Chapter 12 The Nervous System
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Monoplegia is paralysis of a single limb, usually an arm, which can be caused by cerebral palsy or affect just one muscle group. Paraplegia is impairment of motor and sensory function in the lower extremities, usually from spinal cord injury or conditions like spina bifida. Quadriplegia/tetraplegia is paralysis of all four limbs and the torso, resulting in loss of both sensation and motor control. Anesthesia temporarily blocks sensation including pain, allowing patients to undergo surgeries and procedures without distress. It is a pharmacologically induced reversible state of amnesia, loss of consciousness, and decreased stress response.
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Cns clinical evaluation of hemiplegia slideshare upload
This document discusses the clinical evaluation of hemiplegia. It provides details on brain anatomy, physiology, handedness and the contra-lateral control of the brain. It describes the blood supply of the brain including the Circle of Willis. The document examines the pathology of ischemic stroke and discusses assessing features such as the site of lesion localization, whether the deficit is ischemic or hemorrhagic in nature, and if it represents a transient ischemic attack, evolving stroke or completed stroke. Precise neurological examination is emphasized to determine the structures and tracts involved.
Chapter 12 nervous system
The central nervous system consists of the brain and spinal cord. General anesthesia affects the central nervous system by shutting down the brain's pain centers so the body does not feel pain. Paralysis can originate from damage to the central nervous system, with injuries or diseases destroying brain cells that can paralyze parts of the body on one side. Paralysis may be spastic if muscles are stiff from brain damage or flaccid if spinal cord nerve cells controlling movement are damaged.
Hemiplegia & paraplegia
Paraplegia is caused by injury to the spinal cord below the neck, resulting in loss of feeling and movement in the legs but full control of the arms. It refers to substantial impairment rather than total paralysis. Paraplegics can sometimes regain some function through physical therapy. Common causes include spinal cord injuries and infections that impede signals from the brain. Hemiplegia is caused by brain injury, usually affecting one side of the body. It can result in learning disabilities rather than just paralysis. Causes include trauma, infections, disorders like leukemia, or complications during childbirth. Both conditions are lifelong but quality of life can be improved through therapy.
Motor paralysis clinical
This document discusses the motor nervous system and motor paralysis from multiple levels including:
- The motor cortex and its connections to other brain areas
- The extrapyramidal and pyramidal systems
- Different types of apraxia and their lesion locations
- Lesions of the brainstem, spinal cord, nerves and muscles that can cause hemiplegia, monoplegia, or paraplegia
- The clinical features and localization of upper and lower motor neuron lesions
- Specific motor syndromes and their etiologies
It provides an overview of the organization of the motor system and localization of lesions throughout the nervous system that can result in different clinical motor deficits.
Seizures
Epilepsy is a brain disorder caused by disturbed neuronal activity in the brain, which can cause strange sensations, emotions, behaviors, or sometimes convulsions. It is classified as either primary generalized or partial seizures. Diagnosis involves EEG, brain imaging, and blood tests to identify potential causes. Treatment primarily consists of anti-seizure medications, but may also include dietary therapies, vagus nerve stimulation, or surgery to remove the affected part of the brain.
Coma
Coma is defined as a loss of consciousness and awareness of the environment with preservation of autonomic functions. Coma is caused by dysfunction of the reticular activating system and cerebral cortex, with the most common causes being toxic or metabolic disorders, trauma, and stroke. The prognosis of a coma depends on its underlying cause, whether the problem can be corrected, and the duration of unconsciousness - the longer a person remains in a coma, the worse the expected outcome generally is, though full recovery is still possible even after weeks. Emergency treatment of coma focuses on maintaining airway, breathing, circulation, controlling seizures, and reducing intracranial pressure through medications and other interventions.
Patient coma (33)
1) A comatose patient requires a thorough history, physical exam, and testing to identify the underlying cause. Important aspects of the exam include assessing ABCs, signs of trauma, meningeal irritation, pupil size/reactivity, eye and limb movements, and abnormal postures.
2) Brainstem lesions can be identified by evaluating pupillary size/reactivity, eye movements including nystagmus, oculocephalic reflex, and caloric response. Hemispheric lesions may cause hemiplegia.
3) The Glasgow Coma Scale is used to assess the level of consciousness on a scale of 3-15 based on the patient's motor response, verbal response, and eye opening
Examination Of The Comatose Patient
1. The document discusses the evaluation of a comatose patient, distinguishing between structural and metabolic causes of coma. 2. It describes assessing a patient's level of consciousness using the Glasgow Coma Scale and checking for signs of herniation. 3. The priority is to identify cases where progressive herniation may lead to further damage or death, and to separate metabolic from structural causes of coma.
Recommended
Cns clinical evaluation of hemiplegia slideshare upload
This document discusses the clinical evaluation of hemiplegia. It provides details on brain anatomy, physiology, handedness and the contra-lateral control of the brain. It describes the blood supply of the brain including the Circle of Willis. The document examines the pathology of ischemic stroke and discusses assessing features such as the site of lesion localization, whether the deficit is ischemic or hemorrhagic in nature, and if it represents a transient ischemic attack, evolving stroke or completed stroke. Precise neurological examination is emphasized to determine the structures and tracts involved.
