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Linares > chapter 5 Etiologies and Neurodiagnostic Tests > Flashcards

chapter 5 Etiologies and Neurodiagnostic Tests Flashcards

1
Q

the most common acquired communication problem in adults…

A

is a stroke (CVA)

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2
Q

Stroke Symptoms

A
  • dizziness
  • numbness on one side of body
  • fainting
  • cramping
  • redness of face
  • speech difficulty
  • comprehension difficulty
  • vision problems
  • headache
  • vomiting
  • paresis to paralysis
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3
Q

stroke survival

A
  • majority of people survive a stroke
  • 2.5 million currently suffer effects from a stroke
  • up to 25% will have noticeable communication problems(likely higher)
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4
Q

neurological insults results from

A
  • CVAs (64%)
  • TBI (25%)
  • other (sports and other, 11%)
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5
Q

strokes are the ____ leading cause of death

A

3rd

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6
Q

CVA Risk Factors

A
  • Age
  • Gender
  • Ethnicity
  • Pre-existing conditions
  • Heart related factors
  • Other factors
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7
Q

CVA Risk Factors- Age

A

risk is 1/1000 at age 50+, 10/1000 at 70+, and 20/1000 at age 80+

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8
Q

CVA Risk Factors- Gender

A

Men are at higher risk, elderly women at higher risk due to living longer

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9
Q

CVA Risk Factors-Ethnicity

A

African Americans are twice as likely to have a CVA as caucasians

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10
Q

CVA Risk Factors-Pre-existing conditions

A
  • diabetes increases risk of stroke due to impaired glucose metabolism
  • previous CVA increases risk of a second stroke by 10x
  • history of CVAs in family
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11
Q

what is an ishemic CVA

A
  • occlusive type
  • some blockage of a vessel has occurred
  • infarct is dead tissue resulting from an injury
  • 80% of all strokes are ischemic
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12
Q

what is a non-ischemic CVA

A
  • nonocclusive type
  • no blockage of vessels occur in this type of CVA
  • the common form is an aneurysm
  • other possible types are hemorrhage and arteriovenous malformation
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13
Q

what are the types of ischemic CVAs

A
  • thrombosis
  • embolism
  • arteriosclerosis(*)
  • transient ischemic attacks(TIAs)
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14
Q

what is thrombosis

A
  • a clot that forms and stays in the same location in a blood vessel has occurred
  • 67% of ischemic strokes are thrombic
  • two thirds of all ischemic strokese are thrombotic in persons over 60 years of age
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15
Q

What is embolism

A
  • a clot that forms away from the brain but travels to the brain
  • 33% of ischemic strokes are embolic
  • women are likely to have more embolisms than men b/c of the effects of birth control pills
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16
Q

what is arteriosclerosis

A
  • hardening of the arteries as a result of plaque build-up from cholesterol
  • from LDL (non metabolized low density lipoprotein) bad one, don’t want to increase
  • plaque build up starts to narrow the vessel (lumin), this process is called stenosis
  • stenosis impedes blood flow, increasing risk of clot formation (thrombosis) or increases the risk of plaque breaking off, causing an embolism
  • risk factors include high fat diet, obesity/diabetes, smoking, hypertension
  • atherosclerosis is degeneration of the blood vessel walls, especially at junctions (when they break down)
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17
Q

what is a transient Ischemic attack

A
  • warning signs of a possible subsequent stroke
  • symptoms mimic a real stroke, but resolve themselves quickly (hours to a day)
  • typically caused by stenotic arteries, arteriosclerosis, or hypertension
  • other causes can include anemia or thyroid problems
  • one-third of TIA victims have CVAs within five years
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18
Q

what are the types of non-ischemic CVAs

A
  • aneurysm
  • Cerebral hemorrhage
  • Arterio-Venous malformation
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19
Q

what is an aneurysm

A
  • typically a congenitally weak blood vessel wall that may not be noticed until adulthood
  • blood vessel balloons out, will need to be clipped or if untreated will burst
  • majority of patients have a headache prior to it bursting (and leading to death)
  • most are found on accident
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20
Q

what is a cerebral hemorrhage

A
  • the result of an aneurysm that has burst, also from a head trauma or hypertension
  • if the spilled blood solidifies, it forms a clot (hemotoma) in the brain
  • the clot can be intracranial (epidural, subdural, or subarachniod hematomas)
  • the clot can be intracerebral (any bleeding inside the brain)
  • bleeding/ clotting can lead to intracranial pressure (and must be relieved)
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21
Q

what is artery-venous malformation

A
  • congenital-based disorder in which a vessel is neither an artery or a vein
  • these formations carry both oxygenated and deoxygenated blood which may create symptoms of a TIA
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22
Q

blood flow

A
  • arteries take blood to the brain with oxygen

- veins take blood away from the brain, deoxygenated

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23
Q

What is another name for head injuries

A

Traumatic Brain Injury

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24
Q

TBIs can result in ________ and ________ injuries

A

open head or closed head

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25
Q

is the #____ killer of persons under ____. The majority of whom are between ___ and ____.

