Chapter 1-3 Flashcards
1
Q
What is an ABI?
A
Underlying disorder in brain function; not heridetary, congenital, degenerative or induced by birth trauma
2
Q
What is a traumatic brain injury?
A
Alteration in brain function, or other evidence of brain pathology, caused by external force
3
Q
Why are brain injured patients at risk of developing significant disability?
A
Often, frequently unidentified, understanding of brain injury is limited, and treatment is not readily available
4
Q
What is a traumatic impact injury/?
A
Traumatic impact injuries result from contact; either the head is struck by/against another object
5
Q
What are the 2 sub-categories of traumatic brain injuries?
A
Open - Penetrating
Closed - Non-penetrating
6
Q
What can happen with closed injuries?
A
Brain lacerations and contusions ; intracerebral hemorrhage within the brain, causing focal injuries (at a specific location within the brain)
7
Q
What is a coup-counter coup injury?
A
linear acceleration, with rapid linear deceleration of the brain resulting in frontal lobe focal lesions.
8
Q
What is the difference between an open and a closed injury?
A
Closed injuries can result in more diffuse axonal injuries resulting from tearing or shearing of axons
Open injuries are a result of a breach of the skull, or the meninges, often resulting in focal injuries such as subdural hematoma or cerebral hemorrhage
9
Q
What is a potentially major complication of a penetrating injury?
A
Secondary infection, often due to the breach of skull/meninges
10
Q
What is traumatic inertial injury?
A
Considered a non-impact injury; resulting from inertial (internal) forces .
Most commonly involve acceleration/deceleration forces
Injury when the brain contacts the skull (coup) and injury when the brain hits the other side of the skull (counter-coupe)
11
Q
What are some examples of non-traumatic brain injury?
A
Damage cause by internal factors such as; lack of oxygen or nutrients, exposure to toxins, pressure from a blockage or tumor, or other neurological disease
12
Q
What determines a brain injury classification of Traumatic or Non-Traumatic?
A
Relates to the cause of the primary injury
13
Q
What is secondary injury?
A
Pathophysiological processes; impaired blood flow, tissue damage, edema formation, inflammation
Delayed non-mechanical processes; metabolic imbalance, membrane permeability, blood brain barrier breakdown
14
Q
What are some aspects of secondary injury?
A
Hypoxia Anemia Metabolic abnormalities Hydrocephalus Intracranial hypertension Delayed release of amino acids Excitatory oxidative free-radical production release of free-radical production and metabolites
15
Q
What does incidence refer to?
Prevalence?
A
The rate or range of occurrence
The # of people with a given condition at a specific time; the # of ppl living with brain injury
16
Q
CNS cells refers to what?
A
Central Nervous System cells, different than the rest of the cells in your body
17
Q
What is the annual cost to society, without identification, support and treatment of Brain Injury?
A
76.5 billion
18
Q
What age group has the greatest risk factor for TBI, within these categories:
Adolescents
Young Adults
Adults
A
15-19
20-24
65+
75+ have highest rate of TBI-hosp/death
19
Q
What is the estimated annual occurrence of TBI amongst these same groups?
Adolescent
Young adult
Adult
A
0-14 years - 511, 257
adults 65+ - 237, 844
Non-accidental trauma (abuse) is the cause of death in 80% of children under 2 who experience head trauma
20
Q
What percentage of domestic violence victims also experience symptoms of brain injury?
A
67%
21
Q
What is a factor in 37-51% of brain injuries?
A
Alcohol/intoxication
22
Q
What kind of challenges are there for populations in prisons, with brain injury?
A
- high proportion of people incarcerated have undiagnosed brain injury
- without diagnoses and treatment, complicates the rehabilitation procedure
- when released to community, no diagnosis and no treatment puts individuals at higher risk of recidivism and non-productivity
25-87% of inmates have experienced a TBI, compared to 8.5% of general population
23
Q
Female inmates convicted of violent crime are more likely to have sustained a pre-crime TBI or some other form of physical abuse. True or False
A
True
24
Q
What are a couple of screening tools used to screen for concussion called?
A
ACE - acute concussion evaluation
HELPS tool
WARCAT - in the military
25
What does "lost productivity" refer to?
Loss of earning potential, payment of taxes and the re-investment of earnings into the economy
26
What percentage of Brain Injury patients are adequately funded for their rehabilitation?
5%. The other 95% require advocacy
27
What is the Rehabilitation Act of 1973?
