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Understanding Human Disease > Chapter 23 - Nervous System > Flashcards

Chapter 23 - Nervous System Flashcards

1
Q

meninges layers

A

dura mater: outer
arachnoid mater: AKA subarachnoid space; CSF here
pia mater: inner most; delicate as fuck

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2
Q

function of cerebrospinal fluid

A

cushion and protect brain

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3
Q

what structure makes cerebrospinal fluid

A

choroid plexus

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4
Q

components of CSF

A

clear
small amount of protein
glucose

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5
Q

two divisions of the nervous system

A

Central and peripheral

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6
Q

components of the brain

A

cerebrum
cerebellum
brain stem

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7
Q

where are vascular interconnections located on the brain

A

base of the brain

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8
Q

what can only move across the blood brain barrier

A

small, fat soluble molecules

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9
Q

what cells make myelin?

A

oligodendrocytes

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10
Q

what cells make cerebral spinal fluid

A

ependymal cells

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11
Q

what cells wrap around axons?

A

schwan cells

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12
Q

EEG

A

electroencephalogram - used to measure electrical activity of the brain

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13
Q

angiography

A

procedure that looks for abnormal distribution of blood vessels in the region of a lesion

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14
Q

when do genetic/developmental diseases typically start their deleterious forces?

A

within the first half of gestation

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15
Q

what is a neural tube defect?

A

incomplete development of brain, spinal cord, and/or meninges

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16
Q

what are the two types of neural tube defects?

A

spina bifida
anencephaly = without brain

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17
Q

many neural tube defects are caused by a deficiency in?

A

folate/folic acid

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18
Q

what tests do you use to diagnose neural tube defects?

A

ultrasound or amniocentesis

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19
Q

what is hydrocephalus?

A

large head from an accumulation of cerebral spinal fluid

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20
Q

causes of hydrocephalus (3)

A

-obstruction in the flow of CSF
-overproduction of CSF
-inability of arachnoid granulations to restore CSF back into circulation

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21
Q

hydrocephalus in children vs. adults

A

children - enlargement of skull
adults - swelling inward, pushing on brain

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22
Q

signs and symptoms of hydrocephalus

A

-dilated pupils
-increased BP
-headache
-nausea/vomiting
-seizures
-drowsiness/altered consciousness

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23
Q

treatment for hydrocephalus

A

-eliminate the cause
-reduce the pressure
-intracranial shunts
-osmotic agents
-craniotomy
-steroid therapy
-medically induced coma
-hypothermia to slow brain metabolism

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24
Q

what is meningitis

A

inflammation of the meninges

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25
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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26
Q

major signs and symptoms of meningitis?

A

-neck rigidity
-fever
-headache

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27
Q

diagnosis of meningitis

A

spinal tap to collect CSF

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28
Q

treatment of meningitis

A

-antibiotics
-steroids to reduce inflammation

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29
Q

what is encephalitis?

A

diffuse inflammation of the brain

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30
Q

what is encephalitis caused by?

A

viral infections; many are mosquito-borne

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31
Q

symptoms of encephalitis

A

-irritability
-drowsiness
-headache

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32
Q

how to diagnose encephalitis

A

depends on culture and type of viral agent by serologic testing

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33
Q

treatment for encephalitis

A

no specific treatment; you either die, recover fully, or partially recover with neurologic defecit

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34
Q

what is poliomyelitis

A

virus that destroys nerve cells in the spinal cord (causing paralysis)

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35
Q

what causes polio?

A

poliovirus

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36
Q

how is polio transmitted?

A

fecal-oral contamination

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37
Q

outcomes of polio

A

most asymptomatic (95%), less than 1% paralytic

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38
Q

what is a cerebrovascular accident?

A

aka: stroke
-sudden neurologic deficit caused by vascular occlusion; leads to infarcts

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39
Q

what is the fourth leading cause of death in the US?

A

stroke or CVA

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40
Q

what is the most common cause of CVA/stroke?

A

cerebral thrombosis

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41
Q

what is a cerebral embolus?

A

blockage of cerebral artery by a fragment of blood clot from arteriosclerotic plaque; less frequently

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42
Q

what is a cerebral hemorrhage?

A

excess bleeding usually from a ruptured cerebral aneurysm; MOST SERIOUS TYPE OF STROKE

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43
Q

how many patients die of CVAs caused by brain hemorrhage?

