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psych 377 > chapter 26: neurological disorders > Flashcards

chapter 26: neurological disorders Flashcards

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1
Q

Which demographic is at the highest risk of traumatic brain injury (TBI)?

A

Males ages 15-30.

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2
Q

What are compensatory behaviours?

A

Behaviours by other mechanisms in the brain that perform the function of an injured/lost function.

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3
Q

Define the terms coup, contrecoup, shearing (in the context of closed-head injuries).

A

Coup: damage to brain at site of blow caused by brain impacting skull

Contrecoup: damage to brain on side of brain opposite to site of area due rebounding and impacting skull

Shearing: twisting and breaking of nerve fibres caused by rapid movement of brain inside skull

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4
Q

Define hematoma and edema.

A

Hematoma: mass of blood trapped in the skull
Edema: swelling that can result in pressure on delicate nervous tissue in brain

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5
Q

Which metrics does the Glasgow Coma Scale measure?

A

Eye opening, motor response, verbal response.

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6
Q

Scores of _ or less on the Glasgow Coma Scale are associated with severe head injury, _ to __ for moderate, __+ for mild injury.

A

8 (severe), 9 to 12 (moderate), 13+ (mild).

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7
Q

Recovery from TBI can take up to __________, most recovery takes place in first __________.

A

2 to 3 years, 6 to 9 months.

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8
Q

What is the distinction between symptomatic and idiopathic seizures?

A

Symptomatic: associated with known cause (e.g. infection, trauma, fever, etc.)

Idiopathic: Spontaneous; no known cause

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9
Q

What is an aura?

A

Subjective sensation, perception, or motor experience associated with the onset of a seizure.

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10
Q

What are some precipitating factors for seizures in susceptible individuals?

A

Drugs, emotional distress, fever, hormonal changes, hyperventilation, sensory stimuli, sleep, sleep deprivation, trauma.

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11
Q

What are focal seizures versus generalized seizures?

A

Focal: begin in one location in brain, electrical activity spreads to involve other regions

Generalized: Seizure activity occurs in both hemispheres, no clear focus

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12
Q

What are the four phases of generalized seizures? Describe their symptoms and associated EEG activity.

A

Start state: no symptoms, normal EEG activity

Tonic phase: patient detects aura; rapidly increasing EEG activity

Clonic phase: stereotyped convulsions, loss of consciousness and/or breathing; EEG pulses

Coma phase: comatose state; EEG activity of coma patient, less brain activity than resting state

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13
Q

What are akinetic seizures and myoclonic spasms? What do they share in common?

A

Akinetic seizure: characterized by sudden collapse without warning

Myoclonic spasm: large seizures characterized by flexion or extension of entire body

Both typically only occur in children

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14
Q

What are dissociative seizures and how are they unique?

A

Seizures that resemble focal seizures but have no EEG changes. Patients report feeling cut off from surroundings (out-of-body experience).

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15
Q

What are some treatments used to end seizures (that have already begun)?

A

GABA agonists, glutamate antagonists.

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16
Q

What are some drugs used to inhibit seizure development or propogation?

A

GABA agonists, sodium-channel blockers, anaesthetics, anticonvulsants.

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17
Q

Drugs are __-__% effective in treating seizures. If not, what other interventions are sometimes resorted to?

A

30-40%; surgery or DBS.

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18
Q

What cells can develop into brain tumours? Why not other kinds of brain cells?

A

Glial cells or other supporting cells. Neurons do not grow and divide and therefore cannot become tumours.

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19
Q

What is the difference between benign and malignant tumours?

A

Benign tumours generally do not reoccur after removal, malignant tumours are progressive.

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20
Q

Describe encapsulated tumours, infiltrating tumours, and their respective differences.

A

Encapsulated tumours: localized in one place, can put pressure on surrounding tissue

Infiltrating tumours: interact with surrounding cells, can destroy or interfere with them

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21
Q

Describe the three types of brain tumours discussed in class (glioma, meningioma, metastatic).

A

Glioma: arise from glial cells and infiltrate surrounding brain (~45% of brain tumours)

Meningioma: arise in the meninges; benign and encapsulated. Symptoms via compression of adjacent tissue

Metastatic: tumour cells from elsewhere in body start to grow in brain. Prognosis poor and treatment difficult

22
Q

What causes headaches and where in the head does pain occur?

A

Factors: stress, neurological disease (e.g. tumours, migraines)

Pain anywhere with vascular tissue: dura mater, blood vessels in brain, cranial and/or cervical nerves

23
Q

What causes migraines? Describe classic migraines versus common migraines.

A

Caused by vasoconstriction of cerebral arteries, subsequent blood loss to occipital lobe

Classic: begin with aura, depolarization spreads outwards. Headache associated with blood flow back to areas

Common: not associated with an aura

24
Q

What are other categories of headaches besides migraines?

A

Muscle-contraction headaches: result from persistent contraction of muscles in scalp and neck due stress

Non-migrainous vascular headaches: associated with dilation of arteries due all kinds of factors

25
Q

What is apraxia?

