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pathophysiology > ch16: disorders of the central & peripheral nervous systems and neuromuscular junctions > Flashcards

ch16: disorders of the central & peripheral nervous systems and neuromuscular junctions Flashcards

1
Q

closed (blunt) trauma

A

injury where skull has not been penetrated, not as serious as open trauma

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2
Q

open (penetrating) trauma:

A

skull has been penetrate; more serious

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3
Q

coup/contrecoup injury

A
  • hit in head really hard → brain gets injured at site [coup]
  • bounce to the back of the skill and have injury there [contrecoup]
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4
Q

focal brain injury

A
  • contusions: vasculature breached = bruising

- isolated to one particular area

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5
Q

diffuse brain injury

A

DAI - diffuse axonal injury

  • neurons themselves damaged (axons torked or separated)
  • injury at multiple different areas
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6
Q

what are 3 types of hematomas?

A
  • extradural hematoma
  • subdural hematoma
  • intracerebral hematoma
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7
Q

what is the most common type of hematoma?

A

subdural hematoma

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8
Q

what is a hematoma?

A

damage in circulatory system that causes massive release of blood

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9
Q

extradural (epidural) hematoma

A

hematoma that occurs outside the meninges and outside of the cerebrum

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10
Q

subdural hematoma

A

hematoma that forms between meninges and cerebrum (brain)

–> most common

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11
Q

intracerebral hematoma

A

hematoma that forms underneath the meninges within the cerebrum itself

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12
Q

concussion

A

bruising of the brain, can be due to multiple foci, coup/contrecoup injury…

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13
Q

mild concussion

A

individual hasn’t lost consciousness

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14
Q

concussive syndrome

A

right after a concussion, can experience dizziness, nausea, retro/anterograde amnesia

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15
Q

classic cerebral concussion

what type of trauma is associated with this?

A

individual has lost consciousness (typically open trauma)

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16
Q

postconcussive syndrome

A

can see effects of concussion months or years later: gait disorders, personality changes, irritability, difficulty speaking

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17
Q

post traumatic seizures

A

brain damaged by concussion; neurons ATTEMPT to regenerate but create seizure like episode

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18
Q

what is the last thing you want to do to someone who is having a seizure?

A

restrain them –> might break their bones

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19
Q

chronic traumatic encephalopathy (CTE)
“dementia pudulisma”
–> what sport is it more common in?

A

repeated head injury causes tau protein polymerization –> display similar signs and symptoms as alzheimer’s disease
–> common in football players

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20
Q

what are 4 types of primary spinal cord trauma?

A
  • hyperextension injury
  • flexion injury
  • axial compression injury
  • flexion rotation injury
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21
Q

hyperextension injury

A

injury of spinal cord; blow from the bottom front causes head to go up and back
- can lead to SPINAL CORD COMPRESSION

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22
Q

flexion injury

A

injury of spinal cord; blow from back causes head to go down
- can lead to WEDGE FRACTURE

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23
Q

axial compression injury

A

injury of spinal cord; blow from top crushes spine

- can lead to COMPRESSION FRACTURE with or without SPINAL CORD COMPRESSION

24
Q

flexion rotation injury

A

injury of spinal cord; excessive rotation of the neck causes DISRUPTION OF INTERVERTEBRAL DISCS

25
Q

comminuted (burst) fracture

A

multiple fractures that result in multiple bone fragments

26
Q

dislocation

A

moved to a position that is not supposed to be there

27
Q

spinal shock

what can it temporarily cause

A

can happen anywhere along the spine and leads to a dysfunction in nerves that join here
–> can temporarily cause paralysis

28
Q

what are common sites of spinal injury/trauma?

A

C1-C2, C4-C7, T10-L2

29
Q

what are some degenerative spine disorders?

A
  • degenerative disc disease

- herniated intervertebral disc

30
Q

degenerative disc disease (DDD)

- what site is most common

A

damaged disc causes pain

–> lumbar vertebrae most common site of trauma

31
Q

what are 3 types of degenerative disc diseases?