Set foundation for state vocational rehab system (VR)
Federally supported system of services assisting people with disabilities in pursuing meaningful careers
- assists in gaining meaningful employment
- designed to assist disabled to attain competitive community based jobs
28
What must providers of brain injury support services provide?
Person Centered Planning (PCP) that supports max. independence :
- Age appropriate services/supports
- Freedom to move about in the community
- Integrated and accessible services
- PCP involving vocational + integrated employment goals, volunteer work or other day time activities
- In an 'at-home-like' setting within the community
29
Define Brain Injury as a chronic disease
- Not an event, or a fixed outcome
- Beginning of a chronic progression
- Impacts multiple organ systems
- Can cause/accelerate disease
30
What are the brain injury mortality stats?
2x more likely to die than non brain injured
7 yr life reduction
37x more likely to die from seizures
12x more likely to die from septicemia
4x more likely to die from pneumonia
3x more likely to die of other respiratory problems
31
What are the co-morbidity rates of Brain injury?
5% of entire epileptic population
| TBI patients; 1.5-17x more likely to develop SUDEP (sudden death in epileptic patients)
32
What is the prevalence of disorder incidence after TBI?
Post-traumatic epilepsy:
Mod Injury - 4.2%
Severe - 16.7%
Sleep disorder - 36.7%
33
What are the symptoms of Chronic Traumatic Encephalopathy?
Begins slowly with:
deterioration of concentration, attention, memory and judgement, insight
headaches, dizziness occasionally
Severe cases eventually show symptoms of Parkinsonism;
Disturbed coordination
Slurred speech, masked faces, difficulty swallowing, tremors
Severely correlates with # of injuries
34
What is the prevalence of neuroendocrine disorders in B.I patients?
Dysfunctional pituitary gland greater than 30%
Growth hormone deficiency or insufficiency - 20%
Hyperthyroidism - 5%
Gonadotropin deficiency - 12-15%
35
What is the most debilitating consequence of TBI?
Psychiatric/psychological mood disorders.
| - OCD, anxiety, psychotic mood disorders, and major depression
36
What musculoskeletal dysfunction is prevalent following B.I?
Spasticity: characterized by muscle tone resulting in abnormal patterns.
Requires life-long treatment, left untreated it can result in muscle contractures, tissue breakdown and skin laceration
37
What is made up of the brain and spinal cord?
Central Nervous System (CNS) which enables movement and action
38
How much does the brain weigh?
less than 1lb at birth, grows to 3lb, bathed in cerebrospinal fluid
39
What is the blood-brain barrier?
It is a barrier that ensures harmful substances canno pass through to the membrane and harm the brain
40
What 3 meninges cover the brain?
Outer layer; Dura matter - like a heavy plastic covering
Arachnoid layer - Like a spider web that bridges the brains wrinkles/folds
Pia matter - (tender) Molds around every tiny crook/crevice on brains surface
41
What is the function of the Spinal Cord?
Neurological superhighway
- Controls all nerve communication between brain/body
- Complex interconnection of nerves execute all body functions
42
What are the common neuroimaging techniques, and when were they developed?
Began in the 1970's with:
```
Computed Tomography ( CT )
- Using an x-ray beam tech, creatures digital image of the brain, one section or slice at a time to harmlessly detect foreign objects
```
Magnetic Resonance Imaging (MRI)
- Greater anatomical detail/clarity in the image; displays pathologies more sensitively
43
What is a neuron made up of, and what is its function?
3 parts: Cell body, Axon (long slim wires that transmit signals from one cell body to another), Dendrites (networks of short wires that receive info at the synapse, from other neurons.)
Neurons receive/transmit information in a relay where electrical impulses alternate with chemical messengers (neurotransmitters)
44
What is an action potential?
Miniature information center, which does or does not fire electrical impulse. Depends on numerous signals it receives every moment.
45
After brain injury, how can neural pathways be affected?
Many pathways may be torn apart, stretched, metabolically slowed or chemically disrupted, causing information transmission to be delayed or no longer possible in the affected neurons/regions of the brain
46
What is the function of the brain stem?
Relays info in/out of the brain
Central point for all incoming/outgoing information and basic life functions
Made up of the Medulla, Pons and the Midbrain
Contains many of the centers for the sense of hearing, touch, taste and balance
47
What is the Reticular Activating System (RAS) and what is its function?
A collection of nerve fibers and nuclei.
Modulates or changes arousal, alertness, concentrations and basic biological rhythm
Brain injury can result in turned down RAS
48
What is the Medulla?
