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NURS216B > Neuro I Quiz 1 > Flashcards

Neuro I Quiz 1 Flashcards

1
Q

whats the highest cranial cavity content?

A

blood and CSF (each 10%)

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2
Q

vegetative state
brain death
have some self-awareness

A

vegetative: damage to gray and white matter
brain death: no brainstem reflex and motor response, apnea
self-awareness: minimally conscious state

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3
Q

hypoxia vs ischemia

A

deficient delivery of O2 to the tissue

lack of oxygen/removal of waste within a tissue

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4
Q

global ischemia can lead to

A

watershed infarct and reperfusion injury

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5
Q

how do electrolyte imbalances lead to cerebral edema?

A

K, Na, Ca
accumulation or depletion of neurotransmitters

calcium cascade –> protein breakdown, DNA injury, free radical formation, lipid peroxidation, mitochondrial injury –> cell death

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6
Q

What does monroe-kellie hypothesis say?

A

content compartments compensate to maintain homeostasis (BAD)

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7
Q

min CPP and profound ischemia CPP

A

45mmHg, <40mmHg

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8
Q

CPP is the pressure gradient between

A

internal carotid artery and subarachnoid veins

pressure required to perfuse the brain

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9
Q

CPP=

A

MAP-ICP

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10
Q

brain herniation happens when

A

ICP is too HIGH

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11
Q

cushing triad

A

hypertension, wide pulse pressure, bradycardia

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12
Q

two types of cerebral edema

A

vasogenic and cytotoxic

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13
Q

vasogenic vs cytotoxic

A 
BBB dysfunction (infection, hemorrhage, brain injury, tumor, prolonged ischemia) 外
intracellular fluid overload (electrolyte imbalance) 內
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14
Q

4 treatment to preserve brain function

A
  1. cause
  2. ICP/cerebral edema
  3. maintain vital sign
  4. preserve function
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15
Q

what is concussion

A

traumatic biomechanical forces

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16
Q

s&s of concussion

A

headache, amnesia, confusion, heightened sensitivities, nausea, irritability, insomnia, poor concentration

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17
Q

how to treat concussion

A

low stimulation, prevent more impact, slow return to normal activities

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18
Q

what is post-concussion syndrome

A

when symptoms persist more than 3 months

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19
Q

encephalomyelitis

A

brain and spinal cord

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20
Q

myelitis

A

myelitis spinal cord

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21
Q

encephalitis

A

brain parenchyma

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22
Q

meningitis

A

meninges (pia matter, arachnoid, subarachnoid space)

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23
Q

what does the CSF present

A

subarachnoid space

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24
Q

common types of meningitis

A

bacterial and viral

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25
Q

Which pathogen causes the highest mortality in meningitis

A

Streptococcus pneumoniae

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26
Q

pathology of meningitis

A

severe inflammation –> BBB compromised 威脅 –> capillary leaking –> cerebral edema –> vascular congestion –> cellular death

meningeal thickening –> meningeal adhesions –> vascular congestion and decreased CSF outflow (hydrocephalus)

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27
Q

S&S of meningitis

A

Brudzinski sign (flexion of neck lead to flexion of hip and knee), petechial rash, stiff neck, headache, fever, N&V

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28
Q

treatment of meningitis

A

immediate broad-spectrum antibiotics & potent anti inflammatories

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29
Q

names of antibiotics for meningitis?

A

cephalosporins, penicillins, vancomycin

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30
Q

another drug for meningitis?

A

glucocorticosteroids (dexamethasone)

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31
Q

how is a brain tumor different from other cancers?

A

less rate of primary brain tumor metastasize

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32
Q

how is a brain tumor and seizure diagnosed?

A

MRI, EEG

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33
Q

treatment for brain tumors

A

surgery, radiation, chemotherapy

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34
Q

how does temozolomide work as chemotherapy?

A

alkylating agents that add alkyl group to DNA to damage

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35
Q

s/e of temozolomide

A

hair loss, GI upset, bone marrow suppression, low blood cell counts

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36
Q

“spontaneous, abnormally synchronous electrical discharges from neurons in the cerebral cortex” is _______.

A

seizures

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37
Q

two classifications of seizures and treatment type

A
  1. idiopathic (genetic, unknown) –> long-term antiepileptic meds
  2. symptomatic (brain injury) –> short-term antiepileptic meds
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38
Q

three classes of seizures

A
  1. Focal- one hemisphere
  2. generalized- both hemispheres (e.g. absence seizures, tonic-clonic seizures)
  3. unknown- don’t fit in either (e.g. febrile seizures)
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39
Q

S&S of seizures

A

loss of consciousness
aura
automatisms

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40
Q

seizures are localized to ______ region of the brain OR can span both ______

A

one region, both hemispheres

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41
Q

seizures may ______ to other seizures

A

progress

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42
Q

what life-threatening symptoms can seizures lead to?

