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Degenerative disorders - Coggle Diagram

- - - - Intracerebral tumours
        
        Gliomas
        
        Spread infiltrating surrounding neural tissues
        
        Causing damage to vital organs
        
        Astrocytomas
        
        Medulloblastomas
      - Tumours arising from supporting structures
        
        Aucostic neuromas
        
        In the 8th cranial nerve
        
        For hearing
        
        Balance
        
        Arise within internal auditory meatus
        
        Frequently expand
        
        Filling the cerebellopontine recess
        
        Hearing loss
        
        Vertigo
        
        Tinnitus
        
        Staggering gait
        
        Tumour growth progression
        
        Painful sensation on the face
        
        5th cranial nerve compression
        
        Pituitary adenomas
        
        Exert pressure on the adjacent structures
        
        Hormonal changes
        
        Hypofunction
        
        Hyperfunstion
        
        optic nerve
        
        optic chiasma
        
        Hypothalamus
        
        3rd ventricle
        
        Cavernous sinuses invasion
        
        Effect of pressure of all these structures
        
        Headaches
        
        Sleep disorder
        
        Appetite
        
        Temperature
        
        Emotions
        
        Increased ICP
        
        Enlargement and erosion of the sell turcica
        
        Meningiomas
        
        Encapsulated tumours of arachnoid cells
        
        Slow growing
        
        Compression on brain tissue
      - Developmental tumours
        
        Dermoid,epdermal,teroma,craniophsryngoma
        
        Angiomas
      - Metastatic lesions
  - - - Vomiting
      - Headache
      - Nausea
      - Sixth -nerve palsy
      - Personality changes
      - Focal deficit
        
        Motor deficit
        
        Sensory deficit
        
        Cranial nerve dysfunction
  - - - Prevent aspiration
        
        Position on the side
        
        Suctioning PRN
      - To promote nutrition
        
        Evaluate swallowing reflex
        
        Gag reflex evaluation
        
        Sitting up postion
        
        Advise the patient to use unaffected side
        
        Semi-soft diet
        
        Neurological function assessment
        
        Monitor vital signs
        
        Orientation
        
        Verbal response
        
        Motor function
        
        Pupil size
        
        Pupils reaction to light
        
        Pupil s equality
        
        Dietician
      - Promotion of safety
        
        Pillow padding
        
        Nurse in a closed cotbed
      - Palliative care
        
        To relieve pain and discomfort
        
        Morphine
      - Nursing diagnosis
        
        Imbalance nutrition
        
        Anxiety
        
        Self care deficit
        
        Interrupted family process
    - - Biopsy
      - PET
      - MRI
      - CTscan
      - EEG
      - Cerebral angiography
      - CSF
    - - Chemotherapy
      - Radiation therapy
      - Intravenous bone marrow transplant
      - Corticosteroids
      - Gene transfer therapy
      - Photodynamic therapy
      - Anticonvulisants
      - Mannitol
      - Heparin
      - Chemotherapeutic agents
        
        Lomustine
        
        Carmustine
        
        Topotecan
    - - Cranniotomy
      - Transphenoidectomy
      - Brachytherapy
      - Laser
      - Radiosurgery
        
        Gamma knife
- - - - Postural instability
      - Gait disturbance
      - Hypokinesia
        
        Appear after tremour
        
        Freezing
        
        Decreased arm swing
        
        Microphagia
        
        Shrinking slow handwriting
        
        Masklike face and expressionless
        
        Frequent blinking decrease
        
        Dysphonia
        
        Soft ,slurred,low pitched and less audible speech
        
        Dysphagia
        
        Drooling
      - 3 cardinal signs
        
        Tremor
        
        Resting tremour
        
        Slow , rhythmic turning motion
        
        Rigidity
        
        Resistance to passive movement
        
        Muscle rigidity
        
        Jerky
        
        Neck , trunk and shoulders stiffness
        
        Bradykinesis
        
        Common feature
        
        Difficulty initiating movement
        
        Difficulty completing activities
      - Dermentia
    - - Destruction of dopaminergenic neurological cells :
        
        Degeneration of dopaminogernic nigrostriatal pathway
        
        Imbalance of excitatory and inhiting dopamine neurotransmitters
        
        Depletion of dopamine stores
        
        Impairement of extrapyrimidal tracts controlling complex body movements
        
        Tremour, rigidity and Bradykinesis
    - - Impaired physical mobility
      - Self care deficit
      - Imbalance nutrition
      - Impaired verbal communication
    - - Improving moblity
        
        Daily exercises
        
        Passive
        
        Active
        
        Physiotherapy
        
        Warm baths and massage
      - Self care enhancement
        
        Teaching, encouragement and support
        
        Environment modification
        
        Bedside rails
        
        Rope tied on the foot end
        
        Occupational therapy
        
        Adaptive devices
        
        Care giver
      - Improving nutrition
        
        Dietician
        
        Semisolid diet
        
        Upright position during meals
        
        Swallowing technique sequence
        
        Saliva buildup control
        
        Massaging face and neck muscles
        
        Weight monitoring
        
        Nasogastric tube feeds
      - Improving communication
        
        Speech therapy
        
        Patient teaching
        
        To face the listener
        
        Exaggerate pronounciation
        
        Electrical amplifier
      - Support and coping abilities
        
        Encourage active participation
        
        Multidisciplinary combination approach
        
        Group support
        
        Assist and encourage goal achievements
        
        Therapeutic programmes
        
        Social events
        
        Recreational events
      - Home and community based care
        
        Family education
        
        Information on ongiong adaptation
        
        Educate on medication effects and side effects
    - - Pharmacological therapy
        
        Increasing striatal dopaminergic activity
        
        Reducing excessive influence of excitary cholinergic neurons
        
        Acting on neurotransmitter pathway
        
        Anticholinergic therapy
        
        Biperiden
        
        Used in combination with levodopa
        
        Couneract the action of neurotransmitter acetylcholine
        
        Antiparkinson medications
        
        Levodopa
        
        Precipitate oxidation
        
        Carvidopa
        
        Maximise Levodopa effect
        
        Minimise side effects
        
        Antiviral therapy
        
        Symmmetrel
        
        Reduce rigidity,tremor,bradykinesia
        
        Dopamine agonists
        
        Bromocryptine mesylate
        
        Pergolide
        
        Mirapex
        
        Requip
        
        Monoamine oxidase inhibitors
        
        Antihistamines
        
        Antidepressants
      - Surgical management
        
        Stereotactic procedures
        
        Thalamotomy
        
        Pallidotomy