer's
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Reversible Dementia
Reversible Dementia
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Irreversible Dementia
Irreversible Dementia
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Hallucinations
Hallucinations
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Parkinson's Symptoms
Parkinson's Symptoms
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Average Age of Diagnosis - Parkinson's Disease
Average Age of Diagnosis - Parkinson's Disease
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What are Lewy Bodies?
What are Lewy Bodies?
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Multiple Sclerosis (MS)
Multiple Sclerosis (MS)
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MS Symptoms
MS Symptoms
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Myasthenia Gravis (MG)
Myasthenia Gravis (MG)
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Guillain Barre Syndrome (GBS)
Guillain Barre Syndrome (GBS)
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Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic Lateral Sclerosis (ALS)
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Common Type of Headaches
Common Type of Headaches
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Study Notes
How the Brain Affects the Body
- The slides focus on examining the pathophysiology and care of several neurological conditions.
- Neurological conditions discussed include dementia, Parkinson's disease, multiple sclerosis, Guillain-Barré, myasthenia gravis, amyotrophic lateral sclerosis, and headaches.
- An overall study learning outcome is to be able to assess and care for neurological conditions
Central Nervous System (CNS)
- The CNS includes the brain and spinal cord
Peripheral Nervous System (PNS)
- The PNS consists of the nerves that reach every part of the body
- The Somatic Nervous System controls voluntary movement and sensation in the skin, muscles, and joints
- The Autonomic Nervous System controls automatic functions like breathing, heart rate, and digestion
Neuron Anatomy
- Neurons sends messages to each other, through electrical and chemical signals
- A Neuron is comprised of a soma, nucleus, dendrites, axon, myelin sheath, schwann cell, node of ranvier, and axon terminal
Common Neurological Disorders and Mechanisms
- Neurological disorders include Alzheimer's disease, Parkinson's disease, multiple sclerosis, Guillain-Barré syndrome, myasthenia gravis, and amyotrophic lateral sclerosis
- Huntington's disease involves too much movement (chorea, hyperkinesia) due to a loss of inhibition
- Parkinson's disease involves too little movement (bradykinesia, rigidity) due to a loss of dopamine
Memory and Aging
- Most people experience some problems with memory as they age
- 40% of people will experience some form of memory loss after age 65
- Between 5-8% of people over 60 years old will experience dementia
Dementia
- It is defined as an extremely low condition of mental function and mental incapacity
- The term is derived from the Latin word "dementia," meaning "madness, insanity," or literally "a being out of one's mind"
- Dementia is actually an unbrella term for the loss of memory and thinking abilities severe enough to interfere with daily life
Anatomy of the Brain
- Frontal lobe: Responsible for reasoning, planning, paying attention, and moving specific body parts
- Parietal lobe: Responsible for perceiving things like touch, taste, and pain
- Temporal lobe: Responsible for making sense of what is heard
- Occipital lobe: Responsible for making sense of what is seen
- Hypothalamus: Responsible for body temperature, hunger, and thirst
- Pituitary gland: Controls the release of most hormones
- Cerebellum: Coordinates movement
- Brainstem: Controls breathing, heartbeat, and facial expressions
- Hippocampus: Helps make long-term memories
Types of Dementia
- Alzheimer's Disease: Abnormal amyloid plaques and tau tangles throughout the brain
- Frontotemporal Dementia: Abnormal tau and TDP-43 proteins accumulate inside neurons in the frontal and temporal lobes
- Lewy Body Dementia: Abnormal deposits of the alpha-synuclein protein affect the brain's chemical messengers
- Vascular Dementia: Conditions like blood clots disrupt blood flow in the brain
Key Symptoms of Dementia
- Forgetfulness
- Wandering and getting lost
- Impulsivity
- Confusion
- Poor judgement
- Hallucinations
- Delusions
Age of Dementia Onset
- Alzheimer's: Mid 60s and above, with possible cases in mid-30s to 60s
- Frontotemporal: Between ages 45 and 64
- Lewy Body: Age 50 or older
- Vascular: Over the age of 65
Lewy Body Dementia
- Lewy body dementia (LBD) is a common progressive dementia after Alzheimer's disease
- LBD is caused by abnormal protein deposits in the brain, called Lewy bodies
- Diagnoses include Parkinson's disease and dementia with Lewy bodies (DLB), both associated with alpha-synuclein aggregation in the brain
