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D&D Final > Disorders of Brain Function > Flashcards

Disorders of Brain Function Flashcards

1
Q

How do brain injuries occur?

A 
Ischemia
Trauma 
Tumors
Degenerative processes 
Metabolic Derangements
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2
Q

Hypoxia and Ischemic Injury

A

Hypoxia

  • low O2
  • interferes with delivery of oxygen to the brain
  • Ischemia

Low Blood Flow (think systematic)

  • interferes with delivery of oxygen and glucose along with removal of waste products
  • ex: hypovolemic shock, profusion issue
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3
Q

What causes Hypoxia and Ischemic Injury?

A

Strokes, Hypovolemic Shock, any profusion issue

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4
Q

What factors are involved with Increased Intracranial Pressure (ICP)

A

the amount of blood, brain tissue and CSF

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5
Q

What is the normal intracranial pressure?

A

0-15 mmHg while supine

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6
Q

Herniation

A

Displacement of brain tissue through skull

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7
Q

What is the brain protected by?

A

non-expandable skull and supporting septa

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8
Q

What do we do when there is ICP?

A

either drill a hole in the skull to drain the blood or if it is a CSF issue we can put a shunt in

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9
Q

What compensatory mechanisms does the brain have to control intracranial pressure?

A

Mainly controlling how much cerebrospinal fluid is pushed in and out of the brain cavity, also it can adjust Blood Pressure but this doesn’t affect the pressure nearly as much as controlling the CSF

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10
Q

What can cause ICP?

A

tumor, problems with vasculature (hemorrhagic stroke), hematoma, increased CSF, swelling from injury

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11
Q

What is Hydrocephalus?

A

abnormal increase in CSF volume in any part or all of the ventricular space

treatment: ventriculoperitoneal Shunt placement (so CSF can get out of the ventricular space)

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12
Q

What is a TBI?

A

traumatic brain injury

-structural damage to the brain and skull

could be an open head injury or closed

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13
Q

What is the leading cause of death of people under the age of 24?

A

TBI

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14
Q

What is the leading contributing factor/cause of TBIs?

A

lack of helmets and seatbelts

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15
Q

What are the 4 main types of Skull fractures (list)? What are the other types?

A

Simple (closed: skin is not broken)
Compound (open: skin is broken, laceration)
Depressed (like a cracked hard boiled egg)
Basilar

other types: linear, greenstick (incomplete fracture), comminuted (broken into 3 pieces or more)

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16
Q

Coup-Contrecoup

A

contusion resulting from a strong blow to the head, causing the brain to slam against the inside of the skull

Coup (primary)- injury of the brain where a direct hit has occurred
Contrecoup (secondary)- results when the brain impacts the side of the skull opposite the point of impact

  • diffuse axonal injury
  • widespread brain effects
  • permanent brain injury
  • coma/vegetative
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17
Q

Concussion

A

-recovery w/in 24 hours with mild concussions

S/S : headache, irritability
-s/s may persist for months (post concussion syndrome)

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18
Q

What is Post Concussion Syndrome?

A

where symptoms of the concussion can last days/weeks/months

-headaches, memory lapses

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19
Q

Traumatic Intracerebral Hematomas

A
  • can occur in any lobe of the brain
  • may be single or multiple
  • occur most often in alcoholics and elderly (they fall a lot)
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20
Q

Vascular Deformity (AVM - arteriovenous malformation)

A

some vascular malformations lie deep in the brain and can cause hemorrhage directly into brain tissue

abnormal connection of the arteries and veins, by passing the capillary beds
-no exchange of gases…no capillary beds

-congenital

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21
Q

How can you know if you have a Vascular Deformity?

A

you wont know until you have a CT scan and it is found or it ruptures

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22
Q

Epidural Cerebral Hematoma

A

bleeding is rapid because of Skull Fracture and severance (ruptured) of Meningeal Artery

(bleeding between bone of skull and dura)

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23
Q

Subdural Cerebral Hematoma

A

bleeding is slow and results from tearing of veins that extend across the subdural (subarachnoid) space

  • bleeding b/w dura and arachnoid space
  • tearing of the small bridging veins
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24
Q

Acute Cerebral Hematoma

A

lasts 48 hours

s/s: could range from headache, ipsilateral SP?? (one sided) pupil that is fixed and dilated, confusion

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25
Q

Subacute Cerebral Hematoma

A

2-14 days

get better and then decline

S/S can be chronic

can have continual tears

seen in alcoholic and elderly (harder to diagnose in elderly)

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26
Q

What is a Cerebral Vascular Accident?

A

a stroke (requires rapid emergency treatment)

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27
Q

What are the major risk factors for CVA (stroke)?

A 
Age, Gender (male), African American
Heart disease, HTN
high cholesterol
Cigarette smoking
prior stroke, diabetes
Atrial Fibrillation (A-fib patients are high risk for throwing clots)
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28
Q

What are the two types of Stroke?

A

Ischemic and Hemorrhagic

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29
Q

What is a Ischemic stroke?

A
  • interruption of blood flow in a cerebral vessel

- bloodless infarct of brain tissue caused by arterial Ischemia due to atherosclerotic blood vessels supplying the brain

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30
Q

What is a Hemorrhagic stroke?

A
  • bleeding into brain tissue, associated with a much higher fatality rate than ischemic strokes
  • usually caused by uncontrolled HTN
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31
Q

What are Ischemic strokes caused by ?

A

thrombosis or emboli

32
Q

What is a TIA?