A

Inability to make or copy voluntary movements (in the absence of paralysis or other impairment). Usually follows damage to neocortex.

26
Q

What is ataxia?

A

Failure of muscle coordination or irregularity of muscular action. Commonly follows cerebral damage.

27
Q

What is athetosis?

A

Ceaseless slow, sinuous, writhing movements, especially in the hands; due to abnormal function of extrapyramidal system.

28
Q

What is cataplexy?

A

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

29
Q

What is chorea?

A

Variety of ceaseless, jerky movements that appear well coordinated but that are performed involuntarily.

30
Q

What is hemiplegia? How is the Babinski reflex test used to diagnose it?

A

Complete or partial paralysis to one half of the body. Usually follows damage to contralateral motor cortex.

Babinski reflex test: in intact individuals, toes flex downward after stimulus; those with hemiplegia extend toes.

31
Q

What is palsy?

A

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

32
Q

What is paralysis?

A

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

Usually permanent damage to motor neurons, temporary after damage to motor cortex (BA 4).

33
Q

What is spasticity? What is the clasp-knife reflex?

A

Increased tone in certain muscle groups that maintain posture against force of gravity.

Clasp-knife reflex: if spastic limb is moved against rigidity, resistance will initially increase then tone will suddenly melt.

34
Q

What is tardive dyskinesia?

A

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

35
Q

What is myasthenia gravis and what is it caused by?

A

Severe muscle weakness characterized by muscle fatigue after little activity or exercise; muscles innervated by cranial nerves first to show symptoms.

Caused by acetylcholine receptors at neuromuscular junction destroyed by immune system (autoimmune neuromuscular junction disorder).

36
Q

What disease involves myelin being attacked and destroyed in the motor and sensory tracts?

A

Multiple sclerosis (MS).

37
Q

Describe paraplegia, quadriplegia, Brown-Séquard Syndrome.

A

Paraplegia: spinal cord damage at level of thoracic through lumbar spine; paralyzes legs and lower torso

Quadriplegia: damage at level of cervical spine; paralyzes all four limbs

Brown-Séquard Syndrome: only one side of spinal cord is damaged, impairing only some of the ascending and descending pathways

38
Q

What are the discussed examples hyperkinetic-dystonic syndromes, hypokinetic-rigid syndrome, and which brain area are they a result of illness of?

A

Hyperkinetic: Huntington’s Disease (Chorea), Tourette’s syndrome

Hypokinetic: Parkinson’s Disease

Result from diseases of the basal ganglia.

39
Q

What causes Huntington’s disease (chorea)?

A

Mutation in the Huntington gene which results in defective protein accumulating in basal ganglia.

40
Q

What are the stages of Tourette’s?

A

Initially: symptoms of tics in face, limbs, body

Second stage: tics accompanied by inarticulate cries

Final stage: echolalia and corprolalia, in addition to tics and cries

41
Q

What are the positive and negative symptoms of Parkinson’s?

A

Positive symptoms: tremors at rest, muscular rigidity (due antagonistic contraction), involuntary movements

Negative symptoms: postural disorders, righting disorders, locomotive disorders, speech disturbances, akinesia

42
Q

Parkinson’s is often idiopathic. What are some potential causes for it?

A

Damage to substantia nigra following encephalitis (postencephalitic Parkinsonism), drug induced (to treat schizophrenia), damage to dopamine receptors.

43
Q

Parkinson’s has no direct cure. What are some treatments for it?

A

L-dopa: crosses BBB to supplement lost dopamine

Monoamine oxidase inhibitors and tricyclic antidepressants: enhance dopamine transmission

Anticholinergenic drugs: block acetylcholine signalling that increases as dopamine decreases

DBS and stem cell transplants

44
Q

What is an infarct?

A

Region of brain that is directly impacted by a stroke, is characterized by dead and dying cells.

45
Q

What as a cerebral ischemia?

A

Cerebral ischemia: blood vessel is blocked by clot. Thrombosis refers to static clot that remains where it forms, embolism is a clot formed in larger vessel that has clogged smaller one.

46
Q

What is a migraine stroke?

A

Blood flow to brain region interrupted by constriction of a blood vessel. Cause of vascular spasm is unknown.

47
Q

What is a cerebral hemorrhage?

A

Cerebral blood vessel fails, resulting in bleeding in the brain. Causes can be high blood pressure, trauma, toxic chemicals.

48
Q

What is an angioma?

A

Abnormal blood vessel that diverts normal bloodflow. Results in abnormalities in pattern and amount of blood flow.

49
Q

What is an angioma?

A

Region of cerebral vascular tissue where elasticity is defective, vessel walls balloon out and weaken structure of vessel.

50
Q

What are some treatments of cerebral vascular disorders (angioma and aneurysm)?

A

Restoring blood supply, calcium channel blocking, surgery.

psych 377 (8 decks)

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