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Psych 377 > Chapter 26 > Flashcards

Chapter 26 Flashcards

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1
Q

Neurological disorders are associated with

A

abnormality of or injury to the brain

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2
Q

A neurologist asks about

A

the history of the patient and their family history

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3
Q

A neurologist observes

A

behaviors while taking the history to assess mental status, motor control, and speech abnormalities

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4
Q

Neurologist can perform basic

A

cognitive tests, such as memory and attention

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5
Q

The function of all 12 cranial nerves can be assessed in

A

about 2 minutes

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6
Q

Follow-up testing can use

A

EEG, CT, or MRI scans

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7
Q

Incidence of TBI is difficult to determine because

A

many go unreported

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8
Q

Males between the ages

A

of 15 and 30 are at higher risk of TBI from sports injuries and car accidents

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9
Q

following TBI

A

There is a long-term decrease in glucose metabolism

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10
Q

Open Head Injuries

A

Traumatic brain injuries where the skull is penetrated by an object

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11
Q

Closed Head Injuries

A

A blow to the head that does not penetrate the skull

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12
Q

Coup

A

damage to the brain at the site of the blow caused by the brain impacting with the skull

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13
Q

Contrecoup

A

damage to the brain at the side of the brain opposite the site of the blow, caused by the brain rebounding from the initial injury and impacting the skull

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14
Q

Shearing

A

the twisting or breaking of nerve fibers caused by the rapid movement of the brain inside the skull

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15
Q

Hematoma

A

mass of blood trapped in the skull

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16
Q

Edema

A

swelling that can result in pressure on the delicate nervous tissue

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17
Q

Effects of Closed Head Injury

A

Coma, impact functions located at the site of the coup or contrecoup injuries, Injuries can also result from the widespread trauma throughout the brain and are associated with loss of complex cognitive functions and efficiency

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18
Q

patients with closed head injuries report

A

difficulty concentrating, Personality and social behaviors are also impacted, Behavioral changes from head injuries may make patients more susceptible to further head injuries

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19
Q

Behavioral Assessment of Head Injury

A

Neuroimaging can provide some information about TBI, but behavioral assessments are most valuable

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20
Q

2 kinds of behavioral effects result from closed head injuries

A
  1. discrete impairments 2. more generalized impairments
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21
Q

generalized impairments

A

minute lesions and lacerations scattered throughout the brain, loss of complex cognitive functions, including reductions in mental speed, concentration, and overall cognitive efficiency

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22
Q

Discrete Impairment’s

A

damage to the frontal and temporal lobes, the areas most susceptible to closed head injuries

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23
Q

Glasgow Coma Scale

A

used to quantify unconsciousness and recovery of consciousness using three scales

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24
Q

3 scales of the Glasgow Coma Scale

A

eye opening, motor response, verbal response

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25
Q

Glasgow Coma Scale 8 or less - 9-12 - 13+

A

8 or less associated with severe head injury, 9-12 indicates moderate head injury, 13+ indicate mild head injury, but these individuals still experience consequences related to their injury

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26
Q

recovery from TBI

A

can occur over 2 to 3 years, but most recovery occurs within the first 6 to 9 months

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27
Q

Memory recovers

A

more slowly than other cognitive functions

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28
Q

If the damage involves the brainstem

A

the prognosis for recovery is not as good

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29
Q

Most head injuries are

A

preventable, such as using safer practices and better equipment in sports and education in the workplace

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30
Q

Assessment of symptoms using

A

smartphones and wearable technology is helping assess severity for auto accidents and combat injuries

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31
Q

Primary brain injuries, immediate on impact

A

coup, countercoup, fiber shearing or stretching, macro/microscopic lesions, Primary brain injuries, immediate on impact

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32
Q

Secondary injuries

A

Intracranial hemorrhage and edema, Ischemic or bleed-induced damage, Increased intracranial pressure or distortion, Effects of multiple injuries and hypoxia

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33
Q

Injurious effects, delayed

A

Degeneration of gray and white matter, Hydrocephalus

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34
Q

Epilepsy

A

is a brain disorder caused by seizure

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35
Q

Seizure

A

spontaneous, abnormal discharges of brain neurons as a result of scarring from injury, infections, or tumors.

