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NS374—Pathophysiology > Neuro > Flashcards

Neuro Flashcards

1
Q

awareness of oneself & environment

A

consciousness

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2
Q

awakeness

responsiveness to stimuli

A

arousal

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3
Q

encompasses all cognitive functions

A

awareness

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4
Q

loss of awareness & mental capabilities

A

vegetative state

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5
Q

brain can no longer maintain internal homeostasis

A

brain death

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6
Q

irreversible coma - death of cerebral hemispheres, excluding brain stem & cerebellum

A

cerebral death

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7
Q

individual aware & thinking, unable to move or communicate

A

locked in syndrome

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8
Q

inability to interpret sensations & recognize things

A

agnosia

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9
Q

deficiency in generation of speech and/or comprehension

A

dysphasia

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10
Q

loss of ability to understand or produce speech

A

aphasia

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11
Q

abrupt change in brain causing confusion

A

delirium

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12
Q

sensation perceived by pt preceding condition affecting brain (ex seizure, migraine)

A

aura

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13
Q

low muscle tone - decreased DTR

A

hypotonia

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14
Q

high muscle tone - overly active DTR

A

hypertonia

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15
Q

certain muscles continually contracted

A

spasticity

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16
Q

inability to relax muscles during muscle tone assessment

A

paratonia

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17
Q

(oppositional paratonia) - subject involuntarily resists passive movement

A

Gegenhalten

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18
Q

muscles contract uncontrollably

A

dystonia

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19
Q

increased muscle tone, stiffness or inflexibility of muscle

A

rigidity

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20
Q

excessive muscle movement

A

hyperkinesia

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21
Q

low muscle movement

A

hypokinesia

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22
Q

muscle weakness caused by nerve damage

A

paresis

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23
Q

loss of ability to move all or part of body

A

paralysis

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24
Q

used to assess LOC

A

Glasgow coma scale

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25
Q

3 parts of the Glasgow coma scale

highest and lowest scores

what score is comatose?

A

eye opening; verbal response; motor response

3-15

8 or less is comatose

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26
Q

“passing out”

A

loss of consciousness

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27
Q

overactivity of or problems with pain-sensitive structures in head

A

primary headache

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28
Q

h/a that is a sx of a problem

A

secondary headache

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29
Q

“headband” h/a

A

tension

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30
Q

h/a behind an eye - one drooping eye - runny nose - occur over 7-10 days

A

cluster h/a

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31
Q

unilateral h/a with aura, photophobia, phonophobia, n/v

A

migraine

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32
Q

h/a red flags

A

first h/a in life after 50yo

waking up with h/a

“worst h/a of my life”

thunderclap h/a

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33
Q

sudden uncontrolled electrical disturbance in brain

A

seizure

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34
Q

having one seizure _____ the threshold for having another

(except in the case of ______ seizures)

A

lowers

febrile

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35
Q

seizure affecting both sides of brain

A

generalized

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36
Q

seizure where person stops moving altogether

A

petit mal

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37
Q

seizures with LOC, bilateral jerking, rigidity and shaking

A

tonic clonic (grand mal)

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38
Q

_____ is rigidity

_____ is shaking

A

tonic

clonic

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39
Q

seizure localized in one brain are

A

focal

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40
Q

2 types of focal seizures

A

simple partial - one location in brain

complex partial - an area of the brain

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41
Q

one finger or hand shaking indicates a ________ seizure

A

focal

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42
Q

continuous seizure

A

status epilepticus

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43
Q

life threatening seizure

A

status epilepticus

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44
Q

3 potential causes of seizures

A

bleeding

tumor

epilepsy

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45
Q

Complications - learning difficulty (esp in children); aspiration; biting tongue or mouth; injury from fall; brain damage

A

seizures

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46
Q

elevated pressure around brain

A

elevated ICP

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47
Q

potential causes of high ICP

A

bleeding

swelling

tumor

idiopathic

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48
Q

can cause papilledema - borders around optic nerve are no longer clear

A

high ICP

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49
Q

irreversible, fatal complication of high ICP

A

herniation of brain into spinal cavity

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50
Q

edema in brain

A

cerebral edema

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51
Q

involuntary flexion/extension of arms and legs

indicates severe brain injury

A

posturing

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52
Q

involuntary flexion of arms into chest, clenched fists, extended legs

A

decorticate posturing

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53
Q

involuntary extension of upper extremities in response to external stimuli - head arched back, arms extended by sides, legs extended

A

decerebrate posturing

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54
Q

which type of posturing is “better”?

