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6- Neuro Diag > Ex1 / Ch5 Brain and Environs > Flashcards

Ex1 / Ch5 Brain and Environs Flashcards

Ex1

1
Q

3 cranial fossae

A

anterior

middle

posterior

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2
Q

3 layers of meninges

A
  1. Dura
  2. Arachnoid
  3. Pia
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3
Q

Cerebrospinal fluid: Made by

A

by ependymal cells in the 2 lateral ventricles

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4
Q

CSF function

A
  1. mechanical protection (makes brain floating/absorb impact)
  2. Chemical protection (act as a buffer)
  3. nutrients waist transfer
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5
Q

CSF Volume

A

150 cc

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6
Q

CSF filtration rate

A

20 cc per Hour

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7
Q

3 spaces (meninges)

A

epidural

subdural

subarachnoid

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8
Q

_____ is a Common neurological symptom: benign, maybe bad

A

Headache

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9
Q

Brain has nociceptors (true/false)

A

false

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10
Q

which nerves are Intracranial sensory

A

V

IX

X

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11
Q

Headeach + neck stiffness + fever =

A

meningitis

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12
Q

Sudden explosive headache (worst headache ever) =

A

subarachnoid hemorrhage

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13
Q

Types of headaches

A

Vascular

Inflammatory

Tension type

Increased ICP

Fatigue

Traumatic

Toxic/metabolic

Infectious

Referred

Low pressure

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14
Q

Types of Vascular Headache

A

Migraine

Cluster

Dissection

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15
Q

Migraine is most common in (men/women)?

A

women

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16
Q

Type of migraine:

unilateral and throbbing, lasts a few hours, bright light and loud sound makes it worse, prodrome (aura)

A

Classic migraine

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17
Q

Type of migraine:

same as classic + other neuro finding (blinding in 1 eye, tingling, weakness)

A

Complicated migraine

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18
Q

Type of migraine:

doesn’t give a headache, causes nausea and other debilitating symptoms.

A

Atypical migraine

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19
Q

Type of a vascular headaches:

middle aged men, unilateral behind 1 eye, last minutes, short and intense, alcohol and stress make it worse

A

Cluster

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20
Q

Intracranial tumors causes

A
  1. increased ICP
  2. Focal deficit (also global deficit)
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21
Q

Dissection (neurologic) causes damage to

A

the tunica intima

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22
Q

Damage to the tunica intima leads to

A

blood flowing into the false lumen

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23
Q

Dissection (neurologic) results in

A

thrombus or embolism formation at this site resulting in ischemia

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24
Q

Tension Type Headache aka

A

Cervicogenic/ subluxation

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25
Q

Tension Caused by

A

dehydration

stress

psychological

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26
Q

Tension Described as

A

squeezing (hatband)

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27
Q

Fatigue Headache is related to:

A

sleep deprivation

eye strain

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28
Q

Causes of Toxic/Metabolic Headachea

A
  1. dehydration (hangover)
  2. chemical exposure
  3. rebound (withdrawal ie: caffeine)
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29
Q

Cuases of Referred Headache

A
  1. dental
  2. eye strain
  3. sinus irritation (frontal or maxillary sinus)
  4. neck pain suboccipital
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30
Q

Inflammatory Headache (Temporal) aka

A

giant cell arteritis

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31
Q

Inflammatory Headache common in (who)

A

elderly patients

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32
Q

Inflammatory Headache risks

A

inflammation of temporal aa
ophthalmic aa

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33
Q

Inflammatory cells invade tunica ____

A

media

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34
Q

Fibrotic change results in the tunica _____

A

intima

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35
Q

Fibrotic change due to Inflammatory Headache leads to the closur of the ____

A

lumen

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36
Q

Inflammatory Headache Signs and symptoms:

A

Swelling of the superficial temporal artery

Will be hard and palpable

Scalp pain

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37
Q

Causes of neurological deficits?

(Increased Intracranial Pressure)

A
  1. compression
  2. destruction
  3. herniation
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38
Q

Increased Intracranial Pressure-

Signs and symptoms (Cushing triad)

A

increase bp (pressure in skull)

decrease HR (due to the coratid receptor, dorsal nucleus of vagus)

irregular respiration

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39
Q

Increased Intracranial Pressure- Global symptoms

A

headache

changes in mental status

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40
Q

Increased Intracranial Pressure - Focal symptoms

A

specific to the area of brain preforming that function

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41
Q

Def: optic disc gets swollen and puffy (due to increased ICP)

A

Papilledema

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42
Q

Nervous System Herniation Locations:

A
  1. cingulate gyrus
  2. inferior media temporal lobe
  3. cerebellar tonsil
  4. new opening
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43
Q

Hydrocephalus happens due to

A

obstructed CSF flow

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44
Q

Hydrocephalus symptoms (adults)

A

increased ICP

Dementia

Urinary incontinence

Gait impairment

loss of forward and back ward stability

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45
Q

Hydrocephalus symptoms (children)

A

increased ICP

big head (skull is not fused)

setting sun sign (rolling down eye)

high pitch scream

poor head control (weight of water)

transillumination (shine a light on one side, and be visible on the other)

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46
Q

Intracranial tumors causes

A
  1. increased ICP
  2. Focal deficit (also global deficit
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47
Q

What do benign tumors do to the surrounding tissue?

