Question

Nursing/homework no hand writing please, required Nursing research citation, and references.

for example Disease Profile on Influenza please follow example below its Definition:, Etiology:, PATHOGENESIS:, and its CLINICAL MANIFESTATIONS

Complete the Following Disease Profiles

• Subarachnoid Hemorrhage
• Multiple Sclerosis
• Myasthenia Gravis

Answer 1

Answer :

Subarachnoid hemorrhage :

Definition : A subarachnoid hemorrhage occurs when blood leaks into the space between two of the membranes surrounding the brain . A swollen blood vessel or aneurysm , usually ruptures and causes the condition .

Causes :

• Several factors may lead to a subarachnoid hemorrhage .
• Aneurysm .
• Arteriovenous malformations
• Severe head injury .

Risk factors :

• Hypertension.
• Alcohol abuse .
• Smoking .
• Sympathomimetic drugs cocaine and phenylpropanolamine.
• Certain genetic syndromes such as ADPKD ,
• Brain tumours .

Pathophisiology :

• Results from development defects in the media and elastica of the arteries .
• Aneurysmal process initiation > by focal destruction of the internal elastic membrane ,which is producef by hemodynamic forces at the apices of bifurcation.
• As a result of local weakness in the vessel wall ,the intima bulges outward, covered only by adventitia ,the sad then gradually enlarges and finally ruptures .
• At the site of rupture , the wall thins and the tear that allows bleeding is often =< 0.5 mm long .
• Those > 7 mm, at the top of the basilar artery and at the origin of the posterior communicating artery are at the greatest risk of rupture .
• The annual risk of rupture For aneurysms <10 mm is ~0.1 % and For > 10 mm is 0.5 to 1%.

Clinical manifestations :

• Headaches .
• Photophobia.
• Nausea .
• Vomitings .
• Seizures
• Decreased LOC.
• Neurological deficits .
• Stiff neck.

Multiple sclerosis :

Definition : multiple sclerosis is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system.

Causes and risk factors :

• Cause of MS is still hot known ,scientists believe that theinteraction of several different factors may be involved .
• Immunological factors
• Environmental factors.
• Infectious factors.
• Genetic factors.

Pathophysiology :

Blood brain barrier breakdown : the BBB prevent entrance of T cells into the nervous system .the blood brain barrier is normally not permeable to these types of cells , unless triggered by infection or virus , which decreases the integrity of the tight junctions .

Autoimmunology : the immune system attacks the nervous system ,forming plaques or lesions .commonly involves white matter .destroys oligodendrocytes _ causing demylination .

Inflammation : T cells attacks on myelin triggers inflammatory processes , stimulating other immune cells and soluble factors like cytokines and antibodies.leaks from in the BBB causes swelling ,activation of macrophages and more activation of cytokines and other destructive proteins .

Clinical manifestations :

• Nystagmus
• Optic neuritis
• Diplopia
• Dysarthria.
• Dysphagia.
• Weakness
• Spasms
• Pain
• Hypoesthesis
• Paraesthesiasis
• Incontinence
• Cognitive imparment
• Unsteady gait
• Fatigue etc.

Myasthenia gravis :

Definition : myasthenia gravis is an autoimmune disorder affecting the myoneural junction is characterised by varying degrees of weakness of the voluntary muscles .

Causes : in MG ,the receptors at the muscle surface are destroyed or deformed by antibodies that prevent a normal muscular reaction from occuring .

Causative factor is unknown ,Gud the disorder may have a genetic link.

Risk factors :

• Female gender and age under 40 years
• Male gender and age over 60 years.
• Other autoimmune disorders.

Factors that worsen the myasthenia gravis :

Fatigue

Illness

Stress

Extreme heat.

Some medications such as beta blockers , calcoum channel blockers , quinine and some antibiotics.

Patgophysiology :

Clinical manifestations :

Diplopia

Ptosis .

Weakness of the muscles of the face and throat , generalised weakness.

Weakness of the facial muscles results in bland facial expression.

Laryngeal irritation causes voice impairment and dysphonia and increases the patient risk For choking and aspiration.

Myasthenia gravis is purely a motor disorder with no effect on the the sensation and co ordination .

Generalised weakness of all extrenmmities and intercoastal muscles resulting in decreased respiratory capacity and vital capacity .