A
  • 1; 34

- 15; 24

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26
Q

how may TBIs occur annually

how many result in death

A
  • about 1 million

- 56,000 deaths

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27
Q

what is the percentage breakdown of causes of TBIs

A
  • vehicle accidents(50%)
  • falls(21%)
  • firearms (12%)
  • sports (10%)
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28
Q

how many TBIs require therapy?

A

1/3

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29
Q

TBI can range from a _________ to a ___________.

A

concussion, coma

30
Q

what are the five c’s of head injury?

A
  • concussion
  • contusion
  • coma
  • coup
  • contra-coup
31
Q

what is a concussion

A

an injury with no cisible signs of head trauma, but the person experiences headache, nausea, dizziness, concentration problems, (visual focus problems) etc.

32
Q

what is a contusion

A

a bruise resulting from an injury with no torn skin (can see)

33
Q

what is a coma

A

a state of unconsciousness and unresponsiveness

34
Q

what is a coup

A

the internal site of injury to the brain

35
Q

what is a contra-coup

A

an internal injury at the opposite point of coup injury

36
Q

What else may TBIs lead to

A
  • seizures
  • uneven heart functions
  • intracranial hemorrhage
  • neck stiffness
  • visual problems
  • hearing problems
  • vomiting
37
Q

what is diffuse axonal injury

A

microscopic damage to neurons from abrupt changes in velocity (sudden stopping of a car tends to shear the neurons resulting in widely spread but undetectable breakage
-symptoms are very minor (headache, memory) but can slowly worsen over years mimicking alzheimers or other degenerative diseases

38
Q

what is cerebral inflammation

A
  • redness/swelling of tissue in response to an injury/ infection
  • infection can be from bacteria or a virus, only bacteria respond to drugs
  • meningitis is inflammation of meninges (constricting the lumina, increasing pressure)
  • encephalitis is inflammation of cerebral tissue due to a virus
  • both meningitis and encephalitis can cause an abscess (tiny area of tissue destruction)
  • inflammation can also be caused b long-term diseases, such as rheumatic disease, syphilis, leukemia, and sickle cell disease; all of these cause vascular system disruption
39
Q

what is neurodegenerative diseases

A

gradual irreversible destruction of brain tissue

40
Q

what are the different types of neurodegenerative diseases

A
  • multi-infarct CVA
  • Picks Disease
  • alzheimer’s
  • late onset alzheimer’s disease
  • non-genetic causes
  • Others
41
Q

what is multi-infarct CVA

A

a series of strokes, either TIAs, occlusive strokes or atherosclerosis

42
Q

what is picks disease

A
  • a rare degeneration of frontal/ temporal lobes
  • occurs as early as 20 years of age
  • referred to as one of the possible presenile dementias
  • personality changes, odd behaviors
43
Q

what is alzheimers disease

A
  • 2/3 of all dementias are caused by alzheimers
  • fourth leading cause of death, with 100,000 deaths per year
  • also one of the presenile dementias if occurs before age 60
  • cause is a defective chromosome 14, typically inherited
44
Q

what is late onset alzheimer’s disease

A

variation of AD, caused by defective chromosome 12 and 21

45
Q

what are some non-genetic causes of AD

A

some cases of AD have been attributed to children born of young fathers or who had poor linguistic abilities in early life (toxins, mercury)

46
Q

what are other disease that cause brain degeneration

A
  • creutzfeld-jakob disease
  • progressive supranuclear palsy
  • parkinson’s
47
Q

brain tumors

A
  • typically form from astrocytes or oligodendrocytes
  • can be low grade/benign to fast growing/dangerous tumors
  • deep seated(cant get to it) tumors are difficult to remove surgically and are therefore life threatening
  • disruption in the flow of CSF may give symptoms of a tumor or other anomalies
48
Q

Epilepsy

A
  • idiopathic epilepsy is so termed because there is no definite cause
  • non-idiopathic epilepsy is a symptom resulting from a CVA, TBI, or tumor
  • petit mal seizures produce whole body twitches/jerks perhaps unconsciousness
  • in jacksonian seizures, the twitching starts small and spreads to whole body
49
Q

