UHD Exam 5 > Chapter 23 > Flashcards

Chapter 23 Flashcards

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1
Q

glia cells

A
  • astrocytes
  • oligodendrocytes
  • ependymal cells
  • microglia
  • schwan cells
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2
Q

which cells correspond with the CNS?

A
  • astrocytes
  • oligodendrocytes
  • ependymal cells
  • miicroglia
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3
Q

what cell correlates with the PNS?

A

schwan cells

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4
Q

meninges

A
  • dura mater (outer)
  • arachnoid mater
  • pia mater (inner)
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5
Q

what is cerrebrospinal fluid made by?

A

choroid plexus

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6
Q

components of CSF

A
  • clear
  • small amount of protein
  • glucose 50-80 mg/dl
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7
Q

where is CSF stored?

A

subarachnoid space

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8
Q

signs and symptoms of diseases of the nervous system

A
  • headache
  • one sided weakness
  • nausea and vomiting
  • motor disturbances (stiff neck/back, rigid muscles, seizures, convulsions, paralysis)
  • sensory disturbances, especially vision or speech
  • drowsiness, confusion, or coma
  • mood swings
  • intellectual disturbances
  • memory capabilities
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9
Q

tests for diseases of the nervous system

A
  • analysis of CSF (lumbar tap)
  • electroencephalagram (EEG)
  • skull x-rays to detect fractures
  • angiography
  • neurologic exam
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10
Q

what does a lumbar tap look for?

A

examined for presence of leukocytes, red blood cells, neoplastic cells, and microorganisms

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11
Q

what does an angiography used for?

A
  • look for abnormal distribution or distortion of vessels in the region of a lesion
  • find the site of rupture of an intracranial aneurysm
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12
Q

what does a neurologic exam include?

A
  • exam of motor and sensory systems
  • observing gait, posture, and symmetry of muscle mass
  • testing muscle strength, coordination, and reflexes
  • testing of cognitive function
  • eliciting a careful history of abnormal sensations
  • testing for diminished or absent sensory perception
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13
Q

genetic/developmental diseases of the nervous system definition

A

deleterious forces action within first half of gestation

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14
Q

what are genetic/developmental diseases of the nervous system due to?

A
  • genetics
  • infection
  • traumatic insult to brain
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15
Q

examples of genetic/developmental diseases of the nervous system

A
  • down syndrome
  • neural tube defects
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16
Q

neural tube defects definition

A

incomplete development of brain, spinal cord, and/or meninges (common)

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17
Q

types of neural tube defects

A
  • spina bifida
  • anencephaly (without brain)
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18
Q

what vitamins are deficient in neural tube defects?

A

folic acid/folate (B vitamins)

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19
Q

diagnosis of neural tube defects

A
  • ultrasound
  • amniocentesis
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20
Q

hydrocephalus

A

accumulation of excess CSF

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21
Q

what does hydrocephalus result from?

A
  • obstruction to flow of CSF
  • over production of CSF
  • inability of arachnoid granulations to restore water of CSF back into circulation
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22
Q

hydrocephalus differences in children in adults

A
  • more noticeable in children (head swells)
  • can happen in adults, presents as headaches
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23
Q

hydrocephalus signs and symptoms

A
  • dilated pupils
  • increased blood pressure
  • headache
  • nausea/vomiting
  • seizures
  • drowsiness/altered consciousness
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24
Q

