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HLSC 222 - Midterterm 2 > Neruo Class 1 > Flashcards

Neruo Class 1 Flashcards

1
Q

Signs and symptoms of meningiomas?

A

They are slow growing and because of this signs and symptoms are present when the growth pushes on the functional areas of the brain

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2
Q

What are structural brain alternations in arousal?

A

infection, vascular alterations, neoplasms, traumatic injury congenital, degenerative, polygenic traits & metabolic disorders

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3
Q

What are the 4 primary brain tumours?

A

1.) Astrocytomas
2.) Glioblastomas
3.) Meningiomas
4.) Nerve sheath

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4
Q

What are the 3 different kinds of cerebral edema?

A

1.) Cytotoxic
2.) Interstital
3.) Vasogenic

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5
Q

What is amnesia?

A

Mild or severe loss of memory

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6
Q

What is Stupor?

A

Minimal movement
-Responds in groans and moans

-Awakens briefly only with repeated stimulation

Ex.) Passed out drunk

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7
Q

What is paraplegia?

A

– weakness or paralysis of lower extremities due to spinal cord injury

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8
Q

What senses can agnosia be?

A

Can be tactile, visual, or auditory – usually only one sense is affected

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9
Q

What are metabolic alternations in arousal? What can these disorders be caused by?

A

– alterations in delivery of energy – hypoxia, electrolyte disturbances, or hypoglycemia –

disorders caused by renal or liver – alter neuron excitability as medications and toxins are not properly cleared

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10
Q

What is brain death?

A

– brain is damaged beyond the point of recovery – cannot maintain the body – brainstem functions have stopped – etiology is not reversible – i.e. drug overdose

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11
Q

What is vasogenic cerebral edema caused by?

Where does it start?

A

caused by increased permeability of the capillary endothelium of the brain, caused by injury of the vascular structures

starts in area of injury and spreads to white matter of the same side

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12
Q

Where does the arterial supply come from?

A

Arterial supply comes from internal carotid arteries and vertebral arteries

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13
Q

Grade 1 and 2 astrocytomas are?

A

grade 1 & 2 slow growing – can progress to a higher grade, faster growing tumour

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14
Q

What is Lethargy?

A

Altert and originated x3 but is quite sluggish

-Sleeps frequently but wakens to voice, or gentle shaking

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15
Q

Where does the subarachnoid space lie? What does this contain?

A

Between arachnoid and Pia layers

-This contains CSF

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16
Q

What is Aphasia?

A

more sever form of dysphasia – inability to communicate using language

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17
Q

What is locked in syndrome?

A

complete paralysis of voluntary muscles – except eyes – fully conscious but unable to communicate except through eye movements

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18
Q

Signs and symptoms for all types of cerebral edema?

A

Headache, stiffness, N&V, dizziness, vision loss, memory loss, loss of muscle coordination

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19
Q

What are cerebral blood flow disorders associated with?

A

Cerebral blood flow disorders are related to decreased blood flow

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20
Q

What is hypotonia?

A

decreased muscle tone – passive movement of a muscle has little resistance if any

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21
Q

Damage to the upper neuron results in? Followed by?

A

Damage to the upper neurons results in initial paralysis followed by partial recovery

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22
Q

Frontal Lobe controls?

A

-Problem solving
-Emotional traits
-Speaking
-Voulantary motor movements
-Reasoning (judgement)

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23
Q

Characteristic of meningiomas?

A

Sharply circumscribed and adapts to the shape it occupies

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24
Q

What is disorientation?

A

progressive confusion – comes with anxiety, restlessness – starts with losing time – place - person

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25
Q

What do astrocytomas begin as?

A

they begin in the astrocytes in the brain and grow at different rates, slow to very quickly

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26
Q

What are the meninges?

A

3 protective membranes – the dura mater, the arachnoid, and the pia matter

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27
Q

Signs and symptoms for hypotonia?

A

weak and tire easily, difficulty rising from sitting, walking up stairs – joints become hyperflexible – loss of muscle mass – look flabby and flat

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28
Q

What is Dyskinesia?