A

up to half of patients because of accumulation of blood; rapidly elevates intracranial pressure

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44
Q

signs and symptoms of CVAs

A

-impaired speech or consciousness
-hemiparesis
-poor coordination
-confusion

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45
Q

outcomes of CVAs

A

-1/3 die within 2 weeks
-1/3 recover w/ deficit
-1/3 recover with no deficit (dissolved embolus)

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46
Q

Traumatic brain injury (TBI)

A

brain collides with the inside of skull; causes bleeding, bruising, and tearing of nerve fibers

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47
Q

coup vs. contrecoup

A

coup = direct; primary impact
contrecoup = indirect; secondary impact

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48
Q

results of CNS trauma/tbi

A

-fracture
-injury within the brain (intraparenchymal)
-vascular injury

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49
Q

what is the most common head injury?

A

concussion

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50
Q

definition of cerebral concussion

A

immediate loss of consciousness for seconds to minutes

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51
Q

etiology of a concussion

A

-blunt force impact to head
-brain strikes and rebounds from skull
-disruption of normal brain activity (loss of consciousness)

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52
Q

epidural hemorrhage of brain

A

-hemorrhage above the dura mater; usually in meninges artery
-forms quickly; fatal within 24 hours

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53
Q

subdural hemorrhage of brain

A

-hemorrhage under dura mater
-slow, venous bleeding; 4-6 weeks

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54
Q

subarachnoid hemorrhage of brain

A

-hemorrhage between arachnoid and pia mater where CSF is
-arterial bleeding
-typically from circle of Willis

55
Q

intracerebral hemorrhage of brain

A

-hemorrhage within brain tissue

56
Q

treatment of TBIs; mild and severe

A

mild = bed rest and analgesic meds (painkillers)
severe =
-diuretics
-antiseizure and coma-inducing meds
-surgery to remove clots, repair fractures
-craniotomy

57
Q

what is a seizure?

A

alteration of brain function caused by disorderly discharge of cerebral neurons (abnormal brain electrical activity)

58
Q

epilepsy

A

2 or more unprovoked seizures occur more than 24 hours apart

59
Q

causes of provoked seizures

A

-fever
-electrolyte imbalances
-hypoglycemia
-hypoxia
-arrhythmias
-CNS infection/damage
-head trauma

60
Q

causes of unprovoked seizures

A

idiopathic; strong genetic basis

61
Q

partial seizure

A

focal; only one small area of the brain

62
Q

simple seizure

A

w/o loss of consciousness

63
Q

complex seizure

A

loss of consciousness

64
Q

generalized seizure

A

occurs in both hemispheres of brain, can be convulsive or nonconvulsive

65
Q

absence (petit mal) seizure

A

brief loss of consciousness

66
Q

atonic seizure

A

loss of muscle tone

67
Q

myoclonic seizure

A

muscles contract

68
Q

clonic seizure

A

repetitive jerking movements

69
Q

tonic

A

muscle stiffness, rigidity

70
Q

grand mal seizure

A

muscles contraction; loss of consciousness

71
Q

how to diagnose a seizure

A

-EEG
-MRI/CT

72
Q

treatment of seizures

A

-avoid precipitant
-anti-convulsants (reduce electrical activity)
-surgery (remove seizure focus)

73
Q

degeneration of what is Alzheimer’s Disease

A

cortical neurons

74
Q

degeneration of x = MS

A

myelin

75
Q

degeneration of x = parkinson’s and huntington’s disease

A

basal ganglia

76
Q

general etiology of neurodegenerative disorders

A

-genetic predisposition
-environmental toxins
-oxidative stress
-aging

77
Q

multiple sclerosis definition

A

damaged myelin sheaths; disease of oligodendrocytes

78
Q

what is the most common neurologic disability in young adults?

A

multiple sclerosis
-chronic, progressive, irreversible

79
Q

what percentage of MS patients are unable to walk without assistance 15 years after onset?

A

50%

80
Q

etiology of MS

A

autoimmune disease that attacks myelin
-genetic susceptibility
-environmental trigger

81
Q

is MS associated with peripheral neurons?

A

no - central

82
Q

symptoms of MS

A

-visual impairment
-urination
-motor weakness
-numbness
-fatigue
-mood swings

83
Q

treatment of MS

A

-relieve symptoms
-drug therapy to slow progression

84
Q

prognosis for MS

A

-no cure
-usually die from infections, not disease itself

85
Q

what is dementia

A

irreversible deterioration of cerebral cortex

86
Q

is dementia age related?

A

no - not normal part of aging

87
Q

losses in dementia

A

-orientation
-memory
-language
-judgment
-decision making

88
Q

what is the most common form of dementia?

