NR 283 PATHOPHYSIOLOGY FINAL EXAM STUDY GUIDE, NR 283: Pathophysiology, Chamberlain College of Nursing

PATHOPHYSIOLOGY – FINAL EXAM STUDY GUIDE

NEURO – TERMS TO KNOW


CONSCIOUSNESS
 The state of being aware, or perceiving physical facts or mental concepts; a state of general
wakefulness and responsiveness to environment; a functioning sensorium. [L. conscio, to know, to
be aware of]
 totally aware of surrounding activities and incoming stimuli
 oriented to time, place, and people
 person can respond quickly and appropriately to questions, commands, or events.
 Various levels of reduced consciousness may present as
o Lethargy
o Confusion
o Disorientation
o memory loss
o unresponsiveness to verbal stimuli
o difficulty in arousal
 Glasgow Coma Scale
o Used for assessing LOC
 Coma
o Most serious level of loss of consciousness
o Affected person does not respond to stimuli (pain, or verbal)
o Some reflexes may still be present
 Deep coma
o Loss of all reflexes
o Fixed and dilated pupils
o Slow and irregular pulse and respirations

AROUSAL
 Reticular Activating System
 determines the degree of arousal or awareness of the cerebral cortex
 The pons and medulla influence the brain's awareness of the incoming pain stimuli
o PONS – composed of bundles of both afferent (incoming) and efferent (outgoing) fibers
o MEDULLA
 contains vital control centers that regulate respiratory and cardiovascular function
 contains the coordinating centers that govern coughing, swallowing, vomiting

VEGETATIVE STATE
 Loss of awareness and mental capabilities
 Results from diffuse brain damage

AMNESIA
 Loss of memory

,CONVULSION
 sudden, involuntary movement with loss of awareness, caused by uncontrolled neuronal discharge in
the brain.
TONIC
 In a state of continuous unremitting action; denoting especially a muscular contraction. 2.
Invigorating; increasing physical or mental tone or strength.

CLONIC/CLONIC STATE/CLONIC SPASM
 Relating to or characterized by clonus
 Movement marked by repetitive muscle contractions and relaxations in rapid succession.
 Alternate involuntary contraction and relaxation of a muscle

DYSPHASIA
 Difficulty comprehending language or speaking; partial impairment of communicating ability
 Less severe form of aphasia
 Caused by damage to the brain
APHASIA
 Inability to comprehend or express language; total loss of communicating ability
 Receptive—damage to Wernicke’s area
 Expressive—damage to Broca’s area
 Mixed, global—damage to both areas or to the fibers and tracts between them

PARESIS
 Muscle weakness
 Mild paralysis

OTORRHEA
 Leaking of CSF from the ear
 Occurs with fractures
 Tearing of meninges
o Allows CSF to pass out of the subarachnoid space

SEIZURES
Seizures (look up types of seizures)
● Generalized
o Absence seizures (petit mal)
▪ Lapses of awareness lasting only a few seconds

▪ Appear without warning/end abruptly

▪ More common in children

▪ Are frequently so brief, they go undetected
o Tonic-clonic (grand mal)
▪ Most common

▪ Begin with stiffening of limbs (tonic phase)

, ▪ Followed by jerking of the limbs/face (clonic phase)
o Myoclonic
▪ Rapid, brief contractions of bodily muscles

▪ Occur at the same time on both sides of body

▪ Usually involve one arm or a foot

▪ “sudden jerk” movements or “clumsiness”
o Atonic (akinetic, astatic, or drop attacks)
▪ Abrupt loss of muscle tone

▪ Can produce head drops, loss of posture, or sudden collapse

▪ Appear without warning

▪ Can result in injuries to head and face

▪ Seizures are resistance to Rx therapy

▪ Protective headgear recommended
o Lennox-Gastaut Syndrome (febrile seizures)
▪ Form of severe epilepsy

▪ Begins in childhood

▪ Characterized by multiple types of seizures and intellectual disability

▪ Child experiences frequent seizures (mixed type seizures)

▪ Interrupts neurological development
 resulting in learning disabilities
 delayed motor development
▪ Difficult to control, even with Rx medication

● Partial
o Simple partial
▪ one area of the body is experiencing spasm/twitch

▪ person does not lose consciousness during seizure

▪ while fully aware, person may not be able to speak/move until seizure is over

▪ person may feel odd or altered sensations (affects all five senses)

▪ nausea may be present

▪ emotions may also be affected
o Complex partial (psychomotor)

, ▪ Affect larger area of brain

▪ Affect consciousness; person may appear to altered state of consciousness

▪ During a seizure, person cannot interact normally

▪ Actions are typically unorganized, confused, and unfocused

▪ Unable to control body movements, speech, and actions

▪ Unaware of actions

▪ Does not remember what happened during seizure

▪ “temporal lobe epilepsy”


● Continuous seizures (status epilepticus)
o in/out of seizures every second – constant/continuous state of seizure
o Increased metabolism of glucose and oxygen
o May be life-threatening
o primary focus = PATIENT SAFETY
▪ cannot stop a seizure

▪ ABCs + safety
o Death or brain damage from status seizures (as opposed to death from the underlying cause) is
most likely to result from:
▪ Direct damage to the brain caused by the injury that causes the seizures

▪ Stress on the system from repeated generalized tonic clonic seizures

▪ Injury from repeated electrical discharge in the brain




ALZHEIMER’S DISEASE (AD) (tends to be more psychosocial)(can be considered primary)
● Progressive cortical atrophy
o Neurofibrillary tangles and plagues
o ACh deficit caused by loss of neurons
● No definite diagnostic tests available
o Exclusion of other disorders
o Careful medical and psychological history
● Specific cause unknown
o Repetitive DNA sequences on different chromosomes have been associated with AD.
● Five stages