A
  1. constriction of muscles including the airway
  2. impairs respiratory rate/depth
  3. injury
  4. severe VS changes (tachycardia, hypertension, reflex hypotension, hyperventilation)
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43
Q

treatment for seizures (aka. sedative hypnotic/CNS depressant drug)

A

benzodiazepines
barbiturates
anticonvulsants

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44
Q

benzodiazepines and barbituates increase effects of ____?

A

GABA

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45
Q

benzodiazepines and barbituates act as a ________agonist.

A

chloride channel

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46
Q

what is the kinetics for benzodiazepines?

A

hepatic metabolism, renal excretion, crosses placenta/breastmilk

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47
Q

benzodiazepines cannot be taken in which population

A

pregnant women

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48
Q

side effect of benzodiazepines and barbituates

A

respiratory depression (dose-dependent), drug to drug interactions, altered LOC & CNS activity (amnesia)

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49
Q

how to treat benzodiazepines overdose?

A

receptor antagonist Flumazenil

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50
Q

suffix for benzodiazepines?

A

-am

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51
Q

flunitrazepam is known as _____.

A

roofies

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52
Q

how is barbituates differ from benzodiazepines

A

more potent, narrow TI, more addictive and high degree of tolerance

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53
Q

how to treat barbituates overdose?

A

activated charcoal, sodium bicarbonate (urine alkalinization)

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54
Q

suffix for barbituates

A

-barbital

55
Q

how much secobarbital is used for euthanasia

A

9 grams, PO

56
Q

diazepam is combined with ____ and ____ agents for euthanasia

A

paralytic and anesthesia agents

57
Q

anticonvulsant is _______ and _____ specific

A

calcium and sodium

58
Q

anticonvulsant pathophysiology?

A

alter electrolyte movement

59
Q

sides effect of anticonvulsants

A

arrhythmias, drug to drug interactions, bleeding (vitamin K interference), toxicity (Dilantin has narrow TI)

60
Q

vitamin k is essential for

A

clotting

61
Q

how does the ketogenic diet used in seizure control?

A

elimination of carbohydrates –> altered metabolic state changes neuronal function –> decrease in neural activity

62
Q

status epilepticus occurs when

A

seizure type progresses to an unstoppable state (life-threatening)

63
Q

treatment for status epilepticus

A

benzodiazepines IV (diazepam and lorazepam)

64
Q

sleep is a state of _____

A

diminished consciousness (unconsciousness)

65
Q

sleep is a period of ____ and ____

A

inactivity and restoration (cellular growth, repair)

66
Q

what anatomical structures are involved during sleep

A

reticular formation, thalamus, cerebral cortex, hypothalamic suprachiasmatic nucleus, pineal gland

–> how each involves in sensory pathways

67
Q

what is the hypothalamic suprachiasmatic nucleus responsible for?

A

circadian rhythm

68
Q

melatonin is synthesized in and secreted by

A

pineal gland; pinealocytes

69
Q

what is the precursor of melatonin

A

tryptophan

70
Q

whats the relationship between SCN and melatonin

A

a feedback loop (night –>higher melatonin)

71
Q

tryptophan is synthesized into and then converted to

A

serotonin and then melatonin

72
Q

what happens when melatonin is in excess?

A

drowsiness, sleepiness, lethargy, depression

73
Q

sleep onset steps

A

circadian rhythm input –> decreased RAS –> decreased cortical stimulation –> decreased excitory neurotransmitter activity & increased inhibitory neurotransmitter & increased melatonin synthesis

74
Q

what neurotransmitter is increased and decreased during sleep?

A

increase: serotonin
decrease: norepinephrine and acetylcholine

75
Q

what are the sleep stages?

A

nonREM 1-4 (light to deep)

REM (muscle paralysis, altered VS, decreased BMR & cerebral blood flow, dreaming)

76
Q

what stage does nightmare and night terror occur

A

nightmare: REM

night terror: non REM

77
Q

insomnia is a type of

A

sleep disorder

78
Q

definition of insomnia

A

difficulty with sleep initiation, quality, and duration, ability to resume sleep

79
Q

sign and symptoms of insomnia

A

alternation in quality of ADLs (fatigue, decreased memory, GI upset, irritability)

80
Q

what is the affected demographic for insomnia

A

elderly, post-menopausal, other illnesses, stimulant use (caffeine, nicotine, ETOH), drug side effects (glucocorticoids)

81
Q

diagnosis for insomnia

A

sleep study (polysomnography), EEG, Vital sign, oximetry

82
Q

treatment for insomnia

A

melatonin: feedback loop
benzodiazepines: -am meds
non-benzodiazepines: Buspirone
antihistamines; antidepressants: diphenhydramine

83
Q

how does buspirone work to treat insomnia

A

serotonin agonist + dopamine 2 presynaptic binding (decreases post-synaptic dopamine)

84
Q

CNS drugs withdrawal symptoms

A

fever, psychosis, agitation, anxiety, panic, seizures, disorientation, impaired memory and focus, VS changes, blurred vision, loss of appetite

85
Q

avoid ____ when taking CNS drugs

A

ETOH

86
Q

obstructive sleep apnea is a type of

A

sleep disorder

87
Q

pathology of obstructive sleep apnea

A

the collapse of the upper airway –> pharyngeal wall collapse –> vocal cord approximation –> tongue obstruction of the oropharynx

88
Q

where in the airway is collapsed in patients with obstructive sleep apnea

A

pharynx

89
Q

what stage of sleep does obstructive sleep apnea prominent?