A

push the tissue away

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48
Q

What do malignant tumors do to the surrounding tissue?

A

invade the surrounding tissue

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49
Q

is the benign tumor encapsulated?

if yes, what is the capsule made of?

A

Yes, with fiber/calcium

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50
Q

is the malignant tumor encapsulated?

if yes, what is the capsule made of?

A

No

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51
Q

benign tumor growth rate

A

slow

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52
Q

malignant tumor growth rate

A

fast

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53
Q

Benign tumor recurrence

A

less likely

54
Q

Malignant tumor recurrence

A

more likely

55
Q

Tumor types

A

mets (metastatic)

glioma

meningioma (benign)

pituitary tumor

Schwannoma

56
Q

metastatic precentage of all tumors

A

23%

57
Q

glioma precentage of all tumors

A

40%

58
Q

what’s the ratio of benign to malignant glioma

A

1:1

59
Q

meningioma precentage of all tumors

A

17%

60
Q

is meningioma benign or malignant

A

benign

61
Q

pituitary tumor percentage out of all tumors

A

5%

62
Q

Schwannoma percentage out of all tumors

A

5%

63
Q

Trauma injury sites

A

Linear impact coup

Rebound impact Contrecoup

64
Q

Rotational Shear Damage

A
  1. Rotational component of injury affect the lower parts of brain
  2. Basal ganglia and thalamus
  3. Corpus callosum
65
Q

the Cause of concussion

A

Mild head trauma

66
Q

concussion symptoms

A

loss of consciousness

headache

vomiting

amnesia

disorientation

seizure

focal neurological deficit

fatigue

67
Q

concussion Signs

A

oculomotor difficulties

vistibulo-ocular disturbance

balance and postural instability

68
Q

Define:

Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

A

computerized baseline compared to post injury

69
Q

ImPACT measures

A
  1. attention span
  2. working memory
  3. sustained and selective attention time
  4. response variability
  5. nonverbal problems solving
  6. reaction time
70
Q

SCAT5 characteristic

A
  • Sport concussion assessment tool
  • Has immediate on field assessment
  • Also has office assessment
71
Q

On field assessment includes

A
  • Red flags
  • Observable neurologic signs
  • Memory assessment
  • Glasgow coma scale and cervical examination
72
Q

Off Field assessment includes

A
  • History of injury
  • Symptoms scale
  • Cognitive assessment
  • Neurological and balance exam
  • Delayed recall – short term memory
  • Decision making – problem solving
73
Q

Guidelines for Concussion Management

A
  1. removal from contest following signs and symptoms of concussion
  2. no return to play in current game
  3. medical evaluation following injury
  4. rule out more serious intracranial pathology
74
Q

Step wise to return to play

A
  • No activity rest until asymptomatic
  • Light aerobic excersise
  • Sport specific training
  • Non-contract drills
  • Full contract drills
  • Game play

Generally about 24 hours per step

75
Q

Post Concussive Syndrome can last

A

days to weeks after injury

76
Q

Post Concussive Syndrome

sign & symptoms

A
  • Fatigue
  • difficulty concentrating
  • irritability
  • light sensitivity
  • noise sensitivity
  • emotional lability
  • dizziness
  • headache
  • neck pain
  • nausea
  • vomiting
77
Q

Contusion aka

A

Traumatic Intracerebral or Intraparenchymal Hemorrhage

78
Q

Epidural Hematoma location

A

between dura mater and skull

79
Q

Epidural Hematoma gets worse over the course of (time)

A

hours (rapidly)

80
Q

Epidural Hematoma complications

A
  • Rupture of middle meningeal artery
  • Lens shaped convex hematoma
  • Rapid progressing
  • Displaces brain tissue
  • Leads to herniation
81
Q

Subdural hematoma complication

A
  • rupture of bridging veins, slower in developing
  • Shear force tear of bridging veins
  • Crescent shaped bleed
82
Q

