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Pathophysiology > Alterations of Neurologic Function > Flashcards

Alterations of Neurologic Function Flashcards

1
Q

What GCS ratings indicate mild, moderate and severe brain injury?

A 
Mild= 13-15
Moderate= 9-12
Severe= 3-8
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2
Q

What are the physical symptoms of a severe concussion?

A

Increased ICP, LOC that can be >24 hours, spastic paralysis, peripheral nerve injury

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3
Q

What are the cognitive symptoms of a severe concussion?

A

disorientation, confusion, dysphagia, poor judgement

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4
Q

What are the behavioural symptoms of a severe concussion?

A

agitation, blunted affect, impulsiveness, social withdrawal, depression

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5
Q

What is post concussive syndrome?

A

Persistent concussive symptoms that last from weeks to months: headache, nervousness/anxiety, irritability, insomnia, depression, inability to concentrate, fatigue

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6
Q

Which TBI is usually caused by bleeding from an artery and 90% of patients also have a skull fracture?

A

Epidural hematoma

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7
Q

What are the signs and symptoms of an epidural hematoma?

A

LOC, period of lucidity including headache, vomiting, drowsiness, seizure, hemiparesis and possibly ipsilateral pupillary dilation

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8
Q

How long can it take for subacute subdural hematoma to develop?

A

From 48 hours to 2 weeks

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9
Q

What is usually the source of bleeding in a subdural hematoma?

A

A vein

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10
Q

What is an intracerebral hematoma?

A

Hematoma formed within brain parenchyma with or without blood distention into ventricles

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11
Q

Define “coup” and “contrecoup”

A

Coup: brain damage that occurs directly under point of impact
Contrcoup: brain damage occurs on the opposite side of the brain from site of impact

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12
Q

Where do spinal cord traumas usually occur?

A

C1-2, C4-7 or T1-L2

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13
Q

What is the treatment for spinal cord injuries?

A

Immobilize spine to prevent further injury. Surgical decompression and stabilization necessary, corticosteroids to decrease risk of secondary injury

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14
Q

What is the cause of over 40% of spinal cord injuries

A

Motor vehicle collisions

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15
Q

Define hypereflexia

A

uncompensated cardiovascular response to stimulation of SNS. Occurs any time after spinal shock ceases. Hypertension, headache, blurred vision, sweating above level of lesion, nasal congestion, nausea, bradycardia. Most common cause is distended bladder or rectum

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16
Q

List the 3 types of primary intracerebral tumors and their preceding cell types

A

Astrocystoma-astrocytes-slow growing
Glioblastoma multoforme-glial cells-rapidly growing
Pituitary adenoma-pituitary cells-secreting tumor

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17
Q

List the 2 types of primary extracerebral tumors and their preceding cell types

A

Meningioma-arachnoid cells

Neurofibroma-schwann cells

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18
Q

Which parts of the body is brain cancer most commonly metastasized from?

A

Lung, breast, skin or kidney cancer

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19
Q

What are the risk factors for strokes?

A

Arterial hypertension, impaired cardiac function, atrial fibrillation
Smoking
Diabetes/insulin resistance
Polycythemia and thrombocythemia

20
Q

What is the difference between a thrombotic and an embolic stroke

A

Thrombotic- caused by a blood clot in an artery going to the brain
Embolic- fragments of clots formed elsewhere (heart or neck) that occludes a blood vessel leading to, or in the brain

21
Q

Define a completed stroke

A

CVA has reached max destructiveness in producing neurological deficits

22
Q

Define a transient ischemic attack

A

intermittent blockage-all neurological deficits completely clear within 24 hours
Usually an indicator of future stroke

23
Q

What causes a hemorrhagic stroke?

A

hypertension, ruptured aneurysms, bleeding in a tumor, bleeding disorders or anticoagulants, head trauma or illicit drug use

24
Q

Define hemorrhagic infarcts

A

can happen with reperfusion as resumption of blood flow may compromise recovery by accelerating the sequence of metabolically damaging events
Primary cause of cerebral hemorrhage is hypertension, aneurysms in smaller vessels or arteriolar necrosis

25
Q

What are treatment interventions for strokes?

A

Treatment within 6 hours minimum
Drug therapy prevents further thrombotic events, augments blood flow and repurfuses tissues
Controlling cerebral edema anf increased ICP
Preventing further emboli

26
Q

What is a seizure?

A

Sudden disorderly discharge of neurons characterized by sudden, transient alteration in brain function

27
Q

What are contributing factors to epilepsy?

A

metabolic defects, congenital malformation, perinatal injury, postnatal trauma, infection, brain tumor, vascular disease, drug or alcohol abuse

28
Q

What are possible seizure triggers?

A

Hypoglycemia, fatigue, emotional/physical stress, febrile illness, excess H20 ingestion, constipation, use of stimulants, withdrawal from depressant drugs, hyperventilation, environmental stimuli

29
Q

What defines a general seizure?

A

bilateral neuron involvement, general onset, originates from subcortical or deeper. Impaired or LOC

30
Q

What defines a partial seizure?

A

Unilateral neuron involvement, originate from cortical brain tissue, maintains conciousness but may become generalized

31
Q

Define: status elipeticus

A

multiple seizures without regaining conciousness or one seizure lasting >30min

32
Q

Define: post-ictal state

A

time period immediately following a seizure

33
Q

Define: epileptogenic focus

A

group of neurons with more permeable membranes that are hypersensitive to stimuli (like hypoxia, hypoglycemia or hyperthermia)

34
Q

Define: aura

A

A partial seizure immediately preceding a generalized seizure

35
Q

Define: prodromal (as it relates to seizures)

A

An early manifestation that can occur hours before a seizure

36
Q

What are the signs and symptoms of meningitis?

A

Fever, chills, petechial rash and neck stiffness

37
Q

What are the most common bacteria causing meningitis?

A

Meningococcal and streptococcus bacteria

38
Q

What is relapsing-remitting MS?

A

most common. MS that relapses for at least 24 hours where symptoms worsen followed by a remission where symptoms go away

39
Q

What is primary MS?

A

worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions.

40
Q

What pharmacological interventions are used for MS?

A

Steroids (acutely) and interferon (chronically)

41
Q

What is myasthenia gravis?

A

Chronic autoimmune disorder mediated by anti-acetylcholine receptor antibodies. Insidious onset with progressive muscle weakening

42
Q

How is myasthenia gravis diagnosed?

A

Tensilon test, antibody assay and electromyography

43
Q

What is electromyography?

A

A test measuring muscle response to nerve stimulation via electrodes

44
Q

What pharmacological interventions are used for myasthenia gravis?

A

steroids, anticholinterase drugs, immunosuppresants

45
Q

What is Gullian-Barre syndrome?

A

Inflammatory disease resulting in demyelination of peripheral nerves. Almost always preceded by a viral illness. First sign is weakening of leg muscles

46
Q

What pharmacological intervention is commonly used for alzheimer’s?

A

Anticholinergics- cholinterase inhibitors

47
Q

What are the symptoms of parkinsons disease?

A

resting tremor, rigidity, bradykinesia and postural instability

Pathophysiology (9 decks)

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