PATHOPHYSIOLOGY
|PHARMACOLOGY II (NURS 432)
STUDY SHEET FOR EXAM 4 (a
comprehensive and thorough
review of all the material that will
be tested on Exam 4 in this course)
PACE UNIVERSITY.
, NURS 432 – Pathophysiology/Pharmacology II Exam 4 Study Sheet
Nervous System
(Patho Chapter 11)
Nervous System A&P Basics – Self-Review: (Chapters 12, 13 & 20) → Review Lehne’s TB
Seizures: (Chapter 24)
Seizure Classification:
➢ Partial Seizures: not easily defined; some begin as partial then spread; some present w/ both types; no clear pattern
• Partial: (focal) one part of the brain
• Other DX: easily confused with migraines, narcolepsy, syncope, psychiatric disorders
• Subtypes:
o Simple partial: no loss of consciousness (20-60s); discrete symptoms
▪ Motor: twitching thumb
▪ Sensory: numbness & hallucinations
▪ Autonomic: nausea, flushing, salivation, urinary incontinence
▪ Psychoillusory: unreality, fear, depression
o Complex partial: impaired consciousness, lack of responsiveness (45-90s)
▪ Gaze: is motionless and fixed
▪ Automatism: repetitive, purposeless movements, lip smacking, hand wringing, circling
o Secondarily generalized: consciousness is lost for 1-2m
▪ Dx Process: begins as simple or complex partial seizures, and evolves into generalized tonic-
clonic seizures
➢ Generalized Seizures: abnormal activity on both sides of brain
• Postictal state: post seizure CNS depression (confusion, fatigue, deep sleep)
• Subtypes:
o Tonic-clonic Seizure: aka grand mal seizure
▪ Discharge: throughout both hemispheres of cerebral cortex (≤ 90s)
▪ Major convulsions: elicit a loud cry → forceful air expiration
▪ Muscle rigidity: tonic phase
▪ Synchronous bilateral jerks: clonic phase
▪ Voiding: urination, but no defecation
▪ Marked impairment: of consciousness → postictal state
o Absence Seizure: aka petit mal seizure
▪ Prevalence: mainly in peds; cessation typical by early teens
▪ Brief LOC: 10-30s
▪ Frequency: hundreds/day
▪ Motor Activity: mild, symmetric motor activity (eye blinking, staring into space) or no motor
activity at all
o Atonic Seizure:
▪ Prevalence: mainly in peds
▪ Sudden loss of muscle tone:
• Neck: “head drop”
• Limbs & trunk: “drop attack”, sudden collapse
o Myoclonic Seizure:
▪ Sudden muscle contraction: for about 1s
• Affecting 1 limb: focal myoclonus
• Entire body: massive myoclonus
o Status epilepticus: (SE)
▪ Duration: ≥ 15-30min
▪ Episodes: may be recurrent w/ LOC
▪ Types: generalized convulsive SE, absence SE, myoclonic SE
• Generalized convulsive SE: life threatening
o Febrile Seizure:
▪ Prevalence: common in peds (6m – 5yo)
▪ Manifests: as short periods of generalized tonic-clonic convulsions
▪ No high risk: for epilepsy later in life
➢ Mixed Seizures:
• Lennox-Gastaut Syndrome: severe form of epilepsy, TX difficult
o Onset: develops during preschool years
o S/S: developmental delay & mix of partial & generalized seizures
o Types: partial, atonic, tonic, generalized tonic-clonic, atypical absence
1
|PHARMACOLOGY II (NURS 432)
STUDY SHEET FOR EXAM 4 (a
comprehensive and thorough
review of all the material that will
be tested on Exam 4 in this course)
PACE UNIVERSITY.
, NURS 432 – Pathophysiology/Pharmacology II Exam 4 Study Sheet
Nervous System
(Patho Chapter 11)
Nervous System A&P Basics – Self-Review: (Chapters 12, 13 & 20) → Review Lehne’s TB
Seizures: (Chapter 24)
Seizure Classification:
➢ Partial Seizures: not easily defined; some begin as partial then spread; some present w/ both types; no clear pattern
• Partial: (focal) one part of the brain
• Other DX: easily confused with migraines, narcolepsy, syncope, psychiatric disorders
• Subtypes:
o Simple partial: no loss of consciousness (20-60s); discrete symptoms
▪ Motor: twitching thumb
▪ Sensory: numbness & hallucinations
▪ Autonomic: nausea, flushing, salivation, urinary incontinence
▪ Psychoillusory: unreality, fear, depression
o Complex partial: impaired consciousness, lack of responsiveness (45-90s)
▪ Gaze: is motionless and fixed
▪ Automatism: repetitive, purposeless movements, lip smacking, hand wringing, circling
o Secondarily generalized: consciousness is lost for 1-2m
▪ Dx Process: begins as simple or complex partial seizures, and evolves into generalized tonic-
clonic seizures
➢ Generalized Seizures: abnormal activity on both sides of brain
• Postictal state: post seizure CNS depression (confusion, fatigue, deep sleep)
• Subtypes:
o Tonic-clonic Seizure: aka grand mal seizure
▪ Discharge: throughout both hemispheres of cerebral cortex (≤ 90s)
▪ Major convulsions: elicit a loud cry → forceful air expiration
▪ Muscle rigidity: tonic phase
▪ Synchronous bilateral jerks: clonic phase
▪ Voiding: urination, but no defecation
▪ Marked impairment: of consciousness → postictal state
o Absence Seizure: aka petit mal seizure
▪ Prevalence: mainly in peds; cessation typical by early teens
▪ Brief LOC: 10-30s
▪ Frequency: hundreds/day
▪ Motor Activity: mild, symmetric motor activity (eye blinking, staring into space) or no motor
activity at all
o Atonic Seizure:
▪ Prevalence: mainly in peds
▪ Sudden loss of muscle tone:
• Neck: “head drop”
• Limbs & trunk: “drop attack”, sudden collapse
o Myoclonic Seizure:
▪ Sudden muscle contraction: for about 1s
• Affecting 1 limb: focal myoclonus
• Entire body: massive myoclonus
o Status epilepticus: (SE)
▪ Duration: ≥ 15-30min
▪ Episodes: may be recurrent w/ LOC
▪ Types: generalized convulsive SE, absence SE, myoclonic SE
• Generalized convulsive SE: life threatening
o Febrile Seizure:
▪ Prevalence: common in peds (6m – 5yo)
▪ Manifests: as short periods of generalized tonic-clonic convulsions
▪ No high risk: for epilepsy later in life
➢ Mixed Seizures:
• Lennox-Gastaut Syndrome: severe form of epilepsy, TX difficult
o Onset: develops during preschool years
o S/S: developmental delay & mix of partial & generalized seizures
o Types: partial, atonic, tonic, generalized tonic-clonic, atypical absence
1
