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Advanced Pathology > Nervous System: Part 2 > Flashcards

Nervous System: Part 2 Flashcards

1
Q

Cerebral Vascular Attack (CVA)

A
  • Stroke

- Brain Attack

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2
Q

Types of CVA

A
  1. Ischemic

2. Hemorrhagic

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3
Q

What causes an ischemic CVA?

A

interruption of blood flow in a cerebral vessel

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4
Q

What causes an hemorrhagic CVA?

A

bleeding into brain tissue

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5
Q

What events can prompt a CVA?

A
  • Vessel rupture
  • HTN
  • Aneurism
  • Arteriovenous malformation
  • Head injury
  • Blood dyscrasias
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6
Q

Is ischemic or hemorrhagic stroke more common?

A

Ischemic

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7
Q

What percentage of CVA are ischemic?

A

70-80%

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8
Q
  • Ischemic Penumbra
  • Transient Ischemic Attack (TIA)
  • Large Vessel (Thrombotic)
  • Small Vessel (Lacunar
  • Infarct
  • Cardiogenic Embolic Stroke
A

Types of ischemic CVA

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9
Q

Types of ischemic CVA

A
  • Ischemic Penumbra
  • Transient Ischemic Attack (TIA)
  • Large Vessel (Thrombotic)
  • Small Vessel (Lacunar
  • Infarct
  • Cardiogenic Embolic Stroke
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10
Q

Example of Ischemic stroke

A
  • embolus like a blood clot in the brain

- causing death to that area

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11
Q

Cerebral Aneurysms

A

A weakness in a blood vessel in the brain that balloons and fills with blood

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12
Q

Symptoms of small Aneurysms

A

asymptomatic

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13
Q

Symptoms of large Aneurysms

A
  • chronic headache

- neurologic deficits

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14
Q
  • signs of meningeal irritation
  • cranial nerve deficits
  • stroke syndrome
  • cerebral edema
  • increased ICP
  • pituitary dysfunction
A

Manifestations of Aneurysms

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15
Q

Manifestations of Aneurysms

A
  • signs of meningeal irritation
  • cranial nerve deficits
  • stroke syndrome
  • cerebral edema
  • increased ICP
  • pituitary dysfunction
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16
Q

What can be the result of subarachnoid hemorrhage?

A
  • subarachnoid hemorrhage
  • massive release of catecholamines
  • HTN and cardiac dysrhythmias
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17
Q

Types of Aneurysms

A
  1. Saccular
  2. Fusiform
  3. Ruptured
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18
Q

Saccular Aneurysms

A
  • sac
  • forms like a berry
  • formed from wall
  • very thin walled out pouch
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19
Q

Where do saccular Aneurysms typically occur?

A

The anterior circulation of major artery branch points

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20
Q

What percentage of Saccular Aneurysms occur in the anterior circulation of major artery branch points?

A

90%

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21
Q

Why is management of aneurism different from ICP and stroke management?

A
  • You want low BP

- keep aneurism from growing and rupturing

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22
Q

Aneurysmal Subarachnoid Hemorrhage

A

Ruptured aneurism bleeds into subarachnoid space

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23
Q

Phases of Aneurysmal Subarachnoid Hemorrhage

A
  • Before rupture

- After rupture

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24
Q

Causes of Aneurysmal Subarachnoid Hemorrhage

A
  • Congenital defect
  • Acute increases in ICP
  • Smoking
  • HTN
  • Excessive alcohol
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25
Q

Encephalitis

A

Infection of parenchyma of brain or spinal cord

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26
Q

Result of Encephalitis

A
  • Local necrotizing hemorrhage
  • Progressive degeneration of nerve cell bodies
  • Prominent edema
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27
Q

Transmission of Encephalitis

A
  • Ingestion
  • Mosquito
  • Rabid animal
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28
Q

Types of Encephalitis

A
  • Viral
  • Bacteria
  • Fungi
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29
Q

What are some examples of types of viral encephalitis are there?

A
  • Herpes simplex virus
  • West Nile virus
  • HIV
  • Enteroviruses
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30
Q

What are some examples of types of bacterial encephalitis are there?