A

decorticate

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55
Q

partial or total memory loss

A

amnesia

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56
Q

loss of memory of things that happened in the past

A

retrograde amnesia

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57
Q

inability to form new memories

A

anterograde amnesia

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58
Q

group of symptoms affecting memory, thinking, social abilities

A

dementia

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59
Q

early signs of dementia

A

losing recent memories

unable to draw a clock face (MMSE)

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60
Q

interventions for (some) pts with dementia

A

frequently orient them to surroundings

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61
Q

abnormal deposits of alpha-synuclein in brain

slow dementia

hallucinations

pts may be called “combative”, “violent”

A

Lewy Body dementia

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62
Q

uncommon dementia affecting frontal & temporal lobes

radical personality changes

A

frontotemporal dementia

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63
Q

dementia secondary to CVA

sudden “steps down” in function after each event

A

vascular dementia

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64
Q

Involves amyloid plaques & neurofibrillary tangles - shrinking of the brain

A

Alzheimer’s

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65
Q

chromosomal anomaly increasing risk for early onset Alzheimer’s

A

trisomy 21

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66
Q

closed head TBI

A

no skull fracture

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67
Q

open head TBI

A

skull fracture

penetration of brain

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68
Q

TBI with displacement of a piece of skull below skull level

A

depressed skull fracture

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69
Q

area of brain damaged is contralateral to an injury

A

contrecoup TBI

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70
Q

why does high ICP cause vomiting?

A

pressure on neurons in medulla

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71
Q

dangerous complication of concussion

A

second impact syndrome

can cause chronic traumatic encephalopathy

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72
Q

tx concussion

A

sitting, resting, low light, doing nothing

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73
Q

collection of blood w/i skull

A

intercranial hematoma

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74
Q

types of intercranial hematoma (based on location)

A

epidural

subdural

subarachnoid

intercerebral

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75
Q

which types of spinal cord injury are reversible, and which are irreversible?

A

reversible - bruising

irreversible - ischemia & necrosis

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76
Q

what not to do for a pt with a halo

A

do not grab the halo

do not raise head of bed without sitting pt up first

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77
Q

temporary loss or depression of spinal cord reflexes below level of a lesion

A

spinal shock

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78
Q

paraplegia; quadriplegia; flaccid muscle tone; all sensation below transection lost

A

spinal shock

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79
Q
  • Acute elevation in BP with brady/tachycardia
  • Massive sympathetic response that cannot be controlled from brain - dual action from both SNS and PSNS
A

autonomic dysreflexia

80
Q

Etiology - full bladder or rectum; infection; genital stimulation; other painful stimuli

A

autonomic dysreflexia

81
Q

skin differences above & below lesion; blurred vision; h/a; intracranial or subarachnoid hemorrhage; retinal detachment; death

A

autonomic dysreflexia

82
Q

Protrusion of nucleus pulposus of intervertebral disc

A

herniated disc

83
Q

usual location of herniated discs

A

lumbosacral

84
Q

is a herniated or bulging disc more severe?

A

herniated

85
Q

herniated disc sx are usually (unilateral/bilateral)

A

unilateral

86
Q

inflammation of meninges

A

meningitis

87
Q

which pathogens are more/less virulent in meningitis?

A

virus - less

bacteria - more

88
Q

r/f - younger population; immunocompromise; crowding (prison, etc); IV drug use; splenectomy; DM; infection; ventroperitoneal shunt (drains CSF into abdomen); alcoholism

A

meningitis

89
Q

fever; nucal rigidity (stiff neck); photophobia; n/v; petechiae; confusion

A

meningitis

90
Q

how to test for meningitis

A

lumbar puncture

91
Q

brain inflammation

A

encephalitis

92
Q

usually direct result of necrotic liquefactive pus

A

brain abscess

93
Q

unencapsulated brain abscess/inflammation

A

cerebritis

94
Q

brain abscess has a __% fatality rate

A

32

95
Q

“mini stroke”

A

transient ischemic attack

96
Q

stroke that resolves on its own/without intervention

A

TIA

97
Q

warning sign of thrombotic CVA

A

TIA

98
Q

sudden death of some brain cells due to lack of O2 when bloodflow to brain is impaired by blockage or rupture