A

abnormal movements that occur as spasms – tardive dyskinesia is movements of the face –

Ex.) Tourette’s syndrome – unwanted tics

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29
Q

What blocks nerve regeneration?

A

Scarring

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30
Q

What should any new neurological symptom in a cancer patient do?

A

any new neurological symptom in a cancer patient should have brain metastasis ruled out first

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31
Q

Increased respiration decreases?

A

increased respiration decreases CO2 levels so respiration rate decreases

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32
Q

What is Dysphasia associated with?

A

Dysphasia is associated with cerebral vascular accidents involving specific areas of the brain

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33
Q

Where do meningiomas originate from?

A

Usually originate from the meningeal cells in the dura mater

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34
Q

What is selective attention?

A

ability to focus – we can choose what we are going to pay attention to

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35
Q

What is retrograde amnesia?

A

difficulty with past personal history or facts

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36
Q

Signs and symptoms of nerve sheath tumours? What are they usually?

A

They are Slow growing and because of this S&S depend on location.

Can see muscle weakness, numbness, tingling
- Usually benign

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37
Q

What is interstitial edema?

A

Edema that is caused by blockage of CSF pathways – treatment is dependent on cause

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38
Q

What is cushings triad?

A

occurs in late stages of acute head injury. Indicates that brain stem herniation is imminent

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39
Q

Parietal lobe controls?

A

-Sensation
-Knowing right form left
-Reading
-Body orientation

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40
Q

What does edema promotes?

A

Edema prometes more edema due to ischemia

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41
Q

Signs and symptoms for hypertonia?

A

tire easily, weakness – passive and active affected equally, can see either hypotrophy or hypertrophy dependent on decrease in muscle use or overstimulation of muscle fibres

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42
Q

What are the 3 components of cushings triad?

A

Increased SBP with decreased DBP or widening pulse pressure
Decreased HR
Decreased RR – Irregular RR

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43
Q

What is the primary regulator for blood flow within the CNS? What does it ensure?

A

Carbon dioxide

-It is a vasodilator

-Ensure adequate blood supply

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44
Q

What is agnosia associated with?

A

damage caused by cerebral accidents can be caused by damage to specific areas of the brain

45
Q

Temporal lobe controls?

A

-Behaviour
-Understanding language
-Hearing
-Memory

46
Q

Cranial nerves can be?

A

Cranial nerves can be both sensory and motor, or just sensory, or just motor

47
Q

What is Dipegia?

A

– paralysis of corresponding parts of both sides of the body – cerebral hemisphere injuries of specific part of the brain

48
Q

What is hyperkinesia?

A

– excessive purposeless movements - could be tremors, or abnormal involuntary movements

49
Q

Glioblastomas are more common in? and have a greater incidence in?

A

It is more common in older adults
greater incidence in men

50
Q

Nerve regeneration depends on?

A

on location of injury, type of injury, inflammatory response, and scarring.

51
Q

What do metastatic brain tumours resemble?

A

Metastatic brain tumours – resemble glioblastomas

52
Q

What is hypertonia caused by?

A

upper neuron damage

spasticity, paratonia (inability to relax muscle during assessment), dystonia (contract uncontrollably), or rigidity

53
Q

Is amnesia Permian or temporary?

A

Can be both

54
Q

What is a grade 4 astrocytoma?

A

Grade 4 astrocytoma is called a glioblastoma - most common and lethal type of astrocytoma

55
Q

Consciousness is?

A

a state of awareness of oneself and of the environment – as well as how to respond to that environment

56
Q

What is a vegetative state that lasts longer than 12 months considered?

A

A vegetative states that last longer than 12 months are considered permanent

57
Q

What is confusion?

A

Progressive disorientation - forgeting things

-Difficulty following commands
-Restless/agitated

58
Q

Brocas area Vs Wernickes area?

A

– Broca’s area – can’t create speech, Wernicke’s area – can’t comprehend speech

59
Q

What is Hypertonia?