First part in the lower brain stem
- involved in many basic living functions
- if injured, life is immediately threatened
49
What are the Pons?
Just above the medulla
| Essential for facial movement, sensations, hearing and coordinating eye movement
50
What is the Diancephelam?
Made up of the thalamus, hypothalamus, and other structures. Cm's above the midbrain.
Master relay center for forwarding information, sensation and movement
51
What is the cerebrum?
hemispheres and lobes; can sustain serious injury; unresponsive thinking but life is sustained
52
What is the thalamus?
Sits at the very top of the brainstem, beneath the cortex
Major relay for incoming and outgoing sensory information.
Injury can cause severe attention and concentration difficulty, difficult memory storage, weak mental stamina, decreased sensory info
53
What is the cerebellum?
Lower, back of the brain. Coordinates, modulates and stores all body movement. 1/8th of brain mass, own arrangement of brain cells
54
What does the 'tree of life' refer to?
Governs every movement, monitors impulse from motor and sensory centers (brainstem, basal ganglia, sensorimotor cortex) to help control the direction, rate, force and steadiness of a persons movements. Enables development and storage of motor skills
55
What is the cerebral cortex?
left/right hemisphere. each has 4 lobes; frontal, parietal, temporal and occipital
dedicated to highest levels of thinking, moving and acting
56
What is the corpus collosum?
A complex band of nerve fibers that exchanges info between the two hemispheres of the brain. Surgeries to eliminate seizures resulted in cutting this out.
57
What studies showed that the hemispheres process information differently?
Bogen and Sperry
Left - more linear, verbal- analytic and logical
Right - more holistic, visual-spatial and intuitive
58
What side does each cerebral hemisphere control?
The opposite side of the body
59
What does the left hemisphere of the brain control?
Helps a person process information into a logical linear manner; better comprehension and use of language
60
What does the right hemisphere of the brain control?
Responds to information in a more holistic and spacial sense (shapes, faces, music, art)
61
How often do the hemispheres communicate? What happens if they are damaged?
Hemispheres communicate 1000x per second through the corpus callosum. Sustaining injury/swelling may damage this relay system, resulting in impaired processing of information.
Significant damage to one hemisphere and the corpus callosum an create very complex cognitive difficulties and many compensatory strategies are needed to live effectively.
62
What are the four lobes of the brain? How are they connected?
Parietal, frontal, temporal and occipital - named ater the main skull bone that covers them
They are connected by complex neural fibers, projecting out of the brainstem and relay impulses and information to and from the cortex.
The association fibers loop/link together different sections of the same hemipshere and modulate the cerebral cortex.
63
What is the function of the primary motor cortex?
Sends signals down to the muscles of the body, voluntary movement.
64
What is the function of the prefrontal cortex? What happens when it is injured?
much larger part of the frontal lobes/ in front of the sensory motor cortex. responsible for various emotional responses to circumstances
difficulty synthesizing environmental signals, making decisions, organizing, prioritizing, initiate/inhibit, control emotions, make plans and interact socially
65
What commonly occurs following frontal lobe damage?
Complete personality change. Critical to our sense of identity/self-awareness and self appraisal. May result in loss of ability to perceive strengths/weaknesses. Self perception may be out of sync with reality, creating potential problems. Also responsible for goal oriented behavior and motivation
66
What is the antecedent-based behaviour model?
Refers to what is happening before behaviour.
| - Can sometimes eliminate behavior once antecedents are known/understood
67
WHere are the parietal lobes located?
They are set behind frontal lobes/ where w find primary sensory cortex, which is the 1st part of the brain to consciously register physical sensations. They are posterior (behind) the primary motor cortex and respond to sensory info; touch, heat, cold, pain sense of bodily awareness
68
Where are the temporal lobes located and what is their function?
On both sides of the brain; centers for language (hearing, memory) together, parietal lobes + temporal lobes direct the smooth transfer of thought and expression into speech.
69
What is the Broca's area responsible for? Where is it located?
The lower portion of the motor cortex in the left-frontal temporal lobe.
Controls face/mouth muscles for speech.
Injury may result in dysarthic speech, largely comprides of action words.
70
What is the Wernickes area responsible for? Where is it located?
Carl Wernicke -
Left-temporal parietal lobe.
Governs understanding of speech and ability to make sense of spoken words.
71
What is the process of hearing?
A series of events that takes place;
Sound waves are picked up and passed through the outer ear to middle ear to the inner ear
Transmuted sound waves vibrate through thousands of tiny, sensitive hairs in the organ of Corti (spinal organ) inside the cochlea.