Chapter 12 nervous system
The central nervous system consists of the brain and spinal cord. General anesthesia affects the central nervous system by shutting down the brain's pain centers so the body does not feel pain. Paralysis can originate from damage to the central nervous system, with injuries or diseases destroying brain cells that can paralyze parts of the body on one side. Paralysis may be spastic if muscles are stiff from brain damage or flaccid if spinal cord nerve cells controlling movement are damaged.
Hemiplegia & paraplegia
Paraplegia is caused by injury to the spinal cord below the neck, resulting in loss of feeling and movement in the legs but full control of the arms. It refers to substantial impairment rather than total paralysis. Paraplegics can sometimes regain some function through physical therapy. Common causes include spinal cord injuries and infections that impede signals from the brain. Hemiplegia is caused by brain injury, usually affecting one side of the body. It can result in learning disabilities rather than just paralysis. Causes include trauma, infections, disorders like leukemia, or complications during childbirth. Both conditions are lifelong but quality of life can be improved through therapy.
Motor paralysis clinical
This document discusses the motor nervous system and motor paralysis from multiple levels including:
- The motor cortex and its connections to other brain areas
- The extrapyramidal and pyramidal systems
- Different types of apraxia and their lesion locations
- Lesions of the brainstem, spinal cord, nerves and muscles that can cause hemiplegia, monoplegia, or paraplegia
- The clinical features and localization of upper and lower motor neuron lesions
- Specific motor syndromes and their etiologies
It provides an overview of the organization of the motor system and localization of lesions throughout the nervous system that can result in different clinical motor deficits.
Seizures
Epilepsy is a brain disorder caused by disturbed neuronal activity in the brain, which can cause strange sensations, emotions, behaviors, or sometimes convulsions. It is classified as either primary generalized or partial seizures. Diagnosis involves EEG, brain imaging, and blood tests to identify potential causes. Treatment primarily consists of anti-seizure medications, but may also include dietary therapies, vagus nerve stimulation, or surgery to remove the affected part of the brain.
Coma
Coma is defined as a loss of consciousness and awareness of the environment with preservation of autonomic functions. Coma is caused by dysfunction of the reticular activating system and cerebral cortex, with the most common causes being toxic or metabolic disorders, trauma, and stroke. The prognosis of a coma depends on its underlying cause, whether the problem can be corrected, and the duration of unconsciousness - the longer a person remains in a coma, the worse the expected outcome generally is, though full recovery is still possible even after weeks. Emergency treatment of coma focuses on maintaining airway, breathing, circulation, controlling seizures, and reducing intracranial pressure through medications and other interventions.
Patient coma (33)
1) A comatose patient requires a thorough history, physical exam, and testing to identify the underlying cause. Important aspects of the exam include assessing ABCs, signs of trauma, meningeal irritation, pupil size/reactivity, eye and limb movements, and abnormal postures.
2) Brainstem lesions can be identified by evaluating pupillary size/reactivity, eye movements including nystagmus, oculocephalic reflex, and caloric response. Hemispheric lesions may cause hemiplegia.
3) The Glasgow Coma Scale is used to assess the level of consciousness on a scale of 3-15 based on the patient's motor response, verbal response, and eye opening
Examination Of The Comatose Patient
1. The document discusses the evaluation of a comatose patient, distinguishing between structural and metabolic causes of coma. 2. It describes assessing a patient's level of consciousness using the Glasgow Coma Scale and checking for signs of herniation. 3. The priority is to identify cases where progressive herniation may lead to further damage or death, and to separate metabolic from structural causes of coma.
Coma
1. Coma results from damage to the reticular activating system in the brainstem or widespread damage to both cerebral hemispheres.
2. Lesions in the upper brainstem can cause pupillary dilation and loss of eye movement, while more diffuse lesions cause preserved pupillary function.
3. Cerebral mass lesions and herniations, like uncal herniation, can compress brain structures and blood vessels, causing coma.
4. Metabolic disorders that disrupt brain energy supply like hypoglycemia or hypoxia can induce coma by interrupting neuronal function.
hemiparesis
A 38-year-old man was brought to the health center due to seizures that started in his right arm and progressed to his right leg and then his whole body. This has been occurring for 3 months around 3 times per month. The patient also complains of frequent headaches and feeling unsteady when walking or holding things as his right hand and leg feel weak. Based on the symptoms, differential diagnoses include stroke, brain tumor, and brain abscess. Further tests like CT scan or MRI are needed to confirm the diagnosis.
Chapter 12 ppt to post
This document discusses medical terminology related to the nervous system. It defines terms ending in -plegia, meaning paralysis, and -esthesia, meaning feeling or sensation. Specific terms discussed include paraplegia (paralysis of the lower half of the body), quadriplegia (paralysis of the arms and legs), and hyperesthesia (excessive sensation). Causes of paralysis include strokes, spinal cord injuries, and neurological diseases. Treatments for conditions like hyperesthesia include analgesics, antidepressants, and anticonvulsants.
