308 Final Red Flashcards
1
Q
Part of the brain or skull missing
A
Anencephaly
2
Q
brain and meninges. refers to a herniation or protrusion of various amounts of brain and meninges through a defect in the skull, resulting in a saclike structure
A
Encephalocele
3
Q
Meninges only! It is a cystlike dilation of the meninges protrucing through a defect in the posterior arch of the vertebra. A type of Spina Bifida
A
Meningocele
4
Q
Meninges, spinal cord, spinal fluid. More severe than meningocele.
A
Myelomeningocele
5
Q
Disorder of movement, muscle tone, or posture that is caused by injury or abnormal development in the immature brain, before, during, or after birth
A
Cerebral Palsy
6
Q
Causes of CP include:
A
impaired implantation, chromosomal abnormalities, infection, trauma, radiation exposure, asphyxia, and toxic substances.
7
Q
Disorder accompanied by systemic nonmotor and neurologic symptoms. MAIN FEATURE: degeneration of the basal ganglia (corpus striatum) involving dopaminergic nigrostriatal pathway.
A
Parkinson’s Disease
8
Q
Parkinson’s Classic Motor Symptoms:
he stated either not enough dopamine or damage to dopamine receptors
A
resting tremors, bradykinesia/akinesia, rigidity, postural abnormalities. ALONE OR IN COMBO. As disease progresses, all four are present. Autonomic dysfunction and cognitive-affective symptoms*
9
Q
Clinical Manifestations: initial onset can be subtle with cramping or weakness that affects a limb, incoordination, slurring of speech, difficulty swallowing.
A
ALS (Lou Gehrig’s Disease)
10
Q
Pathophysiology: Autoimmune, upper and lower motor neuron degeneration (neurons of the cerebral cortex, brainstem, and spinal cord)
A
ALS (Lou Gehrig’s Disease)
11
Q
Lower motor neuron syndrome of flaccid paresis:
A
ALS- weakness of individual muscles, progressing to paralysis, associated with hypotonia and primary muscle atrophy.
12
Q
Autoimmune and destroys neuromuscular junction receptors.
Pathophysiology: defect in nerve impulse transmission at the neuromuscular junction. Acetylcholine receptor antibodies block the acetylcholine receptor and inhibit the stimulating effect of acetylcholine on the postsynaptic membrane
A
Myasthenia Gravis
13
Q
Clinical Manifestations Include: drooping eyelid (ptosis), weakness and fatigue of muscles of the eyes and the throat, causing diplopia, difficulty chewing, talking, and swallowing.
A
Myasthenia Gravis
14
Q
Triggers to Migraine Headaches include:
A
altered sleep, missed meals, overexertion, weather change, stress or relaxation from stress, hormonal changes, excess afferent stimulation (bright lights and strongs smells) and chemicals (nitrates and alcohol).
15
Q
Name and describe the 2 classes of Migraine Headaches.
A
- Migraine with Aura: at least some of the attacks are temporarily associated with distinct aura symptoms suggestive of focal brain dysfunction (flashing lights, visual loss)
- Migraine without aura: no associated focal neurologic symptoms. One sided.
16
Q
Vertebral defect that allows the protrusion of the neural tube contents
A
Spina Bifida
17
Q
2 types of Spina Bifida
A
Meningocele and Myelomeningocele (both occur during the first 4 weeks of pregnancy when the neural tube fails to close completely)
18
Q
Progressive failure of the cerebral (cognitive) functions not caused by an impaired level of consciousness.
-includes impairment of intelect, decrease in orienting memory, language, alterations.
A
Dementia
19
Q
Greatest risk factor for Dementia is _____.
A
Age
20
Q
Dementia Classifications
1. Cortical ____________
2. Subcortical ________
Cortical and subcortical _________
A
- Cortical (Alzheimer’s)
- Subcortical (Parkinson’s)
Cortical and subcortical (Infectious and Creutzfeidt-Jacob)
21
Q
Pathophysiology of Dementia
A
Neurodegeneration
Atherosclerosis
Trauma
Compression
22
Q
Patho of Delirium
A
acute state of brain dysfunction associated with right middle temporal gyrus or left temporo occipital junction disruption
23
Q
Differences in clinical manifestations with Delirium and Dementia…
A
Delirium last hours to days vs years with dementia
24
Q
_enlargement of the lateral and third ventricles and the widening of the frontocortical fissures and the sulci
_genetic predisposition (new info implicates copy # variables in genes
_brain dopamine pathways are altered
_underactivation of glutamate receptors.