A

bacterial meningitis

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31
Q

Symptom of Encephalitis

A

ICP

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32
Q

How does encephalitis cause ICP?

A
  • infection
  • inflammatory process
  • swelling of brain and spinal cord
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33
Q

Symptoms of encephalitis

A
  • nuchal rigidity

- Brudzinski’s sign

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34
Q

nuchal rigidity

A

inability to flex the neck forward due to rigidity of the neck muscles

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35
Q

Brudzinski’s sign

A

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed

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36
Q

Symptoms of bacterial meningitis in children

A
  • nuchal rigidity
  • stiff neck pain
  • N&V
  • rash
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37
Q

Seizure

A

Sudden, uncontrolled electrical disturbance in the brain

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38
Q

Types of Seizures

A
  1. Generalized Seizures

2. Focal/Partial Seizures

39
Q

Types of Generalized Seizures

A
  1. Tonic Clonic (Grand Mal)
  2. Atonic
  3. Myoclonic
  4. Clonic
  5. Tonic
  6. Absence/petit mal
40
Q

Types of Focal/Partial Seizures

A
  1. Simple

2. Complex

41
Q

Tonic Clonic (Grand Mal) Seizure

A
  • loss of consciousness

- violent muscle contractions

42
Q

Atonic Seizure

A

muscles suddenly become limp

43
Q

Myoclonic Seizure

A

brief shock-like jerks of a muscle(s)

44
Q

Clonic Seizure

A

repeated jerking movements

45
Q

Tonic Seizure

A

sudden stiffness or tension in the muscles

46
Q

Absence/petit mal Seizure

A

brief, sudden lapses in attention

47
Q

Simple vs Complex partial seizure: : Sense of surroundings

A

Simple: No loss
Complex: Yes loss

48
Q

Simple vs Complex partial seizure: Duration

A

Simple: <2 min
Complex: > 2 min

49
Q

Example #1:

  • 1-5 min
  • Entire body falls
  • Stiffens
  • Jerks
  • Bites tongue
  • Blueish
  • lack of oxygen
  • incontinence
  • sleepy

Which type of seizure:

a. tonic clonic
b. absence seizure
c. complex partial
d. simple partial

A

a. tonic clonic

50
Q

Example #2:

  • few seconds
  • staring spell or blinks eyes
  • most common in children
  • mistaken for daydreaming

Which type of seizure:

a. tonic clonic
b. absence seizure
c. complex partial
d. simple partial

A

b. absence seizure

51
Q

Example #3:

  • 1 to 2 min
  • purposeless activity
  • impaired consciousness
  • may appear confused, drunk, psychotic
  • smacks lips
  • struggles when restrained

Which type of seizure:

a. tonic clonic
b. absence seizure
c. complex partial
d. simple partial

A

c. complex partial

52
Q

Example #4:

  • jerking of one limb or side of body
  • consciousness maintained

Which type of seizure:

a. tonic clonic
b. absence seizure
c. complex partial
d. simple partial

A

d. simple partial

53
Q

Major difference between generalized and partial seizures

A

Generalized- usually lose consciousness

Partial- usually consciousness maintained

54
Q

Which type of seizure typically causes the most issues?

A

Tonic clonic

55
Q

Status epilepticus

A
  • continuous seizures
  • constant seizure activity in brain
  • Doesn’t stop spontaneously
56
Q

Treatment for Status epilepticus

A
  • Not much you can do

- Benzodiazepines to get seizure activity to stop

57
Q

If Status epilepticus untreated or not stopped it can lead to what?

A

death

58
Q

Why would someone with untreated status epilepticus die?

A

respiratory failure

59
Q

Which neurotransmitter is important in regard to seizures? Why?

A
  • GABA

- too much excitatory

60
Q

Myasthenia Gravis

A

-Disorder of transmission at neuromuscular junction that -affects communication between motor neuron & innervated muscle cell.

61
Q

What causes Myasthenia Gravis?

