Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HLSC 222 Pathophysiology 🧫 > Chapter 16- Disorders of CNS, PNS and NMJ > Flashcards

Chapter 16- Disorders of CNS, PNS and NMJ Flashcards

1
Q

What can alter CNS function?

A

Traumatic injury
Vascular disorders
Tumour growth
Infections
Inflammatory processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is affected by alterations PNS function?

A

Nerve route, plexus, nerve themselves or neuromuscular junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the primary cause of death and disability in individuals under age 40 in Canada?

A

Traumatic brain injury (TBI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

30% of all TBIs are sustained by what group?

A

Children and youth
-Many caused by sports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a TBI?

A

Alteration in brain function or other evidence of brain disease caused by an external force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 2 types of TBIs?

A

Primary
Secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes a primary TBI?

A

Direct impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Focal

A

Affecting one area of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diffuse

A

Affecting more than one area of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is a primary TBI focal or diffuse?

A

Can be focal or diffuse (diffuse axonal injury DAI)
Focal = 2/3 injuries
Diffuse= 1/3 injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes a secondary TBI?

A

Indirect result of primary injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens when someone has a secondary TBI?

A

Systemic responses and cascade of cellular and molecular cerebral events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are TBIs diagnosed?

A

Glasgow Coma Scale (GCS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Glasgow Coma Scale?

A

Scores 1-6 based on best eye response, best verbal response and best motor response. Totals are calculated and classified from mild-severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a score 2 on the GCS?

A

-Eye opening to pain
-Incomprehensible sounds
-Extension to pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a score 3 on the GCS?

A

-Eye opening to verbal command
-Inappropriate words
-Flexion to pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The lower the score the more ______________________?

A

Severe the damage
-Severe head injury = GCS score of 8 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Are primary focal TBIs closed or open?

A

Can be closed or open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of primary focal TBI is more common?

A

Closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the appearance of the brain of a closed primary focal TBI?

A

Dura mater remains intact, Brain tissue not exposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes a closed primary focal TBI?

A

Head striking a hard surface
Moving object striking head
Blast waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the appearance of the brain of an open primary focal TBI?

A

Break in dura mater
Brain tissue exposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes an open primary focal TBI?

A

Penetrating trauma
Skull fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Examples of primary focal closed TBIs?

A

Coup/Contrecoup
Contusion
epidural (extradural) hematoma
Subdural hematoma
Intracerebral hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Examples of primary focal open TBIs?

A

Compound skull fractures
Missile injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is a Primary focal closed TBI?

A

Specific, observable brain injuries that occur in a precise location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What percent of primary focal closed TBIs are mild?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some severe primary focal closed TBIs?

A

Contusions
Epidural
Subdural
Hematomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Coup

A

Injury at the site of impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Contrecoup

A

Injury from brain bouncing back and hitting opposite side of skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a contusion?

A

Brain bruising caused by the compression of th eskull at the point of impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the contusion the result of?

A

Blood leaking from injured vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What causes a more severe contusions?

A

Smaller contact area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the most common site of contusion injuries?

A

Frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What forms after a contusion?

A

Edema because of increased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When an edema forms in the brain after a contusion what happens?

A

Hemmorhages, edema, infarction and necrosis making the tissue become pulpy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When do the greatest injury effects peak after a contusion?

A

18-36 hours after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is a contusion diagnosed?

A

Glasgow coma scale
CT scan
MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How is a contusion treated?

A

Surgical removal of large contusions and areas of haemorrhage may be required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is an epidural hematoma (EH)?

A

Bleeding between dura mater and skull
-Artery bleeding and hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the most common site of EH?

A

Temporal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are symptoms of EH?

A

Loss of consciousness
Hematoma grows= severe headache, confusion and seizure
Hemiparesis
Pupil dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is hemiparesis?

A

Weakness or inability to move one side of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When is injury prognosis of a epidural hematomy good?

A

If treated before both pupils dilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How is EH treated?

A

medical emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does dural refer to?

A

Dura Mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is a subdural hematoma?

A

Bleeding between dura mater and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the two kinds of subdural hematoma?

A

Acute
Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is an acute subdural hematoma?

A

Develop quickly, within hours
-Hematomas grow, ICP rises, pressure is applied to bleeding veins (short-term limitation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the symptoms of an acute subdural hematoma?

