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Patho II > E3: acute adult neuro > Flashcards

E3: acute adult neuro Flashcards

1
Q

intracranial adaptive capacity

A

the ability of any of the 3 components of the brain to adapt to changes in size

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2
Q

increased intracranial pressure

A

increased pressure inside cranium, can lead to brain cell injury and death

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3
Q

brain cells are

A

voracious consumers of o2 and glucose

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4
Q

if the brain cells are deprived of o2 and glucose, what happens

A

irreversible damage in minutes

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5
Q

brain tissue %

A

80%

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6
Q

blood %

A

10%

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7
Q

CSF %

A

10%

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8
Q

cerebral perfusion pressure

A

required to perfuse brain cells

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9
Q

normal CPP

A

60-90 mm/hg

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10
Q

how much of the cardiac output does the brain require

A

15-20%

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11
Q

formula for CPP

A

CCP=MAP minus ICP

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12
Q

normal ICP

A

5-15 mm/Hg

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13
Q

etiology in increased ICP

A
  1. swelling of brain
  2. increased blood volume
  3. increased CSF
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14
Q

early clinical mani of increased ICP in LOC

A

confusion
restlessness
lethargy

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15
Q

late clinical mani of increased ICP in loc

A

loss of consciousness

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16
Q

early clinical mani of increased icp in pupil

A

subtle, sluggish reaction

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17
Q

late clinical mani of increased ICP in pupils

A

dialating, fixed

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18
Q

Cushing triad

A

late signs of VERY HIGH increased ICP

  1. widening pulse pressure (S increases, d decreases)
  2. bradycardia
  3. respirations decrease and are irregular
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19
Q

other signs of increased icp

A
  1. severe headache
  2. projectile vomiting
  3. seizures
  4. papilledema (edema of optic disc/nerve)
  5. altered motor function
    (extremity strength and movement,
    abnormal posturing
    -decorticate
    -decerebrate)
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20
Q

decorticate

A

abnormal flexion in increased ICP

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21
Q

decerebrate

A

abnormal extension in increased ICP

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22
Q

herniation of the brain

A
  • sever increased ICP
  • shifting of brain from one compartment to another
  • places pressure on cerebral blood vessels and vital centers (medulla)
  • death
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23
Q

traumatic brain injury (TBI)

A

damaged brain tissue swells

24
Q

contrecoup

A

injury on opposite side of brain in TBI

front of head hits, slams against cranium (coup), then flies back and hits back of cranium (contrecoup)

25
Q

types of skull fracture

A
  • linear
  • compound
  • depressed
  • basilar
26
Q

what can happen with skull fracture

A

bleeding and CSF leak can happen

look for CSF out of the nose or ear

27
Q

concussion

A

mild injury to head, reversible, some swelling

28
Q

s/s of concussion

A

headache, confusion, difficulty concentrating

29
Q

contusion

A

bruising of brain (worse than concussion)

30
Q

s/s of contusion

A

same as concussion and may see s/s of increased ICP

31
Q

epidural hematoma

A
  1. bleeding between skull and dura (furthest out)
  2. ARTERIAL bleed (meningeal artery)
  3. medical emergency
  4. bleeding compresses brain toward opposite side
32
Q

subdural hematomas

A
  1. bleeding between dura and arachnoid matter

2. VENOUS bleed

33
Q

s/s of subdural hematomas

A

same as increased ICP

34
Q

types of subdural hematomas

A
  1. acute
  2. subacute
  3. chronic
35
Q

acute subdural hematoma time

A

symptoms within 48 hrs

36
Q

subacute subdural hematoma time

A

symptoms 2 days-2 weeks (slow bleed)

37
Q

chronic subdural hematoma time

A

symptoms 2 weeks-several months (very slow bleed)

38
Q

subarachnoid hemorrhage (SAH)

A
  • bleeding into subarachnoid space
  • ARTERIAL source
  • poor prognosis
39
Q

clinical mani of subarachnoid hemorrhage

A
  • increased ICP
  • blood mixing with CSG irritates meninges
  • –nuchal rigidity (stiff neck)
  • –photophobia (sensitivity to light)
  • –diplopia (double vison)
40
Q

brain tumors

A
  • benign or malignant
  • primary or metastasized (breast or lung)
  • occupies space (increased ICP, necrosis)
41
Q

clinical mani of brain tumors

A
  • headache (early)
  • seizures (early)
  • increased ICP
42
Q

intracerebral hemorrhage

A
  • farthest IN all four types of bleed
  • similar to SAH but further in
  • usually produces a hemorrhagic stroke
  • POOR PROGNOSIS
43
Q

stroke etiology

A

rupture of cerebral artery or occlusion of cerebral artery

44
Q

anoxia

A

lack of o2 and cerebral edema occurs in area of CVA

45
Q

TIA

A

temporary interruption of arterial blood flow in the brain caused by platelet clumps
OR
blood vessel spasm
(little stroke, warns of stroke, s/s gone in 24 hrs)

46
Q

risk factors for stroke

A
  • hypertension
  • heart failure
  • hyperlipidemia
  • diabetes
  • smoking
  • chronic A. fib without anticoag
  • obesity
  • physical inactivity
47
Q

clinical mani of TIA

A
  • blurred vision
  • slurred speech
  • weakness/numbness on one side of body
  • decreased LOC
48
Q

occlusive stroke

A

cerebral thrombosis

  • mot common 85%
  • atherosclerosis of artery causes occlusion (clot)
  • leads to brain necrosis
  • scar tissue remains
49
Q

hemorrhagic stroke

A
  • sudden onset
  • blood vessels ruptures
  • bleeding into cranium
  • necrosis and scar tissue result
50
Q

cerebral emoblus

A
  • clot breaks loose (heart) travels to brain
  • occludes cerebral artery
  • causes tissue death
  • onset is sudden
51
Q

clinical mani of stroke

A
  • headache
  • dizziness
  • confusion
  • aphasia
  • symptoms of increased ICP
  • hemiparesis (paralysis) on opposite side of stroke
52
Q

aphasia

A

change in speech- symptom of stroke

53
Q

expressie aphasia

A

cant express self but can understand

54
Q

receptive aphasia

A

cant receive messages

55
Q

global aphasia

A

both expressive and receptive

Patho II (23 decks)

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