treatment of hydrocephalus

A
  • eliminate the cause
  • reduce the pressure
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25
what options are there to reduce pressure if a person has hydrocephalus?
- hydrocephalus = intracranial shunts - edema = osmotic agents - craniotomy - steroid therapy (cortisol) - medially induced coma - hypothermia = slow brain metabolism
26
inflammatory diseases in the nervous system
numerous infectious diseases involve the brain preferentially (meningitis and encephalitis)
27
meningitis
inflammation of the meninges
28
what is the most common cause of meningitis?
bacteria, gains access to brain and spinal cord via the blood
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major signs and symptoms of meningitis
- onset is usually abrupt - fever - headache - neck rigidity
30
how do you diagnose meningitis?
sample the CSF
31
treatment of meningitis
- bacterial = antibiotics - viral = let run its course
32
encephalitis
diffuse inflammation of the brain
33
what is the most common cause of encephalitis?
viral, mosquito borne, west nile encephalitis
34
signs and symptoms of encephalitis
- generalized - irritability - drowsiness - headache
35
diagnosis of encephalitis
serologic testing
36
treatment of encephalitis
- no specific treatment - patients die, recover fully, or recover with variable neurologic deficit
37
poliomyelitis
caused by poliogenesis
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pathogenesis of poliomyelitis
- transmitted by fecal-hand-oral contamination - ventral horn = effects skeletal muscle motor neurons
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outcomes of poliomyelitis
- 95% asymptomatic - 4-8% minor nonspecific illness - 1-2% nonparalytic aseptic meningitis (no paralysis but infection in meninges) - <1% paralytic
40
cerebrovascular accident (CVA)
- stroke - sudden neurologic deficit caused by vascular occlusion - leads to infarcts
41
CVA/stroke is ranked where in the causes of death in the U.S.?
4th
42
etiology of a CVA
- cerebral thrombosis - cerebral embolus - cerebral hemorrhage
43
cerebral thrombosis
most common, thrombosis of cerebral artery narrowed by atherosclerosis, lead to infarct
44
cerebral embolus
occurs less frequently, blockage of cerebral artery by fragment of blood clot from an arteriosclerotic plaque or from heart
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cerebral hemorrhage
most serious type of stroke, usually from rupture of a cerebral aneurysm
46
cerebral thrombus
vascular occlusions result in infarcts in brain tissue supplied by affected vessel
47
damaged brain tissue due to a cerebral thrombus results in what?
- loses function within minutes - becomes soft and necrotic within a few days - tissue is lost from the area
48
cerebrovascular accidents
CVAs caused by brain hemorrhage
49
signs and symptoms of cerebrovascular accidents
- depend on location and size - up to half of patients die within hours because of accumulation of blood (displaces adjacent tissue, rapidly elevates intracranial pressure)
50
do strokes occur suddenly?
suddenly or preceded by transient ischemic attacks, speed is important for treatment
51
what are transient ischemic attacks (TIA)?
- temporary often recurrent episodes of impaired neurological activity resulting from insufficient blood flow to a part of the brain - mini stroke - warning for impending stroke
52
signs and symptoms of a CVA
- impaired speech or consciousness - hemiparesis - poor coordination - confusion
53
outcomes of CVAs
- 1/3 die within first two weeks - 1/3 recover with neurological deficit - 1/3 recover with no deficit - dependent on area of brain affected and size
54
when the brain is damaged by ischemia following a cerebrovascular accident..
- neurons and oligodendroglia readily die - astrocytes proliferate rapidly and repair the injury structurally by forming a scar
55
traumatic brain injury (TBI)
occurs when the brain collides with the inside of the skull
56
what does a TBI cause?
- bleeding - bruising - tearing of nerve fibers - possibly producing physical, intellectual and emotional changes
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what can a TBI be due to?
- transportation accidents - falls - sports-related event - violence
58
direct or indirect CNS trauma
- coup = direct - contrecoup = indirect
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results of CNS trauma
- fracture - intraparenchymal injury within the brain - vascular injury - consequences depend on location and size of lesion
60
cerebral concussion
- most common head injury - immediate loss of consciousness for seconds to minutes
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etiology of cerebral concussion
- blunt force impact to head - brain strikes and rebounds from skull - disrupts normal brain activity
62
epidural hemorrhages in brain
- artery - fatal within 24 hours - forms quickly - above the dura mater
63
subdural hemorrhage in brain
- under dura mater - slow venous bleeding - 4-5 weeks
64
subarachnoid hemorrhage in brain
- between arachnoid and pia - not as commonly due to trauma - arterial bleeding - typically from circle of willis
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intracerebral hemorrhage in brain
in brain tissue
66
treatment of mild TBI
bed rest and analgesic, keep in dark rooms
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treatment of severe TBI
- diuretics - antiseizure and coma-inducing medications - surgery to remove clots, repair fractures or create an opening to provide place for the brain to swell
68
seizure
sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons
69
epilepsy
present when 2 or more unprovoked seizures occur at an interval greater than 24 hours apart
70
causes of provoked seizures
- fever >102 - electrolyte imbalances (hypocalcemia, alkalosis) - hypoglycemia - hypoxia - arrhythmias - CNS infection or damage - head trauma
71
causes of unprovoked seizures
- idiopathic - strong genetic bias
72
partial seizures
focal area
73
simple seizures
without loss of consciousness
74
complex seizures
loss of consciousness
75
generalized seizures
both hemispheres, convulsive and non convulsive
76
absence (petit mal) seizures
brief loss of consciousness
77
atonic seizures
loss of muscle tone
78
myoclonic seizures
muscles contract
79
clonic seizures
repetitive jerking movements
80
tonic seizures
muscle stiffness/rigidity
81
grand mal seizures
