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brain and behavior > Lecture 70, 66: Neural Damage, Repair, TBI > Flashcards

Lecture 70, 66: Neural Damage, Repair, TBI Flashcards

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1
Q

Injury in the soma is based on…

A

Spreading excitotoxicity

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2
Q

Describe mechanism of excitatory toxicity

A

F

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3
Q

Can a focally demyelinated axon remyelinate?

A

Yes, good prognosis

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4
Q

It’s easier to regenerate after axonal damage if…

A

The connective tissue wrappings are still present (epi, peri, endoneurium)

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5
Q

The worst prognosis is associated with loss of?

A

Epineurium

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6
Q

Axonal loss is picked up in neural conduction studies with what finding?

A

Decreased AP amplitude

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7
Q

Wallerian Degeneration (PNS)

A

Intra-axonal organelle/microtube breakdown –> macrophages enter –> path cleared for axons to regrow proximal to distal

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8
Q

Does degeration work better in the CNS or PNS?

A

PNS

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9
Q

How long does it take to begin to regrow peripheral nervous tissue?

A

Weeks to months

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10
Q

What’s different in CNS degeneration? (2)

A
  1. Junk not cleared for regrowth; 2. CNS cells are inhibitory for regeneration
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11
Q

What are two potential targets for recovery after CNS injury?

A

CNS extrinsic inhibitors and intrinsic RAGs (regeneration associated genes)

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12
Q

Growth cone contains…

A

Actin bundles and microtubules

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13
Q

What can we control in an acute nerve injury situation?

A

Fever, hyperglycemia, infection

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14
Q

What is more realistic that regeneration?

A

Re-routing!

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15
Q

In rehab, what is more effective that general exercise alone? Describe the presentation of these tasks.

A

Learning skilled, task specific, repetitive tasks with random practice order (better than ordered blocks)

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16
Q

Three stem cell types

A

Totipotent (can form any body cell and extra fetal tissues); pluripotent (can form any cell in body); multipotent (can form a speciic lineage)

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17
Q

What stem cell is important in regeneration research? Source?

A

Pluripotent; excess IVF-derived embryos (non-implanted)

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18
Q

Fetal stem cells contain few, if any…where in the fetus?

A

Pluripotent stem cells; extra-fetal/aborted fetal tissue

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19
Q

Adult stem cells are of what type?

A

Multipotent

20
Q

All stem cells are?

A

Renewable!

21
Q

Describe somatic cell nuclear transfer; what type of cell? Completely autologous?

A

Adult somatic cell nuclei + donor egg cell; pluripotent; NO – donor cytoplasm/mitochondria

22
Q

Describe induced pluripotent stem cells; what type of cell? Completely autologous?

A

Adult somatic cells + activated stem cell genes; pluripotent; 100% autologous

23
Q

Stem cell uses (4)

A

Developmental studies; disease-specific cells for in vitro drug screening; cell transplants (replace degenerated cells); organ transplants

24
Q

Which would be a better stem cell target, HD or Alzhemier’s? What about ALS, PD?

A

HD: one type of neuron in one site; ALS and PD = one type of neuron but many sites

25
Q

How might stem cells be used for axonal injury?

A

Might help circuits remyelinate via plasticity

26
Q

Scale to assess coma. What does it assess?

A

Glasgow Coma Scale: eye opening, motor response, verbal response

27
Q

What do you learn about while examining the patient with a head injury (5)

A

Level of consciousness, motor response, pupil reaction, ability to talk/orientate, ability to breath

28
Q

What are signs of skull fracture? (4)

A

Raccoon eyes, Battle’s sign (blood behind ear), CSF rhinorrhea/otorrhea (beta-2-transferrin), hemotypanum (blood behind ear drum)

29
Q

% of head injuries associated with neck injuries

A

10%

30
Q

Gold standard for evaluating head injuries

A

CAT scan (better than MRI for acute blood and bone)

31
Q

Epidural hematoma is associated with what classical sign? Prognosis?

A

“Lucid interval”; good if treated surgically because the brain is OK

32
Q

What is the typical source of bleeding in epidural hematoma?

A

Arterial

33
Q

Subdural hematomas generally involves; associated with?

A

Bridging veins; shaken babies, alcoholism

34
Q

Mortality with subdural hematoma compares to EDH how?

A

Much higher: often associated with underlying brain injury/edema

35
Q

Brain contusion (def); where, mass effect, operable?

A

Cell death accompanied by hemorrhage often at a site distant from impact, little mass effect, not operable

36
Q

How to treat intracranial hypertension (4 first tier therapies)

A

Positioning, ventricular drainage, osmototic diuresis, hyperventiliation

37
Q

Subarachnoid hemorrhage

A

F

38
Q

Diffuse axonal injury caused by what forces? Scan findings

A

Shearing; person often looks worse than the scans, but sometimes “punctate” scarring

39
Q

Concussion definition and scan findings

A

Transient alteration of consciousness due to an impact to the head; NORMAL catscan

40
Q

Most common memory deficit following concussion?

A

Anterograde amnesia

41
Q

Post-concussion syndrome can last how long? Common symptoms.

A

Few days to months; headache, N/V, fatigue, difficulty concentrating

42
Q

Second impact syndrome (def)

A

Reinjury occurs before resolution of previous concussion leading to cerebral edema –> death

43
Q

Chronic traumatic encephalopathy: definition/symptoms and a proposed mechanism

A

Repetitive brain injury w/ mental decline, depression, erratic behavior; related to repetitive axonal stretching and deformation

44
Q

Early symptoms of CTE

A

STM impairment, cognitive dysfunction, depression and emotional instability

45
Q

Late symptoms of CTE

A

Dementia, PD

46
Q

How to get a certain diagnosis CTE? Describe findings.

A

Only through autopsy; brain atrophy, pallor of monoamine nuclei, tau-opathy (more severe than AD)

47
Q

Tip-off for CTE

A

VERY severe tau-opathy

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