A
  • Autoimmune disease

- Antibody mediated loss of acetylcholine receptors in neuromuscular junction

62
Q

Without acetylcholine what happens to the body?

A

Cannot eat, talk, swallow, ect…

63
Q

Myasthenic Crisis

A
  • complication of myasthenia gravis

- worsening of muscle weakness

64
Q

Result of Myasthenic Crisis

A
  • respiratory failure

- requires intubation

65
Q

Cholinergic Crisis

A

over-stimulation at a neuromuscular junction due to an excess of acetylcholine

66
Q

Neuropathy

A

Weakness, numbness, and pain from nerve damage

67
Q

Mononeuropathy

A

neuropathy involving a single nerve

68
Q

Polyneuropathy

A

neuropathy involving multiple nerves

69
Q

Peripheral Neuropathy

A

damage to a nerve outside the brain and spinal cord

70
Q

What is an example of a Mononeuropathy?

A

Carpal tunnel Syndrome

71
Q

Carpal tunnel Syndrome

A

-Compression of the median nerve

72
Q

Where is the median nerve located?

A

Travels with the flexor tendons through a canal made by the carpal bones and transverse carpal ligament

73
Q

Symptoms of Carpal tunnel Syndrome

A
  • Pain
  • paresthesia
  • numbness of thumb, 1st, 2nd and ½ digits of the hand
  • pain in wrist and hand which worsens at night
  • atrophy of abductor pollicis muscle
  • weakness in precision grip
74
Q

What can be used to diagnose Carpal tunnel Syndrome?

A

Tinel or Phalen sign

75
Q

Results of Peripheral Neuropathy

A

Muscle weakness with or without atrophy & sensory changes

76
Q

Involvement of nerves in Peripheral Neuropathy

A

Can involve a single nerve (mononeuropathy) or multiple nerves (polyneuropathy)

77
Q

Symptoms of Peripheral Neuropathy

A
  • loss of feeling
  • freezing
  • tingling
  • hypersensitivity
  • sharp, jabbing pain. burning sensation
  • numbness
78
Q

Diabetic Peripheral Neuropathy

A

nerve damage that can occur with diabetes

79
Q

As a clinician what is important to teach patients with Diabetic Peripheral Neuropathy?

A

need to wear good shoes

80
Q

Why do pts with Diabetic Peripheral Neuropathy need to wear good shoes?

A
  • loss of feeling

- ex: could get splinter in foot and they aren’t going to feel it

81
Q

Guillain-Barre Syndrome

A

-destruction of myelin sheath

82
Q

Cause of Guillain-Barre Syndrome

A
  • Can be autoimmune

- Can result from mild infection

83
Q

What disorder is Guillain-Barre Syndrome similar too?

A

MS

84
Q

How are Guillain-Barre Syndrome and MS differnt?

A
  • Guillain-Barre Syndrome- PNS

- MS-CNS

85
Q

How does Guillain-Barre Syndrome progress?

A
  • begins in lower extremities
  • ascends bilaterally
  • Paralysis
86
Q

Symptoms of Guillain-Barre Syndrome?

A
  • weakness
  • ataxia
  • bilateral paresthesia
87
Q

Does muscle atrophy in Guillain-Barre Syndrome?

A

Minimally

88
Q

is paralysis in Guillain-Barre Syndrome bilateral or unilateral?

A

bilateral

89
Q

How long does it take for Guillain-Barre Syndrome to progress?

A

hours to days

90
Q

Risk factors for Guillain-Barre Syndrome

A
  • possibly autoimmune
  • association with immunizations
  • frequently preceded by mild resp or intestinal infection
91
Q

What problems occur in Guillain-Barre Syndrome?

A
  • Respiration
  • Talking
  • Swallowing
  • Bowel/Bladder Function
92
Q

How does Guillain-Barre Syndrome symptoms travel?

A

PNS to CNS

93
Q

Treatment for Guillain-Barre Syndrome

A

Supportive care

94
Q

Why is supportive care provided for Guillain-Barre Syndrome

A
  • After a few days the lungs become atrophied.

- Pt needs help moving around

Advanced Pathology (27 decks)

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