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36
Q

Epilepsy is diagnosed after

A

at least one seizure, but typically after multiple seizures

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37
Q

Seizures occur in about

A

1 in 20 individuals during their lifetime

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38
Q

Symptomatic seizures are

A

associated with a known cause, such as infection, trauma, fever, or other disorder

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39
Q

Idiopathic seizures are

A

spontaneous and without any known or obvious cause

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40
Q

genetics and seizures

A

There is likely a genetic predisposition to seizures; influenced by numerous genes

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41
Q

Aura

A

a subjective sensation, perception, or motor experience associated with seizure onset

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42
Q

consciousness and seizures

A

Loss of consciousness, ranging from staring into space to complete loss

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43
Q

Movement

A

many seizures include full body movements or repetitive behaviors

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44
Q

Precipitating factors in susceptible individuals

A

drugs, emotional stress, fever, hormonal changes, hyperventilation, sensory stimuli, sleep, sleep deprivation, trauma

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45
Q

Classifying Seizures

A

EEG typically confirms the diagnosis of epilepsy

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46
Q

t/f not everyone with an abnormal EEG has seizures

A

True

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47
Q

Focal seizures

A

seizures begin in one location in the brain and the electrical activity spreads to involve other brain regions

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48
Q

focal aware seizures

A

the person is conscious throughout the seizure

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49
Q

focal impaired awareness seizure, or complex partial seizure

A

the person is generally aware that a seizure is beginning, performs automatic behaviors, has a fixed posture, and loses conscious awareness of the condition

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50
Q

Automatic behaviors

A

onreflexive actions performed without conscious volition associated with focal impaired awareness seizures

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51
Q

Generalized seizures

A

Seizure activity occurs in both hemispheres without a clear focus

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52
Q

Generalized seizures typically cycle through a number of stages (3)

A

tonic stage, clonic stage, postseizure, a postictal depression

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53
Q

Tonic stage

A

body stiffens and breathing stops

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54
Q

Clonic stage

A

rhythmic shaking occurs

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55
Q

postseizure, a postictal depression

A

during which the patient loses affect and is confused

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56
Q

Grand mal

A

also known as a generalized tonic-clonic seizure

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57
Q

Akinetic seizures

A

ordinarily seen only in children, child collapses suddenly, seizures are often of very short duration, and the child may get up after only a few seconds

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58
Q

Myoclonic spasm

A

massive seizures that basically consist of sudden flexion or extension of the body and often begin with a cry

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59
Q

Dissociative seizures

A

are seizures or attacks that feature many of the characteristics associated with focal seizures but that are accompanied by no discernable change in EEG or any other brain-scan measure

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60
Q

Incidence of dissociative seizures is about

A

2 to 3 per 10,000 people

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61
Q

epileptic seizures self-

A

terminate

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62
Q

when a seizure does not stop

A

GABA agonists or glutamate antagonists can be administered to end the seizure

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63
Q

Drugs are used to

A

inhibit the development of seizures or their propagation

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64
Q

drugs used to prevent seizures

A

GABA agonists, Sodium-channel blockers,

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65
Q

Most common drugs are

A

anesthetics and anticonvulsants

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66
Q

Drugs are not effective for

A

30% to 40% of the population, who rely on deep brain stimulation or surgery to remove the brain regions where seizures start

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67
Q

Tumors

A

Mass of new tissue that grows independent of surrounding cells and does not have a physiological purpose

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68
Q

Brain tumors originate from

A

glia or other supporting cells, as the neurons do not grow and divide

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69
Q

Benign tumors generally

A

do not reoccur after removal

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70
Q

malignant tumors

A

are progressive

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71
Q

Encapsulated tumors

A

are localized in a distinct location, but put pressure on surrounding tissue

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72
Q

Infiltrating tumors

A

interact with surrounding cells and either destroy them or interfere with their function

