CNS Flashcards
What is the brain made up of?
Cerebral hemispheres including grey matter, white matter, basal ganglia, ventricular system. Brain stem. Cerebellum.
What are the meninges?
Membranous coverings of the CNS. Protective function and production of cerebrospinal fluid. Made up of Dura mater, arachnoid and pia mater.
What happens if the volume of fluid inside the skull increases?
The intracranial pressure rises. This results in herniation where a part of the brain moves from one compartment of the skull to another.
What are the 5 sections of the spinal cord?
Cervical - 8 Thoracic - 12 Lumbar - 5 Sacrum - 5 Coccygeal - 1
What is the frontal lobe responsible for?
Decision making, emotions, memory, fluent speech.
What is the parietal lobe responsible for?
Sensory cortex and processing of info.
What is the temporal lobe responsible for?
Language functions and auditory cortex. Memory
What is the occipital lobe responsible for?
Visual cortex
What is the brain stem responsible for?
Motor and sensory pathways. Control of cardiorespiratory function and consciousness.
What is the cerebellum responsible for?
Precise motor control.
What are focal neurological signs?
A set of symptoms or signs in which causation can be localised to a site in the CNS.
What is generalised neurological abnormality?
An alteration in level of consciousness.
How is consciousness assessed?
A - Alert V - Voice P - Pain U - Unresponsive Using the Glasgow Coma Scale.
What is cerebrovascular disease?
Incorporates strokes, TIAs, intracerebral haemorrhage.
What are the 2 main pathological processes in cerebrovascular disease?
Hypoxia, ischaemia and infarction due to impaired blood supply.
Haemorrhage from CNS vessels.
What does tissue survival depend on?
Collateral circulation, duration of ischaemia, magnitude and rapidity of flow reduction.
What are the symptoms of cerebrovascular disease?
Hypotension, cardiac arrest, neuronal dysfunction.
What is a stroke?
Major neurological disorder.
What are the symptoms of a stroke?
Facial drooping, arm weakness or numbness, Slurred speech, Time - ring 999 urgently.
What is a TIA?
Transient Ischaemic Attack - temporary loss of function that resolves itself within 24 hours. Mini-stroke.
How are TIAs treated?
Anti-platelet therapy: aspirin or clopidogrel. Control BP. Lower cholesterol.
What are the 2 types of stroke?
Ischaemic, Haemorrhagic.
What are the risk factors for a stroke?
Hypertension, DM, Heart disease e.g AF, previous TIAs, Hyperlipidaemia.
What are the causes of a stroke?
Hypoxia of brain from blockage of blood vessel by atheroma or embolus. Bleed into the brain - HTN related or aneurysm.
How is a stroke managed?
NICE guidance, Thrombolysis, Aspirin/Clopidogrel, Physio, OT, SALT, Supportive treatment.
What are the causes of hemorrhagic events?
HTN, Vascular malformation e.g aneurysm, Neoplasia, Trauma, Drug abuse.
What is an intracerebral haemorrhage?
Haemorrhagic stroke - presents as headache with rapid decrease in conscious level. Few survive.
What is a subarachnoid haemorrhage?
Spontaneous, often catastrophic, 80% are rupture of aneurysms.. Thunderclap headache and meningitis like signs.
What is a subdural haemorrhage?
Fluctuant conscious level. Often in patients on anticoags. Bleeding from bridging veins. Blood between dura and arachnoid.
What is an extradural haemorrhage?
Post head injury, slowly falling conscious level. Often with fractured temporal or parietal bone.
What is dementia?
Progressive and largely irreversible clinical syndrome with widespread impairment of mental function.
What are the signs of dementia?
> 65 years old increased risk. Memory loss, speed of thought, language, understanding/judgment, difficulties in controlling emotions. Can be mimicked by depression.
What is dementia caused by?
70% by Alzheimers disease. 15% by vascular dementia (recurrent small strokes).
What is Alzhemier’s disease?
An accumulation of amyloid, neurofibrillary tangles and plaques, and loss off neurones and synapses. Causes defects of visual-spaital skills and memory loss.
What is epilepsy?
Spontaneous, intermittent, abnormal electrical activity in the brain, manifest as seizures. No identified cause.
What can a diffuse infection cause?
Meningitis
What can a focal infection cause?
Abscess.
What are the causes of meningitis?
Bacteria - neirsseria meningitidis, pneumococcus, meningococcus. Viral and Fungal.
What are the symptoms of meningitis?
Headache, cold hands and feet, pyrexial, neck stiffness, non-blanching rash, seizures.
What is a brain abscess?
Caused by focal infection. Can lead to focal brain damage or mass effect. Presents with headaches, seizures, temperature.
What is Parkinson’s Disease?
Movement disorder, rigidity, resting tremor, postural instability.
What is the treatment for Parkinsons?
L-dopa eg Madopar.
What are the symptoms of a brain tumour?
Headaches, seizures, cognitive or behavioural change, vomiting, altered consciousness.
Where can brain tumours metastasise from?
Breast, small cell lung cancer.
What are meningiomas?
Benign tumours. Slow growing. Derived from meningothelial cells. Enlarge slowly.
What can pituitary tumours cause?
Cause compression symptoms, they can be hormonally active.
What are the other types of brain tumours?
Glioblastoma, astrocytomas.
