Ch. 26 Flashcards
What does CTE stand for, and what is it?
Chronic traumatic encephalopathy; progressive, degenerative disease seen in people w/ history of multiple TBIs/concussions
What are the 3 kinds of possible damage sustained from closed-head injuries?
Coup, Contrecoup, Shearing
Describe Coup, Contrecoup, and Shearing damage
Coup -> damage at site of blow; Contrecoup -> damage at opposite side of blow due to pressure from the coup pushing the brain; Shearing -> twisting/shearing of nerve fibers causing lesions
What is a hematoma?
Blood trapped in the skull that acts as a growing mass, exerts pressure on the brain
Closed head injuries can cause discrete or generalized impairment. Describe them.
Discrete impairment -> affects specific functions at site of damage; Generalized impairment -> widespread trauma throughout brain, loss of complex cognitive functions
What’s the difference between symptomatic & idiopathic seizures?
Symptomatic -> can identify a specific trigger/cause for the seizure; Idiopathic -> seizure occurring spontaneously & in absence of other CNS diseases
What are two broad ways we can classify types of seizures?
Focal seizures & Generalized seizures
Describe the “Jacksonian March”
Seizure attack begins w/ jerking in one part of body (generally a limb) and works its way towards the core of the body one step at a time
What are the two types of focal seizures?
Simple focal seizure/Focal aware seizure; Complex partial seizure/Focal impaired awareness seizure
Describe a focal seizure based on brain activity:
Begins locally in the brain & spreads
Describe a generalized seizure based on brain activity:
Bilaterally symmetrical, no focal onset
Generalized seizures typically cycle through which three stages?
Tonic (body stiffens); Clonic (rhythmic shaking); Postseizure (postictal depression/confusion)
What is an akinetic seizure?
A seizure that produces temporary muscle paralysis -> sudden collapse without warning
What is a myoclonic seizure?
A massive seizure consisting of sudden flexions/extensions of the body, often begins with a cry
What are dissociative seizures?
Non-epileptic “seizures” where patient loses consciousness/dissociates; no change in EEG or brain scan measures -> treated psychiatrically
What is “status epilepticus”?
The event in which a seizure does not self-terminate
Do brain tumors grow from glia or neurons?
Glia/other support cells
What is the difference between benign & malignant tumors?
Benign -> not likely to recur after removal; Malignant -> often progressive & recurring
What is a Glioma?
A tumor arising from glial cells
What is the difference between encapsulated and infiltrating tumors?
Encapsulated -> distinct from cortical structures; Infiltrating -> not clearly distinct from surrounding tissue
What is a meningioma?
A tumor that grows on the brain’s meninges
What is a metastatic tumor?
A tumor that began in one part of the body and spread its cells to another
What’s the difference between classic & common migraines?
Classic -> preceded by aura; Common -> no aura, but tends to present w/ gastrointestinal effects
What is a hemiplegic migraine?
Migraine leading to paralysis of one side of the body
What is an ophthalmologic migraine?
Migraine leading to vision loss in one eye
What is a cluster headache?
A unilateral pain in head/face that rarely lasts 2+ hours, but recurs repeatedly for weeks-months
What are the four types of CNS infections?
Viral, Bacterial, Mycotic, Parasitic
What does it mean when a virus is “neurotropic”?
It has an affinity for CNS cells
What does it mean when a virus is “pantropic”?
It attacks other body tissues as well as the CNS cells
What is a brain abscess?
A pocket of pus-producing bacteria that causes necrosis of cells in the affected region
What is a mycotic infection?
A fungal infection
What is a “protozoa”?
A single-celled organism (parasite)
How can we treat viral CNS infections?
Typically involves symptom management and allowing the virus to pas
How can we treat bacterial CNS infections?
Antibiotics
How can we treat mycotic or parasitic CNS infections?
No satisfactory treatment; antibiotics may be used to treat associated disorders
What is the difference between apraxia and ataxia?
Apraxia -> inability to copy voluntary motor movements; Ataxia -> loss of muscular coordination
What is the difference between catalepsy and cataplexy?
Catalepsy -> muscular rigidity in which voluntary movements are reduced/absent but posture is maintained; Cataplexy -> complete loss of movement & posture during which muscle tone is absent
What is the difference between hemiplegia and paraplegia?
Hemiplegia -> complete/partial paralysis to one half of the body; Paraplegia -> paralysis of the lower torso & legs following spinal-cord damage
What is athetosis?
Ceaseless slow, writhing movements, especially in the hands, due to abnormal function of the part of the motor system responsible for involuntary actions
What is tardive dyskinesia?
Slow, persisting movements, particularly of mouth & tongue
What is chorea?
Literally, “to dance”; wide variety of ceaseless, jerky movements that appear well coordinated but involuntary
What is palsy?
Usually refers to persisting movement disorders due to perinatal brain damage
What is spasticity?
Increased tone in certain muscle groups that maintain posture against the force of gravity
What is myasthenia gravis?
Severe, sudden onset of muscle weakness -> disorder of the muscle receptors
What is poliomyelitis?
Disorder of the motor-neuron cell bodies due to an acute infection by a neurotropic virus; causes paralysis & muscle wasting
What is multiple sclerosis (MS)?
Disorder of myelinated motor fibers; characterized by loss of myelin in motor & sensory tracts
What is quadriplegia?
Paralysis of all four limbs due to spinal-cord damage
What is “spinal shock”?