Each hair is connected to 1000s of nerve fibers which send signals through the 8th cranial (acoustic) nerve, to the brainstem.
Many of the neve fibers cross over before the acoustic nerve delivers the signals up to the auditory cortex, located at the top- of the temporal lobe, for processing.
72
Where is memory stored? What happens when these areas are injured?
Short-term; stored in hippocampus
Long-term; stored throughout the brain.
Temporal lobes, connected to the hippocampus, help in long-term storage of permanent memories (where you went to school, friends names)
Injury creates difficulty in learning new things, yet retains pre-injury memories
73
How many structural vertabrae are there and what is their function?
There are 33 vertabrae (bones) joined together with discs (cartiliage) and ligaments (fibrous tissue)
They provide support to muscles/organs and protect the spinal cord from shearing, blunt trauma
74
What 5 sections of the spine are there? What are their relative vertabraes
```
Cervical : C1-C7
Thoracic: T1-T2
Lumbar: L1-L5
Saccral
Coccygeal
```
75
What is referred to as the atlas? The axis? What are their functions?
1st vertabra is the atlas, 2nd vertabrae is the axis.
Atlas supports the skull on its two articular facets (joints), which sit laterally and are responsible for most of the heads movement in the midline.
The axis is the 2nd cervical vertebra, upward projection (dens), which inserts into the atlas anteriorly with multiple ligaments to guide and stablize. Responsible for most horizontal movement
76
Where does the spinal cord run? What about facets?
The spinal cord runs through the forearm, while the facets lie horizontally to provide better mobility.
77
How many nerves to the 7 vertebrae have?
8. The first 7 project above the vertebrael bodies, the 8th projects below the 7th.
78
Where is the thoracic spine?
Spinal bones at back of chest; easily identified; ribs connect with them to provide stability, decreasing tendency to destabilizing injury
There are 12 vertebral bodies and associated nerve roots to each side in the thoracic spine.
79
What part of the spine is most susceptible to injury and why?
The lumbar spine is is adapted to the task of carrying the bodies frame. Also the cervical spine as it is tasked with carrying the weight of the head.
80
What part of the spinal column does the sacrum and coccyx make up?
The tailbone.
The sacrum appears as one bone; actually 5 fused together
The sacrum articulates with the hip (ilia) bone at the sacroiliac joints laterally forming the basis of the pelvic girdle.
81
What is the Cauda Equina (Horse tail)?
The nerves that project out from the bottom of the spinal cord, lumbar to sacral region
82
What are Major Descending Tracts?
Efferent nerve bundles headed away from the brain
83
What is the anterior corticospinal tract?
Ventral-medial cord, carries impulses from motor cortex to muscles/organs
84
What is the Lateral Corticospinal Tract?
Lateral, slightly dorsal, aspect of the cord. Sends impulses to control muscles/other orangs.
85
What is the rubrospinal tract?
It descends from the midbrain with input from the cerebral cortex on same side of the body, and contralateral cerebellur nuclei with projections to the anterior cervical spinal cord va interneurons.
It assists with manual dexterity in upper extremities by facilitating flexor muscle activity (bending toward the body) while inhibiting extensor activity (bending away from the body)
86
Tectospinal tract refers to what?
The tract that descends from the superior colliculus (a small round structure in the mid-brain) to below the thalamus.
87
Like the brain, the spinal cord has 3 levels of meninges: dura matter, arachnoid matter and pia matter.
What happens when sticking a need through the dura matter?
There is a resistance and pop - if the hole persists, allowing CSF to leak, a nasty headache will result
88
What is the spinal arachnoid matter?
A web-like material that coats the space between the dura/pia matter
89
Where is Cerebral Spinal Fluid created in the brain?
| How is CSF circulated?
CSF is created in the Choroid Plexus (plexus of cells)
It circulates in the ventricles of the brain through the median aperture (foramen of Magendie) and ten into the space around the spinal cord.
90
What is Vascular Supply, and what is its function?
Arteries/Veins. They bring nutrients and oxygen in, and carbon dioxide and waste products away from the spinal cord.
91
What is an artery?
Arteries are high-pressure systems with thick walls, and cause significant neuro-damage, if damaged.
92
How does the spinal cord send and receive information?
S.C sends information through Afferent tracks of nerves, and receives information through Efferent tracks of nerves
93
Where does the spinal cord end?
Conus Medullaris, which terminates between L1/L2 vertabrae.
94
What is the spinotectal tract?
