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Patho > Brain problems > Flashcards

Brain problems Flashcards

1
Q

What is the reticular activating system?

A

Key role in consciousness for arousal and waking state, contributes to muscle tone, mood, attention, motivation, learning and memory.

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2
Q

What parts of the Brain are responsible for the reticular activating system?

A

the brain stem and the thalamus and part of the hypothalamus

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3
Q

What are the 7 levels of consciousness changes in waking state

A
  • Fully conscious
  • Confusion
  • Delirium
  • Lethargy( slow and tired)
  • Obtundation
  • Stupor
  • Coma
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4
Q

Describe what “fully conscious” is

A

The states of being awake and alert: aware of ones environment and cable of responding appropriately

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5
Q

Describe what “confusion” is

A

The affected person is disoriented to time and place; they have difficulty following instructions

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6
Q

Describe what “Delirium” is

A

The affected person experiences disorientation and mental confusion as a result of hallucinations and delusions

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7
Q

Describe what “Lethargy” is

A

The affected person is drowsy, but can be aroused by moderate stimuli

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8
Q

Describe what “Obtundation” is

A

The affected person is more drowsy than in lethargy, with less interest in their environment and slowed response when roused

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9
Q

Describe what “Stupor” is

A

The affected person can be aroused only by vigorous stimulation, and immediately lapses into their previously unresponsive state

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9
Q

Describe what “Stupor” is

A

The affected person can be aroused only by vigorous stimulation, and immediately lapses into their previously unresponsive state

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10
Q

Describe what “Coma” is

A

The affected person is unresponsive and cannot be aroused from this state

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11
Q

What are some common intracranial ALOC causes?

A

Head injury,
hemorrhage,
Degenerative conditions,
Space-occupying lesions (SOL),
Increased intracranial pressure,
Vasospasm of cerebral vasculature

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12
Q

What are some common Extracranial ALOC causes?

A

Hypoxia, HTN, profound hypotension, systemic infection, hepatic or renal dysfunction, hypo- or hyperglycemia, electrolyte imbalances, pH balance, medications and other chemicals

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13
Q

What things is the Glasgow coma scale checking

A

Measuring the responses of eyes opening, verbal commands, and motor movement

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14
Q

What is a Cerebrovascular accidents (CVA)

A

( stroke) caused by blood vessels being blocked or bleeding (ischemic vs hemorrhagic)
-involves a Cerebral infarction
- Consequences of stroke depend on part of brain effected

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15
Q

What is a Cerebral infarction and what are the 2 types

A

blockage of O2 causing cells to die – neurons will die
*Primary infarction zone – neurons irreversibly injured (will no longer work)

*Secondary infarction zone – immediately around the primary zone – cells injured but can recover if blood flow is restored quick enough

16
Q

What is a Transient ischemic attack (TIA)

A

stroke like symptoms that occur due to hypoxic event, but have recovered and are okay (usually in 24hrs)
-Usually an indicator of underlying thrombotic disease
-Warning sign that high risk of CVA
-Antithrombotic drugs can decrease chance of having a CVA
-Still needs and investigation

17
Q

What are risk factors for CVA’s

A
  • over the age of 65 (slower metab, hormones change, heart disease, aging of organs, lack of mobility)
    -sex (high in males)
    -HTN
    -hyperlipidemia
  • increased alcohol intake
  • Smoking
  • Lack of exercise
    heart diseases
  • Family Hx (Death rates high in ppl of European decent)

Leading cause of death in Australia and New Zealand 7-10% of all deaths

18
Q

How are CVAs diagnosed

A

-CT, MRI, angiography, bloods (rule of other LOC)
-Physical assessment, obs, neuro obs, motor/ sensory assessment Hx

-Need to determine if ischemic or hemorrhagic

19
Q

How are CVAs treated

A

Thrombolysis if ischemic cause

surgical clipping if hemorrhagic

20
Q

What is the circle of Willis

A

Circle of blood vessels in in the brain… if there is a blockage, there is another blood vessel that can get to that area of the brain

21
Q

what is an Aneurysm

A

Ballooning of the vessel making it have weak areas of walls. Can burst and bleed out.

22
Q

Language happens in what area of the brain

A

Broca’s area, Wernicke’s area

23
Q

Speech happens in what area of the brain

A

Broca’s area

24
Q

Voluntary movement (or muscle weakness) happens in what area of the brain

A

Frontal lobe, brain stem

25
Q

Vision happens in what area of the brain

A

Occipital lobe, brain steam

26
Q

Confusion (or disorientation) happens in what area of the brain

A

Frontal lobe

27
Q

Balance (or disequilibrium) happens in what area of the brain

A

Brain stem, cerebellum

28
Q

eye movments happens in what area of the brain

A

Brain stem

29
Q

Altered coordination and gait happens in what area of the brain

A

Cerebellum

30
Q

What is meningitis and what are the 2 classifications

A

inflammatory process of the membranes that surround the brain and spinal cord.

Two classifications:
Bacterial (common) - enter the CNS by violating the blood-brain barrier after an upper airway infection with mucosal involvement, or via the bloodstream when a patient has bacteremia.
pathogens: Streptococcus pneumoniae and Neisseria meningitides.

Viral – milder and short lived. Causitive agents include HSV, cytomegalovirus, enteroviruses. Most people will recover

31
Q

Signs and symptoms of Meningitis

A

-Elevated temp
(common among CNS infection)
-Nuchal rigidity (stiffness of the neck due to meningeal irritation).
-Kernig’s sign – flexing the hip & extending the knee to elicit pain in the back & the legs
-Brudzinski’s sign – passive flexion of the neck elicits flexion of the hips
-Opisthotonos (extreme hyperextension of the head and arching of the back due to irritation of the meninges)
-Altered mental state
-Nausea, vomiting
-Headache- severe
-Photophobia (don’t like bright lights)
-Seizures
-Multiple petechiae on the body
-Non-blanchable rashes

32
Q

what would be the physical assessment for meningitis

A

-Investigation ‘classic triad’ - nuchal rigidity, fever, and altered mental state
–Positive kernig’s or Brudzinski’s sign
–Papilloedema, photophobia
–Nausea & vomiting
–Lumbar puncture – presence of causative agent
–FBC, blood cultures, electrolyte levels
–CT scan brain

33
Q

what is the pathophysiology of bacterial meningitis

A

Gain access to bloodstream by disabling cilia & mucosal Ig-A mediated immune protection
Bacteria is encapsulated, harder for immune system to detect
Easily cross BBB & colonise tissue
Release of bacterial toxins damage CNS structures
Inflammation induces vascular response – leads to cerebral edema
Edema causes increase of ICP,
compression, herniation & ischemia

34
Q

what are the diagnostic evaluation procedures for meningitis

A

*Lumbar puncture to identify the causative organism in the CSF (will be Turbid)
*Blood cultures
*Physical examination

Patho (5 decks)

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