A

Headache to confusion
-Loss of consciousness
-Pupil dilation
-Hemianopia
-Anopia

51
Q

What is hemianopia?

A

Blindness over half of the field of vision

52
Q

What is anopia?

A

Blindness

53
Q

What is a chronic subdural hematoma?

A

-Develop over weeks to months
Subdural mass bleeding causing the subdural space to fill with blood, and a vascular membrane forms around hematoma

54
Q

Chronic subdural hepatomas are common in those who?

A

Abuse alcohol

55
Q

What are symptoms of a chronic subdural hematoma?

A

Headaches
Tenderness over hematoma
Worsening dementia and paranoia (rigidity)

56
Q

How are chronic subdural hepatomas treated?

A

Craniotomy to remove jelly-like blood

57
Q

What is a intracerebral hematoma?

A

Bleeding within the brain
-Penetrating and shearing force injure small blood vessels causing a mass and edema

58
Q

What percent of head injuries are intracerebral hematoma?

A

2-3%

59
Q

What areas of the brain are the common sites of intracerebral hematomas?

A

Frontal and temporal lobes

60
Q

What are symptoms of intracerebral hematomas?

A

Sudden rapid decrease in level of consciousness
Pupil dilation
Positive Babinski reflex

61
Q

What is a positive Babinski reflex?

A

Big toe bends up and back to the top of the foot and the other toes fan out

62
Q

What is a Compound Skull Fracture (CSF)?

A

Opens a path between cranial contents and the environment
-Open primary focal TBI

63
Q

When should a CSF be considered?

A

Whenever cuts of the scalp, tympanic membrane, sinuses, eye or mucous membranes occur

64
Q

What are the causes of Compound skull fractures (CSF)?

A

Crush or stretch injuries

65
Q

What is a crush injury?

A

Cutting or crushing
-Whatever the missile touches

66
Q

What is a stretch injury?

A

Blood vessel or nerve damaged without direct contact

67
Q

What are symptoms of open brain injuries?

A

Unconscious

68
Q

What is a basilar skull fracture?

A

Involves at least one of the bones that compose the base of the skull. Generate spinal fluid leaking from ear or nose and blackened eyes.

69
Q

What causes basilar skull fractures?

A

Substantial blunt force trauma

70
Q

What causes Primary diffuse injuries (diffuse axional)?

A

High levels of acceleration or deceleration (whiplash) or rotational forces

71
Q

What is a primary diffuse injury?

A

Widespread injury caused by forces which lead to the shearing of axonal fibers and white matter tracts

72
Q

The cognitive consequences of a primary diffuse injury are based on?

A

The degree of shearing
-Higher degree = extensive cognitive impairments
e.g Car crash survivors

73
Q

How are primary diffuse TBIs diagnosed?

A

Electron microscope to detect axonal damage

74
Q

What syndromes are included as secondary brain injuries?

A

Trauma and stoke syndromes

75
Q

What systemic process are involved in secondary brain injuries?

A

Hypotension, hypoxia etc.

76
Q

What cerebral processes are involved in secondary brain injuries?

A

Inflammation, edema, increased ICP

77
Q

How do primary brain injuries lead to secondary brain injuries?

A

Effects of primary TBIs cause a disruption to the BBB which causes neuronal death

78
Q

How are secondary brain injuries managed?

A

Prevention of hypoxia
Maintenance of cobra perfusion pressure
Removal of hematomas
Nutritional management

79
Q

What are the categories of TBIs?

A

Mild
Moderate
Severe

80
Q

What is a mild TBI?

A

aka Mild concussion
Characterised by immediate but transitory clinical manifestations

81
Q

How long does loss of consciousness last for a mild TBI?

A

less than 30 minutes

82
Q

What is the GCS score for a mild TBI?

A

13-15

83
Q

What are symptoms of mild TBIs?

A

Headache, nausea, vomiting

84
Q

How are mild TBIs diagnosed?

A

Blood test to determine need for CT scan

85
Q

How long does loss of consciousness last for a moderate TBI?

A

30mins to 6 hours

86
Q

What is the GCS score for a moderate TBI?

A

9-12

87
Q

Moderate TBIs cause permanent defects in what?

A

Arousal and attention

88
Q

What are symptoms of moderate TBIs?

A

Confusion and amnesia lasting more than 24v hours
Abnormal brain imaging

89
Q

How long does loss of consciousness last for a severe TBI?