This tract travel in the ventral-latera cord and carries info from the spinal cord to the tectum, which processes info from the eyes and other sensory organs
95
Fasciculus Cuneatus and Funiculus Gracilis are nerve tracts responsible for what functions?
These tracts lie in the dorsal-medial aspect of the spinal cord and transmit joint and muscle sensation to the brain
96
Spinorecticular tract is responsible for what?
Sends sensory info from the body to the reticular formation of the thalamus. Most likely responsible for reflex responses like pain.
97
What are the 4 spinal cord syndromes?
Central Cord Syndrome: weakness, numbness, primarily in arms; usually paired with incontinence
Brown Sequard Syndrome: occurs when only 1 side of the spine is damaged; ipsilateral paralysis; nerves affect opposite sides of body
Anterior Cord Syndrome: common. Anterior 2/3 of cord is controlled by one artery / more susceptible to injury
Posterior Cord Syndrome: Rare. Occurs primarily with intraoperative complications in spinal surgery
98
What are 3 types of Neuroimaging?
CT (Computerized tomography) - uses several x-rays and computer processing to create cross sectional images
MRI (Magnetic Resonance Imaging) - Non-invasive. Produces 3D detailed anatomical images
DTI (diffusion tensor imaging) - analyzes the anatomy of nerve bundles and complex neuronal network of the brain
99
When is a DTI effective?
When Corpus Collosum is damaged, the nerve tracts thin out. If there is specific damage to a cortical region, such as the frontal lobe, the DTI illustrates the neural pathways which are affected.
100
What is a functional MRI? (fMRI)
This is when a person performs a task while the scanning occurs, showing the activated regions
101
What is the purpose of contemporary neuroimaging?
It provides a mechanism to quantify the brain/amount of damage that has occurred.
102
What practical implications occur when the brain is bouncing around?
Movement often rips, tears and stretches blood vessels/delicate nerve tissues
103
Many acceleration/deceleration injuries result in what?
Force of impact at a high velocity of speed often result in injury from contact with these rough surfaces in the skull interior. This can lead to brain bleeds, causing blood/fluid swelling.
Because the skulls is closed, there is no extra room for swelling or fluid.
104
What can happen when there is tremendous pressure that builds within the skull after an injury?
Pressure can deprive the brain of oxygen which can result in coma, or death if the swelling is not released.
105
What symptoms typically present with slow brain bleeds?
Forgetfulness, confusion, brief loss of consciousness, disorientation and severe headaches
106
Brain injuries are often comprised of two injuries. What does this mean?
1st injury is from the blow.
2nd injury is from the swelling, bleeding, compression, contusions and changes in chemistry or metabolism within the brain
107
What is a Diffusional Axonal Injury? (DAI)
A DAI can occur when white matter tracts stretch and break, resulting in extensive and entire brain injury.
108
What is Hypoxia? What is Anoxia?
Occurs when breathing is stopped. Caused by severe blood loss in any region of body, which decreases oxygen getting to the brain.
Anoxia is when the brain stops getting oxygen completely.
Both may cause brain cells to die, which causes chemicals to be released, which has the potential to contribute to the death of cells around them.
109
What are some causes of Anoxia?
Near-drowning, heart attacks, suffocation, smoke inhalation, asthma attacks and strangulation
110
What is a penetrating injury, and what are the effects of it
A penetrating injury is one that breaches the skull.
- Can cause significant bleeding of the brain, and large amounts of tissue damage causing large amounts of scar tissue, which is more likely to cause electrochemical disruption leading to increased prevalence of seizures
111
What does the primary injury refer to?
| What does the secondary injury refer to?
Primary damage, mechanical damage
Pathophysiological processes, delayed non-mechanical processes
112
What is phase 1 of the secondary injury?
Impaired blood flow, metabolic imbalance
Tissue damage, membrane impermeability
Edema formation, inflammation, blood brain barrier breakdown
113
What is phase 2 of secondary injury?
Axon-terminal depolarization, release of excitatory neurotransmitters
Intracellular breakdown, free radical generation
Apoptosis, necrosis
CELL DEATH
114
What is neuroplasticity?
Adaptation/reorganization of brain, due to environment around it, or due to cell death
115
What is the neuroprotective compound strategy?
| What is the only approved neuroprotective compound available for stroke?
One that limits neuronal death following injury and/or enhances recovery function
Tissue plasminogen activator (TPA) ; a protein involved in the breakdown of blood clots and approved for therapeutic use in stroke patients
116
What is a traumatic inertial injury?