The loss of reflex (thermoregulatory & bladder control) activity following spinal cord severing -> some reflexes gradually return, but movement, thermoregulation, and bladder control do not
What is Brown-Sequard Syndrome (BSS)?
A neurological condition following a lesion of the spinal cord; results in weakness/paralysis on one side of the body & loss of sensation on the opposite side
What two reflexes are absent in hemiplegia?
Abdominal reflex -> muscles react when stroked; Cremasteric reflex -> retraction of testicles when inner thigh is stroked
Name 7 disorders of the motor neurons & spinal cord:
Myasthenia Gravis, Hemi-Para-Quadriplegia, BSS, Poliomyelitis, MS
Which of the following are hyperkinetic disorders? Huntington’s, Parkinson’s, Tourette’s
Huntington’s, Tourette’s
Which of the following are hypokinetic disorders? Huntington’s, Parkinson’s, Tourette’s
Parkinson’s
What are the two groups of motor symptoms associated with motor disorders involving the basal ganglia?
Hyperkinetic (increased motor activity) & Hypokinetic (decreased motor activity)
What is Huntington’s Disease?
Hereditary disorder characterized by chorea & progressive dementia, ending in death
What is Tourette’s Syndrome?
Disorder of the basal ganglia characterized by tics, involuntary vocalizations, and odd, involuntary movements of the body
What are the three stages of Tourette’s progression?
1) Symptoms are limited to multiple tics; 2) Vocal tics join motor tics; 3) Vocal tics, motor tics, & emission of articulate words w/ echolalia & coprolalia
What is the difference between echolalia & coprolalia?
Echolalia -> repeating what others have said; Coprolalia -> obscene/lewd speech
What is Parkinson’s Disease?
Disorder of motor system correlated w/ loss of dopamine in the brain; characterized by tremors, muscle rigidity, akathesia, postural disturbance, and changes in emotion & memory
What is the difference between akathesia and akinesia?
Akathesia -> the inability to remain still/involuntary motor movements; Akinesia -> slowness of movement, difficulty w/ repetitive motion
Parkinson’s has positive & negative symptoms. What are some positive symptoms?
Tremor at rest, muscular rigidity, involuntary movements
Parkinson’s has positive & negative symptoms. What are some negative symptoms?
Postural disorders, righting disorders, locomotive disorders, speech disturbance, akinesia (slowness of movement)
What are the three major types of Parkinson’s disease?
Idiopathic (cause unknown); Postencephalitic (following encephalitis); Drug induced (associated w/ abuse of major tranquilizers)
What is a cerebral vascular accident (CVA)?
Another name for stroke; sudden appearance of neurological symptoms due to interrupted blood flow
What are the two types of cerebral ischemia?
Thrombosis -> blood in a vessel that coagulated to form a clot that stays where it was formed; Embolism -> a clot/plug brought through the bloodstream from a larger vessel into a smaller one, blocking it
What is an infarct?
An area of dead/dying tissue due to interrupted blood flow
What is cerebral ischemia?
Any group of disorders in which symptoms are caused by vessel blockage interrupting blood flow to the brain
What is cerebral arteriosclerosis?
Condition marked by loss of elasticity in & thickening/hardening of the arteries -> eventually leads to dementia
When ischemia is temporary, it may be termed ______ or ______.
Cerebral vascular insufficiency or transient ischemia
What is a migraine stroke?
Transient ischemic attack w/ variety of neurological symptoms -> immediate cause of stroke is some kind of vasoconstriction (unknown root cause)
What is a cerebral hemmorhage?
A massive brain bleed
What is an angioma?
A congenital collection of abnormal vessels that divert normal flow of blood
What are arteriovenous malformations (AVMs)?
Masses of enlarged cortical vessels causing abnormalities in amount & pattern of blood flow
What is an aneurysm?
Vascular dilations resulting from localized defects in a vessel’s elasticity -> balloon-like expansions of vessels that are week & prone to rupture
Neuronal death following an ischemic stroke is primarily attributed to dysfunction of what neurotransmitter & why?
Glutamate -> surge of glutamate (excitatory neurotransmitter) following stroke eliminates the refractory period following an action potential; neurons essentially fire themselves to death
What is diaschisis?
A form of neural shock -> leads to changes in localized and surrounding tissue
99% of strokes occur on the _____ (arterial/venous) side; why?
Arterial -> arteries have thicker walls than veins as well as much higher blood pressure -> leads to greater consequences if blood flow is interrupted
Migraine strokes commonly affect which cortex?
Occipital -> also the reason for visual aura
Between open-head & closed-head TBIs (assuming you survive the initial injury), which is associated with a higher recovery chance?
Open-head injuries
What is a concussion?
A disturbance of consciousness following a blow to the head with no obvious contusion (bruise/bump)
What are the three response groups considered in the Glasgow Coma Scale?
Eye opening, Motor response, Verbal response
What is PTA?
Posttraumatic Amnesia -> can be a measure of severity of injury; correlates w/ future memory disturbance
What is the difference between hypnagogic and hypnopompic hallucinations?
Hypnogocic -> as you’re falling asleep; Hypnopompic -> as you’re waking up
What is the difference between obstructive & central sleep apnea?
OSA -> occurs in dream sleep, may be caused by collapse of oropharynx during sleep paralysis; CSA -> CNS disorder characterized by failure of diaphragm & associated muscles to move