Consciousness, ras and approach to coma
This document provides information on examining patients presenting with coma. It defines consciousness and the reticular activating system. It describes the examination of a comatose patient, including assessing respiratory pattern, pupils, ocular motility, motor response, and differentiating structural from toxic-metabolic causes of coma. It also discusses signs of brain herniation seen in comatose patients.
Paralysis
Paralysis is the complete loss of muscle function for one or more muscle groups and often includes loss of feeling in the affected area. It can be caused by damage to upper motor neurons, which convey signals from the brain to the nervous system, or lower motor neurons, which connect to muscles. Signs and symptoms depend on the location and severity of damage and may include numbness, tingling, pain, vision problems, speech difficulties, and breathing issues. Treatments focus on physical and occupational therapy to regain mobility, muscle strength, and independence through techniques like range of motion exercises and home modifications.
Chapter 12
This document provides information about different types of paralysis and weakness caused by damage to the nervous system. It defines quadriplegia/tetraplegia as paralysis of all four limbs and the torso, usually caused by spinal cord injury. Plegia is defined as a suffix meaning paralysis. Specific types of plegia discussed include hemiplegia (one side of the body), paraplegia (the legs), and quadriplegia/tetraplegia (all four limbs). Paraplegia describes paralysis of the legs and possibly the trunk. Paresis is defined as muscular weakness caused by nerve damage or disease, representing partial paralysis. The key difference between plegia and paresis is that p
Coma and brain stem death
This document summarizes key aspects of coma and brain stem death. It discusses the neurological structures involved in consciousness and what is required to induce coma. Coma is defined as unarousable unresponsiveness, distinguished from an alert state. Assessing a comatose patient involves obtaining history, performing a general and neurological exam including the Glasgow Coma Scale, and considering appropriate investigations and management. Brain death is defined as the irreversible loss of all brain functions including the brainstem, determined by coma, absence of brainstem reflexes, and apnea on testing.
Coma
This document discusses altered mental status and coma. It describes different levels of consciousness including light coma and deep coma. The Glasgow Coma Scale is introduced as a tool to assess a patient's level of consciousness based on their eye, verbal, and motor responses. Common causes of altered mental status are summarized using the AEIOU TIPS mnemonic, covering factors like alcohol, electrolyte imbalances, infections, and trauma. Clinical presentations and emergency treatments including airway management, glucose administration, and antidotes for overdoses are outlined.
Coma usmf
This document discusses states of normal and impaired consciousness, including coma. It describes coma as an extreme state of unresponsiveness where an individual exhibits no voluntary movement or behavior. The document outlines an approach for clinically evaluating a comatose patient, including examining vital signs, skin features, breath odor, and performing a neurological examination to help identify potential underlying causes of coma. It also introduces the Glasgow Coma Scale for assessing the level or depth of impaired consciousness or coma.
evaluation & management of patient in coma
This document discusses the evaluation and management of coma. It begins by defining coma as prolonged unresponsiveness. It then describes the anatomy of arousal centered around the ascending reticular activating system. Assessment of coma involves the Glasgow Coma Scale and examining for signs of increased intracranial pressure. Common causes of coma include metabolic derangements, structural lesions of the brainstem or supratentorial regions. Management involves stabilizing ventilation, circulation, controlling seizures, reducing intracranial pressure and maintaining temperature. Detailed neurological examination can help localize lesions through assessment of reflexes, eye movements, respiratory patterns and posture.
Definitions, and approach to Coma
This document provides information on consciousness and coma:
- Consciousness has two components - arousal from the reticular activating system and awareness from the cerebral cortex. Stimulation of the RAS produces arousal while its destruction causes coma.
- The Glasgow Coma Scale and newer scales like FOUR are used to evaluate patients in comatose or reduced states of consciousness. The FOUR scale assesses eye, motor, brainstem, and respiratory responses.
- Causes of coma can be structural/focal brain injuries or non-structural/diffuse issues like hypoxia, infections, or toxic exposures. An approach is outlined to initially stabilize an unconscious patient and guide further examination and investigations.
Coma Clinical Examination
The document provides guidance on performing a neurological examination on a patient presenting with coma. It describes assessing the level of consciousness using the AVPU and Glasgow Coma scales. Key aspects of the physical exam are outlined, including vital signs, signs of trauma, skin appearance, neck stiffness, pupil size/reactivity, and posture responses that may indicate lesions in specific areas of the brain or brainstem. Priority is given to the ABCs to ensure adequate oxygenation and circulation as underlying life-threatening conditions are addressed first before a more thorough neurological assessment.
Coma
This document discusses coma, including its definition, causes, and approach to assessment and management. Coma is the deepest state of impaired consciousness where a patient cannot be aroused. Causes include structural brain injuries, infections, metabolic derangements, and drugs. Evaluation of a comatose patient involves assessing vital signs, neurological exam including pupil response and eye movements, investigations like blood tests and imaging, and treatment of reversible causes. Brain death is the complete and irreversible loss of brain function while cardiac and respiratory functions may be maintained artificially.