A

cerebral vascular accident

99
Q

3 types of CVA

A

thrombotic

embolotic

hemorrhagic

100
Q

CVA with gradual onset; occurs at rest; minimal ICP elevation; localized

A

thrombotic

101
Q

cause of thrombotic CVA

A

atherosclerosis in cerebral arteries

102
Q

cause of embolotic CVA

A

Clot - Systemic source or atherosclerosis in carotid artery

103
Q

atrial fibrillation increases risk for _____ stroke

A

embolotic

104
Q

CVA with sudden onset; minimal ICP elevation; localized

A

embolotic

105
Q

CVA with sudden onset; often with activity; elevated ICP; widespread & severe; can be fatal

A

hemorrhagic

106
Q

cause of hemorrhagic stroke

A

bleeding in brain

107
Q

localized dilation of cerebral vessel

A

intracranial aneurysm

108
Q

2 demyelinating disorders

A

Guillan barre

multiple sclerosis

109
Q

demyelination in PNS

A

guillian barre

110
Q

demyelination in CNS

A

MS

111
Q

ascending paralysis; prickling; paresthesia; weakness; unsteady gait

A

guillian barre

112
Q

s/s - variable, may change unexpectedly - numbness; tremor; visual impairment; speech problems; fatigue; dizziness; alteration in bladder or bowel function

A

MS

113
Q

Autoimmune - Type II hypersensitivity- postsynaptic muscle membrane is distorted and simplified

A

myasthenia gravis

114
Q

what is going on with ACh in myasthenia gravis?

A

ACh released normally, but receptors on end-plate membrane are reduced - antibodies attach to membrane causing decreased effects of ACh

115
Q

muscle weakness; eye drooping; diplopia (double vision); dysphagia; severe fatigue

A

myasthenia gravis

116
Q

test for myasthenia gravis

A

Tensil test - injection of high levels of ACh - pt will suddenly be able to move normally again

117
Q

genetic progressive atrophy of brain

A

Huntington’s

118
Q

effects of Huntington’s on the CNS

A

caudate nucleus atrophies

degeneration of inhibitory medium spinal neurons

decreased neurotransmitters (GABA, substance P)

119
Q

onset after 40yo; movement changes (chorea); tremor; personality or behavior changes (usually aggression & anger)

A

Huntington’s disease

120
Q

tx for Huntington’s

A

none

it leads to death

121
Q

Neurodegenerative disorder affecting mainly dopamine-producing neurons in substantia nigra of brain

degeneration of basal ganglion

A

Parkinson’s

122
Q

neurotransmitter lost in Parkinson’s

A

dopamine

123
Q

tell tale early sign of Parkinson’s

A

resting tremor that abates with intentional movement

124
Q

dementia that can arise from Parkinson’s

A

Lewy body

125
Q

tx for Parkinson’s

A

dopamine increasing meds

126
Q

Lou Gehrig’s disease

A

amyotrophic lateral sclerosis

127
Q

degeneration of these parts of brain in ALS

A

corticospinal tracts, anterior horn cells, bulbar motor nuclei, or combo

128
Q

cramps; weakness; muscle atrophy of hands or feet; weakness progresses to forearms, shoulders, lower limbs; spasticity; hyperactive DTRs; extension plantar reflexes; clumisness; stiffness; wt loss; fatigue; difficulty controlling facial expression & tongue movement

A

ALS

129
Q

tx ALS

A

supportive

there is no cure

130
Q

excess CSF in skull

A

hydrocephalus

131
Q

2 types of hydrocephalus

A
  • Noncommunicating/obstructive - flow of CSF in ventricular system is blocked
  • Communicating - impaired absorption of CSF
132
Q

type of hydrocephalus in babies

A

noncommunicating/obstructive

133
Q

vomiting; poor feeding; elevated ICP; seizure; poor response to touch

A

hydrocephalus

134
Q

tx for hydrocephalus

A

ventroperitoneal shunt

135
Q

open neural tube birth defect

A

spina bifida

136
Q

open neural tube birth defect

A

spina bifida

137
Q

open neural tube birth defect

A

spina bifida

138
Q

pregnant mothers prevent spina bifida by eating…

which contains…

A

green leafy

folic acid

139
Q

spinous processes do not fuse - no herniation of spinal cord or meninges

A

spina bifida occulta

140
Q

herniation of meninges

A

meningocele

141
Q

herniation of spinal cord, meninges, CSF, nerves

A

myelomeningocele

142
Q

warning signs for spina bifida (if it isn’t visible)

A

caudal dimple

tuft of hair on lower spine

143
Q

Nonprogressive disorders of movement & posture caused by interruption of O2 to fetus

A

cerebral palsy

144
Q

etiology of cerebral palsy

A

interrupted O2 to fetus causing brain asphyxia DURING fetal period, NOT during birth