A
SCHIZOphrenia
25
_Genetic Predisposition and environmental factors
| _ HPA and HPT dysregulation
Mood disorders
26
condition in which the foreskin cannot be retracted back over the glans
Phimosis
27
foreskin is retreacted and cannot be moved forward to cover glans
Paraphimosis
28
varying degrees of curvature/ sexual dysfunction tough fibrous thickening of the fascia in the erectile tissue
Peyronie Disease (Bent Nail Syndrome)
29
Recite the function of the Fallopian Tubes
1. Conduct ova from the spaces around the ovaries to the uterus
2. Once the ovum has entered the fallopian tube, cilia and peristalsis keep it
3. The ampulla is the site of fertilization
30
The vagina warrior :-)
_acid base balance discourages proliferation of most pathogenic bacteria
_Thickness of the vag
31
Before puberty vs at puberty PH
before: 7 (neutral)
| At : 4-5 (more acidic) squamous epithelium thickens
32
Clinical Manifestations of Testicular Cancer
Painless testicular enlargement is the first sign
Gradual enlargement
testicular heaviness
dull ache in abdomen
33
Pathophys of Vulvitis
Inflammation of the vulva
it is from contact dermatitis (soaps, detergents, lotions, sprays, shavings, pads/tampons, perfumed toilet paper, tight clothing)
34
Common causes for cycle irregularites
Failure to ovulate
35
Menorrhagia
prolonged heavy bleeding at regular intervals
36
Metrorrhagia
bleeding at irregular intervals
37
Primary Dysmenorrhea
painful menses, associated with release of excessive prostaglandins
38
Secondary dysmenorrhea
painful menses, related to pelvic pathology (cysts, endometriosis, etc), usually later in life
39
Clinical manifestations of Dysmenorrhea
usually subsides by day 2 of cycle, pelvic pain, also bachache, anorexia, vomiting, diarrhea, syncope, and headache
40
Primary Amenorrhea
Cause: Ovaries do not get the signal to ovulate
Manifestations: lack of the first period, cause of the amenorrhea determines whether the sex characteristics and height are affected
41
Absence of menstruation for a time equivalent to three or more cycles in women who have previously menstruated
Secondary Amenorrhea
42
Main cause of Amenorrhea?
Getting knocked up (other causes... malnutrition or excessive exercise)
43
Manifestations of Amenorrhea
infertility, vasomotor flushes (hot flashes), vaginal atrophy, acne, osteopenia, and hirsutism, anovulation, hyperprolactinemia
44
Common causes of infertility (men)
thyroid disturbances
| low testo, most can be reversed
45
Common causes of infertility (women)
ovulatory factors (hormonal imbalances), stress, TUBAL PATHOLOGIES
46
causes of Dysfunctional Uterine Bleeding:
anovulation, lack of progesterone, estrogen withdrawal,
47
inflammation if this tissue seen in sexually active males and STI will be a common cause, rare before puberty, caused by unprotected anal sex also caused by reflux of sterile urine into the ejaculatory ducts
Epididymitis
48
acute infection of the testes, uncommon except as a complication of systemic infection or as an extension of an associated epididymitis
Orchitis
49
Benign Ovarian cysts are most common during______ but can occur during any part of life.
Reproductive years and the extremes of those years (when hormonal imbalances are more common)
50
Very common cyst (4 leading cause of gynecological hospital admissions)
Benign Ovarian Cyst
51
Benign ovarian enlargement
2 types: follicular and corpus luteum
caused by variations of normal physiologic events
Functional Cysts (women are asymptomatic)
52
enlargement of the prostate gland, symptoms are spectrum of lower urinary tract symptoms, urge to urinate often, some delay in urination, and decreased force of urinary stream
Clinical manifestations of Benign Prostatic Hyperplasia
53
As obstruction progresses with Benign Prostatic Hyperplasia, often over several years, the bladder cannot empty all the urine and the increasing volume leads ______________.
long term urine retention
54
Most common cancers in men and women:
Prostate and breast
Lung
Colon
55
Most common childhood cancer
ALL
56
Most childhood cancers originate from the ________.
Mesodermal germ layer (CT, bone, cartilage, muscle, blood, blood vessels, gonads, kidney, lymph)
57
Cancer pain can correlate with the _____ of cancer.
Stage
58
What other factors can intensify cancer pain?
fear, anxiety, sleep loss, fatigue, overall physical deterioration
59
Mechanisms of Cancer pain:
pressure, obstruction, invasion of sensitive structures (stressing of visceral surfaces) tissue deterioration and inflammation
60
Cancer pain occurs why?
direct pressure, obstruction, invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection and inflammation
61
Cancer fatigue occurs why?
(most frequently reported symptom) sleep disturbances, biochemical changes in the body secondary to disease and treatment, psychosocial factors, level of activity, nutritional status, etc
62
Cancer cachexia (syndrome that includes many symptoms including anorexia, early satiety (filling), weight loss, anemia, asthenia-weakness, taste alterations, altered nutrition metabolism..... occurs why?
