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Pathopharm Exam 3 > Module 6: Part 4 (79-103) > Flashcards

Module 6: Part 4 (79-103) Flashcards

1
Q

Whats the normal range for ICP?

A

5-15 mmHg

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2
Q

What causes increased ICP?

A

Caused by increased intracranial content
Tumor growth, edema, excessive CSF, or hemorrhage

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3
Q

What happens in stage 1 of increased ICP?

A

Attempted compensation by vasoconstriction to decrease CSF

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4
Q

What happens in stage 2 of increased ICP?

A

Decreased neuronal oxygen, increased arterial constriction

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5
Q

What happens in stage 3 of increased ICP?

A

Increased CO2 causes increased vasodilation increasing intracranial pressure

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6
Q

What happens in stage 4 of increased ICP?

A

Pressure shifts brain tissue increasing constriction on vessels

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7
Q

What are the 3 subtypes of supratentorial herniation?

A

Uncal: Uncus or hippocampal gyrus (or both) shifts from the middle fossa through the tentorial notch into the posterior fossa

Central: Downward shift of the diencephalon through the tentorial notch

Cingulate: Cingulate gyrus shifts under the falx cerebri

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8
Q

What is cerebral edema?

A

Increase in the fluid (intracellular or extracellular) within the brain

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9
Q

What are the 4 types of cerebral edema? What are each associated with?

A

Vasogenic: Increased cap. permeability after vascular injury

Cytotoxic: Metabolite build up causes loss of K+ and gain of Na+ and H2O

Ischemic: Vasodilation due to CO2 increases permeability

Interstitial: CSF movement from ventricles to extracellular spaces

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10
Q

What is hydrocephalus?

A

Excess fluid within the cranial vault, subarachnoid space, or both

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11
Q

What causes hydrocephalus?

A

Caused by interference in CSF flow
- Decreased reabsorption
- Increased fluid production
- Obstruction within the ventricular system

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12
Q

Noncommunicating hydrocephalus is caused by _____

A

obstruction which may be congenital or tumor

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13
Q

_____ is Caused by poor CSF absorption

A

Communicating (extraventricular) hydrocephalus

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14
Q

Communicating (extraventricular) hydrocephalus may be seen in:

A

head trauma, subarachnoid hemorrhage

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15
Q

Hydrocephalus ex vacuo

A

CSF fills space but not under pressure
Due to cerebral atrophy

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16
Q

Normal-pressure hydrocephalus

A

Seen more in middle age, due to head injury or SA hemorrhage
Arachnoid obstruction (thickening) blocking subarachnoid space

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17
Q

Alterations in motor function include:

A

Hypotonia
Hypertonia
Spasticity
Gegenhalten (paratonia): Resisting of movement (attempt by other to move limb)
Rigidity

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18
Q

Paresis (weakness) and paralysis include both ____ and ____ syndromes.

A

Pyramidal motor syndromes
Upper motor neuron syndromes

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19
Q

What are the upper neuron syndromes?

A

Hemiparesis or hemiplegia (same side)
Diplegia (upper or lower symmetry)
Paraparesis or paraplegia (lower extremities)
Quadriparesis or quadriplegia (upper and lower)
Spinal shock

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20
Q

What is spinal shock?

A

Loss of spinal function below lesion
Flaccid paralysis of affected areas

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21
Q

Lower motor and upper motor neuron diagram

A
22
Q

Motor Cortex (Precentral gyrus)

A
23
Q

What are the lower motor neuron sydromes?

A

Flaccid paresis or flaccid paralysis
Hyporeflexia or areflexia
Gamma neuropathies
Fibrillation

24
Q

What are gamma neuropathies?

A

lower motor neuron syndrome
Small motor neurons that maintain normal motor tone

25
Q

What are the Amyotrophies?

A

Paralytic poliomyelitis
Nuclear palsies
Progressive spinal muscular atrophy
Progressive bulbar palsy

26
Q

Bulbar palsy usually involves which cranial nerves?

A

IX, X, XII

27
Q

What are the clinical manifestations of Bulbar palsy?

A

Drooping face, usually one-sided
May affect speech through articulation

28
Q

What is Hyperkinesia? What are the s/s?

A

Excessive movement
Chorea, wandering, tremor at rest, postural tremor, etc.

29
Q

Paroxysmal dyskinesias and Tardive dyskinesia are 2 examples of what?

A

alterations in movement

30
Q

Huntington disease is aka ___

A

chorea

31
Q

Huntington Disease

A

Also known as chorea
Autosomal dominant hereditary-degenerative disorder
Severe degeneration of the basal ganglia (caudate and putamen nuclei) and frontal cerebral cortex
Depletion of gamma-aminobutyric acid (GABA)
Choreaform movements
Disrupted thought processes

32
Q

Huntington disease is an autosomal recessive hereditary-degenerative disorder T/F

A

FALSE
Autosomal dominant hereditary-degenerative disorder

33
Q

What is hypokinesia? what does it involve?

A

Decreased movement
Akinesia
Bradykinesia
Loss of associated movement

34
Q

What is parkinsons?

A

Severe degeneration of the basal ganglia (corpus striatum) involving the dopaminergic nigrostriatal pathway

35
Q

What are the s/s a/w parkinsons?

A

Parkinsonian rigidity
Parkinsonian bradykinesia
Parkinsonian tremor
Postural abnormalities
Autonomic and neuroendocrine symptoms
Cognitive-affective symptoms

Disorientation, confusion, memory loss, distractibility, and difficulty with concept formation, abstraction, calculations, thinking, and judgment
Symptoms fluctuate, but they progressively worsen

36
Q

50% of persons with ______ have depression, an inherent part of the pathologic state and not a situational response

A

parkinsons

37
Q

30% treated on outpatient basis have dementia; 80% of persons requiring institutional care have dementia

A

Parkinsons

38
Q

Excessive daytime sleepiness is experienced in more than _____% of persons with Parkinsons

A

50

39
Q

May be a/w Parkinsons and dementia

A

Anxiety disorders; impulse-control disorders; and punding, a disorder of stereotypic motor behavior in which there is intense fascination with repetitive handling and examining of mechanical objects

40
Q

What is dystonia? What are the different postures a/w it?

A

Dystonic postures and movements
Decorticate posture – upper brainstem damage
Decerebrate posture – corticospinal tract damage (1 or both)
Basal ganglion posture – Parkinson’s disease or syndrome
Senile posture – atrophy of muscles and joints

41
Q

Senile posture =

A

atrophy of muscles and joints

42
Q

Basal ganglion posture =

A

Parkinson’s disease or syndrome

43
Q

Decerebrate posture =

A

corticospinal tract damage (1 or both)

44
Q

Decorticate posture =

A

upper brainstem damage

45
Q

What are the disorders of gait?

A

Spastic gait
Scissors gait
Cerebellar gait
Basal ganglion gait
Senile gait

46
Q

Hypermimesis usually involves _____

A

laughter and crying

47
Q

Hypomimesis

A

Poor voice modulation, including emotional loss

48
Q

Dyspraxias and apraxias

A

Partial and full inability to perform purposeful motor tasks

49
Q

What are the disorders of expression?

A

Hypermimesis
Hypomimesis
Dyspraxias and apraxias

50
Q

What are the basal ganglia motor syndromes?

A

Parkinson’s, Huntington’s

51
Q

What are the 3 cerebellar motor syndromes?

A

Rostral vermis: Ataxia of stance and gait

Caudal vermis: Body sway, falls, doll’s eyes

Neocerebellar syndrome: Impaired ipsilateral limb movement, tremors, gait abnormalities

Pathopharm Exam 3 (18 decks)

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