Substance abuse includes

A
  • stimulants
  • depressants/ sedatives
  • alcohol
  • neurotoxins
  • anoxia
  • other potential causes
50
Q

stimulants

A
  • affect release/uptake of neurotransmitters
  • can affect the vascular system
  • includes amphetamines/speed, methamphetamines/meth, cocaine, steroids, solvents, nitrites, antidepressants
  • symptoms include high blood pressure, heart pressure, heart rate and blood velocity
  • meth stays in system longer; affects the limbic system
  • meth behavioral symptoms include agitation, anxiety, psychoses, confusion, memory problems, attention problems, (weight loss, skin lesions, bad teeth)
51
Q

depressants/sedatives

A
  • downers
  • have a calming effect; increase serotonin levels or inhibit excitatory neurotransmitters
  • includes PCP, opium, LSD, heroin, morphine, demerol
  • specific sedatives include barbiturates (phenobarbitol/luminol)
  • also include benzodiazepines (valium Halicon, xanax)
52
Q

alcohol

A
  • alcohol consumption is highly associated with TBI incidence
  • can be lethal in combination with other drugs
  • affects brain function, as well as other body organs (liver)
53
Q

neurotoxins

A
  • toxic metals include arsenic, lead, manganese, mercury, and tin
  • toxic solvents are those that dissolve fats, oils, resins, waxes, plastics, polymers
  • toxins are easily found in household and most industry-related businesses
54
Q

anoxia

A
  • can result from a heart attack if no oxygen reaches the brain for five minutes
  • subsequently, if brain exhausts its 10 minute reserve of oxygen, glutamate is released which kills neurons
  • within a day, widespread degeneration of neurons begins due to chromatolysis
  • days later, brain tissue disintegrates, being replaced by scavenger cells
55
Q

other potential causes of brain insult

A
  • microwave radiation, especially from cell phones(in rats)

- nerve gas exposure, as seen in soldiers suffering from post-traumatic syndrome

56
Q

Test for Medical Diagnosis and Lesion Localization

A

*Computer Axial Tomography (CAT/CT)
*Magnetic Resonance Imaging (MRI)
MR Spectroscopy
MR Projection Angiography
Magnetoencephalogoraphy (MEG)
*Functional MRI (fMRI)
MRI
*Spinal Tap/ Lumbar Puncture
*Electroencephalography (EEG)
*Evoked Potentials
Brain Electrical Activity Mapping (BEAM)
*Brain Scan
*Angiography
*Doppler Sonography
*Positron Emission Tomography (PET)

57
Q

What is Computerized Axial Tomography

A

(CAT/CT scan)

  • xray camera rotates about the head taking a picture every 2-10 mm intervals
  • if successful, lesion will show up as a dark spot
58
Q

What is Magnetic Resonance Imaging

A

MRI

  • patient is put inside cylindrical chamber
  • series of images are recorded over several minutes; all are collapsed to get a 3-D version of the brain, allowing a computer to rotate/slice the picture from different angles
  • does not used radiation, no metals can be inside chamber due to magnetic forces applied
59
Q

What is MR Spectroscopy

A

analyzes chemical composition of body tissue/organ

60
Q

what is MR Projection Angiography

A

views blood vessels/ blood flow

61
Q

what is magnetoencephalogoraphy

A

(MEG)

measures normal vs abnormal neural activity

62
Q

what is functional MRI

A

fMRI

-shows blood flow to active areas of brain (vs rest/damaged areas)

63
Q

what is MRI- Tensor Diffusion Imaging

A

measures water flow in nerves, esp. in multiple sclerosis

64
Q

What is Spinal Tap/Lumbar Puncture

A

analyzes CSF in spine for bleeding , infection, pressure

65
Q

what is electroencephalography

A

EEG

-measures electrical activity via surface electrodes

66
Q

what is evoked potentials

A

measurement of electrical activity to visual stimuli (visual evoked responses-VER) suditory stimuli (AER or ABR) or proprioceptive stimuli

67
Q

what is brain electrical activity mapping

A

(BEAM)

displays evoked potentials as lateral views of the brain

68
Q

what is Brain Scan

A
  • radioactive material is injected into the carotid artery
  • xrays of videotaping images are taken to see where the isotope pools
  • infarcted areas absorb this substance
69
Q

what is an angiography

A

isotope is injected into carotid or vertebral artery and the circulating dye is followed to examine the diameter of blood vessels

70
Q

what is a doppler sonography

A

high frequencies are aimed at a target area, echoes are measured and displayed as visual images; also known as ultrasound

71
Q

what is positron emission tomography

A

(PET)
patient inhales or recieves injection of a positron emitter and an isotope tracer
combined these two light up active areas of the brain
a modified version is SPECT (single photon emission computed tomography) which measures particular areas of blood flow in the brain, called regional cerebral blood flow (rCBF)

Linares (6 decks)

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