A

Trans-Ischemic Attack
“mini-stroke” “mini brain attack”

symptoms last 24 hours or less

33
Q

What is a Large Vessel Stroke?

A

stroke caused by thrombus in large vessel of brain

34
Q

What is Small Vessel Stroke?

A

stroke caused by thrombus in small, deep vessels

35
Q

What is a Cardiogenic Embolic Stroke?

A

blood clot moves to brain from another area (carotid artery)

36
Q

What should we be mindful of when treating a patient who is suffering from an Hemorrhagic Stroke?

A

(Bleeding into the brain)

wouldn’t want to give anticoagulants to these patients because it thins blood and could cause even more damage

37
Q

What kind of stroke is most frequently fatal?

A

hemorrhagic stroke

38
Q

What are the risk factors for hemorrhagic stroke?

A

advancing age, HTN, Aneurysm, Trauma, Drugs, Erosion by tumors, blood coagulation disorders, results in edema, compression and/or spasm

39
Q

What is an Aneurysmal Subarachnoid Hemorrhage?

A

Bleeding into the subarachnoid space

40
Q

What usually causes an Aneurysmal Subarachnoid Hemorrhage?

A

a ruptured cerebral aneurysm

41
Q

What are the risk factors for Aneurysmal Subarachnoid Hemorrhage?

A

smoking and HTN

average age is 50 years old

42
Q

What portion of patients suffering from Aneurysmal Subarachnoid Hemorrhage recover without major disability?

A

1/3

43
Q

How will a patient with an Aneurysmal Subarachnoid Hemorrhage present coming into the hospital?

A

Atypical Headache “Worst of my life”

44
Q

What is Meningitis?

A

inflammation of the pia mater, the arachnoid and the CSF filled subarachnoid space

45
Q

Why are brain infections harder to treat?

A

because the medication has to be able to penetrate the blood-brain barrier

46
Q

What is Bacterial Meningitis caused by?

A

S. pneumoniae, H. influenzae or Neisseria meningitdis (<– yes that is spelled right according to our notes)

47
Q

What should people do if they were exposed to Bacteria that causes Meningitis?

A

ATB therapy (antibiotic)

48
Q

What most often causes Viral Meningitis?

A

enteroviruses

49
Q

Which type of Meningitis is less severe?

A

Viral

50
Q

Viral Meningitis

A

self limited and require only symptomatic treatment

51
Q

Encephalitis

A

generalized infection of parenchyma of brain and spinal cord

52
Q

Seizure Disorders

A

abnormal, uncontrolled discharge of impulses from the brain

53
Q

When may a seizure occur?

A

almost all serious illness or injuries affecting the brain
-infections, tumors, drug abuse, vascular lesions, congenital deformities and injury

could be provoked or unprovoked.

54
Q

What is an example of a provoked seizure?

A

seizure brought on by flashing lights

55
Q

Simple Seizure

A

30-60 seconds, no loss of consciousness, sudden jerking, sensory phenomena, transient weakness or loss of sensation

56
Q

Complex Seizure

A

1 to 2 minutes, may have aura, automatisms, unaware of environment, may wander, amnesia for seizure events, mild to moderate confusion during, sleepy afterwards

57
Q

Secondarily Generalized Seizure

A

starts as a partial seizure.

it starts in one limited area of the brain. The forms they take vary as much as other partial seizures. But then the seizure spreads throughout the brain, becoming a “generalized” seizure

58
Q

What are the types of partial Seizures?

A

Simple, Complex and Secondarily Generalized

59
Q

What are the Epileptic Syndromes?

A 
Generalized seizures
Absence seizures
Atonic Seizures
Myoclonic Seizures
Tonic-Clonic Seizures
60
Q

Generalized Seizures

A

Primary generalized seizures

61
Q

Absence seizures

A

brief impairment of consciousness (stare off and then come back)

62
Q

Atonic Seizures

A

Abrupt loss of muscle tone - head drops, loss of posture, or sudden collapse (see the children with the helmets on)

63
Q

Myoclonic Seizures

A

sudden, brief, involuntary muscle jerks

64
Q

Tonic-Clonic Seizures

A

grand mal or a convulsion

65
Q

What is Dementia?

A

intellectual deterioration

66
Q

What disease is the cause of 50-70% of all cases of dementia?

A

Alzheimer’s Disease

67
Q

Alzheimer’s Disease

A

the most common form of dementia

cortical atrophy, loss of neurons

insidious and progressive

68
Q

How is Alzheimer’s officially diagnosed?

A

during an autopsy, but usually drs cant suspect Alzheimers through signs and symptoms before the person dies

69
Q

What causes Alzheimer’s?

A

no known cause

70
Q

Besides Alzheimer’s what are the other types of Dementia are there?

A 
Vascular Dementia
Pick Disease
Creutzfeldt-Jakob
Wernicke-Korsakoff
Huntington's Disease
71
Q

Vascular Dementia

A

-infarcts in the brain from bleed

Risk Factors: HTN, CVA, smoking

results in psychomotor deficits

72
Q

Pick Disease

A

Form of dementia

RARE degernative neurological disorder

atrophy of frontal and temporal areas of the brain

73
Q

Creutzfeldt-Jakob

A

form of Dementia

infective protein called a prion

Transmittable (can catch it)

74
Q

Wernicke-Korsakoff

A

form of Dementia

results from chronic alcoholism

75
Q

Huntington’s Disease

A

form of dementia

INHERITED autosomal dominant disorder

localized loss of brain cells

D&D Final (6 decks)

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