NURS 2003H Lecture Notes - Lecture 2: High-Protein Diet, Nuclear Magnetic Resonance Spectroscopy, Methylprednisolone
26 Jun 2018
School
Department
Course
Professor
SEMINAR PARTICIPATION
Fill in the chart each week by answering the questions indicated; more information may be added
as it fits the categories, the questions are just to provide guidance.
Topic Key Points
Etiology
-The cause of MS is unknown
-Research findings suggest a relation to the environmental and
infectious (viral) factors, dietary deficiencies (vitamin D), and
immunological and genetic factors
-Susceptibility appears to be inherited through first, second and
third-degree relatives
-Role of precipitating factors is controversial, it is possible that
their association to MS is random and without cause and
effect relationship
- Possible precipitating factors might include infection, trauma,
emotional stress, excessive fatigue, pregnancy, and a state of
poor health
Pathophysiology
-Characterized by chronic inflammation, demyelination
(damage to the myelin sheath of a neuron), and gliosis
(scarring) in the CNS
-The primary neuropathological condition is an autoimmune
disease caused by autoreactive (cells produced by the body
and attacks its own cells or tissues) T cells (lymphocytes)
-The activated T cells in the systemic circulation migrate to the
CNS, causing blood brain barrier disruption. This is likely the
initial event in the development of MS
-Next, an antigen-antibody reaction within the CNS results in
activation of the inflammatory response and through multiple
effector mechanisms leads to demyelination of axons
-The disease process consists of loss of myelin, disappearance
of oligodendrocytes (type of glial cell in the CNS that
provides support and insulation to axons), proliferation of
astrocytes (star shaped glial cell in the CNS)
-These alterations result in characteristic plaque formation, or
sclerosis, with plaques scattered throughout multiple regions
find more resources at oneclass.com
find more resources at oneclass.com
of the CNS
-Initially the myelin sheaths of the neurons in the brain and
spinal cord are attacked, early in the disease the myelin sheath
is damaged, but the nerve fibers are not, and nerve impulses
are still transmitted (at this stage the patient may experience a
noticeable impairment of function, such as weakness)
-However, myelin sheath can regenerate, and symptoms can
disappear, resulting in remission
-Myelin is replaced by glial scar tissue, which forms hard,
sclerotic plaques in multiple regions of the CNS
-Without myelin sheath, nerve impulses are slower, and
without destruction of nerve axons, impulses are totally
blocked, resulting in permanent loss of function
-In many chronic lesions, demyelination continues with
progressive loss of nerve function
Clinical
Manifestations (signs
and symptoms)
-Onset is gradual with vague symptoms that occur
intermittently over months or years
-This means that it may not be diagnosed until long after the
onset of the initial symptoms
-The disease process has an unpredictable distribution in the
CNS, therefore signs and symptoms can vary over time
chronic, progressive deterioration in some and remissions
and exacerbations in others
-With repeated exacerbations, however, progressive scarring of
the myelin sheath occurs, and the overall trend is progressive
deterioration in the neurological function
-Common signs and symptoms of MS include motor, sensory,
cerebellar, and emotional problems
-What do you think are examples of motor symptoms?
-Motor symptoms include weakness or paralysis of the limbs,
the trunk or head, diplopia (double vision), scanning speech,
and spasticity of the muscles that are chronically affected
-What are some sensory abnormalities?
-Variety of sensory abnormalities, including numbness and
tingling and other paresthesia (pins and needles), patchy
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Fill in the chart each week by answering the questions indicated; more information may be added as it fits the categories, the questions are just to provide guidance. Research findings suggest a relation to the environmental and infectious (viral) factors, dietary deficiencies (vitamin d), and immunological and genetic factors. Susceptibility appears to be inherited through first, second and third-degree relatives. Role of precipitating factors is controversial, it is possible that their association to ms is random and without cause and effect relationship. Possible precipitating factors might include infection, trauma, emotional stress, excessive fatigue, pregnancy, and a state of poor health. Characterized by chronic inflammation, demyelination (damage to the myelin sheath of a neuron), and gliosis (scarring) in the cns. The primary neuropathological condition is an autoimmune disease caused by autoreactive (cells produced by the body and attacks its own cells or tissues) t cells (lymphocytes) The activated t cells in the systemic circulation migrate to the.