Acute Subdural hematoma

A

within 24 hours severe neurologic deficits, 50% mortality

83
Q

Subacute Subdural hematoma

A

1-14 days post injury with focal neurologic deficits

84
Q

Chronic Subdural hematoma

A

2-6 weeks after injury

headache

balance problems

weakness

85
Q

the worst type of hematoma

A

Subarachnoid hematoma

86
Q

Subarachnoid hematoma complications

A
  • Often from aneurysm
  • Ticking time bomb
  • Worst headache of my life
  • Congenital aneurysms
  • Blood fills subarachnoid space
  • 40-50% mortality
87
Q

Intracerebral hematoma caused by

A

high bp

diabetes

small vessels

88
Q

Hypertensive hemorrhage

A
  • High blood pressure threatens deep penetrating arteriols
  • form micro aneurysms
  • The micro aneurysms harden
  • Continued pressure causes them to rupture
  • Happens in basel ganglia pons cerebellum
89
Q

Laceration

A

tearing of nervous system

90
Q

Central Nervous System Infection can be caused by:

A

bacteria

viral

parasitic

prions

91
Q

CNS infections Spread via

A

blood

92
Q

the most common Symptoms with infections in the CSF

A

fever (bacterial & viral)

neck stiffness

headache

93
Q

Bacterial meningitis may be fatal within _____

A

Hours of onset

94
Q

the most fatal bacteria that cuause meningitis

A

Neisseria meningitis

Strep. pneumonia

Haemophilus influenzae

95
Q

Bacterial meningitis signs and symptoms

A
  1. headache
  2. fever
  3. neck stiffness
  4. CSF cloudy full of puss
96
Q

Def Brain abscess

A

pocket full of puss in the brain

97
Q

Brain Abscess symptoms

A

headache

fever

neck stiffness

neurological signs specific to that area

98
Q

Chances of survival with treatment (percentage)

A

80%

99
Q

Lyme Disease is caused by

A

borelia burdoferri

100
Q

Lyme Disease is transmitted by

A

deer tick

101
Q

Lyme Disease stage 1 timing

A

Days to weeks after infection

102
Q

Lyme Disease stage 1 symptoms

A
  • Muscle + joint pain
  • Swollen lymph nodes
  • erythema migrans (thigh, groin, axilla)
103
Q

Lyme Disease Stage 2 timing

A

Weeks to months

104
Q

Lyme Disease Stage 2 symptoms

A
  • Unilateral facial paralysis
  • Mild meningitis
105
Q

Lyme Disease Stage 3 timing

A

Months to years after untreated infection

106
Q

Lyme Disease Stage 3 symptoms

A
  • Chronic Lyme arthritis (MC knee)
  • Nervous system problems: memory loss and difficulty concentrating
  • chronic pain in muscles and unrestful sleep
107
Q

describe lyme disease target rash

A

: pimple surrounded with a red ring

108
Q

Viral meningitis aka

A

aseptic meningitis

109
Q

what’s a special sign about viral meningitis

A

Clear CSF

110
Q

Defince Encephalitis

A

viral infections that involve the brain parenchyma

111
Q

is Encephalitis (more/less) severe than typical viral meningitis?

A

more severe

112
Q

encephalitis results in

A

meningoencephalitis

113
Q

exapmle of primary viral infection

A

west nile

114
Q

west nile is transmitted by

A

mosquito

115
Q

example of secondary viral infection

A

herpetic rash

116
Q

Subacute sclerosing panencephalitis is caused by

A

persistent measles infection

117
Q

Subacute sclerosing panencephalitis symptoms

A
  • Intellectual deterioration
  • Forgetfulness
  • Hallucination
  • Seizures
  • Neurological signs through CNS
118
Q

Subacute sclerosing panencephalitis prognosis

A

Variable prognosis (recovery to death)

119
Q

Sleeping Sickness aka

A

African trypanosoma

120
Q

Sleeping Sickness stage 1 symptoms

A

fever

joint pain

headache

121
Q

Sleeping Sickness stage 2 symptoms

A

sleep/wake cycle disruption

confusion

ataxia

tremor

122
Q

Cysticercosis is caused by

A

tenia solium

123
Q

Cysticercosis symptoms

A
  • Headache
  • Nausea
  • Vomiting
  • seizure
124
Q

what are prions?

A

protein fragments

125
Q

Creutzfeldt-Jakob disease symptoms

A

rapid progressive dementia

ataxia

hallucination

startle response

myoclonus

126
Q

Prions Incubation period

A

2-25 years

127
Q

prions are tramitted from

A

from organ transplant

beef with BSE

128
Q

prions prognosis

A

death within 6-12 months

129
Q

prions infections are differentiated using

A

lumbar puncture

spinal tap

130
Q

lumbar puncture is taken at which level?

A

L4/L5 (below the spinal cord)

131
Q

Too much fluid drawn or too fast during the lumbar puncture is the cause of

A

low pressure headache

6- Neuro Diag (10 decks)

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