Management of coma and altered sensorium 19.4.01
This document discusses the management of patients presenting with coma or altered sensorium. Key points include evaluating vital signs and providing emergency treatment to maintain ventilation, circulation, control seizures, and manage intracranial pressure. Further tests such as bloodwork and imaging studies can help identify potential metabolic, structural or toxic causes. Ongoing care focuses on preventing complications through careful monitoring and stimulation techniques.
Altered sensorium Case 2014
A 21-year-old female patient with systemic lupus erythematosus (SLE) on steroids presented with generalized tonic-clonic seizures and altered sensorium. The top differential diagnoses included posterior reversible encephalopathy syndrome (PRES), posterior circulation ischemia/infarction, vasculitis, hypoglycemia, sinovenous thrombosis, thrombotic microangiopathies, status epilepticus, and reversible cerebral vasoconstriction syndrome. The document discusses PRES in more detail, describing its typical parieto-occipital involvement on imaging, various atypical manifestations, pathogenesis related to hypertension and endothelial dysfunction, and common causes like preeclampsia/eclampsia, infection
Coma
This document defines coma as an unarousable unresponsiveness state where patients cannot be aroused or respond appropriately to stimuli. Coma is caused by damage to the ascending reticular activating system in the brainstem or diffuse bilateral damage to the cerebral hemispheres. A thorough neurological exam is needed to assess coma, including tests of arousal, motor function, and cranial nerves like pupils and eye movements to localize lesions. Early intervention is important to preserve life and brain function for comatose patients.
Coma
The document discusses various states of consciousness including coma, stupor, and drowsiness. It describes potential causes of coma such as lesions in the reticular activating system or both cerebral hemispheres. Clinical signs that can help localize lesions are described, such as pupillary abnormalities suggesting brainstem involvement. The initial approach and assessment of a patient presenting with altered mental status or coma is outlined, including interventions, ancillary testing, and treatment in the emergency department. Various clinical signs are also described that may provide clues to the cause of coma.
The nervous system
Hemiplegia is partial or total paralysis of one side of the body that results from injury or disease in the motor centers of the brain. It is most commonly caused by strokes in elderly individuals. In children, hemiplegia often has no identifiable cause. Symptoms include difficulty with movement, balance, motor skills, speech and swallowing. While not progressive, hemiplegia symptoms do not improve once the injury has occurred. Anesthesia refers to the temporary loss of sensation, including pain, induced pharmacologically. It can be local, regional, general or dissociative depending on the area of the body or brain affected.
Spinal cord injury
This document discusses spinal cord injuries, including causes such as trauma from accidents, most common vertebral levels injured, types of injuries, symptoms depending on injury level, complications, assessment, management including initial care, drug therapy, and long term care needs. Key points include trauma as the main cause, cervical vertebrae most commonly affected, complete versus incomplete injuries determined by degree of sensation and motor function loss below injury level, and management focusing on respiratory, cardiovascular, bladder, bowel and skin integrity issues.
9 coma
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system, thalamus, or diffuse lesions in both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering supportive medications. A thorough neurological exam evaluates level of consciousness, brainstem reflexes, motor function, and more to localize lesions and distinguish structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
Nervous system
The document discusses the nervous system and different types of paralysis. It explains that the nervous system is divided into the central and peripheral nervous systems. It then defines several medical terms related to paralysis, including hemiplegia as partial or total paralysis on one side of the body. Hemiplegia can be present at birth or occur later in life, and is often caused by a brain lesion or stroke disrupting blood flow to the brain.
Chapter 12 presentation
The suffix -plegia means paralysis and can refer to paralysis of different parts of the body. Some examples are:
1) Monoplegia refers to paralysis of one limb.
2) Quadriplegia refers to paralysis of all four limbs.
3) Hemiplegia refers to paralysis of one side of the body.
4) Paraplegia refers to paralysis of the lower half of the body.
The suffix -esthesia means feeling or sensation. It can refer to abnormal sensations like anesthesia (loss of sensation), hyperesthesia (excessive sensation), or paresthesia (abnormal sensations like burning or tingling).
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Coma
1. Coma results from damage to the reticular activating system in the brainstem or widespread damage to both cerebral hemispheres.
2. Lesions in the upper brainstem can cause pupillary dilation and loss of eye movement, while more diffuse lesions cause preserved pupillary function.
3. Cerebral mass lesions and herniations, like uncal herniation, can compress brain structures and blood vessels, causing coma.
4. Metabolic disorders that disrupt brain energy supply like hypoglycemia or hypoxia can induce coma by interrupting neuronal function.
hemiparesis
A 38-year-old man was brought to the health center due to seizures that started in his right arm and progressed to his right leg and then his whole body. This has been occurring for 3 months around 3 times per month. The patient also complains of frequent headaches and feeling unsteady when walking or holding things as his right hand and leg feel weak. Based on the symptoms, differential diagnoses include stroke, brain tumor, and brain abscess. Further tests like CT scan or MRI are needed to confirm the diagnosis.
