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Diagnostics > Lecture TBI & Stroke + Lecture Cortical Dementia > Flashcards

Lecture TBI & Stroke + Lecture Cortical Dementia Flashcards

1
Q

What is a traumatic brain injury?

A

A TBI is damage to the living brain tissue caused by an external force.

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2
Q

What are the difference between an open and closed TBI? (*not one is a break or penetration in the skull)

A

Open: often results in death, tends to damage localized areas. more predictable dissabilities
Closed: more prevelant, causes diffused tissue damage, disabilities are more generalized

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3
Q

What is a primary injury and what is a secondary injury in TBI?

A

Primary injury: damage that occurs at the time of the impact
Secondary: damage caused by the effect of the physiological processes set in motion by the primary injury

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4
Q

What are some examples of what can happen in the brain with primary injurys?

A

Bruising of the brain, laceration of nerve fibers and disruptions of blood vessels

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5
Q

What is acceleration and deceleration?

A

Acceleration: moving object against fixed head (bal tegen je hoofd)
Deceleration: Moving head against stationary object (loopt tegen een muur)

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6
Q

What is coup and contre-coup?

A

Coup: disruption of tissue at the point of the impact
Contre-coup (indirect): disruption of tissue located opposite to the site of impact

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7
Q

The upper part of the brain moves faster/ slower than the lower part of the brain?

A

Faster

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8
Q

What states the law of inertia (wet van traagheid)?

A

Once an object is in motion, it remains in motion at a constant speed until acted upon by a force in opposite direction

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9
Q

What is hyperextension and hyperflexion and where does the brain collides with the inside of the skull (front or back)?

A

Hyperextension: the head moves backwards, brain collides with front of skull
Hyperflexion: head moves forward, brain collides with front of skull

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10
Q

The layers furthest/ closest to the brain move faster

A

Furthest (each layer moves different)

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11
Q

What is diffuse axonal injury (DAI)?

A

The shearing (tearing) of the brain’s long connecting nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the skull

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12
Q

Is a disruption of blood vessels a primary or secondary inury?

A

Primary (leading to secondary such as swelling and intracranial pressure)

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13
Q

What is an epidural hematoma?

A

Bleeding between the inside of the skull and the outer covering of the brain

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14
Q

What is a subdural hematoma?

A

Bleeding between dura mater and underlying membrames covering the brain

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15
Q

Where does TSAH stands for?

A

Traumatic subarachnoid heamorrhage (epidural and subdural bleeding)

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16
Q

What can secondary injury on intracerebral level cause?

A

Delayed axotomy, intracranial pressure, disturbed blood flow

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17
Q

What is delayed axotomy?

A

Axonal injury (primal) causes release of many neurotransmitters. Cause chemical damage to brain tissue

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18
Q

What can secondary injury on extracerebral cause?

A

Hypoxia (cerebral anoxia) due to massive loss of blood in other parts of the body

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19
Q

What is hypoxia?

A

Loss of oxygen

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20
Q

Patients suffering TBI pass through predictive phases, what are those?

A

Impairment of consciousness, post traumatic amnesia (best indicator of serverity injury), recovery period

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21
Q

The severity of TBI can be measures by 3 things, what are those?

A

Score on the GCS, duration of PTA and loss of consciousness

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22
Q

What are some cognitive consequences following a TBI

A

Speed of information processing: mental slowness
Attention and concentration: distraction, divided and sustained attention
Memory
EF
Speech and language
Social cognition

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23
Q

If complaints from a TBI aren’t gone after 3 months it’s called?

A

Post-concussion syndrome

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24
Q

What is cogniform disorder?

A

Patients have excessive cognitive complaints and/ or unexpectedly poor cognitive performance given the mild severity of the TBI

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25
Q

What is a cerebrovascular accident?

A

Focal neurological disorder of abrupt development due to a pathological process in the blood vessels (stroke)

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26
Q

What happends in normal aging?

A

Osteoporotic (bone structure less dense), posture changes, loss in muscel and brain & enlarged ventricles

27
Q

What are some ways to diagnose neurodegenerative diseases?

A

Imaging, EEG, Genetics & NPA

28
Q

What is the main difference in Mild cognitive impairment & Major cognitive impairment?

A

In Mild CI, cognitive deficits do not interference with capacity for independe in everyday activities, in Major CI they do

29
Q

What are two symptoms of MildCI amnestic?

A

Memory: short term and delayed recall
EF: Slowing, intact comprehension

30
Q

In which brain areas do you specifically see atrophy in MCI?

A

Medial temporal lobe, hippocampus & entorhinal cortex

31
Q

What is a delerium?

A

Disturbance in attention and awareness, develops over a short period of time. Is a direct psysiological consequence of another medial condition (e.g. lung infection)

32
Q

In early onset Alzheimers disease what is the most relevant factors that plays a role in developing the disease

A

Familiarity

33
Q

What are some pronounced symptoms of AD?

A

Memory (short term)
Orientation
Visuoconstruction
EF
Language

34
Q

When is it unlikey that a patients has AD?

