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Pathopharm > Copy of CNS LECTURE FLASHCARDS > Flashcards

Copy of CNS LECTURE FLASHCARDS

1
Q

The afferent pathway refers to sensory or motor pathways?

A

Sensory-coming into the brain (A=arriving)

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2
Q

The efferent pathways deal with:

A

Effector/motor pathways-leaving the brain (E=exiting)

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3
Q

T or F: the CNS includes the brain and spinal cord.

A

TRUE

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4
Q

T or F: The PNS includes the brain, spinal cord, and peripheral nerves.

A

FALSE-peripheral nerves only.

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5
Q

The Monro-Kellie doctrine refers to:

A

The three components (brain tissue, IV blood, CSF) are equal within the vault (brain)

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6
Q

CPP stands for:

A

Cerebral perfusion pressure

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7
Q

T or F: CPP can’t be knocked out of balance

A

FALSE- increases or decreases in blood flow or CSF can alter the CPP.

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8
Q

T or F: The skull can expand to accommodate changes in pressure/fluid

A

FALSE. The skull is a rigid vault that does not expand

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9
Q

What are 6 possible etiologies of brain injuries?

A 
Trauma
Tumors
Strokes
Metabolic derangements
Degenerative disorders
Infections, inflammatory disease
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10
Q

Where does CSF flow in the brain?

A

Between the ARACHNOID layer and pia matter

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11
Q

CAD, HTN, PVD
Clotting disorders
Diabetes, Glucose, fluid and electrolyte
disorders are all:

A

Underlying conditions that are risk factors for brain injury

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12
Q

What are two examples of a degenerative disorder that can cause brain injuries?

A

Systemic lupis, Alzheimer’s

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13
Q

What are 3 mechanisms of brain injury?

A
  1. Ischemia/hypoxia
  2. Cerebral edema and Cerebral
    Pressure
  3. Increased Intracranial Pressure
    (IICP)
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14
Q

Define hypoxia:

A

Low cellular oxygen with or without blood flow

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15
Q

Define ischemia

A

interrupted, reduced blood flow causing hypoxia

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16
Q

Decreased ATP, severe anemia, and CO2 toxicity are all pathological effects of:

A

hypoxia and ischemia

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17
Q

If a patient is hypoxic or ischemic in the brain neurons are:

A

compensating with anaerobic metabolism, creating lactic acidosis

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18
Q

List 8 clinical signs/symptoms of ischemia/hypoxia

A 
Euphoria, drowsiness
Level of consciousness
Seizures
Concentration, attention, problem
solving
Cerebral necrosis- coma and death
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19
Q

What is a treatment for ischemia in the brain?

A

Reperfuse brain tissue

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20
Q

How can one reperfuse the brain without a blood transfusion?

A

Give pt oxygen and fluids-to expand concentrated hemoglobin

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21
Q

If a patient has an increase work of breathing what should you do?

A

Decrease their metabolic needs through rest or sedation if necessary

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22
Q

Why would you give a pt glucose who is suffering from hypoxia/ischemia?

A

To increase their energy production and raise their metabolic functions

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23
Q

_________________is defined as increased tissue volume r/t abnormal accumulations

A

Cerebral edema

24
Q

Interstitial edema is caused by:

A

Increased Na and H2O (white matter)

25
Q

Vasogenic edema is due to:

A

Increased ECF

26
Q

Cytoxic edema is due to

A

Actual swelling of cells

27
Q

Cerebral Perfusion is dependent on:

A

Blood flow and ICP

28
Q

The volume of the brain is made up by:

A

Tissue, CSF, blood

29
Q

Define mean arterial pressure (MAP):

A

average arterial pressure during cardiac cycle

30
Q

What is a normal MAP range?

A

70-100 mm Hg

31
Q

For perfusion of vital organs we must maintain a pressure of:

A

> 60 mm Hg

32
Q

What is the most valuable number for determining the cerebral pressure?

A

CPP

33
Q

CPP=

A

MAP- ICP

34
Q

CPP >

A

60mmHg

35
Q

ICP =

A

0-15 mmHg

36
Q

Why do we put brain injury patients in an induced coma?

A

To decrease O2 needs, metabolic needs so that brain can recover more quickly

37
Q

T or F: The newest research shows HOB, Diuretics, and Steroids are the best form of treatment for a brain injury

A

FALSE. This is the classic mindset, new research shows that oxygenation of tissue is more important than immediately reducing ICP/edema

38
Q

Define intracranial pressure:

A

is the pressure exerted by brain tissue, blood volume & cerebral spinal fluid (CSF) within the skull.

39
Q

ICV =

A

Vbrain + Vblood + Vcsf

40
Q

In cerebral edema, what is displaced first?

A

CSF

41
Q

What is altered second in cerebral edema?

A

Cerebral blood flow

42
Q

In an attempt to increase MAP and offset IICP ______________________ occurs first followed by _________________ to decrease the ICP (compensation)

A

Venous Vasoconstriction; arterial Vasoconstriction

44
Q

T or F: An increased ICP results from an increased volume of brain tissue, blood, and / or CSF.

A

TRUE

45
Q

What are the three main life threatening effects of IICP?

A
  1. obstructs blood flow, 2. Destroys brain cells, 3. Displaces brain tissue- herniation
46
Q

List the 5 most common clinical presentations of increased intracranial pressure:

A

Decreased level of consciousness, Bradycardia, Headache, Increased systolic blood pressure, Seizures

47
Q

Decreased level of consciousness relates to an increase in ICP because:

A

Usually, the greater the decrease in LOC, the more serious the injury is.

48
Q

Two clinical symptoms of ICP that show the body is attempting to compensate are:

A

Bradycardia and Increased systolic blood pressure

49
Q

A person who can t think rapidly and clearly is:

A

Confused

50
Q

A person who begins to loose consciousness and awareness to Time, place, and self is:

A

Disoriented

51
Q

Define lethargy:

A

spontaneous speech and movement limited

52
Q

Define obtundation:

A

arousal (awakeness) is reduced

53
Q

A person in a deep sleep or unresponsive, but opens eyes to vigorous or repeated stimuli is in a:

A

Stupor

54
Q

A person who responds to noxious stimuli only is in a:

A

Coma

55
Q

A person who demonstrates Unresponsive coma, No reflexes (pupils, gag, corneal, cough), No spontaneous respiration, Dilated fixed pupils is most likely in:

A

Brain death

56
Q

Acute CNS catastrophe, Exclusion of complicating medical condition, No drug intoxication or poisoning, Core temp >90F are all prerequisites for a diagnosis of:

A

Brain death

57
Q

Define Acute Confusional States:

A

Acquired mental disorder characterized by deficits in attention and coherence of thoughts and action

58
Q

T or F: delirium is defined as irreversible Decreased cognitive functions, while Dementia is defined as an Acute Confusional state.

A

FALSE. Delirium is an acute confusional state, vs dementia which is an irreversible alteration in cognitive function.

Pathopharm (11 decks)

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