Increased resting expenditures
mechanical interference with nutritional intake
results in WASTING
63
Cancer Anemia occurs why?
```
chronic bleeding (iron deficiency)
severe malnutrition
cytotoxic chemotherapy
malignancy in the blood forming organs
Iron is mal-absorbed in individuals with gastric, pancreatic, upper intestinal cancers
```
64
Cancers named according to the tissues from which they arise, often including the -oma suffix.
EX: lipoma, adenoma
Benign :-) Please note -oma suffix can also be malignant
65
Carcinoma - epithelial tumors (skin and lining of organs)
| Sarcoma - bone, cartilage, fat, muscle, vessels, other CT.
These are Malignant Tumors
66
Malignancies of the lymphatic tissue are referred to as ________.
Lymphomas
67
Malignancies of the blood forming cells are called _______.
Leukemias
68
Malignancies of the plasma cells are called ________.
Myelomas
69
pre invasive epithelial malignant tumors of the glandular or squamous cell origin that have not briken through the basement membrane or invaded the surrounding stroma
--often seen in cervix, skin, oral cavity, esophagus, bronchus, stomach, breast, and endometrium--
CIS or Carcinoma in situ
70
Benign tumors grow ______ and _____ differentiated.
slowly, well
71
Benign tumors DO or DO NOT metastasize.
DO NOT METASTASIZE
72
Tumor cell markers are found on __________.
plasma cell membranes, blood, CSF, and urine.
73
Name some tumor cell markers.
hormones, enzymes, genes, antigens, antibodies
74
Tumor cell markers are used to _______.
Screen, identify high risk individuals
diagnose
observe clinical course of cancers
75
Which marker is used to evaluate a tumor of the adrenal gland
Catecholemines
76
By what mechanisms do local invasion of cancer cells occur?
- Tumor Spread (direct invasion or metastasis to distant organs)
- Invasion and Metastasis
- Decreased cell to cell adhesions
- Increased motility
77
Which cancer are individuals with Down Syndrome at risk for?
Acute Leukemia (table 14-1)
78
Which cancer are individuals with Beckwith-Wiedemann at higher risk for?
Wilms tumor, sarcoma, brain tumors, neuroblastoma, hepatoblastoma
79
Which cancer are individuals with twin or siblings who have leukemia at higher risk for?
leukemia
80
What is apoptosis
mechanism to self destruct
programmed cell death
the pathway to apoptosis is DISABLED in advanced cancers
81
Spread of cancer cells from the side of the original tumor to distant tissues
Metastasis
82
what is the first step in the process of metastasis?
invasion or local spread
83
GI effects of chemotherapy include:
alopecia, n/v, mucositis, diarrhea, marrow toxicity, neuropathy
84
Chromosome translocation is large changes in chromosome structure in which a piece of one chromosome is ____________.
translocated to another!!
85
Translocation can activate oncogenes in one of two distinct mechanisms......
1. excess and inappropriate production of a proliferation factor
2. production of novel proteins with growth promoting properties
86
normal nonmutated genes that code for cell growth
Proto Oncogenes
87
gene that has been mutated and causes proliferation
Oncogene
88
makes protiens that normally prevent cell division or will cause mutated genes to allow uncontrolled cell growth
Tumor suppressor gene
89
Of the 2 hit hypothesis:
First hit _______
Second hit _____
first hit is genetic/hereditary
second hit is environmental
**pg 378 says** it takes 2 hits to inactivate the two alleles of a tumor suppressor gene
90
Congenital factor that will increase the liklihood a child will develop acute leukemia?
Trisomy 21 is the most common genetic defect linked to the development of ALL
91
List lifestyle risk factors that increase risk for cancer.
Tobacco use, diet, obesity, infection, sexual and reproductive behaviors, HPV, lack of physical activity, many others, but these are the biggies.
92
Stage 1 cancer is confined to _________.
its organ or origin
93
Stage 2 is locally _______.
invasive
94
Stage 3 cancer has spread _________, such as lymph nodes.
regionally
95
Stage 4 cancer has spread to ______________, such as liver cancer spreading to lunch and prostate.
distant sites
96
Name 3 phases of a seizure.
Tonic, Clonic, Postictal
97
seizure phase, muscle contraction, increased muscle tone
TONIC
98
seizure phase, alternating contraction and relaxation
CLONIC
99
phase following a seizure
postictal
100
The order that a seizure progresses:
tonic, clonic, postictal
101
state of continued seizures lasting more than 5 minutes, rapidly occurring before the person has had a chance to fully regain consciousness from the preceeding event (lasting longer than 30 mintues)
Status epilepticus
102
With status epilepticus, the person is still ______ when the next seizure occurs.
Postictal
103
Most common seizure is
generalized
104
With ___________ (seizure type) motor movements do not extend into adjacent areas.
