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Disease, diagnostics and therapeutics > Diseases of the nervous system > Flashcards

Diseases of the nervous system Flashcards

1
Q

basics on Spina Bifida

A

a neuronal tube defect. occurring when vertebrae don’t form properly around the spinal cord leaving a ‘gap’ in the spinal cord

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2
Q

severity of spina bifida depends on

A

where the ‘gap’ is located

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3
Q

spina bifida causes problems with

A

movement, bladder and bowel

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4
Q

spina bifida is associated with

A

Hydrocephalus- excess fluid in the brain

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5
Q

the higher up the spine where the gap has occured

A

the more neuronal function the patient will have

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6
Q

when does the spine fail to close propely

A

during the first month of pregnancy

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7
Q

function fo CSF

A

produces a constant, controlled environment for the brain cells and protects from toxins. Prevents escape of NT

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8
Q

what may cause the BBB to become more permeable allowing substances normally excluded from he blood brain barrier

A

inflammation irradiation and tumours

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9
Q

which solutes have the same inc ocnentration in the CSF as the blood
CSF=blood

A

Na+
Cl-
HCO3-
Osmolarity

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10
Q

[CSF}< blood

A 
K+
Cas2+
Glucose
Amino acids
pH
cholesterol
protein
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11
Q

solutes CSF> blood

A

Mg2+

Creatinine

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12
Q

which substances are usually negligible in CSF

A

cholesterol and protein

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13
Q

urinary incontinence

A

a condition when a individual suffer from involuntaryy leakage of urnine

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14
Q

causes of urinary incontinence

A

1`- ads release reduction

  • diuretcis which inhibit Na+ reabsorption
  • anticholinergics- inhibit muscuarinic ACh receptors- less detrusor muscle contraction
  • dpamine antagonist- less NT available so less detgusor regulation
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15
Q

antimuscarinics help urinary inconitence by

A

cholinergic antagonists block activate of muscarinic ACh receptors therefore inhibiting detrusor muscle contraction and keeping internal sphincter closed - treats urge to wee

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16
Q

what is used to treat overflow UI

A

cholinergic antagonist- increases detrusor muscle contraction

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17
Q

what would be targeted for an antagonist drug for urinary incontinence

A

muscarinic ACh receptor

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18
Q

what would be prescribed to someone who constantly needs to wee?

A

drug which binds to muscarinic receptor to inhibit contract or detrusor

19
Q

stroke basics

A

occurs when the blood supply to part of the brain are cut off. Blood carrying oxygen and nutrients can no longer reach certain cells, so they can n longer aerobically respire

20
Q

two types of stroke

A

ischaemic- block (80%)

Haemorrahgic - bleed (20%)

21
Q

deficits will depend on

A

how large the are of the brain being supplied is, s well as how long the occlusions have occurred

22
Q

death of neurones during stroke is due to

A

excitotoxicity

23
Q

excitotoxicity

A
  • Lack of oxygen and sugar means ATP cannot be generated
  • ATP reliant transporters like Na+/Ca2+ fail
  • Depolarization too much calcium flows in
  • Calcium triggers release of Glutamate (NT) into synaptic cleft
  • NMDA receptor stimulated by Glu, when certain level of depolarization calcium block in AMPA channel allows the post synaptic neurone to be depolarized further
  • Over excitation
  • Calcium causes and increase in:
  • ->Free radicals and
  • ->ROS
  • ->Calpain
  • -> Endonucleases
  • ->ATPases
  • -> Phospholipases
  • Membrane becomes more permeable harmful chemicals get into cell
  • Mitochondria break down- releasing apoptotic factors
  • Necrosis- releases more Glu
  • VICIOUS CYCLE.
24
Q

what may also occur after stroke

A

reperfusion injury

25
Q

reperfusion injury

A

the tissue damaged caused when the blood supply return to the tissue after a period of schema or hypo

26
Q

why does reperfusion cause damage to tissue

A

The absence of oxygen and nutrients from the blood during the ischemic period creates a condition in which the restoration of circulation results in inflammation and oxidative damage- oxidative stress-

27
Q

when blood flow is restored and oxygen reintorduced

A

there are not enough antioxidants (not produced during hypoxia)= oxidative stress
- oxygen free radicals destroy cell membrane and leads to necrosis

28
Q

which TF react to hypoxia

A

HIF -mediates the effects of hypoxia- e.g. helping the cells adapt to low oxygen conditions - growth of blood vessels

29
Q

stroke and the brainstem

A
  • can affect both sides of the body nd leave someone in ‘locked in’ state- unable to speak or achieve any movement below the neck
  • usually causes death since the damage can prevent vital functions e.g. breathing
30
Q

medulla

A

breathing, swallowing, bp, hr, vomiting, sneezing, coughing

31
Q

midbrain

A

vision adhering, digestion, hr, br

32
Q

pons

A

breathing and regulation of deep sleep

33
Q

which is the arty most often occluded in stroke

A

Middle cereal artery- which supplies frontal lobe and lateral surge of the temporal and parietal lob

34
Q

cerebellum and stroke

A

may result in lack of coordination, clumsiness, shaking or the muscular difficulties

35
Q

if a stroke occurs in the right side of the brain

A

the right side of the body will be affected

  • paralysis of the left side of the body
  • vision problems
  • memory loss
  • quick, inquisitive behavioural style
36
Q

stroke on the left side of the brain

A
  • affects right side of the body
  • paralysis
  • speech and language problems
  • slow, cautious behavioural style
  • memory loss
37
Q

parietal

A

unable to understand spoken or written language

38
Q

temporal

A

decreased visual and verbal memory and decreased understanding of words

39
Q

occipital

A

disability involving vision

40
Q

frontal lobe

A
  • personality change
  • changing emotions
  • decreased voluntary movement
  • hard to convert thoughts into words
41
Q

biomarkers of stroke

A

correct diagnosis of ischaemic stroke is essential to treat and prevent further stroke.
-BNP
CRP
-lipoptein associated phosplipase A2

42
Q

what is the treatment for sichaemic stroke

A

T-PA

43
Q

T-PA

A

tissue-plasminogen actiavtor

- dissolves blood clot by bidding to plasminogen and activating plasmin which dissolves fibrin

44
Q

what synthesises CSF

A

ependymal cells in the choroid plexuses of the ventricles of the brain

Disease, diagnostics and therapeutics (53 decks)

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