Chapter 12 ppt to post
This document discusses medical terminology related to the nervous system. It defines terms ending in -plegia, meaning paralysis, and -esthesia, meaning feeling or sensation. Specific terms discussed include paraplegia (paralysis of the lower half of the body), quadriplegia (paralysis of the arms and legs), and hyperesthesia (excessive sensation). Causes of paralysis include strokes, spinal cord injuries, and neurological diseases. Treatments for conditions like hyperesthesia include analgesics, antidepressants, and anticonvulsants.
Consciousness, ras and approach to coma
This document provides information on examining patients presenting with coma. It defines consciousness and the reticular activating system. It describes the examination of a comatose patient, including assessing respiratory pattern, pupils, ocular motility, motor response, and differentiating structural from toxic-metabolic causes of coma. It also discusses signs of brain herniation seen in comatose patients.
Paralysis
Paralysis is the complete loss of muscle function for one or more muscle groups and often includes loss of feeling in the affected area. It can be caused by damage to upper motor neurons, which convey signals from the brain to the nervous system, or lower motor neurons, which connect to muscles. Signs and symptoms depend on the location and severity of damage and may include numbness, tingling, pain, vision problems, speech difficulties, and breathing issues. Treatments focus on physical and occupational therapy to regain mobility, muscle strength, and independence through techniques like range of motion exercises and home modifications.
Chapter 12
This document provides information about different types of paralysis and weakness caused by damage to the nervous system. It defines quadriplegia/tetraplegia as paralysis of all four limbs and the torso, usually caused by spinal cord injury. Plegia is defined as a suffix meaning paralysis. Specific types of plegia discussed include hemiplegia (one side of the body), paraplegia (the legs), and quadriplegia/tetraplegia (all four limbs). Paraplegia describes paralysis of the legs and possibly the trunk. Paresis is defined as muscular weakness caused by nerve damage or disease, representing partial paralysis. The key difference between plegia and paresis is that p
Coma and brain stem death
This document summarizes key aspects of coma and brain stem death. It discusses the neurological structures involved in consciousness and what is required to induce coma. Coma is defined as unarousable unresponsiveness, distinguished from an alert state. Assessing a comatose patient involves obtaining history, performing a general and neurological exam including the Glasgow Coma Scale, and considering appropriate investigations and management. Brain death is defined as the irreversible loss of all brain functions including the brainstem, determined by coma, absence of brainstem reflexes, and apnea on testing.
Coma
This document discusses altered mental status and coma. It describes different levels of consciousness including light coma and deep coma. The Glasgow Coma Scale is introduced as a tool to assess a patient's level of consciousness based on their eye, verbal, and motor responses. Common causes of altered mental status are summarized using the AEIOU TIPS mnemonic, covering factors like alcohol, electrolyte imbalances, infections, and trauma. Clinical presentations and emergency treatments including airway management, glucose administration, and antidotes for overdoses are outlined.
Coma usmf
This document discusses states of normal and impaired consciousness, including coma. It describes coma as an extreme state of unresponsiveness where an individual exhibits no voluntary movement or behavior. The document outlines an approach for clinically evaluating a comatose patient, including examining vital signs, skin features, breath odor, and performing a neurological examination to help identify potential underlying causes of coma. It also introduces the Glasgow Coma Scale for assessing the level or depth of impaired consciousness or coma.
evaluation & management of patient in coma
This document discusses the evaluation and management of coma. It begins by defining coma as prolonged unresponsiveness. It then describes the anatomy of arousal centered around the ascending reticular activating system. Assessment of coma involves the Glasgow Coma Scale and examining for signs of increased intracranial pressure. Common causes of coma include metabolic derangements, structural lesions of the brainstem or supratentorial regions. Management involves stabilizing ventilation, circulation, controlling seizures, reducing intracranial pressure and maintaining temperature. Detailed neurological examination can help localize lesions through assessment of reflexes, eye movements, respiratory patterns and posture.
Definitions, and approach to Coma
This document provides information on consciousness and coma:
- Consciousness has two components - arousal from the reticular activating system and awareness from the cerebral cortex. Stimulation of the RAS produces arousal while its destruction causes coma.
- The Glasgow Coma Scale and newer scales like FOUR are used to evaluate patients in comatose or reduced states of consciousness. The FOUR scale assesses eye, motor, brainstem, and respiratory responses.
- Causes of coma can be structural/focal brain injuries or non-structural/diffuse issues like hypoxia, infections, or toxic exposures. An approach is outlined to initially stabilize an unconscious patient and guide further examination and investigations.
Coma Clinical Examination
The document provides guidance on performing a neurological examination on a patient presenting with coma. It describes assessing the level of consciousness using the AVPU and Glasgow Coma scales. Key aspects of the physical exam are outlined, including vital signs, signs of trauma, skin appearance, neck stiffness, pupil size/reactivity, and posture responses that may indicate lesions in specific areas of the brain or brainstem. Priority is given to the ABCs to ensure adequate oxygenation and circulation as underlying life-threatening conditions are addressed first before a more thorough neurological assessment.