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73
Q

Meningioma

A

encapsulating tumor

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74
Q

Glioblastoma

A

Infliltrating tumor

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75
Q

Glioblastoma

A

Infiltrating tumor

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76
Q

Glioma

A

Any brain tumor that arises from glial cells and infiltrate the surrounding brain

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77
Q

Glioma accounts for

A

45% of brain tumors

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78
Q

Meningioma

A

An encapsulated brain tumor that grows from the meninges

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79
Q

Meningioma are

A

Benign and encapsulated

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80
Q

Meningioma cause symptoms by

A

by compressing adjacent brain tissue

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81
Q

Metastatic tumor

A

Tumor cells from elsewhere in the body start to grow in the brain

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82
Q

prognosis of metastatic tumor

A

multiple tumors that have a poor prognosis and are difficult to treat

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83
Q

factors of Headache

A

stress, neurological diseases such as tumors, or migraines

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84
Q

pain of headaches occurs in

A

dura mater, the arteries and veins of the brain, and the cranial and cervical nerves

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85
Q

headache Pain results from

A

pressure, displacement, or inflammation

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86
Q

Migraine impacts

A

5% to 20% of the population at some point in their lives

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87
Q

Migraines are often

A

Often unilateral and preceded by an aura or mood disturbance

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88
Q

Classic migraines

A

Start with an aura, thought to be caused by vasoconstriction of the cerebral arteries that results in loss of blood flow to the occipital cortex, Depolarization spreads to surrounding neurons, Headache is associated with blood flow returning to normal

89
Q

Common migraines are not associated

A

with an aura

90
Q

Cluster headaches are

A

unilateral and recur for days or weeks before disappearing

91
Q

Muscle-contraction headaches

A

results from persistent contraction of the muscles of the scalp and neck due to stress

92
Q

hemiplegic migraine

A

A migraine that leads to paralysis of one side of the body

93
Q

ophthalmologic migraine

A

A migraine that affects vision

94
Q

Nonmigrainous vascular headaches

A

associated with dilation of the arteries and can be caused by fever, eating disorders, high altitude, food, or chemicals

95
Q

Infections

A

Pathogenic microorganisms that invade the brain and evoke reactions by the tissue to their presence and to the toxins they generate

96
Q

treating migraines

A

ergotamine compounds, which block vasodilation-producing serotonin receptors on blood vessels, are often given in conjunction with caffeine

97
Q

Infections kill neural cells via several processes

A

interference, disturbing processes, altering neuronal characteristics, pus, edema

98
Q

Interference of infection

A

Interfering with the neuronal blood supply to produce thrombosis, hemorrhaging of capillaries, or even complete choking off of larger blood vessels.

99
Q

Disturbing processes of infections

A

Disturbing glucose or oxygen metabolism in brain cells severely enough to kill them.

100
Q

Altering characteristics of infections

A

Altering the characteristics of neural-cell membranes, thus changing the neurons’ electrical properties or interfering with their basic enzymatic processes, producing an array of abnormal conditions.

101
Q

pus and infections

A

it changes the composition of the extracellular fluids surrounding a neuron, thus altering neuronal function, and its presence increases pressure on the brain, disturbing normal functioning

102
Q

edema and infections

A

leads to compression of the brain tissues, resulting in dysfunction.

103
Q

4 Types of CNS Infection

A

Viral infections, Bacterial infections, Mycotic infections, Parasitic infections

104
Q

viral infections

A

A virus has an RNA or a DNA genome and invades host cells to replicate

105
Q

vectors for viral infections

A

mosquitos for West Nile virus and Zika virus

106
Q

Bacterial infections

A

Bacteria replicate by cell division

107
Q

Bacterial meninges

A

the meninges are infected by the bacteria and become inflamed

108
Q

Brain abscesses

A

are pockets of pus produced by bacteria that destroy the cells in the area

109
Q

Mycotic infections

A

Fungal infections of the brain by yeasts, molds, and mushrooms

110
Q

Is the brain resistant to mycotic infections

A

Normally, the brain is resistant to such infections, but can be susceptible following cancer or tuberculosis