A

– increased muscle tone – passive muscle movement with resistance to stretch

60
Q

What is obtundation?

A

Extreme drowsiness, minimally responsive, barely follows commands

-Requires bigourious stimulation to awaken

-Stays awake for mere minutes

61
Q

What is a nerve sheath tumour?

A

autosomal dominant disorder – neurofibromas – can occur peripherally (Type 1)or
Centrally (type 2)

-Usually benign

62
Q

What causes cerebral edema?

A

– distortion of blood vessels, displacement of brain tissues, increase in ICP, and eventually herniation

63
Q

Damage to the lower neuron’s leads to? Followed by?

A

damage to lower neurons leads to paralysis unless peripheral nerve damage is followed by nerve regeneration

64
Q

What is ADHD?

A

attention-deficit/hyperactivity disorder – ability to function is impaired by inattentiveness, hyperactivity, impulsivity

65
Q

What does the type of astrocytoma determine?

A

type of astrocytoma determines its grade, the lower the grade, the slower its growth

66
Q

What is Quadriplegia?

A

weakness or paralysis of all four extremities due to spinal cord injury – looking at this in our spinal cord trauma

67
Q

What lies between the dura and arachnoid?

A

Subdural space

68
Q

What does the brain rely on to regulate if LOC decreases?

A

– if the LOC decreases the brain relies on CO2 levels to regulate respiration

69
Q

Early signs Vs late signs of brain tumours?

A

Early – headache, irritability, personality changes – progresses to increased ICP, papilledema (swelling of the optic disc), vomiting or seizures

Late –hemiparesis, dysphasia, visual field deficits

70
Q

Causes of hypotonia?

A

cerebral damage - causing ataxia and tremor

can be paired with exaggerated reflexes

spinal cord injury or cerebral vascular accident where the nerve impulses are lost

71
Q

Cranium protects?

A

The brain and associated structures

72
Q

Giloblastomas are?

A

glioblastoma is highly vascular, irregular, and infiltrative making surgery difficult.

73
Q

What is Vasogenic cerebral edema?

A

It is the late stages of cerebral edema where the Blood-brain barrier compromised

74
Q

Patho behind vasogenic edema?

A

plasma proteins leak into the extracellular spaces, drawing water to them

75
Q

What is absent in brain death?

A

Absence of motor responses, no spontaneous respirations, no brain functions. Tests are performed to confirm brain death - doll’s eyes, corneal reflex, ice in ears
Need to insure there is an absence confounding factors such as hypothermia or drug toxicity

76
Q

What is a metastatic brain tumour?

A

Metastatic is a secondary tumour that has metastasized to the brain and is 10 times more common than primary tumours 20-40% – primary sites include lung, breast, kidney, colon, and skin

77
Q

What is Hemiparesis/hemiplegia?

A

upper and lower motor neuron syndrome on one side. Usually happens with cerebral vascular accidents (stroke)

weakness or the inability to move on one side of the body,

78
Q

What is a vegetative state?

A

– unawareness of self or surrounding environment
– does not speak or understand speech,

cannot follow commands, sleep-wake cycles present, spontaneous eye opening, BP & RR

79
Q

What is LOC? What is it tested with?

A

most critical clinical index – improvement or deterioration – confusion, disorientation, to coma – tested with a Glasgow coma scale – assessing if they are opening their eyes, oriented, follow commands

80
Q

What is cytotoxic or metabolic cerebral edema?

A

it is the early stages of cerebral edema and the Blood-brain barrier stays intact

81
Q

What is hypokinesia?

A

loss of voluntary movement – decrease or slowness of voluntary movements – delay in time that it takes to start to perform a movement

82
Q

What happens initially and over time with spinal shock?

