Module 18 Flashcards
What pathologic changes occur in Parkinson disease?
Degeneration of basal ganglia dopamine-producing neurons, formation of Lewy bodies.
What are the 3 classic clinical manifestations of Parkinson disease?
Resting tremor, rigidity, and bradykinesia.
What are the two different types of cerebral edema?
Vasogenic (fluid from vessels into interstitial space) and Cytotoxic (cellular swelling due to ischemia or intoxication).
How do the clinical manifestations of acute hydrocephalus differ from normal-pressure hydrocephalus?
Acute: Rapid onset, signs of IICP; Normal-pressure: Slow onset, memory changes, gait disturbance, urinary incontinence.
What is the normal range for intracranial pressure (ICP)?
0–15 mm Hg.
What are compensatory mechanisms for increased ICP?
CSF reabsorption, venous compression, arterial vasoconstriction.
What causes fixed dilated pupils?
Brain herniation compressing cranial nerve III.
What is the earliest indicator of increased ICP?
Decreasing level of consciousness (LOC).
How does a focal brain injury differ from a diffuse brain injury?
Focal involves a specific area (e.g., contusion); diffuse affects widespread brain areas (e.g., concussion, DAI).
What is the source of bleeding for an epidural hematoma?
Meningeal artery or vein, usually from temporal fossa injury.
What clinical manifestations are expected with an epidural hematoma?
Brief LOC, lucid interval, rapid deterioration, ipsilateral pupil dilation, contralateral hemiparesis.
What causes a diffuse axonal injury?
Shearing forces from acceleration–deceleration injury.
What would be a normal response to the oculocephalic reflex (Doll’s eyes)?
Eyes move in the opposite direction of head turn.
What is a TIA and why are the clinical manifestations transient?
Transient ischemic attack—brief neurological deficit without infarction due to temporary ischemia.
What are lacunar strokes?
Small vessel strokes caused by arteriosclerosis from chronic hypertension or diabetes.
What are the clinical manifestations of a hemorrhagic stroke?
Sudden onset, vomiting, headache, contralateral hemiplegia, coma.
What organisms may cause meningitis?
Bacteria (e.g., Neisseria, Streptococcus pneumoniae), viruses.
What are positive Brudzinski and Kernig signs?
Brudzinski: Neck flexion causes hip/knee flexion; Kernig: Inability to straighten leg when hip is flexed.
What is an aura?
Sensory disturbance before a seizure, often visual or olfactory.
What are the pathologic findings in Alzheimer’s disease?
Amyloid plaques and neurofibrillary tangles in cerebral cortex and hippocampus; loss of acetylcholine.
What are the two types of cerebral edema?
Vasogenic edema and Cytotoxic edema.
What causes vasogenic edema?
Hemorrhage, brain injury, and infections.
What causes cytotoxic edema?
Water intoxication and severe ischemia.
What are the clinical manifestations of vasogenic edema?
Focal neurologic deficits, disturbances in consciousness, severe intracranial hypertension.
What are the clinical manifestations of cytotoxic edema?
Stupor and coma.
What are the causes of hydrocephalus?
Overproduction of CSF, impaired reabsorption of CSF, obstruction of CSF flow.
What are the clinical manifestations of acute hydrocephalus?
Develops rapidly with signs and symptoms of increased intracranial pressure (IICP).
What are the clinical manifestations of normal-pressure hydrocephalus?
Develops slowly with memory changes, gait disturbance, and urinary incontinence.
What are the causes of increased intracranial pressure (IICP)?
Increased brain tissue, CSF, or blood in the skull.
What are the compensatory mechanisms for IICP?
Reabsorption of CSF, venous compression, and arterial vasoconstriction.
What are the types of brain herniation?
Cingulate gyrus herniation, central or transtentorial herniation, uncal herniation, infratentorial herniation.
What are clinical manifestations of IICP?
Decreasing LOC, pupillary changes, altered breathing patterns, widened pulse pressure, bradycardia.
What are the two main types of traumatic brain injuries?
Primary (focal or diffuse injuries) and secondary (brain swelling, infection, ischemia).
What are examples of focal brain injuries?
Contusions, epidural hematomas, subdural hematomas, intracerebral hematomas.
What are examples of diffuse brain injuries?
Concussions and diffuse axonal injuries (DAI).
What causes a concussion?
Acceleration–deceleration injury.
What are the symptoms of post-concussion syndrome?
Headache, irritability, insomnia, poor concentration and memory.
What is the diagnosis method for diffuse axonal injury?
CT scan usually shows no intracranial lesions; based on immediate onset of unconsciousness.
What is the normal highest level of consciousness (LOC)?
Alert and oriented to self, others, place, and time.
What do abnormal oculomotor responses indicate?
Brainstem injury.
What causes Cheyne-Stokes respiration?
Brainstem damage or dysfunction due to increased intracranial pressure or cerebral hypoxia.