111
Q

Parasitic infections

A

Parasites are living organisms that live inside another organism

112
Q

Malaria

A

a parasite transmitted by mosquitos; infects the capillaries of the brain and results in local hemorrhages

113
Q

Toxoplasma gondii

A

causes toxoplasmosis and is transmitted from rats through domestic cats to humans who clean up after the cats

114
Q

Treating CNS Infections

A

Many treatments involve managing symptoms more than removing the infectious agent, particularly for viruses

115
Q

bacterial infections are treated well with

A

antibiotics

116
Q

Apraxia damaged area

A

neocortex

117
Q

Apraxia

A

neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood and there is a willingness to perform the movement

118
Q

Ataxia damaged area

A

cerebellar damage

119
Q

Ataxia

A

Failure of muscular coordination or irregularity of muscular action

120
Q

Athetosis damaged area

A

abnormal function of the extrapyramidal system.

121
Q

Athetosis

A

Ceaseless slow, sinuous, writhing movements, especially in the hands

122
Q

Catalepsy damaged area

A

due to dopamine loss.

123
Q

A feature of Parkinson disease, due to dopamine loss

A

Catalepsy

124
Q

Cataplexy

A

Complete loss of movement and posture during which muscle tone is absent but consciousness is spared

125
Q

Chorea

A

Literally, “to dance”; refers to a wide variety of ceaseless, jerky movements that appear well coordinated but that are performed involuntarily

126
Q

Hemiplegia damaged area

A

contralateral motor cortex

127
Q

hemiplegia

A

Complete or partial paralysis to one half of the body

128
Q

Palsy

A

Usually refers to persisting movement disorders due to brain damage acquired perinatally

129
Q

Paralysis

A

Complete loss of movement (more commonly) or sensation in a part of the body

130
Q

Paralysis damaged region

A

permanent after damage to motor neurons; temporary after damage to motor cortex

131
Q

Paraplegia

A

Paralysis or paresis of the lower torso and legs following spinal-cord damage.

132
Q

Spasticity

A

Increased tone in certain muscle groups that maintain posture against the force of gravity. If the limb is moved against the rigidity, resistance will initially increase and then tone will suddenly melt .

133
Q

Spasticity damaged area

A

damage to the extrapyramidal motor fibers.

134
Q

(clasp-knife reflex)

A

Muscle resistance will initially increase and then tone will suddenly melt

135
Q

Tardive dyskinesia

A

Slow, persistent movements, particularly of the mouth and tongue. Usually follows long-term treatment with antipsychotic drugs.

136
Q

Myasthenia Gravis

A

This is a severe muscle weakness characterized by muscle fatigue after little activity or exercise

137
Q

Myasthenia Gravis most common in

A

females than males and age of onset is typically in the 30s

138
Q

first muscles to show weakness in Myasthenia Gravis

A

Muscles innervated by the cranial nerves are the first to show symptoms, with initial symptoms including drooping eyelids and difficulty chewing and swallowing

139
Q

when do symptoms of Myasthenia Gravis occur?

A

Symptoms initially occur at the end of day and are relieved by sleep

140
Q

Myasthenia Gravis cause

A

Acetylcholine receptors at the neuromuscular junction are destroyed by the immune system

141
Q

Multiple Sclerosis

A

Myelin is attacked and destroyed in the motor and sensory tracts

142
Q

Means of attach in MS

A

could be bacteria, viruses, or antibodies

143
Q

Is myelin loss caused by MS universal

A

not universal, but occurs in patches throughout the nervous system

144
Q

How is MS spotted

A

Disease tends to show symptoms, then the symptoms go away for a while, then they come back

145
Q

MS is more common in

A

in females than males (3:2) and more common in the northern hemisphere

146
Q

innervation in quadra/paraplegia

A

Initially, all innervation is lost, including reflexes and even thermoregulation, but some reflexes return over time

147
Q

Brown–Séquard syndrome

A

occurs if just one side of the spinal cord is damaged, impacting only some of the ascending and descending pathways