A

Initially: Complete paralysis, absence of reflexes, motor, sensory, autonomic function, including disturbances in bowel and bladder function. Shock can last hours to weeks

Over time: spinal shock will resolve – damage to spinal cord remains – so initially they may have loss of all function, but as their reflexes return we get a clearer picture of what damage has been done
Return of spinal reflexes marks the end of spinal shock, what ever deficits remain are what has been caused by the original injury

83
Q

Why do metastatic brain tumours have a poor prognosis?

A

Poor prognosis because there is cancer somewhere else in the body that has already progressed to stage 5
– dependent on primary site of cancer – average survival is 6 months

84
Q

What is cerebral death or irreversible coma?

A

death of hemispheres - not of the brainstem & cerebellum

– damage is permanent –

brain stem continues to maintain homeostasis -

person does not speak, open their eyes or have purposeful movements,

these individuals will not recover, and they are not candidates for organ donation

85
Q

What is a astrocytoma?

A
  • most common intracerebral brain tumour across the lifespan
86
Q

What can selective attention deficits be caused by? What can they be?

A

deficits can be caused by seizures, contusions, subdural hematomas, stroke neoplasms, Alzheimer’s disease, dementia

They can be Temporary, permanent, or progressive

87
Q

What are executive attention deficits?

A

– inability to maintain sustained attention & working memory deficit

Ex.) ADHD

88
Q

Brain stem controls?

A

-Swallowing
-Body temp
-Breathing
-Digestion
-Alterness/sleep

89
Q

Peripheral nerve is composed of? What do they contain?

A

Peripheral nerve is composed of individual axons wrapped in a myelin sheath

Peripheral nerves contain both sensory and motor neurons

90
Q

What do metastatic brain tumours cause?

A

causes headache, nervousness, depression, trembling, confusion, forgetfulness, and gait disorders

91
Q

What is Coma?

A

Does not respond to verbal stimuli, does not speak

-No response to pain

92
Q

What is paresis?

A

condition of muscle weakness caused by nerve damage or disease – partial paralysis – can be confined to one area – limb or lower body or can be general or progressive as we may see in dementia

93
Q

What are meningiomas?

A

They are a extracerbral growth in the meniniges (the membranes that surround the brain) outside of the cerebrum or brain

94
Q

What is anterograde amnesia?

A

– inability to form new memories

95
Q

Why do we need to maintain a constant cerebral perfusion pressure and to control intracranial pressure?

A

To adequately oxygenate the brain

96
Q

What structure normal produces rhythmic patterns of bleeding?

A

Forebrain

97
Q

What is the circle of willis?

A

It provides an alternative route or collateral blood flow if one of the contributing arteries is occluded – safety valve for the brain

98
Q

Crush injury heal (blank) than (blank) injures?

A

Crush injuries will heal faster than cut injuries,

99
Q

What is paralysis?

A

loss of muscle function in part of your body

100
Q

What is Agnosia?

A

failure to recognize the form and nature of objects

101
Q

What kind of recovery will a Injury close to the spinal cord have?

A

Injury close to spinal cord will have poor recovery due to the long distance between the cell body and the peripheral termination of the axon

102
Q

What can aphasia be caused by?

A

Aphasia can be caused by injuries and diseased – vascular, neoplastic, traumatic, degenerative, metabolic, or infectious

103
Q

What is Dysphasia?

A

impaired comprehension or production of language – disturbed or lost

104
Q

What is spinal shock caused by?

A

Caused by a sudden destruction of efferent pathways (sending message down

105
Q

What is spinal shock?

A

is the temporary loss of all spinal cord function below the level of the lesion – consequence of spinal cord injury

106
Q

What are psychogenic alternations in arousal?

A

psychiatric disorders – appear unconsciousness but are actually awake – unresponsiveness

107
Q

Primary Vs secondary cerebral injury/trauma?

A

Primary is the initial trauma – secondary is a consequence of the alterations in cerebral blood flow, intracranial pressure, and oxygen delivery

Secondary injury can occur within seconds or days

108
Q

What are problems associated with recognizing and processing sensory information dependant on?

A

Dependant on what area of the brain is affected

HLSC 222 - Midterterm 2 (9 decks)

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