muscle contraction and loss of consciousness
82
diagnosis of seizures
- electroencephalogram - MRI/CT
83
treatment of seizures
- avoidance of precipitant - anti-convulsants (reduce electrical activity of brain) - surgery (removal of seizure focus)
84
degeneration of cortical neurons
alzheimer disease
85
degeneration of myelin
multiple sclerosis
86
degeneration of basal ganglia neurons
- parkinsons disease - huntingtons disease
87
degeneration of motor neurons
muscle weakness
88
neurodegenerative disorders etiology
- genetic predisposition - environmental toxins - oxidative stress - aging
89
multiple sclerosis
multiple white matter lesions separated in space and time, plaques
90
what cells of the neuron in affected in multiple sclerosis?
oligodendrocytes get destroyed
91
what is the most common neurologic disability in young adults?
multiple sclerosis - chronic, progressive, irreversible disease
92
50% of patients with multiple sclerosis..
unable to walk without assistance 15 years after onset
93
etiology of multiple sclerosis
- autoimmune disease (attacks myelin) - genetic susceptibility - environmental trigger
94
what nervous system does multiple sclerosis affect?
CNS
95
symptoms of multiple sclerosis
- visual impairment (optic nerve) - urination - motor weakness - symptoms come and go - numerous remissions, exacerbations - visual, motor, sensory disturbances - numbness, fatigue, mood swings
96
treatment of multiple sclerosis
- relieve symptoms (bladder control) - drug therapy to slow progression (inhibit immune system)
97
prognosis of multiple sclerosis
- no cure - survival after diagnosis = 15-20 years (infection)
98
dementia
global, irreversible deterioration of cerebral cortex
99
losses due to dementia
- orientation - memory - language - judgment - decision making
100
alzheimers disease
- most common form of dementia - irreversible, progressive, chronic - unknown etiology - atrophy of cortical parts of frontal and temporal parts of brain
101
characteristics of alzheimers disease
- dementia: progressive loss of cognitive functions; memory - emotional disturbances (sun down) - 1 in 10 over age 65 - neurons die, brain shrinks
102
anatomic and biochemical features
- amyloid-beta protein-forming plaques - neurofibrillary tangles - decreased acetylcholine production
103
risk factors of alzheimers disease
- age - chronic hypertension - head injury adults are three times more likely to develop alzheimers disease
104
multi-infarct vascular dementia
- cumulative brain damage from small strokes - second most common cause of dementia - treated by addressing underlying cause, such as hypertension
105
parkinsons disease
- subcortical (beneath cortex) neurodegenerative disorder (basal ganglia) - cause unknown - decreased number of dopaminergic (dopamine) neurons in substantia nigra
106
what does parkinsons disease disturb?
- movement - rigidity - bradykinesia - pill rolling tremor - postural instability
107
treatment of parkinsons
drugs that increase dopaminergic activity (no cure)
108
huntingtons disease
- autosomal dominant neurodegenerative disease - atrophy of cortex, subcortical nuclei; most prominently in caudate, putamen - age associated
109
what is huntingtons disease characterized by?
chorea: involuntary, gyrating movements, progressive dementia, personality disorders
110
brain neoplasms
small, slow-growing tumors that would be benign elsewhere can readily disrupt vital functions in strategic locations and kill the patient
111
can brain neoplasms be inoperable locations?
yes, hard to treat due to location
112
are benign or metastatic tumors of the brain more common?
metastatic
113
glioma
most poor prognosis with deep location in brain, reduced life expectancy; surgery, radiation, chemotherapy
114
lymphoma
T or B cells
115
meningioma
- arise form meninges - benign in a biological sense (not going to metastasize) - press down on brain (severity depends on where it is)
116
common signs and symptoms of brain neoplasms
- increased pressure because of mass lesion - accompanying edema - headaches - vomiting - blurred vision - seizures
117
peripheral nerves
out of spinal cord
118
diseases of peripheral nerves
- axon vs. schwann cells - motor vs. sensory - inflammatory, autoimmune - toxic - trauma - vascular, especially diabetes - tumors - neuropathy
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neuropathy
pathology of neuron, neurons in feet, no sensory nerves, tingling/numbness, painful
120
amyotrophic lateral sclerosis (ALS)
- rare age associated neurodegenerative disease - death of alpha motor neurons
121
what does ALS affect?
- upper and lower motor neurons - atrophy - paralysis of muscles - respiratory problems
122
is there a cure for ALS?
no treatment or cure, cause is unknown
123
two forms of ALS
- sporadic (90%) - familial
124
guillain-barre syndrome
- polyneuropathy: many nerves in different parts of body - autoimmune system attacks peripheral nerves, leading to inflammation, progressive weakness form extremities towards trunk
125
is guillain-barre sydrome rare?
yes
126
symptoms of guillain-barre sydrome
weakness and tingling
127
is guillain-barre sydrome life threatening?
yes because of breathing issues, preceded by viral or bacterial flu-like infection
128
prognosis of guillain-barre sydrome
most recover, some may have permanent nerve damage
129
bell palsy
idiopathic unilateral facial nerve paralysis (temporary)
130
symptoms of bell palsy
- inability to control facial muscles on affected side - twitching, weakness - drooping eyelid - drooling
131
prognosis of bell palsy
good, symptoms recede within 2 weeks after initial onset, and complete recovery within 3-6 months
132
headache
diffuse pain occurring in any portion of the head
133
primary headache
tension, migraine, cluster headaches
134
secondary headache
underlying structural problems
135
what are headaches a result from?
vasodilation
136
migraine headache
- recurrent, intense, throbbing headache - more common in women
137
what can a migraine cause?
- nausea - vomiting - some may have aura - some foods, sunlight, hormones, smells, or changes in weather may trigger - hereditary indications
138
brain death
two successive electroencephalograms taken 24 hours apart both show complete absence of electrical activity of the brain
139
brain organ failure
loss of motor neurons - ALS - paralysis
UHD Exam 5
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