Neuro Brain Disorders Flashcards
Identify the levels of consciousness & why in neurological disorders it is closely monitored
full consciousness-A&O X4
confusion-disoriented to time, place, or person, memory difficulty, difficulty following commands
lethargy-oriented to time, place and person, but slow in mental processes–like motor activity and speech. but pain response is intact.
obtundation-responds verbally with a word, arousable with stimulation, responds appropriately to painful stimulation, follows simple commands, appears very drowsy
stupor-unresponsive except to vigorous stimuli, lies quiet with minimal spontaneous movements may have incomprehensible sounds and/or eye opening
coma: does not respond appropriately to stimuli, sleeplike state with eyes closed, does not make any verbal sounds.
in neurological disorders these LOCs are closely monitored because it could indicate disease progression or a new onset of problems if the level of consciousness declined.
Explain the Monroe-Kellie Hypothesis as it relates to Intracranial Pressure (see Porth Pg. 478-479 Understanding Intracranial Pressure)
normally, a reciprocal relationship exists among the three intracranial volumes such that the ICP is maintained within normal limits. Because these volumes are partially incompressible, a change in one component must be balanced by an almost equal and opposite effect in one or both of the remaining components.
Differentiate cytotoxic edema from vasogenic edema
cytotoxic edema is where there is an increase in intracellular fluid. it can result from hypoosmotic states such as water intoxication or severe ischemia that impair the function of the sodium-potassium membrane pump.
vasogenic edema occurs with conditions that impair the function of the blood brain barrier and allow the transfer of water and protein from the vascular into the interstitial space. It occurs in conditions such as tumors, prolonged ischemia, hemorrhage, brain injury, and infectious processes (meningitis). Occurs in the white matter more because the white matter is more compliant.
- How does acute ischemia affect the neurons?
the neurons die
double check this
Define Traumatic Brain Injury & relate severity of TBI to the Glasgow Coma Scale
Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
the more severe the TBI, the lower the number on the glasgow coma scale, meaning that the more critical condition the person is in because of their loss of consciousness.
Compare & contrast primary versus secondary brain injury
primary injuries are those injuries in which damage is caused by impact. they include focal (contusion, laceration, hemorrhage) and diffuse (concussion, diffuse axonal injury) injuries.
secondary injuries are those injuries in which damage is caused by ischemia secondary to hypoxia and hypotension. Can happen during CPR.
the significance of secondary injuries depends on the extent of the damage caused by the primary injury.
Define autoregulation of blood flow to the brain, how does it change with brain injured patients?
cerebral autoregulation has been classified as the ability of the brain to maintain constant cerebral blood flow despite changes in systemic arterial pressure. the cerebral cortex adjusts cerebral blood flow locally to adjust it’s metabolic needs.
it changes with brain injured patients in that it would not be appropriate (too slow, too fast??)
Differentiate the pathogenesis of Ischemic Stroke versus Hemorrhagic Stroke
Ischemic strokes are strokes where you have a cerebrovascular obstruction caused by thrombosis or emboli.
hemorrhagic strokes result from the spontaneous rupture of a cerebral blood vessel. Blood leaks into the brain and it’s bad.
What results when there is blockage of the middle cerebral artery in ischemic stroke? (See Porth, Pg.486)
damage to the fine manipulative skills of the face and upper limbs, and to receptive and expressive communication functions (aphasia).