- People with DLB tend to have more prominent cognitive symptoms early on, while people with Parkinson's disease tend to experience motor symptoms first
Lewy body shrinkage areas
- Parietal lobe
- Cingulate gyrus
- Temporal lobe
- Midbrain
Lewy Body Dementia Symptoms
- Visual hallucinations
- Issues with movement
- Poor regulation of body functions
- Confusion and memory loss
- Sleep disorders
- Mood changes (depression)
Risk factors for Lewy Body Dementia
- Aging
- Sex (occurs more in men)
- Family history
Dementia in Alberta
- In Alberta, more than 45,800 Albertans are living with dementia as of March 31, 2018
- Under Age 65: About 4,435 people, or almost 10% of the Alberta population with dementia
- Age 65-84: About 21,410 people, almost half of the Alberta population with dementia
- Age 85+: About 19,960 people, or 44% of the Alberta population with dementia
Pathophysiological Mechanisms
- Different diseases or factors damage brain cells and connections
- Symptoms and progression depend on type, location, and extent of damage
- Common causes of brain damage are abnormal protein deposits, impaired blood flow, genetic mutations, infections, or brain injury
Huntington's Disease
- This disease is caused by a mutation in the HTT gene on chromosome 4, which leads to atrophy of the basal ganglia
- There is too much movement, chorea and hyperkinesia, due to loss of inhibition
Reversible Dementia
- This type of dementia can be cured or improved by treating the underlying cause
- It is more common in younger people
- Some examples include infections, brain injuries, metabolic disorders, or nutritional deficiencies
Irreversible Dementia
- An irreversible dementia is progressive and degenerative and cannot be cured or reversed
- It affects mainly older people, but it can also occur in younger people
- Causes and types include neurodegenerative disorders, vascular disease, or infection
Special cases of irreversible dementia
- Wernicke's Encephalopathy: Sudden life-threatening reaction that causes bleeding & damage in the lower brain
- Korsakoff's Syndrome: A chronic and degenerative condition that causes damage in the brain
Modifiable Risk Factors for Dementia
- Diabetes
- Hypertension
- Head injury
- Smoking
- Pollution
- Obesity
- Lack of exercise
- Depression
- Alcohol
- Hearing Impairment
- Social Isolation
- Education Level
Alzheimer's Disease (AD)
- AD is a type of dementia that causes progressive degeneration of brain cells and their connections
- It affects memory, thinking, behavior, and mood
- Alzheimer’s disease damages and kills neurons, reducing the production and release of neurotransmitters
Alzheimer's Hallmarks
- Amyloid plaques is extracellular deposits of a toxic protein called amyloid-beta, which interferes with cell communication and function
- Neurofibrillary tangles are intracellular aggregates of a protein called tau, which disrupts cell structure and transport
Types of Alzheimer's
- Sporadic AD: The most common type, with no clear family history or inheritance pattern, influenced by susceptibility genes and risk factors
- Early Onset AD: General term for Alzheimer's disease that occurs before age 65, regardless of the cause. It affects about 5% of all people with Alzheimer's disease
- Familial AD (FAD): A rare type, with a strong family history and inheritance pattern, caused by deterministic genes
Alzheimer's Diagnosis
- Diagnosed through cognitive and neurological tests, brain scans, psychiatric evaluations, genetic tests, cerebrospinal fluid tests, and blood tests
Cognitive Screening Tests
- Mini-Mental State Examination (MMSE): Tests orientation, attention, memory, language, and visual-spatial skills
- Montreal Cognitive Assessment (MoCA): Assesses multiple cognitive domains, including visuospatial/executive, naming, memory, attention, language, abstraction, and orientation
- Hopkins Verbal Learning Test: Assesses the learning and recall of a list of words
Principles for Dignified Dementia Diagnosis
- Talk directly to the person with dementia
- Tell the truth
- Test early
- Take all concerns seriously
- Deliver the news in plain and sensitive language
- Coordinate with other care providers
- Explain the purpose of tests
- Provide tools for living with the disease
Clinical Manifestations of Dementia
- In early stages: Mild forgetfulness, short-term memory impairment, difficulty finding words, confusion about the location of familiar places, anxiety
- In middle stages: Increasing memory loss, impaired attention, anxiety, mood swings, flat affect, difficulty recognizing family
- In late stages: Loss of most memories, inability to understand words, difficulty eating, inability to perform self-care, and seizures
Measuring the Progression of Alzheimer's Disease
- Scale 1: No cognitive decline
- Scale 2: Very mild cognitive decline
- Scale 3: Mild cognitive decline