A

REM due to muscle relaxation

90
Q

what is a prominent risk factor for obstructive sleep apnea

A

obesity

91
Q

difference between normal and abnormal occurrence in obstructive sleep apnea

A

normal: occasional snoring
abnormal: apnea frequency >5 per hours (

92
Q

what can obstructive sleep apnea lead to?

A

fatigue, headache, irritability, poor memory, depression

93
Q

treatment for obstructive sleep apnea

A

decrease risk factor (Weight loss)

nighttime continuous airflow devices

94
Q

what is NCPAP

A

an airflow device that allows nasal continuous positive airway pressure by an occlusive mask

95
Q

What are the three types of anxiety?

A
  1. generalized anxiety
  2. panic
  3. social phobia
96
Q

treatment for anxiety

A

increase GABA (benzodiazepines)
increase (balance) serotonin (SSRIs)
behavioral and cognitive therapies

97
Q

what is generalized anxiety

A

the excessive, uncontrollable worry with systemic symptoms and unable to modulate; 12% of population, women more affected

98
Q

what is panic

A

an intense fear with systemic symptoms; duration is shorter; very common

99
Q

what emotional centers are involved in panic anxiety

A

the amygdala, hippocampus, prefrontal cortex, hypothalamus, brainstem, HPA axis

100
Q

resting
depolarization
repolarization
hyperpolarization

A

-70mV
-55mV
30mV
-90mV

101
Q

What are the 4 major brain regions?

A

cerebrum, cerebellum, diencephalon, brainstem

102
Q

what is the largest brain area?

A

cerebrum

103
Q

gyrus function

A

increase SA

104
Q

sulcus function

A

separate regions

105
Q

Broca’s area function

A

ability to speak

106
Q

Wernicke’s area function

A

language comprehension

107
Q

basal nuclei function

A

motor control

108
Q

patients with Parkinson’s lack what brain structure?

A

basal nuclei

109
Q

what are the three regions for diencephalon

A

hypothalamus, thalamus, and epithalamus

110
Q

how to distinguish hypothalamus, thalamus, and epithalamus?

A

hypothalamus- emotions, autonomic functions, hormone production
thalamus- relays and processes sensory info
epithalamus- where the pineal gland is, and for melatonin

111
Q

what are the three structures for brain stem?

A

midbrain
pons
medulla oblongata

112
Q

how to distinguish midbrain, pons, and medulla oblongata?

A

midbrain: processes visual and auditory data, generate reflexive somatic motor responses, maintain consciousness
pons: relays sensory info to cerebellum and thalamus

113
Q

medulla oblongata

A

relays sensory info to the thalamus, autonomic centers for visceral function regulations (cardio, GI, respiratory)

114
Q

what are included in cranial meninges?

A

dura mater, arachnoid mater, and pia mater

115
Q

what spaces are not present in cranial meninges?

A

epidural and subdural spaces

116
Q

what space contains CSF?

A

subarachnoid space

117
Q

what are the three functions of CSF?

A

support the brain, cushion the brain and spinal cord against trauma, transport nutrients

118
Q

what are the ventricular systems of the brain?

A

lateral ventricle, third ventricle, and fourth ventricle

119
Q

lateral ventricle communicates via ___

A

interventricular foramen

120
Q

third and fourth ventricle communicates via ____

A

cerebral aqueduct

121
Q

how is CSF produced

A

ependymal cells creates CSF –> choroid plexus secretes CSF –> flow across tight junction junction

122
Q

how is CSF circulated

A

lateral ventricle –> third ventricle –> forth ventricle –> subarachnoid space –> arachnoid villi of dural venous sinuses –> heart and lungs –> back to the three choroid plexus

123
Q

nervous tissue can survive without oxygen in how many seconds only

A

10 seconds

124
Q

nervous tissue apoptosis in how many minutes (aka. depletion of resources)

A

4-6 minutes

125
Q

nervous tissues do not store and recover what?

A

store oxygen and nutrition and recover nervous tissue injury

126
Q

why cant nervous tissues recover?

A

no centrioles

127
Q

brain uses ____ of all oxygen

A

20%

128
Q

brain uses ___ of CO per minute

A

15%

129
Q

brain has ___ of body weight

A

2%

130
Q

how to assess consciousness?

A

LOC, gaslow coma scale

131
Q

what can increased ICP lead to?

A

cushing triad and brain herniation

132
Q

diphenhydramine is treatment for

A

insomnia

133
Q

Buspirone is treatment for

A

insomnia

134
Q

alprazolam is often misused for?

A

calming effects recreationally

NURS216B (6 decks)

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