148
Q

Hemiplegia

A

Loss of voluntary movements on one side of the body and changes to some reflexes

149
Q

Hemiplegia damage

A

damage to the cortex and basal ganglia contralateral to the side of motor impairment

150
Q

Cases of hemiplegia

A

can occur in infants but mostly in older adults with high blood pressure

151
Q

Babinski sign in intact individuals

A

they will flex their toes downward after a stimulus to the bottom of the foot

152
Q

Babinski sign in intact individuals with hemiplegia

A

Individuals with hemiplegia extend their toes

153
Q

Hyperkinetic–dystonic syndromes

A

increase motor activity

154
Q

Hyperkinetic–dystonic syndromes (2)

A

huntingtons disease, Tourette’s

155
Q

Hypokinetic–rigid syndrome

A

decreases movement

156
Q

Hypokinetic–rigid syndrome (1)

A

Parkinsons disease

157
Q

Huntington Disease

A

Behaviors include writhing and twisting movements (choreas), Results in intellectual deterioration and personality changes

158
Q

Huntington’s age of onset

A

typically 30 to 50 years old

159
Q

Huntington impairments

A

Impairments of recent memory, slowed information processing, and emotional changes such as depression and anxiety

160
Q

Huntington cause

A

Caused by a mutation in the huntingtin gene, a dominant gene, which results in a defective protein that accumulates in the basal ganglia

161
Q

Huntingtons physical characteristics of the brain

A

The cortex of patients shows shrinkage and thinning, particularly the basal ganglia

162
Q

Role of the Basal Ganglia

A

Basal ganglia contain multiple pathways to influence movement

163
Q

Indirect pathway of basil ganglia

A

inhibitory for voluntary movement

164
Q

Basil ganglia and huntingtons disease

A

Huntington disease is associated with a decrease in activity in the indirect pathway due to cell loss in the putamen and globus pallidus, resulting in a decrease in inhibition of movement

165
Q

Huntingtons disease impaired tests

A

Performance is also impaired on tests of frontal-lobe function

166
Q

Tourette Syndrome stage I

A

Initially the symptoms are tics of the face, limbs, or body

167
Q

Tourette Syndrome stage II

A

the tics are accompanied by inarticulate cries

168
Q

Tourette Syndrome stage

A

echolalia and coprolalia are added to the tics and cries

169
Q

echolalia

A

repeating what others have said, as well as repeating actions

170
Q

coprolalia

A

The utterance of obscene or lewd words

171
Q

Tourette syndrome does run in families, so is assumed to have

A

a genetic component

172
Q

Tourette’s age of onset

A

between ages 2 and 15

173
Q

physical brain makeup in individuals with Tourette’s

A

have a larger putamen and smaller thalamus

174
Q

In addition to the tics, patients have visuospatial difficulties

A

on tests and in the real world

175
Q

Parkinsons disease

A

Symptoms include tremor, muscular rigidity, involuntary movement, and postural disturbance; these can occur in different parts of the body

176
Q

Parkinsons positive symptoms

A

describe abnormal behaviors that have been gained

177
Q

Parkinsons negative symptoms

A

or normal behaviors that have been lost

178
Q

Positive symptoms of Parkinsons

A

Tremors , Muscular rigidity, Involuntary movements,

179
Q

Negative symptoms of Parkinsons

A

Postural disorders, Righting disorders, Locomotive disorders, Speech disturbances, Akinesia

180
Q

Tremors

A

Alternating movements of the limbs when they are at rest stop during voluntary movements or during sleep

181
Q

Muscular rigidity

A

Simultaneously increased muscle tone in both extensor and flexor muscles is particularly evident when the limbs are moved passively at a joint

182
Q

Involuntary movements sometimes referred to as Akathesia or cruel restlessness

A

These movements may consist of continual changes in posture, sometimes to relieve tremor and sometimes to relieve stiffness but often for no apparent reason

183
Q

Postural disorders

A

An inability to maintain or difficulty in maintaining a body part (head, limbs, and so forth) in its normal position in relation to other body parts is referred to as a disorder of fixation

184
Q

Disorders of equilibrium

A

consist of difficulties in standing or even sitting unsupported

185
Q

Righting disorders

A

Patients have difficulty standing from a supine position

186
Q

Locomotive disorders

A

difficulty initiating stepping

187
Q

Festination

A

take faster and faster steps and end up running forward.