- Scale 4: Moderate cognitive decline
- Scale 5: Moderately severe cognitive decline
- Scale 6: Severe cognitive decline
- Scale 7: Very severe cognitive decline
Nursing Dementia Assessment
- D = Drugs
- E = Eyes and ears
- M = Metabolic and endocrine disorders
- E = Emotional disorders
- N= Neuro disorder and Nutritional Deficiency
- T= Tumors and Trauma
- I= Infection
- A= Alcohol
Subjective Data Collection on Dementia
- History of present illness
- Past medical history
- Family history
- Social history
- Mood and affect
- Functional status
- Safety concerns
Objective Data Collection on Dementia
- Vital signs
- General appearance
- Neurological examination
- Cognitive tests
- Laboratory tests
- Neuroimaging
The 7 A's of Dementia Symptoms
- Anosognosia
- Amnesia
- Aphasia
- Agnosia
- Apraxia
- Altered perception
- Apathy
Parkinson’s Disease (PD)
- A condition caused by Lewy bodies affecting basal ganglia (motor control), which helps with movement and coordination
- PD is classified as a progressive neurological disease
Impact of Parkinson's Disease
- Primary result is protein structure changes which causes neurotransmitter dysregulation within the basal ganglia
- Leads to too little dopamine
Common symptoms of Parkinson's Disease
- Tremor
- Rigidity
- Bradykinesia (slow movement)
- Postural instability
Non-Motor related Symptoms
- Sleep disturbances
- Restless leg syndrome
- REM sleep behavior disorder
- Mood disturbances
- Depression
- Anxiety
- Fatigue
- Cognitive decline
- Excessive daytime sleepiness
- Speech disturbances
- Hallucinations
Risk Factors for Parkinson's Disease
- Age
- Exposure to toxins
- Sex
- Sleep disorders
- Genetics
Stages of Parkinson's
- Stage 1: Mild symptoms
- Stage 2: Symptoms on both sides of the body.
- Stage 3: Moderate symptoms
- Stage 4: Requiring assistance
- Stage 5: Bedbound
Assessment for Parkinson's
- History, medical history, family history, medication use, exposure to toxins, lifestyle habits, and psychosocial factors
- Physical examination, neurological examination, and cranial nerve function, as well as other systems.
- Evaluate ADLs and IADLs, as well as mobility, assistive devices, fall risk, safety, and environmental factors
- Screen for cognitive impairment, dementia, depression, anxiety, apathy, hallucinations, delusions, and other neuropsychiatric symptoms, as well as coping skills, social support, and emotional well-being.
Multiple Sclerosis (MS)
- MS is widely variable and caused by central nervous system lesions affecting motor, sensory, visual, or even autonomic functions
- MS is an autoimmune disease of the central nervous system that degrades myelin
- The plaques interfere with the transmission of nerve signals and cause neurological dysfunction
Origin and prevalence of MS
- One of the highest rates in world in Canada, roughly 1/400
- Average diagnosis is age 43
MS symptoms
- Vision issues
- Weak limbs
- Tingling
- Fatigue
Immune Involvment in MS
- B cells produce immunoglobulins upon entering the CNS
- T cells release inflammation
- Microglia releases interleukin which causes infection
- Macrophages release agents which cause more damage.
Nursing Assessment for MS
- Recognizing symptoms (fatigue, weakness etc)
- Monitoring progression
- Symptom management
- Patient education
- Emotional/safety support
- Promote Independence
Myasthenia Gravis (MG)
- An antibody-mediated autoimmune disorder that often linked to thymoma
- Causes Muscle Weakness, Main symptom, worsens with activity and improves with rest.
Diagnosing MG
- Age of onset varies
- Certain genetic markers are linked
- Ocular symptoms
- Limb weakness
What MG effects
- Neuromusclular junciton
- Respiratory (15-20 may need ventilator support)
- Weakness of muscle (main symptom)
MG Treatments
- Early administration of ivig or plasma change.
- Ongoing continuous monotoring
Guillain Barré Syndrome (GBS)
- Peripheral nerves are attacked
- Symptoms develop rapidly
- Ascending sensory
- Medical history is taken
GBS treatment
- GBS is potentially life-threatening; people with GBS should be treated and monitored as quickly as possible
ALS Overview
- ALS typically diagnosed in late middle age of life
- motor involvement and is a progressive muscle weakness disease
- Can happen to to lower and upper motor neuron
ALS Diagnosis in Canada
- Prevalance of about 3000 canadians
- 1000 new cases and deaths annuall
Genetic Factors for ALS
- Genetic mutations and familial genetics
ALS Pathophysiological and Process
- Transport system impairment
- Mutated proteing effect the transport system
- Mutation which affects RNA with cause future issues
ALS Clinical Manifestations
- Starts with unlateral , progressing to centraily.
Headaches
- A Headache can occur due to structual disease or tension.
- Headaches can be managed with history and nuering accessment
- Types include chronic, migrane, or clusters
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