Simple Focal/Partial Seizures (without jacksonian march)
105
With Jacksonian March, how do movements spread?
Orderly fashion
| into adjacent areas
106
Function of Myelin (lipid material)
insulating substance on a typical neuron,
107
Function of Schwann Cell
- glial cell that wraps around and covers axons in the periphery
- form and maintain the myelin sheath
108
Nodes of Ranvier
form spaces on either side of the Schwann cell
109
Manifestations of Alzheimer's
- forgetfulness, emotional upset, disorientation, lack of concentration, decline in abstraction, problem solving, judgement
- insidious onset
110
Pathophysiology of Alzheimer's
- Neurofibrillary tangles from tau proteins and senile plaques (neuritic plaques)/beta amyloid are the main contributors
- tau proteins cannot be rid and tangle with neurons
111
90% of strokes that occur are
Thrombotic or Embolic
112
Common risk for Embolic stroke is which cardiac condition?
A-fib
rheumatic heart disease,
valvular prosthetics
endocarditis
113
4 types of Incracranial Aneurysms
Saccular-congenital abnormality
Fusiform-GIANT
Mycotic- rare, bacterial
Traumatic/Dissecting-weakening of arterial wall, after procedures or imaging
114
How do MS and GB differ?
Multiple Sclerosis is a disorder of the CNS (autoimmune)
| Guillain-Barre is a disorder of the PNS (acquired)
115
How are MS and GB alike?
they both involve demyelinization
116
Hallmark of SEVERE brain injury
loss of consciousness for greater than 6 hours.
117
Epidural hematomas are faster developing and are more likely to be _______ bleeding.
arterial
118
Blood flow to scalp/skull/meninges are larger vessels that run on the outside of the ____ in the grooves of the skull (arteries) and get ______ as the penetrate.
Dura
| Smaller
119
- Massive uncompensated cardiovascular response to stimulation of the sympathetic nervous system
- stimulation of the sensory receptors below the level of the cord lesion
Autonomic Hyperreflexia (dysreflexia)
120
With Autonomic Hyperreflexia, baro receptors slow heart rate b/c cant control BP. So the patient remains ______.
hypertensive
121
s/s of autonomic hyperreflexia
paroxysmal hypertension, bradycardia, headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection
122
What do we do with Autonomic Hyperreflexia?
Raise HOB, remove stimulus and EMPTY BLADDER (distended bladder is usually the cause (pg. 594)
123
CNS includes
brain and spinal cord
124
PNS includes
cranial nerves, spinal nerves, pathways
somatic nervous system
autonomic nervous system
125
Cancer cells behave differently than normal cells. Name a few.
1. Transformed cells lack contact inhibition- they crowd on top of each other regardless. Normal cells stop dividing when they fill a petri dish.
2. Normal cells wont grow unless they are anchored; cancer cells can divide even when suspended.
3. Normal cells have a limited life span in lab. Cancer cells are virtually immortal.
4. Cancer cells are parasitic in nature-- extract nutrients.
126
Cancer cells have variable size and shape. True or False.
True.
127
Cancer cells have different nutritional requirements. The divide _____ with the consequent requirement for the building blocks of new cells.
rapidly
128
Cancer cells are characterized by _________, or loss of differentiation, and autonomy or independence from normal cellular controls.
ANAPLASIA- recognized by a loss of organization and a marked increase in nuclear size with evidence of ongoing proliferation.
129
Autonomic Nervous System includes (2)
Parasympathetic and Sympathetic
130
Fascicles
myelinated axons in the PNS
131
Plexuses
Group of Rami or Fascicles
132
Dermatomes
skin innervation of spinal nerves (where they feed)
133
Which system mobilizes energy stores in times of need? "Fight or Flight"
Sympathetic
134
Which system receives innervation from cell bodies located from the 1st Thoracic -2nd Lumbar? (thoracolumbar division)
Sympathetic
135
Which system functions to conserve and restore energy? "Rest and Restore"
Parasympathetic
136
Which system receives innervation from cell bodies located in the cranial nerve nuclei and sacral region of the spinal cord? (craniosacral division)
Parasympathetic
137
WHere to preganglionic neurons travel to?
Ganglia close to the organs they innervate
138
Sympathetic preganglionic fibers
acetylcholine and cholinergic receptors
139
sympathetic postganglionic fibers
norepi and adrenergic receptors
140
parasympathetic pre and post ganglionic fibers
acetylcholine and cholinergic receptors
141
Where is epi and norepi released from?
adrenal medula
142
There are only one set of ganglionic fibers that use epi and norepi as neurotransmitters. Which one?
Sympathetic POST
143
The major neurotransmitter for somatic nerve funciton AKA muscle function? (myasthenia gravis)
acetylcholine
144
Progressive, inflammatory, demylinating, autoimmune disorder of the CNS
Multiple Sclerosis