Coma
This document discusses coma, including its definition, causes, and approach to assessment and management. Coma is the deepest state of impaired consciousness where a patient cannot be aroused. Causes include structural brain injuries, infections, metabolic derangements, and drugs. Evaluation of a comatose patient involves assessing vital signs, neurological exam including pupil response and eye movements, investigations like blood tests and imaging, and treatment of reversible causes. Brain death is the complete and irreversible loss of brain function while cardiac and respiratory functions may be maintained artificially.
Management of coma and altered sensorium 19.4.01
This document discusses the management of patients presenting with coma or altered sensorium. Key points include evaluating vital signs and providing emergency treatment to maintain ventilation, circulation, control seizures, and manage intracranial pressure. Further tests such as bloodwork and imaging studies can help identify potential metabolic, structural or toxic causes. Ongoing care focuses on preventing complications through careful monitoring and stimulation techniques.
Altered sensorium Case 2014
A 21-year-old female patient with systemic lupus erythematosus (SLE) on steroids presented with generalized tonic-clonic seizures and altered sensorium. The top differential diagnoses included posterior reversible encephalopathy syndrome (PRES), posterior circulation ischemia/infarction, vasculitis, hypoglycemia, sinovenous thrombosis, thrombotic microangiopathies, status epilepticus, and reversible cerebral vasoconstriction syndrome. The document discusses PRES in more detail, describing its typical parieto-occipital involvement on imaging, various atypical manifestations, pathogenesis related to hypertension and endothelial dysfunction, and common causes like preeclampsia/eclampsia, infection
Coma
This document defines coma as an unarousable unresponsiveness state where patients cannot be aroused or respond appropriately to stimuli. Coma is caused by damage to the ascending reticular activating system in the brainstem or diffuse bilateral damage to the cerebral hemispheres. A thorough neurological exam is needed to assess coma, including tests of arousal, motor function, and cranial nerves like pupils and eye movements to localize lesions. Early intervention is important to preserve life and brain function for comatose patients.
Coma
The document discusses various states of consciousness including coma, stupor, and drowsiness. It describes potential causes of coma such as lesions in the reticular activating system or both cerebral hemispheres. Clinical signs that can help localize lesions are described, such as pupillary abnormalities suggesting brainstem involvement. The initial approach and assessment of a patient presenting with altered mental status or coma is outlined, including interventions, ancillary testing, and treatment in the emergency department. Various clinical signs are also described that may provide clues to the cause of coma.
The nervous system
Hemiplegia is partial or total paralysis of one side of the body that results from injury or disease in the motor centers of the brain. It is most commonly caused by strokes in elderly individuals. In children, hemiplegia often has no identifiable cause. Symptoms include difficulty with movement, balance, motor skills, speech and swallowing. While not progressive, hemiplegia symptoms do not improve once the injury has occurred. Anesthesia refers to the temporary loss of sensation, including pain, induced pharmacologically. It can be local, regional, general or dissociative depending on the area of the body or brain affected.
Spinal cord injury
This document discusses spinal cord injuries, including causes such as trauma from accidents, most common vertebral levels injured, types of injuries, symptoms depending on injury level, complications, assessment, management including initial care, drug therapy, and long term care needs. Key points include trauma as the main cause, cervical vertebrae most commonly affected, complete versus incomplete injuries determined by degree of sensation and motor function loss below injury level, and management focusing on respiratory, cardiovascular, bladder, bowel and skin integrity issues.
9 coma
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system, thalamus, or diffuse lesions in both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering supportive medications. A thorough neurological exam evaluates level of consciousness, brainstem reflexes, motor function, and more to localize lesions and distinguish structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
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Similar to Chapter 12 The Nervous System
Nervous system
The document discusses the nervous system and different types of paralysis. It explains that the nervous system is divided into the central and peripheral nervous systems. It then defines several medical terms related to paralysis, including hemiplegia as partial or total paralysis on one side of the body. Hemiplegia can be present at birth or occur later in life, and is often caused by a brain lesion or stroke disrupting blood flow to the brain.
Chapter 12 presentation
The suffix -plegia means paralysis and can refer to paralysis of different parts of the body. Some examples are:
1) Monoplegia refers to paralysis of one limb.
2) Quadriplegia refers to paralysis of all four limbs.
3) Hemiplegia refers to paralysis of one side of the body.
4) Paraplegia refers to paralysis of the lower half of the body.
The suffix -esthesia means feeling or sensation. It can refer to abnormal sensations like anesthesia (loss of sensation), hyperesthesia (excessive sensation), or paresthesia (abnormal sensations like burning or tingling).
The nervous system
The document discusses different types of neurological conditions and anesthesias. It describes -plegias as weaknesses or paralysis affecting parts of the body, such as hemiplegia affecting one side or monoplegia affecting a single limb. -esthesias refer to loss of sensation, with anesthesia specifically numbing parts of the body. There are three main types of anesthesia: local anesthesia numbing a small area, regional anesthesia blocking pain to a larger area while awake, and general anesthesia affecting the entire body and rendering the patient unconscious.