A

alzheimer’s disease

89
Q

what part of the brain is affected with alzheimer’s disease

A

cerebral cortex; frontal and temporal lobes

90
Q

etiology of alzheimer’s

A

unknown; but it is irreversible, progressive, and chronic

91
Q

what two features are associated with alzheimer’s disease?

A

-amyloid plaques
-neurofibrillary tangles
=decreased acetylcholine production

92
Q

risk factors for alzheimer’s disease

A

-age
-chronic hypertension
-head injury (3x more likely to develop Alzheimers)

93
Q

mult-infarct vascular dementia

A

cumulative brain damage from small strokes; 2nd most common type of dementia

94
Q

what cells are affected with parkinson’s disease

A

basal ganglia (beneath the cortex)

95
Q

cause of parkinson’s disease

A

unknown; but decreased dopaminergic neurons (less dopamine)

96
Q

manifestations of parkinson’s

A

-disturbances of movement
-rigidity
-bradykinesia
-pill rolling tremor
-abnormal gout
-postural instability

97
Q

how do you treat parkinson’s disease

A

drugs to increase dopamine; no cure

98
Q

what cells are affected in huntington’s disease

A

basal ganglia (beneath the cortex)

99
Q

what is huntington’s disease characterized by?

A

chorea = involuntary, gyrating movements, progressive dementia

100
Q

what type of genetic neurodegenerative disease is Huntington’s disease?

A

autosomal dominant; age-associated

101
Q

neoplasia of brain - metastatic tumors vs. primary

A

metastatic tumors are more common than primary tumors

102
Q

glioma

A

poorest prognosis because located deep in the brain; doesn’t respond well to treatment

103
Q

astrocytoma

A

cancer of the astrocyte

104
Q

oligodendroglioma

A

cancer of the oligodendrocytes

105
Q

lymphoma

A

cancer of T or B cells

106
Q

meningioma

A

cancer of the meninges

107
Q

is meningioma benign or malignant

A

benign in biological sense; depends where it is and what it presses on

108
Q

most common signs and symptoms of brain neoplasms

A

-increased pressure
-edema
-generalized headache, vomiting, blurred vision, seizures

109
Q

amyotrophic lateral sclerosis (ALS)

A

death of alpha motor neurons; affects upper and lower motor neurons - damaged nerve fibers

110
Q

ALS only affects what type of muscle

A

skeletal

111
Q

is ALS age-associated?

A

yes

112
Q

is ALS a peripheral or central nervous system disease?

A

peripheral

113
Q

cause of ALS

A

unknown

114
Q

treatment of ALS

A

no treatment or cure

115
Q

manifestations of ALS

A

-muscle atrophy
-paralysis of muscles
-respiratory problems

116
Q

two forms of ALS

A

sporadic - 90%
familial - 10%

117
Q

What is guillain-barre syndrome?

A

autoimmune disease that attacks peripheral nerves leading to inflammation and progressive weakness from extremities toward trunk

118
Q

guillain-barre syndrome is polyneuropathic which means:

A

it affects many nerves in different parts of the body

119
Q

symptoms of guillain-barre syndrome

A

weakness
tingling

120
Q

can guillain-barre syndrome be life-threatening?

A

yes - breathing issues

121
Q

bell palsy

A

unilateral facial nerve paralysis

121
Q

what is guillan-barre syndrome usually preceded by?

A

viral or bacterial “flu-like” infection

122
Q

cause of bell palsy

A

unknown

123
Q

symptoms of bell palsy

A

-inability to control facial muscles
-twitching, weakness
-drooping eyelid
-drooling

124
Q

prognosis of bell palsy

A

good; symptoms decrease within 2 weeks and complete recovery within 3-6 months *temporary

125
Q

definition of headache

A

diffuse pain occurring in any portion of the head

126
Q

primary headache

A

tension, migraine, cluster headaches

127
Q

secondary headache

A

underlying structural problems

128
Q

there are no pain receptors in the brain, so where does the pain come from

A

result of vasodilation – treat with vasoconstrictors

129
Q

migraine headache

A

-recurrent, intense, throbbing headache

130
Q

do migraines affect women or men more?

A

women - estrogen

131
Q

aura (migraines)

A

visual disturbance before the pain of migraine

132
Q

legally brain dead

A

two EEGs taken 24 hours apart show complete absence of electrical activity in the brain

133
Q

loss of motor neurons is called

A

neurogenic paralysis

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