A
  • spondylolysis
  • spondylolisthesis
  • spinal stenosis
32
Q

spondylolysis

A

fracture in the lumbar vertebrae, but no protrusion

33
Q

spondylolisthesis

A

specific type of dislocation; vertebrae moves forwards toward anterior part of the body
(surgery has to go from the front)

34
Q

spinal stenosis

A

narrowing of canal that the spinal cord runs through –> pressure on spine –> SPINAL SHOCK POSSIBLE

35
Q

herniated intervertebral disc

A

rubbery discs that lie between vertebrae of spine protrude out –> pressure on spinal cord –> POSSIBLE SPINAL SHOCK

36
Q

what are 5 types of cerebrovascular disorders (CVA, strokes…)

A
  • transient ischemic attacks (TIAs)
  • thrombotic stroke
  • embolic stroke
  • hypoperfusion
  • hemorrhagic stroke (intracranial)
37
Q

transient ischemic attacks (TIAs)

- what is a sign that person is experiencing this

A

deprivation of blood to the brain (common in geriatric patients), can be caused by occlusion of blood vessel due to clot
SIGN: patient speaks gibberish and has bursts of dementia

38
Q

thrombotic stroke

A

stroke due to blood clots commonly found in CAROTID ARTERIES

  • -> progressive stroke (may have TIAs): slower development
  • -> completed stroke: rapid onset, more serious, COMPLETE occlusion of blood to the brain
39
Q

embolic stroke

A

embolism causes stroke and deprivation of blood to the brain (more rare)

–> lacunar stroke: occurs deeper in brain, due to plaque causing blockage of blood

40
Q

hypoperfusion

A

decreased ability of the blood to perfuse the brain tissue

41
Q

hemorrhagic stroke (intracranial)

A

cerebral hemorrhage…

breach in circulatory system that supplies the brain, due to RUPTURED ANEURYSM

42
Q

what are the two types of intracranial aneurysms?

A

(aneurysm = bulge in blood vessel within the brain)

  • saccular aneurysm: one side of vessel bulges
  • fusiform aneurysm: circumferential, all sides of vessel bulges
43
Q

arteriovenous malformation (AVM)

A

deformation of vessels that can result in aneurysms (genetic or injury)

44
Q

subarachnoid hemorrhage (SAH)

A

hemorrhage that happens between arachnoid layer and pia mater

45
Q

what are some infections/inflammatory disorders of the spinal cord?

A
  • meningitis
  • abscesses
  • encephalitis
46
Q

meningitis
(what bacterial causes it)
–> how to assess pt for it?

A

inflammation of the meninges
caused by: meningococcal meningitis
ASSESS: ask pt to touch chin to chest = if pain = meningitis
ASSESS: spinal tap = if CSF cloudy = meningitis

47
Q

bacterial meningitis

A

most common meningitis, caused by meningococcal meningitis

–> can lead to gangrenous conditions

48
Q

aseptic meningitis

A

meningitis caused by virus or fungus

49
Q

abscess

A

pus filled nodule with a lot of inflammation

50
Q

brain abscesses (2)

A
  • extradural abscesses: outside dura mater of cerebrum

- intracerebral abscesses: below all meninges and within cerebrum

51
Q

spinal cord abscesses (2)

A
  • epidural abscesses: outside dura mater of spinal cord

- intramedullary abscesses: within spinal cord/brainstem

52
Q

encephalitis

A

inflammation of the brain and spinal cord

  • infectious disease and usually VIRAL
  • -> spread by mosquitos (west nile virus)
53
Q

what are three types of tumors of the CNS?

A
  • gliomas (intracerebral tumors)
  • extracerebral tumors
  • spinal cord tumors
54
Q

gliomas (3)

A
  • astrocytomas: tumors of the astrocytes (cells that support nerve cells) MOST COMMON
  • oligodendroglioma: tumors of the oligodendrocytes (cells protecting nerve cells)
  • ependymoma: tumors of CSF (ependymal cells maintain CSF) –> unsteady gait, CSF out of nose
55
Q

extracerebral tumors (3)

A
  • meningioma: tumors of the cells that make up meninges –> pressure on spinal cord –> POSSIBLE SPINAL SHOCK
  • neurofibromas: type of nerve tumor that forms soft bumps on or under skin (affect SCHWANN CELLS that make up myelin sheaths) - usually hereditary
  • metastatic carcinoma: piece of tumor breaks off and spreads via lymphatic system –> stops at meninges and grows there
56
Q

spinal cord tumors (4)

A
  • intramedullary tumors: within spinal cord itself
  • extramedullary tumors: just outside spinal cord
  • intradural tumors: within dura mater
  • extradural tumors: outside dura mater

pathophysiology (16 decks)

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