Review of the Diagnosis and Treatment of Paralysis
Paralysis is a complete loss of motor power in any muscle group. When paralysis affects all four extremities, it is called quadriplegia when it affects only the lower extremities, paraplegia and when it affects the extremities on one side of the body, hemiplegic. For this reason, the term paralysis is generally reserved for more focal, less stereotyped weakness, for instance, affecting all the muscles innervated by a peripheral nerve. Many different anatomical lesions and etiologies can cause paralysis and determine its treatment. Bikash Debsingha | Dr. Gourav Kr. Sharma | Dr. Kausal Kishore Chandrul "Review of the Diagnosis and Treatment of Paralysis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45108.pdf Paper URL: https://www.ijtsrd.com/pharmacy/pharmacology-/45108/review-of-the-diagnosis-and-treatment-of-paralysis/bikash-debsingha
Nervous system ch 12
The nervous system is an organ system made up of specialized cells called neurons that coordinate animal actions and transmit signals throughout the body. It contains networks of neurons that process sensations like pain and sensations like paralysis. General anesthesia affects both the brain and entire body, causing complete unawareness and lack of pain during surgery as well as temporary memory loss of the surgery.
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The document provides guidelines for the management of childhood epilepsy. It discusses the classification of seizures and epilepsy syndromes. Some key seizure types include partial seizures, generalized seizures like absence seizures, myoclonic seizures, atonic seizures, and tonic-clonic seizures. It also discusses approaches to diagnosing and treating common idiopathic or genetic epilepsy syndromes in children like benign childhood epilepsy with centrotemporal spikes and childhood absence epilepsy. Treatment involves antiepileptic drugs and considering neuroimaging in some cases.
How to localize neurological lesion
The structure of the human brain is extremely complex. It is made up of billions of neurons that are linked together by trillions of connections. Each part of the brain performs a certain set of functions. Damage to a specific area of the brain causes distinct clinical symptoms. Knowledge of neuroanatomy, functioning of different sections of the brain, and clinical manifestations caused by injury to a part of the brain are critical in locating a neurological lesion. The complexity of this knowledge frequently presents a problem to health practitioners. This activity emphasizes the significance of the physical examination in the localization of a neurological lesion. It is intended to provide a concise and easy-to-review summary of the subject.
Chapter 12 presentation
Paraplegia is an impairment of motor or sensory function in the lower extremities, usually caused by spinal cord injury or a congenital condition like spina bifida. It affects the thoracic, lumbar, or sacral regions of the spinal canal. Paraplegia can result from traumatic spinal cord injury, inflammation/swelling, or non-traumatic factors like tumors, scoliosis, or spina bifida. Spinal cord injuries causing paraplegia are classified as complete or incomplete based on the retention of feeling or function below the injury point.
Anesthesia & its types
This document discusses different types of anesthesia used in surgery. It describes general anesthesia as making the patient completely unconscious using intravenous drugs and inhaled gases. Regional anesthesia involves injecting local anesthetics around nerves or the spinal cord to numb a specific body region. Local anesthesia temporarily stops pain sensation in a localized area using injections. The stages and phases of general anesthesia are also outlined, including induction to prepare the patient, maintenance during surgery, and recovery afterward. Risks of anesthesia are generally low but can include side effects like nausea, depending on individual health factors.
Cns Neuropathy Davidson07.
This document summarizes different types of neuropathies including focal neuropathies, generalized neuropathies, cranial neuropathies, and hereditary neuropathies. It discusses various causes of neuropathies including metabolic, toxic, inflammatory, and genetic factors. Specific conditions summarized include Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, Charcot-Marie-Tooth disease, and entrapment neuropathies. Diagnostic testing and management of some common neuropathies are also briefly mentioned.
Ppt spinal
The spinal cord extends from the brainstem and down the back, containing bundles of nerve fibers that connect the brain to the peripheral nervous system. It carries sensory information from the body to the brain and motor commands from the brain to the body. Damage to the spinal cord can occur through trauma, compression, or reduced blood flow, resulting in paralysis and loss of sensation depending on the level and completeness of injury. Management involves pharmacological treatment, physical therapy, and sometimes surgery to decompress the spinal cord.
Spinal injuries
This document discusses the anatomy and function of the spinal cord and vertebrae. It describes the different types of spinal cord injuries, including complete transection and incomplete injuries that can cause central cord syndrome, anterior cord syndrome, posterior cord syndrome, or Brown-Sequard syndrome. Risk factors for spinal cord injury are discussed as well as assessment and treatment considerations.
Neuro
This document defines medical terms related to the nervous system, including suffixes that indicate paralysis (-plegia), pain or sensitivity (-algesia), speech disorders (-phasia), and sensation or feeling (-esthesia). It provides the meanings and examples for each term, such as hemiplegia meaning paralysis on one side of the body, analgesia reducing pain perception, aphasia impairing language abilities, and anesthesia reducing or blocking sensation.
