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Medical Pathophysiology > Nervous Damage 2 > Flashcards

Nervous Damage 2 Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the 4 causes of ischaemic stroke?

A

atherothrombotic cerebrovascular disease, cryptogenic so no cause, lacunar

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2
Q

what is atherothrombotic cerebrovascular disease?

A

blockage of the blood supply to the brain

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3
Q

what is lacunar cause of ischaemic stroke?

A

small vessel disease

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4
Q

what are the 2 types of haemorrhagic stroke?

A

intercerebral or subarachnoid

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5
Q

how is anatomical Protection of the brain caused?

A

by the circle of Willis

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6
Q

what are the 4 vessels that supply circle of willis?

A

left and right internal carotid and left and right vertebral

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7
Q

what arteries come out of the circle of willis?

A

anterior, middle and posterior cerebral arteries

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8
Q

what is the function of the arteries coming out of circle of willis?

A

supply distinct areas of the brain

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9
Q

where is supplied by the middle cerebral arteries?

A

lateral regions of the brain

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10
Q

what are the modifiable risks of strokes?

A

smoking, diabetes, high blood pressure, obesity, arrhythmia, drug abuse, alcohol abuse

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11
Q

what are the non-modifiable risk factors of strokes?

A

age, genetics, race, prior strokes, gender

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12
Q

how does a intracerebral haemorrhage begin?

A

vessel rupture leads to extravasation of blood into the brain parenchyma

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13
Q

how does a intracerebral haemorrhage grow?

A

the initial haemotoma causes an increase in local pressure and rupture of other vessels

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14
Q

how might intracerebral haemorrhages be more likely to happen?

A

coagulation disorders causes a higher bleed and higher blood pressure may mean re-bleeding may occur

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15
Q

how does a subarachnoid haemorrhage occur?

A

rupture of saccular anaeuryms in the vessels that supply the brain

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16
Q

where do subarachnoid haemorrhages usually occur?

A

in the circle of willis where bifurcations of major arteries are located

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17
Q

what is a flaw in the circle of willis?

A

high number of junctions and so likely to form aneurysms

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18
Q

what is grade I of intracranial aneurysms?

A

asymptomatic or a minimal headache

19
Q

what is grade II of intacranial aneurysm?

A

headache and moderate neck rigidity

20
Q

what is grade III of intracranial haemorrhage?

A

drowsiness, confusion, mild focal deficit

21
Q

what is grade IV intracranial haemorrhage?

A

stupor, moderate to severe hemi paresis, early decerebrate rigidity

22
Q

what is grade V of intracranial haemorrhage?

A

deep coma, decerebrate rigidity

23
Q

how are haemorrhagic strokes diagnosed?

A

thunderclap headaches, xanthochromic lumbar, star pattern on CT scan

24
Q

how can aneurysms be treated?

A

prevented bursting by clipping aneurysm or using an endovascular coil to prevent blood clotting

25
Q

what types of strokes are most common?

A

ischaemic stroke

26
Q

what makes ischameia so damaging to the brain?

A

high vascular supply, high cellular activities, cell type variations

27
Q

at what time does blood deprivation to the brain become permanent?

A

4 minutes

28
Q

what is the ischaemic core?

A

area most affected by ischaemic event such as low oxygen, low ATP and glucose and low pH

29
Q

what area of the brain is less affected by ischaemia?

A

penumbra

30
Q

what is the left hemisphere responsible for?

A

mathematical and scientific functions

31
Q

what is the right hemisphere responsible for?

A

more artistic and creative functions

32
Q

what kind of stress can happen in the brain?

A

oxidative, mechanical or metabolic

33
Q

how can higher levels of calcium be caused by stress?

A

stress can reduce the concentration of ion pumps, cause membrane damage and release calcium stores from mitochondria

34
Q

what damaging effects happen due to increased calcium?

A

activate unwanted enzymes, disruption to cytoskeleton, cell dysfunction or apoptosis and membrane blobbing

35
Q

what is an ischaemic cascade?

A

lack of blood flow causes ischaemia, impacts pre and post synaptic cells, causes decreased energy of cells and eventually neurones death

36
Q

what things can cause epilepsy?

A

electrolyte imbalance, fever, hypoglycaemia, hypoxia, brain tumours, brain injury

37
Q

what is grand Mal?

A

tonic-clonal seizures

38
Q

what is petit mal?

A

absence seizures with a brief change in consciousness

39
Q

what things can trigger seizures?

A

infections, trauma, drugs, electrolyte imbalance, tumours or strokes, fevers

40
Q

what are the key features of epilepsy diagnosis?

A

that a normal EEG or an abnormal EEG is not sufficient for diagnosis

41
Q

what are the dangers of seizures?

A

chance of injury and brain cells can die

42
Q

what is excitotioxicity?

A

brain cell death during a seizure

43
Q

how does excitotoxicity occur?

A

seizures release glutamate, activation of glutamate NDMA receptors, the double gating system is opened, magnesium ion block is removed and calcium enters mediating neuronal damage

44
Q

what things effect treatment of epilepsy?

A

pre-existing conditions, dosage and monitoring and type of syndrome

Medical Pathophysiology (16 decks)

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