188
Q

Speech disturbances

A

almost complete absence of tone (prosody) in the speaker’s voice

189
Q

Akinesia

A

poverty or slowness of movement may manifest in a blank facial expression or lack of blinking, swinging the arms when walking, spontaneous speech, or typical fidgeting movements

190
Q

cause of Parkinsons

A

cause is unknown, or idiopathic

191
Q

Postencephalitic form of Parkinsons

A

due to damage to cells of the substantia nigra following encephalitis

192
Q

Drug-induced Parkinson disease

A

can result from drugs used to treat schizophrenia, and is reversible

193
Q

Recreational drugs, such as a synthetic form of heroin, can cause

A

permanent damage to dopamine cells, resulting in Parkinsons

194
Q

Parkinson disease is observed when dopamine levels

A

are reduced by more than 90% below normal levels

195
Q

There may be a genetic influence to Parkinsonism, but

A

most cases are likely not genetic

196
Q

is there a cure for Parkinsons?

A

no

197
Q

Pharmaceutical treatment therapy of Parkinsons

A

includes l-dopa, which will cross the blood–brain barrier and be converted to dopamine to supplement what has been lost

198
Q

Monoamine oxidase inhibitory and tricyclic antidepressants enhance

A

dopamine neurotransmission

199
Q

Anticholinergic drugs are used to block the

A

acetylcholine signaling that increases when dopamine decreases

200
Q

Newer treatments for parkinsons include

A

DBS, stem cells to replace lost dopamine neurons

201
Q

Cerebral Vascular Disorders

A

Damage to the blood vessels can reduce or eliminate blood flow to a region

202
Q

Cerebral Vascular Disorders damge

A

most often occurs in the arteries, due to the higher blood pressure

203
Q

Cerebral vascular accident (stroke)

A

sudden appearance of neurological symptoms as a result of blood supply being interrupted

204
Q

infarct

A

is the region of the brain that is directly impacted by the stroke and is characterized by dead and dying cells

205
Q

Types of Cerebral Vascular Disorders

A

Cerebral ischemia
Migraine stroke
Cerebral hemorrhage

206
Q

Cerebral hemorrhage

A

Blood vessel fails, resulting in bleeding into the brain

207
Q

Cerebral hemorrhage causes

A

high blood pressure, trauma, or toxic chemicals

208
Q

Migraine stroke

A

Blood flow is interrupted by a constriction of the blood vessel

209
Q

Migraine stroke causes

A

Cause of the vascular spasm is not known

210
Q

Cerebral ischemia

A

Blood vessel is blocked, preventing enough blood from reaching the brain

211
Q

thrombosis

A

a clot in the vessel that has remained where it was formed

212
Q

Embolism

A

a clot or other plug that formed in a larger vessel and got stuck in a smaller vessel

213
Q

cerebral arteriosclerosis

A

arteries thicken and harden, restricting blood flow

214
Q

Angiomas

A

Abnormal blood vessels that divert the normal flow of blood Result in abnormalities in the pattern and amount of blood flow

215
Q

Aneurysms

A

The walls of blood vessels are normally elastic to withstand the blood pressure, An aneurysm is a region where that elasticity is defective, leading to the vessel walls ballooning out and weakening the structure of the vessel

216
Q

Treating Cerebral Vascular Disorders

A

Ideal treatment is to restore blood supply, but this is not always possible

217
Q

drugs to prevent cell death

A

Drugs to block excitation and calcium channels can be effective to block cell death

218
Q

how to handle and aneurism

A

Surgery to support an aneurysm or remove blood that is putting pressure on surrounding tissue may be effective

Psych 377 (10 decks)

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