Injury to the brain not caused by impact but, as a result of inertial forces, such as acceleration-deceleration
117
What is a closed injury? Open injury? Penetrating injury?
Injury to the brain resulting in brain lacerations, contusions or intracerebral hemorrhage
Injury to the head; a breach of skull or meninges occurs
Any injury that occurs following penetration of a foreign object, fragment, bone chip, through the dura matter.
118
What causes a non-traumatic brain injury?
Damage to the brain, caused by internal factors, such as oxygen or nutrient deprivation to brain cells, pressure from a tumor or blockage, or other neurological disease
119
What is a coup/counter coup injury
Head injury that results from impact of a moving object - occurs at the site of impact
Impact injury resulting from the moving head striking a stationary object - injury occurs at the side opposite of the impact
120
What is loss of conciousness?
Temporary altered state, unlike sleep, when a person is unresponsive to stimuli, usually due to trauma, stroke or other injury
121
What risk factors are associated with brain injury?
Injury severity, age at injury, alcohol misuse, domestic violence, service in the military, participation in sports, previous brain injury
122
What is chronic traumatic encepholopathy?
A condition, diagnosed after death, relative to multiple concussions,
123
What is computed tomography?
A cross sectional series of x-rays used to view body organs allowing medical professionals to view the scans in multiple individual layers; some can be restricted to a 3D image
124
Magnetic Resonance Imaging is what?
Technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues within the body
125
What is diffusion tensor imaging?
MRI method that maps the diffusion of molecules, primarily water, in a persons body non invasively
126
What is intracranial pressure? (ICP)
Pressure inside the skull from the brain and CSF. Pressure may vary due to production and absorption of CSF following injury.
127
What are the neuroprotective compounds and what do they do?
Neuroprotective compounds or strategy limits neuronal death following injury and enhances recovery of function.
Magnesium and Progesterone and Nicotinamide
128
Who introduced the concept of neuroplasticity, and when?
Introduced in 19th/20th century, by William James and Raymon y Cajal.
The idea that LEARNING could produce neuroplasticity was not introduced until the 1950's, by Donald Hebb. "Neurons that fire together wire together"
129
What was discovered by William Greenrough in 1970s?
| What did Michael Merzinch discover after wards?
Mature neurons can grow new dendrites and synapses in response to change in behavior, environments
Michael found that it was possible with adults on a much larger scale , in reorganization of brain regions.
"synaptogenesis and axon sprouting" led to a focus on how behavioural experience can shape brain reorganization after injury"
130
The somatosensory cortex refers to what?
A map of the body, superimposed on surface of the brain
131
What is apoptosis? What can cause it?
"Programmed cell death"; initiated by internal genetic cascades
Edema causes a swelling in cells as a result of imbalances in interstitial osmolarity
132
What is excitotoxicity?
It occurs when a neuron cannot maintain its resting potential resulting in its repeated firing, creating toxic levels of sodium/calcium ions, leading to cell death
133
What is plasticity?
A change in the expression of genes or proteins related to neuroplasticity; can be observed with electrophysiological measures as changes in signaling between neurons.
134
Plasticity occurring with Long Term Potentiation or Long Term Depression can lead to what?
Neurogenesis, ie, the formation sof new neurons; or can be examined on a structural level such as increased complexity of neuronal branching, axonal sprouting and the formation of new synapses reorganization of cortical map reorganization
135
Structural plasticity and cortical map reorganization occur where/when?
Occur around the injury and in areas remote, yet connected, to the injury. Critical to neuro rehabilitation
136
Long term potentiation and long term depression refer to what?
a. strengthening of connections
| b. weakening of connections
137
What is intracortical microstimulation?
They would place electrodes methodologically into the motor cortex, to stimulate and then examine
138
Stroke injury in one hemisphere results in a forelimb that is impaired. Constraint of the good limb for 2 weeks post injury eliminates the plasticity in the cortex opposite the stroke, encouraging greater use of the impaired limb. What is not recommended when it comes to restraint, and why?
If constraint occurs 24 hr/day in the first 7 days post-injury, it decreases behavioural function/recovery in the impaired limb and exaggerates the injury size. Premature and intense restraint therapy may be harmful following recovery. May be harmful and exaggerate the injury size.
139
What is a brain derived neurotrophic factor?
a protein in humans that is encoded by the BDNF gene
140
What is meant by excitatory post-synaptic potential?
Change in membrane voltage of a post synaptic cell. following an influx of positively charged ions into a cell (typically Na+)