A

Acute onset

35
Q

What are some behavioural and psychological symptoms of AD?

A

Delusions, hallucinations and depression (there are more)

36
Q

What is an important biomarker for AD?

A

Amyloid deposition

37
Q

What do you see in an EEG in patients with AD?

A

More slower brain waves and less of the fast brain waves

38
Q

Which two variants of frontotemporal dementia are there?

A

Behavioural and language variant

39
Q

What are some main EF symptoms of FTDbv?

A

Disinhibition, deficits in planning, perseveration (memory is relatively intact, later problamatic)

40
Q

What are the subtypes of primary progressive aphasia?

A

Progressive nonfluent (stotteren), semantic dementia (doesn’t know the meaning of words), logopenic progressive aphasia

41
Q

What is the brain pathology of Lewy Body disease?

A

Accumulation of proteins in the cell leading to cell dysfunction

42
Q

What are criteria/ symptoms of Lewy Body?

A

Fluctuating cognition, visual hallucinations, REM sleep behavior disorder, features of parkinsonism

43
Q

Hoe can you differentiate between dementia and a delirium?

A

Onset of dementia is gradually and delirium acute.
Time of dementia is month (and more) and delirium days, weeks or months.

44
Q

A diagnosis given to individuals who are thought to
have cognitive impairment greater than expected for age and education without an obvious etiology but not sufficiently severe to warrant a diagnosis of dementia, is called?

A

Mild cognitive impairment

45
Q

MildCI patients with memory problems plus other cognitive deficits are at highest risk for conversion
to?

A

AD

46
Q

The distinction between MildCI and AD is blurred. A diagnosis of AD requires that …

A

Memory plus other cognitive domains be affected and that cognitive deficits must be contributing to significant impairment in social or occupational functioning

47
Q

Which regions are gnerally spared in AD?

A

The primary motor and sensory cortical regions are generally spared

48
Q

The DSM specifies that one of the areas in of
cognitive impairment in AD must be?

A

An inability to learn new information or recall previously learned information

49
Q

Why do people whith a hinger education have lower risk in developing AD?

A

A common explanation for this is that people with higher levels of education have more ‘cognitive
reserves’ to compensate for the neuropathological changes resulting from the disease which delays the onset of its clinical presentation.

50
Q

What are the main neuropathological hallmarks of AD?

A

Neurofibrillary tangles and amyloid plaques.

51
Q

Early in the course of the disease, patients show reduced activity in the …. on fMRI imaging.

A

Medial temporal lobe

52
Q

Findings from imaging and cognitive assessments suggest that Alzheimer’s disease can be viewed as a ….., in which there is a breakdown in the communication between brain regions.

A

Disconnection syndrome

53
Q

How is the early behavioral decline in Alzheimer’s disease typically characterized?

A

The early behavioral decline in Alzheimer’s disease is typically characterized as being gradual and unsuspected, and is often confused with depression.

54
Q

What are some common problems that arise in the later stages of AD?

A

In the later stages of the disease, aphasia, apraxia, and various agnosias become prominent problems.

55
Q

What is the most distinguishing cognitive feature of Alzheimer’s disease?

A

The most distinguishing cognitive feature of Alzheimer’s disease is predominant episodic memory disorder.

56
Q

How does impairment of impulse resistance manifest in Alzheimer’s disease?

A

Impairment of impulse resistance in Alzheimer’s disease manifests as slowness on the conflict condition of the Stroop technique.

57
Q

What is frontotemporal lobar degeneration (FTD)

A

Frontotemporal lobar degeneration (FTD) is a degenerative disorder of the frontal and temporal lobes with an insidious onset and slow progression. It is also known as frontotemporal dementia (FTD).

58
Q

What are the three main subtypes of FTD?

A

The three main subtypes of FTD are the behavioral variant, semantic dementia, and primary progressive aphasia.

59
Q

What distinguishes FTD from other dementing disorders in the early stages?

A

In the early stages, FTD can be distinguished from other dementing disorders by the presence of silliness and socially inappropriate and even boorish behaviors with relatively intact cognition. Memory is near-normal in FTD

60
Q

What are the most characteristic features of the behavioral variant of FTD?

A

Profound change in social behavior and personality, alterations in speech and language

61
Q

What are the most striking features of semantic dementia?

A

Word finding difficulties and impaired knowledge of word meaning

62
Q

What are the major features of Lew body dementia?

A

Extrapyramidal signs (motor symptoms similar to PD), visual hallucinations, and severe fluctuations in cognitive functioning

63
Q

How is LBD conceptualized as a cortical or subcortical dementia?

A

It is difficult to conceptualize as either a cortical or subcortical dementia as it shares clinical features with both Alzheimer’s disease and Parkinson’s disease.

64
Q

How does the rate of decline in LBD compare to other degenerative dementias?

A

Patients often have a more rapid decline than those with Alzheimer’s disease and other degenerative dementias.

Diagnostics (8 decks)

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