Localization
This document discusses neurological examination and localization of lesions in the nervous system. It describes the steps in neurological diagnosis and provides information on localization of lesions at different levels of the neuraxis from the cortex to muscles. Key signs and symptoms are outlined for upper motor neuron and lower motor neuron lesions, as well as peripheral nerve disorders, neuromuscular junction disorders, and muscle disorders. Specific examination findings that help localize lesions in different parts of the brain, spinal cord, nerves, and neuromuscular junction are also summarized.
Hereditary spastic paraplegia
Hereditary spastic paraplegia (HSP) is a group of inherited neurological disorders characterized by the progressive stiffening and weakening of the lower limbs. The most common symptoms are difficulty walking and lifting the toes. HSP results from degeneration of nerve fibers in the spinal cord that control the lower body, and can be caused by mutations affecting axonal transport, mitochondria, or myelin. While there is no cure, treatment focuses on physical therapy, medication to reduce spasticity and pain, and addressing complications like contractures.
Chapter 1-intro duction of anesthesia 22439
The document provides an introduction to anesthesia. It discusses the definition of anesthesia and the two main types: general anesthesia and regional (local) anesthesia. General anesthesia involves unconsciousness and is usually required for major surgery, while regional anesthesia blocks sensation in a restricted area of the body and is commonly used for minor procedures and surgery. The document outlines the mechanisms, stages, drugs, and equipment involved in general anesthesia, as well as various regional anesthesia techniques like spinal blocks. It also discusses the scope of practice for anesthesiologists, which includes perioperative care, intensive care, resuscitation, pain management, research, and teaching.
Seminar on Seizure Disorders
The document discusses seizure disorders and epilepsy. It defines epilepsy as a brain disorder causing seizures from abnormal electrical activity in the brain. Seizures are classified as partial or generalized depending on where they originate and spread in the brain. Common causes of epilepsy include genetic factors, brain injuries, infections, and metabolic imbalances. Diagnosis involves a medical history, neurological exam, EEG, and brain imaging. Treatment focuses on medications to control seizures and sometimes surgery for refractory cases. Nursing care includes safety measures during seizures and education on epilepsy management.
Epilepsy
Epilepsy is a central nervous system disorder characterized by abnormal brain activity that causes seizures. Seizures can vary in their symptoms but commonly involve temporary confusion, staring spells, jerking movements, loss of awareness, or changes in emotions and senses. A diagnosis of epilepsy requires at least two unprovoked seizures. Epilepsy affects people of all ages, races and backgrounds. Treatment options include medications or surgery which can control seizures for most people with epilepsy.
fits and siezures deffination and its types
This document discusses the different types of seizures. It begins by explaining that seizures are caused by disturbances in electrical brain activity. Seizures are divided into two broad categories: generalized seizures originating across the entire brain, and partial seizures originating in a small area. Generalized seizures include grand mal, absence, myoclonic, clonic, tonic, and atonic seizures. Partial seizures are further divided into simple and complex, with simple seizures maintaining awareness and complex resulting in lost awareness. Symptoms of epilepsy include repeated seizures with symptoms like convulsions, blackouts, fainting, unresponsiveness, stiffness, falling, blinking, chewing, dazedness, repetitive movements, fear, changes in senses, and jerking
Nervous System Ailments & Function
My most interesting presentation this semester. This one explains suffixes, nervous system ailments and basic functions of the nervous system.
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Review of the Diagnosis and Treatment of Paralysis
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Chapter 12 The Nervous System
- 2. -PLEGIA (paralysis)MONOPLEGIA MONOPLEGIA: is a paralysis of a single limb, usually an arm. It is frequently associated with cerebral palsy. This is the mildest form of cerebral palsy, and individuals with it generally have a good prognosis for later life. It can also be used if just one muscle group or muscle is affected. It is often referred to as HEMIPLEGIA with much less involvement of the other limb.
- 3. -PLEGIA (cont.)PARAPLEGIA PARAPLEGIA: an impairment in motor and/or sensory function of the lower extremities. It is usually the result of spinal cord injury or a congenital condition such as spina bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis, TETRAPLEGIA is the proper terminology.
- 4. -PLEGIA (cont.)QUADRIPLEGIA QUADRIPLEGIA: also known as TETRAPLEGIA, is paralysis caused by illness or injury that results in the partial or total loss of use of all limbs and torso. The loss is usually sensory and motor, which means that both sensation and control are lost.
- 6. -ESTHESIA (sensations)ANESTHESIA Anesthesia, or anaesthesia, has traditionally meant the condition of having sensation, including the feeling of pain, blocked or temporarily taken away. This allows patients to undergo surgeries and other procedures without distress and pain they would otherwise experience.
- 7. -ESTHESIA (cont.)ANESTHESIA ANESTHESIA is a pharmacologically induced reversible state of amnesia, loss of consciousness, loss of skeletal muscle reflexes and decreased stress response. GENERAL ANESTHESIA: a total lack of awareness experienced by the patient. SPINAL ANESTHETIC: a lack of awareness of a part or portion of the body experienced by the patient. (eg. spinal anesthetic, epidural anesthetic or nerve block)