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Patho 1 > 4 - Neuro Disorders > Flashcards

4 - Neuro Disorders Flashcards

1
Q

When are the maximal effects of primary brain injuries seen?

A

18-36 hours

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2
Q

What is the source of bleeding in 85% of epidural hematomas?

A

Arterial

Almost always a medical emergency

Briefly regain consciousness, then unconscious again

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3
Q

Where does epidural bleeding occur?

A

between the dura and the skull

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4
Q

where does subdural bleeding occur?

A

between the dura and the brain

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5
Q

Tears in what veins cause subacute subdural hematomas?

A

Bridging veins

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6
Q

Subdural hematomas are more common in what population?

Why?

A

older adults and alcoholics

some degree of brain atropy cause increased size of epidural space and more stress on the bridge veins

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7
Q

What are the GCS levels for TBI:

Mild

Moderate

Severe

A

13-15

8-13

<8

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8
Q

What is second brain injury?

A

hypotension, hyperglycemia, anemia, cerebral edema

anything that happens as a result of the brain injury

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9
Q

What is chronic traumatic encephalopathy?

A

progressive dementia r/t repeated brain injury

boxers, soldiers, etc.

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10
Q

What is primary and secondary spinal cord injury?

A

primary: the injury from initial trauma/destruction
secondary: cascade of vascular, cellular, and biochemical events (edema etc)

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11
Q

Where do vertebral injuries most often occur in adults?

A

Most mobile portions of the column:

C1-C2

C4-C7

T10-L2

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12
Q

What causes spinal shock?

A

Loss of continuous tonic discharge from the brain or brainstem

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13
Q

What is neurogenic shock?

A

occurs with cervical or upper thoracic cord injury

may exist with spinal shock

sympathetic nerves pass through the spine and are therefore cut off, but parasympathetic activity passes through the vagus and remains intact

get a massive wave of uninhibited parasympathetic activity

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14
Q

With acceleration injuries the greatest stress point is:

A

C4-C5

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15
Q

With deceleration injuries the greatest stress point is:

A

C5-C6

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16
Q

complete quadriplegia results in injury at:

partial quadriplegia:

A

above C6

at or below C6

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17
Q

What is autonomic hyperreflexia?

A

sudden, life-threatening massive reflex sympathetic discharge

associated with spinal cord injury at T6 or above where descending inhibition is blocked

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18
Q

what is the most common cause of autonomic hyperreflexia?

A

distended bladder or rectum

but can be any sensory stimulation that’s unpleasant

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19
Q

What is the cause of most lower back pain?

A

Usually idiopathic and non-specific

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20
Q

What is spondylolysis?

What is spondylolisthesis?

A

fracture of the pars interarticularis (where the vertebral body meets the posterior structures)

displacement of the pars interarticularis (slides forward)

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21
Q

Degenerative Disk Disease pain is caused by:

A

protrusion of the disk

OR

narrowing of the spinal canal/intervertebral foramen by osteophytes

22
Q

what is radiculopathy?

A

compression or inflammation of a spinal nerve root causing dermatomal distribution of pain

23
Q

Where do disk herniatons almost never occur?

A

thoracic

24
Q

What are symptoms of cauda equina syndrome?

A

saddle anesthesia

decreased or absent reflexes in the lower extremities

neurogenic bowel or bladder dysfunction

25
Q

When does a herniated disk merit surgery?

A

severe compression

cauda equina syndrome requires emergency surgical evaluation

26
Q

What is the difference between embolic and thrombotic strokes?

A

Thrombotic strokes are caused by clots that originate in the cerebral vessels

Embolic strokes are caused by clots that migrate from outside the brain (usually the heart, aorta, or common carotid)

27
Q

What are lacunar strokes?

A

small vessel disease caused by perivascular edema, thickening and inflammation of the arterial wall

Usually in the basal ganglia, pons

28
Q

what is a hemodynamic stroke?

A

brain hypoperfusion d/t inadequate blood delivery

29
Q

what is the ischemic penumbra?

A

zone of borderline ischemic tissue that isn’t permanently damaged

Window of opportunity for protecting the penumbra is 3 hours

30
Q

________ is associated with ruptured aneurysms, AVMs, cavernous angioma, or brain trauma

________ is usally just associated with brain trauma

A

SAH

SDH

31
Q

What is an AVM?

A

mass of dilated vessels between the arterial and venous systems

Its an AV fistula in the brain

32
Q

What causes AVMs?

A

persistent embryonic patterns of blood vessels

33
Q

What percentage of AVMs lead to seizures?

A

50%

The other 50% experience a hemorrhagic stroke

34
Q

Which type of head bleeds often reoccur?

A

SAH

especially if it’s due to a ruptured intracranial aneurysm

35
Q

What is the mortality from an SAH?

A

50%

36
Q

40-60% of patients with SAH also experience:

A

Delayed cerebral ischemia (DCI)

Inflammatory substances from the SAH damage cause cerebral artery vasospasms in adjacent (or nonadjacent) vessels

Can prolong cell death in the area up to 3-14 days

37
Q

What is the diagnostic marker of a migraine?

A

Lasts 4-72 hours

38
Q

What neurosubstances are associated with migraine?

A

Elevated CGRP

Increased glutamate

Decreased serotonin

39
Q

What are the most common pathogens to cause bacterial meningitis?

A

meningococcus

pneumococcus

40
Q

How is bacterial meningitis spread?

A

respiratory droplets and contact with contaminated saliva

can be a carrier without exhibiting symptoms

41
Q

Which is worse: bacterial or viral meningitis?

Which has a vaccine?

A

Bacterial

Bacterial

42
Q
A
43
Q

Guillain Barre is a demyelinating disease of the _____

MS is a demyelinating disease of the _____

A

PNS

CNS

44
Q

In MS, what is a clinically isolated syndrome?

A

a demyelinating event that manifests as an acute neurologic episode

45
Q

What happens with botulism poisoning?

A

inhibited release of Acetylcholine leads to severe flaccid paralysis and death

46
Q

What is myasthenic crisis?

A

severe muscle weakness with depressed respiratory function

danger of respiratory arrest

47
Q

What is a cholinergic crisis?

A

often caused by anticholinergic drug toxicity

Massive amounts of acetylcholine at the NMJ

Increased intestinal motility, bradycardia, pupillary constriction, increased salivation, diaphoresis

looks like a myasthenic crisis but occurs 30-60 min after taking an anticholinergic med

48
Q

What is the most lethal and common type of primary brain tumor?

A

Glioblastoma Multiforme (GBM)

Grade IV astrocytoma

49
Q

Which is more common: secondary or primary brain cancers?

A

10x more likely to be from metastasis

50
Q

Describe the anterior and posterior fontanel in infants

A

anterior is diamond shaped and closes at 18 months

posterior is triangular shaped and closes at 2-3 months

51
Q

What usually causes hemorrhagic strokes in children?

A

congential cerebral AVMs

52
Q

What is moyamoya disease?

A

chronic, progressive stenosis of anterior circulation (internal carotids or middle cerebral aa)

Looks like a “puff of smoke” on CTA

Patho 1 (17 decks)

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