145
Q

abnormal reflexes; floppiness; rigidity of limbs & trunk; involuntary movements; unsteady walking

A

cerebral palsy

146
Q

both benign and malignant brain tumors can be life threatening unless…

A

they are accessible for removal

147
Q

largest % of primary malignant brain tumors

A

gliomas

148
Q

Breakdown in relation between thought, emotion, and behavior

A

schizophrenia

149
Q

enlarged cerebral ventricles, thinning of cortex, decreased size of hippocampus

increased dopamine, decreased GABA

A

schizophrenia

150
Q
  • enlarged cerebral ventricles, thinning of cortex, decreased size of hippocampus
  • increased dopamine, decreased GABA
  • Decreased blood flow to frontal lobes
A

schizophrenia

151
Q

psychosis

A

loss of contact with reality

152
Q

sx schizophrenia

A
  • Psychosis
  • Hallucinations
  • Delusions
  • Disorganized speech & behavior
  • Flattened affect
  • Cognitive deficits
  • Occupational & social dysfunction
153
Q

2 types of sx of schizophrenia

A

positive - delusions, bizarre behavior

negative - flat emotions, decreased speech

154
Q

delusions; hallucinations; cognitive function & affect remain relatively well preserved

A

paranoid schizophrenia

155
Q

disorganized behavior & speech

A

disorganized schizophrenia

156
Q

at least 2 of…

  • Immobility
  • Excessive purposeless motor activity
  • Extreme negativism
  • Peculiarities of voluntary movement
A

catatonic schizophrenia

157
Q

does not have characteristics of paranoid, disorganized, or catatonic

A

undifferentiated schizophrenia

158
Q

continued presence of negative schizophrenia symptoms

A

residual schizophrenia

159
Q

definition of anxiety disorder

A

anxiety lasting >6 months & interfering with daily life

160
Q

fear; sleeping problems; palpitations; dyspnea; dry mouth

A

anxiety

161
Q

broad anxiety over months

A

generalied anxiety disorder

162
Q

intrusive thoughts or fears

A

obsessions

163
Q

need to carry out certain rituals

A

compulsion

164
Q

Frequent episodes of intense anxiety that feels like it cannot be controlled

A

panic disorder

165
Q

Intense fear of criticism, embarrassment or humiliation

A

social phobia

166
Q

3 neurotransmitters imbalanced in depression

A

norepinephrine

serotonin

dopamine

167
Q

nearsightedness

A

myopia

168
Q

farsightedness

A

hyperopia

169
Q

farsightedness r/t aging

A

presbyopia

170
Q

irregular lens/cornea curvature

A

astigmatism

171
Q

lazy eye, cross eye

A

strabismus

172
Q

double vision

A

diplopia

173
Q

involuntary eye movement

A

nystagmus

174
Q

hearing loss r/t aging

A

presbycupis

175
Q

hearing better in noisy surroundings

A

paracusis

176
Q

bacteria from skin get into glands of eye

A

stye

177
Q

large & small styes

A

large - chalazion

small - hordeolum

178
Q

indication that conjuntivitis is bacterial

A

purulent discharge

179
Q

damage to optic nerve worsening over time

A

glaucoma

180
Q

pain; halos around light; peripheral vision loss; reddened eyes; n/v; blurred vision

A

glaucoma

181
Q

clouding of lens

A

cataract

182
Q

deterioration of macula

A

macular degeneration

183
Q

loss of central vision

eventual blindness

A

macular degeneration

184
Q

loss of peripheral vision

A

glaucoma

185
Q

subretinal fluid accumulates between neurosensory retina and retinal pigment epithelium

A

detached retina

186
Q

floaters; flashes of light; blurry vision; shadow over visual field

A

detached retina

187
Q

bone problem/obstruction deafness

A

conductive

188
Q

deafness caused by problem with nerve

A

sensorineural

189
Q

infection of middle ear

A

otitis media

190
Q

overgrowth of ear bones

A

otosclerosis

191
Q

hearing loss c low frequencies; balance issues; tinnitus

A

otosclerosis

192
Q

idiopathic disorder of inner ear affecting balance

A

meniere syndrome

193
Q

infectious disease that can increase risk for meniere’s

A

syphilis

194
Q

test for meniere’s

A

dix-hallpike maneuver

195
Q

a catatonic schizophrenic must have at least 2 of these 4 traits

A
  • Immobility
  • Excessive purposeless motor activity
  • Extreme negativism
  • Peculiarities of voluntary movement

NS374—Pathophysiology (18 decks)

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