A

More than 6 hours

90
Q

What is the GSC score for severe TBIs?

A

3-8

91
Q

How does a severe TBI progress?

A

Permanent damage —> vegatative state —-> Death

92
Q

What are signs of a severe TBI?

A

Changes in pupillary reaction, cardiac and respiratory systems
Decerebrate or decorticate posturing
Abnormal brain imaging
Increased ICP 4-6 days after injury

93
Q

Decorticate posturing

A

Person is stiff with bent arms, clenched fists, and legs held out straight

94
Q

Decerebrate posturing

A

Arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward

95
Q

What are symptoms of Severe TBIs?

A

Compromised coordinated movements, verbal and written communication

96
Q

What is the goal of treatment for someone with a severe TBI?

A

Maintain cerebral perfusion and promote neural protection

97
Q

Whta determines probable complications of TBIs?

A

Severity and location of brain injured

98
Q

What are 3 post-traumatic syndromes?

A
  1. Post-concussion Syndrome
  2. Post-traumatic Seizures (epilepsy)
  3. Chronic Traumatic Encephalopathy (CTE)
99
Q

How long does Post-concussion syndrome last?

A

Weeks-months after concussion

100
Q

What symptoms of concussions require further evaluation?

A

Drowsiness, confusion, vomiting
Unequal pupils
CSF drainage from ears or nose
Double vision

101
Q

When should a concussion be under close observation?

A

First 24 hours

102
Q

What percentage of TBIs develop Post-traumatic seizures (epilepsy)?

A

10-20%

103
Q

What kind of brain injuries are at the highest risk for developing Post-Traumatic Seizures?

A

Open brain injuries

104
Q

What causes the increased seizures associated with Epilepsy?

A

Molecular changes cause the sprouting of new hyper excitable neural activity leading to increased seizures

105
Q

What is Chronic Traumatic encephalopathy?

A

Progressive dementing disease that develops with repeated brain injury

106
Q

What is Chronic traumatic encephalopathy associated with?

A

Contact sports (especially football)
blast injuries with soldiers

107
Q

What occurs in the brain of someone with CTE?

A

Tau neurofibrillary tangles

108
Q

What are the consequences of CTE?

A

VIolent behaviour
Change in cognitive and motor function
Depression
Suicide

109
Q

Who is at risk for SPinal cord and vertebral injuries?

A

Male gender 20-39 yoa
Adult 79+ (bc of falls)

110
Q

What causes a Primary Spinal cord injury?

A

Initial mechanical trauma causing immediate tissue damage

111
Q

When does a primary spinal cord injury occur?

A

If the injured spine does not receive adequate immobilization following trauma

112
Q

When can a primary spinal cord injury be life-threatening?

A

If C1-C4 is injured
-Loss of CV and respiratory function

113
Q

What is a secondary spinal cord injury?

A

Disease causing process occuring within minutes and continues for weeks

114
Q

Where does a hemorrhage appear in Secondary spinal cord injuries?

A

In grey matter
-death of all grey matter at the spinal level

115
Q

Where do secondary spinal cord symptoms occur?

A

Two cord segments above and below injury

116
Q

WHat happens when the spinal cord swells during secondary spinal cord injury?

A

Increases dysfunction and makes it difficult to distinguish permanent and temporary damage

117
Q

What cells die during a secondary spinal cord injury?

A

Oligodendrocytes
-Caused by myelin degeneration

118
Q

What are some vertebral injuries?

A

â–ª Vertebral fractures, dislocation, bone
fragments = shearing and compression
â–ª Vertebrae fracture easily due to torn
supporting ligaments
â–ª Vertebra misalignment and dislocation occurs
â–ª Vertebral injuries occur at most moveable
portions of column
â–ª Hyperextension, Flexion, and Rotations damage

119
Q

What is spinal shock?

A

Develops immediately after injury, Complete loss of function at or below level of injury

120
Q

What happens to the hypothalamus during spinal shock?

A

It cant regulate body heat
-person assumes temp of air aka Poikilothermic

121
Q

How long does spinal shock last?

A

7-20 days

122
Q

When does spinal shock return?

A

With reflex of emptying the bladder

123
Q

What is neurogenic shock?

A

Occurs with injury above T6
Unopposed parasympathetic activity (due to absence of sympathetic activity)
➢ Result: Vasodilation, hypotension

124
Q
A

HLSC 222 Pathophysiology 🧫 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions