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UHD Exam 5 > Chapter 23 > Flashcards

Chapter 23 Flashcards

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
Q

what options are there to reduce pressure if a person has hydrocephalus?

A
  • hydrocephalus = intracranial shunts
  • edema = osmotic agents
  • craniotomy
  • steroid therapy (cortisol)
  • medially induced coma
  • hypothermia = slow brain metabolism
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26
Q

inflammatory diseases in the nervous system

A

numerous infectious diseases involve the brain preferentially (meningitis and encephalitis)

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27
Q

meningitis

A

inflammation of the meninges

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28
Q

what is the most common cause of meningitis?

A

bacteria, gains access to brain and spinal cord via the blood

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29
Q

major signs and symptoms of meningitis

A
  • onset is usually abrupt
  • fever
  • headache
  • neck rigidity
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30
Q

how do you diagnose meningitis?

A

sample the CSF

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31
Q

treatment of meningitis

A
  • bacterial = antibiotics
  • viral = let run its course
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32
Q

encephalitis

A

diffuse inflammation of the brain

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33
Q

what is the most common cause of encephalitis?

A

viral, mosquito borne, west nile encephalitis

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34
Q

signs and symptoms of encephalitis

A
  • generalized
  • irritability
  • drowsiness
  • headache
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35
Q

diagnosis of encephalitis

A

serologic testing

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36
Q

treatment of encephalitis

A
  • no specific treatment
  • patients die, recover fully, or recover with variable neurologic deficit
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37
Q

poliomyelitis

A

caused by poliogenesis

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38
Q

pathogenesis of poliomyelitis

A
  • transmitted by fecal-hand-oral contamination
  • ventral horn = effects skeletal muscle motor neurons
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39
Q

outcomes of poliomyelitis

A
  • 95% asymptomatic
  • 4-8% minor nonspecific illness
  • 1-2% nonparalytic aseptic meningitis (no paralysis but infection in meninges)
  • <1% paralytic
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40
Q

cerebrovascular accident (CVA)

A
  • stroke
  • sudden neurologic deficit caused by vascular occlusion
  • leads to infarcts
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41
Q

CVA/stroke is ranked where in the causes of death in the U.S.?

A

4th

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42
Q

etiology of a CVA

A
  • cerebral thrombosis
  • cerebral embolus
  • cerebral hemorrhage
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43
Q

cerebral thrombosis

A

most common, thrombosis of cerebral artery narrowed by atherosclerosis, lead to infarct

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44
Q

cerebral embolus

A

occurs less frequently, blockage of cerebral artery by fragment of blood clot from an arteriosclerotic plaque or from heart

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45
Q

cerebral hemorrhage

A

most serious type of stroke, usually from rupture of a cerebral aneurysm

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46
Q

cerebral thrombus

A

vascular occlusions result in infarcts in brain tissue supplied by affected vessel

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47
Q

damaged brain tissue due to a cerebral thrombus results in what?

A
  • loses function within minutes
  • becomes soft and necrotic within a few days
  • tissue is lost from the area
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48
Q

cerebrovascular accidents

A

CVAs caused by brain hemorrhage

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49
Q

signs and symptoms of cerebrovascular accidents

A
  • 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)
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50
Q

do strokes occur suddenly?

A

suddenly or preceded by transient ischemic attacks, speed is important for treatment

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51
Q

what are transient ischemic attacks (TIA)?

A
  • 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
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52
Q

signs and symptoms of a CVA

A
  • impaired speech or consciousness
  • hemiparesis
  • poor coordination
  • confusion
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53
Q

outcomes of CVAs

A
  • 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
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54
Q

when the brain is damaged by ischemia following a cerebrovascular accident..

A
  • neurons and oligodendroglia readily die
  • astrocytes proliferate rapidly and repair the injury structurally by forming a scar
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55
Q

traumatic brain injury (TBI)

A

occurs when the brain collides with the inside of the skull

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56
Q

what does a TBI cause?

A
  • bleeding
  • bruising
  • tearing of nerve fibers
  • possibly producing physical, intellectual and emotional changes
57
Q

what can a TBI be due to?

A
  • transportation accidents
  • falls
  • sports-related event
  • violence
58
Q

direct or indirect CNS trauma

A
  • coup = direct
  • contrecoup = indirect
59
Q

results of CNS trauma

A
  • fracture
  • intraparenchymal injury within the brain
  • vascular injury
  • consequences depend on location and size of lesion
60
Q

cerebral concussion

A
  • most common head injury
  • immediate loss of consciousness for seconds to minutes
61
Q

etiology of cerebral concussion

A
  • blunt force impact to head
  • brain strikes and rebounds from skull
  • disrupts normal brain activity
62
Q

epidural hemorrhages in brain

A
  • artery
  • fatal within 24 hours
  • forms quickly
  • above the dura mater
63
Q

subdural hemorrhage in brain

A
  • under dura mater
  • slow venous bleeding
  • 4-5 weeks
64
Q

subarachnoid hemorrhage in brain

A
  • between arachnoid and pia
  • not as commonly due to trauma
  • arterial bleeding
  • typically from circle of willis
65
Q

intracerebral hemorrhage in brain

A

in brain tissue

66
Q

treatment of mild TBI

A

bed rest and analgesic, keep in dark rooms

67
Q

treatment of severe TBI

A
  • 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
Q

seizure

A

sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons

69
Q

epilepsy

A

present when 2 or more unprovoked seizures occur at an interval greater than 24 hours apart

70
Q

causes of provoked seizures

A
  • fever >102
  • electrolyte imbalances (hypocalcemia, alkalosis)
  • hypoglycemia
  • hypoxia
  • arrhythmias
  • CNS infection or damage
  • head trauma
71
Q

causes of unprovoked seizures

A
  • idiopathic
  • strong genetic bias
72
Q

partial seizures

A

focal area

73
Q

simple seizures

A

without loss of consciousness

74
Q

complex seizures

A

loss of consciousness

75
Q

generalized seizures

A

both hemispheres, convulsive and non convulsive

76
Q

absence (petit mal) seizures

A

brief loss of consciousness

77
Q

atonic seizures

A

loss of muscle tone

78
Q

myoclonic seizures

A

muscles contract

79
Q

clonic seizures

A

repetitive jerking movements

80
Q

tonic seizures

A

muscle stiffness/rigidity

81
Q

grand mal seizures

A

muscle contraction and loss of consciousness

82
Q

diagnosis of seizures

A
  • electroencephalogram
  • MRI/CT
83
Q

treatment of seizures

A
  • avoidance of precipitant
  • anti-convulsants (reduce electrical activity of brain)
  • surgery (removal of seizure focus)
84
Q

degeneration of cortical neurons

A

alzheimer disease

85
Q

degeneration of myelin

A

multiple sclerosis

86
Q

degeneration of basal ganglia neurons

A
  • parkinsons disease
  • huntingtons disease
87
Q

degeneration of motor neurons

A

muscle weakness

88
Q

neurodegenerative disorders etiology

A
  • genetic predisposition
  • environmental toxins
  • oxidative stress
  • aging
89
Q

multiple sclerosis

A

multiple white matter lesions separated in space and time, plaques

90
Q

what cells of the neuron in affected in multiple sclerosis?

A

oligodendrocytes get destroyed

91
Q

what is the most common neurologic disability in young adults?

A

multiple sclerosis
- chronic, progressive, irreversible disease

92
Q

50% of patients with multiple sclerosis..

A

unable to walk without assistance 15 years after onset

93
Q

etiology of multiple sclerosis

A
  • autoimmune disease (attacks myelin)
  • genetic susceptibility
  • environmental trigger
94
Q

what nervous system does multiple sclerosis affect?

A

CNS

95
Q

symptoms of multiple sclerosis

A
  • visual impairment (optic nerve)
  • urination
  • motor weakness
  • symptoms come and go
  • numerous remissions, exacerbations
  • visual, motor, sensory disturbances
  • numbness, fatigue, mood swings
96
Q

treatment of multiple sclerosis

A
  • relieve symptoms (bladder control)
  • drug therapy to slow progression (inhibit immune system)
97
Q

prognosis of multiple sclerosis

A
  • no cure
  • survival after diagnosis = 15-20 years (infection)
98
Q

dementia

A

global, irreversible deterioration of cerebral cortex

99
Q

losses due to dementia

A
  • orientation
  • memory
  • language
  • judgment
  • decision making
100
Q

alzheimers disease

A
  • most common form of dementia
  • irreversible, progressive, chronic
  • unknown etiology
  • atrophy of cortical parts of frontal and temporal parts of brain
101
Q

characteristics of alzheimers disease

A
  • dementia: progressive loss of cognitive functions; memory
  • emotional disturbances (sun down)
  • 1 in 10 over age 65
  • neurons die, brain shrinks
102
Q

anatomic and biochemical features

A
  • amyloid-beta protein-forming plaques
  • neurofibrillary tangles
  • decreased acetylcholine production
103
Q

risk factors of alzheimers disease

A
  • age
  • chronic hypertension
  • head injury adults are three times more likely to develop alzheimers disease
104
Q

multi-infarct vascular dementia

A
  • cumulative brain damage from small strokes
  • second most common cause of dementia
  • treated by addressing underlying cause, such as hypertension
105
Q

parkinsons disease

A
  • subcortical (beneath cortex) neurodegenerative disorder (basal ganglia)
  • cause unknown
  • decreased number of dopaminergic (dopamine) neurons in substantia nigra
106
Q

what does parkinsons disease disturb?

A
  • movement
  • rigidity
  • bradykinesia
  • pill rolling tremor
  • postural instability
107
Q

treatment of parkinsons

A

drugs that increase dopaminergic activity (no cure)

108
Q

huntingtons disease

A
  • autosomal dominant neurodegenerative disease
  • atrophy of cortex, subcortical nuclei; most prominently in caudate, putamen
  • age associated
109
Q

what is huntingtons disease characterized by?

A

chorea: involuntary, gyrating movements, progressive dementia, personality disorders

110
Q

brain neoplasms

A

small, slow-growing tumors that would be benign elsewhere can readily disrupt vital functions in strategic locations and kill the patient

111
Q

can brain neoplasms be inoperable locations?

A

yes, hard to treat due to location

112
Q

are benign or metastatic tumors of the brain more common?

A

metastatic

113
Q

glioma

A

most poor prognosis with deep location in brain, reduced life expectancy; surgery, radiation, chemotherapy

114
Q

lymphoma

A

T or B cells

115
Q

meningioma

A
  • arise form meninges
  • benign in a biological sense (not going to metastasize)
  • press down on brain (severity depends on where it is)
116
Q

common signs and symptoms of brain neoplasms

A
  • increased pressure because of mass lesion
  • accompanying edema
  • headaches
  • vomiting
  • blurred vision
  • seizures
117
Q

peripheral nerves

A

out of spinal cord

118
Q

diseases of peripheral nerves

A
  • axon vs. schwann cells
  • motor vs. sensory
  • inflammatory, autoimmune
  • toxic
  • trauma
  • vascular, especially diabetes
  • tumors
  • neuropathy
119
Q

neuropathy

A

pathology of neuron, neurons in feet, no sensory nerves, tingling/numbness, painful

120
Q

amyotrophic lateral sclerosis (ALS)

A
  • rare age associated neurodegenerative disease
  • death of alpha motor neurons
121
Q

what does ALS affect?

A
  • upper and lower motor neurons
  • atrophy
  • paralysis of muscles
  • respiratory problems
122
Q

is there a cure for ALS?

A

no treatment or cure, cause is unknown

123
Q

two forms of ALS

A
  • sporadic (90%)
  • familial
124
Q

guillain-barre syndrome

A
  • polyneuropathy: many nerves in different parts of body
  • autoimmune system attacks peripheral nerves, leading to inflammation, progressive weakness form extremities towards trunk
125
Q

is guillain-barre sydrome rare?

A

yes

126
Q

symptoms of guillain-barre sydrome

A

weakness and tingling

127
Q

is guillain-barre sydrome life threatening?

A

yes because of breathing issues, preceded by viral or bacterial flu-like infection

128
Q

prognosis of guillain-barre sydrome

A

most recover, some may have permanent nerve damage

129
Q

bell palsy

A

idiopathic unilateral facial nerve paralysis (temporary)

130
Q

symptoms of bell palsy

A
  • inability to control facial muscles on affected side
  • twitching, weakness
  • drooping eyelid
  • drooling
131
Q

prognosis of bell palsy

A

good, symptoms recede within 2 weeks after initial onset, and complete recovery within 3-6 months

132
Q

headache

A

diffuse pain occurring in any portion of the head

133
Q

primary headache

A

tension, migraine, cluster headaches

134
Q

secondary headache

A

underlying structural problems

135
Q

what are headaches a result from?

A

vasodilation

136
Q

migraine headache

A
  • recurrent, intense, throbbing headache
  • more common in women
137
Q

what can a migraine cause?

A
  • nausea
  • vomiting
  • some may have aura
  • some foods, sunlight, hormones, smells, or changes in weather may trigger
  • hereditary indications
138
Q

brain death

A

two successive electroencephalograms taken 24 hours apart both show complete absence of electrical activity of the brain

139
Q

brain organ failure

A

loss of motor neurons
- ALS
- paralysis

UHD Exam 5 (5 decks)

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