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Pathohysiology > Neurological Disorders > Flashcards

Neurological Disorders Flashcards

1
Q

Blunt Brain trauma

A

Closed
Head strikes hard surface or a rapid moving object strikes the head.
Dura mater is intact and brain tissue is not exposed.

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2
Q

What kind of brain injury can Blunt trauma cause?

A

Focal (local) or diffuse (general) brain injuries.

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3
Q

Open Brain Trauma

A

Penetrating

injury breaks the dura and exposes the cranial contents to the environment.

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4
Q

what kind of injury does open trauma cause?

A

Causes primarily focal injuries.

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5
Q

What are types of injury caused by Bunt Trauma?

A

Coup injury and Contrecoup

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6
Q

Coup Injury

A

Injury directly at the point of impact

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7
Q

Contrecoup

A

Injury on the polar opposite of the site of impact

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8
Q

Focal Brain Injury

A 
Observable brain lesion 
force of impact typically produces contusion 
-extradural hematoma
-subdural hematoma
-Intracerebral hematomas
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9
Q

What are different types of concussions?

A

Mild and classical

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10
Q

Mild concussion

A

temporary axonal disturbance causing attention and memory deficits but NO loss of consciousness

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11
Q

Type I mild concussion

A

confusion
disorientation
memory amnesia

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12
Q

Type II Mild concussion

A

momentary confusion

retrograde amnesia of prior minutes

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13
Q

Type III Mild concussion

A

confusion with retrograde (greater than a few minutes) and anterograde amnesia

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14
Q

Classic concussion

A

Grade IV
loss of consciousness (for more than 6 hrs)
physiological and neurologic dysfunction without substantial anatomic disruption
anterograde and retrograde amnesia

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15
Q

What causes the loss of consciousness in grade IV concussions?

A

Disconnection of cerebral systems from the brain stem and reticular activating system

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16
Q

Your friend takes a huge hit as he is running for the goal line playing “flag football”. He is slow to get up and unsteady on his feet. He goes over to the sidelines and can’t remember what day of the week it is. The next day, he still can’t remember what happened for several hours before or after the game. How severe was the concussion he just experienced?

A

Grade III

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17
Q

cerebrovascular Disorders

A

Any Abnormalities of he brain caused by a pathologic process in the blood vessels

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18
Q

Cerebral Infarction

A

loss of blood flow to brain area

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19
Q

Cerebral Hemorrhage

A

Bleeding within the brain

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20
Q

Transient Ischemic Attacks (TIA)

A

confusion
difficulty communicating
usually no long term dysfunction (<24hrs)
a warning sign of something more severe.

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21
Q

What are different types of cerebrovascular accidents?

A

Hemorrhagic Stroke
Thrombotic Stroke
Embolic Stroke

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22
Q

Hemorrhagic Stroke

A

intracranial/cerebral hemorrhage
from an aneurysm
most common cause is hypertension

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23
Q

Thrombotic Stroke

A

arterial occlusions caused by thrombi formed in arteries supplying the brain or in the intracranial vessels

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24
Q

embolic stroke

A

an thrombus formed outside the brain

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25
What are examples of Intracranial Aneurysms?
Saccular (berry) Aneurysms | Fusiform (giant) aneurysms
26
Saccular (berry) aneurysms
Exacerbated (caused) by hypertension increases risk of hemorrhage the walls move out on one side of the vein, kinda like it's gonna go through exocytosis
27
Fusiform (giant) Aneurysms
walls move out on both sides like when you blow up ling skinny balloons
28
Cavernous Angiomas
group of dilated blood vessels with no other brain tissue | these are not that dangerous because they rarely hemorrhage.
29
capillary telangiectasis
small abnormally dilated capillaries. These are not that dangerous because they rarely hemorrhage.
30
venous angioma
abnormal cluster of veins draining a region of brain tissue. These are not that dangerous because they rarely hemorrhage.
31
Arteriovenous malformation (AVM)
most lethal arteries and veins in tangle of malformed vessels "tangle of worms"
32
Cerebral edema
increase in the fluid (intracellular or extracellular) with the brain
33
What are different types of cerebral edema?
``` vasogenic cytotoxic ischemic interstitial Hyrdocephalus ```
34
Vasogenic edema
increased capillary permeability
35
cytotoxic edema
block active transport | problem transporting ions so you get water movement due to ion imbalances
36
ischemic Edema
follows cerebral infarction increased capillary permeability block active transport (ion imbalances) water movement
37
interstitial edema
CSF moves across ependymal cells from ventricles to interstitial space
38
Hydrocephalus
type of interstitial cerebral edema | result of excess fluid within the cranial vault, subarachnoid space, or both.
39
What is hydrocephalus caused by?
an interference in CSF flow. - decreased reabsorption - increased fluid production - obstruction within the ventricular system
40
snout reflex
lips purse whenever touched lightly
41
palmomental reflex
twitch of cheek when stroking the palm
42
cerebral death
irreversible coma | death of the cerebral hemispheres exclusive of the brainstem and cerebellum
43
do you have behavioral or environmental responses in cerebral death?
No.
44
which functions are normal during cerebral death?
respiratory, cardiovascular, temperature control, and GI function.
45
survivors of cerebral death
remain in coma emerge in a vegetative state -akinetic mutism (AM) -Locked-in syndrome
46
Akinetic mutism
less aware
47
locked-in syndrome
more aware
48
seizures
disruption in balance of excitation and inhibition signals
49
the sudden transient alteration of brain function in seizures is caused by:
an abrupt explosive disorderly discharge of cerebral neurons
50
convulsion
tonic-clonic (jerky, contract-relax) movements associated with some seizures.
51
generalized seizures
bilateral
52
partial (focal) seizures
unilateral
53
status epilepticus
experience of a second seizure before the person has fully regained consciousness/capacity from the preceding seizure or a singe seizure lasting more than 5 minutes
54
what are some consequences of seizures
250% increase in adenosine triphosphate (ATP) demand cerebral oxygen consumption increased by 60% cerebral blood flow also increases aprox 250% available glucose and oxygen are depleted
55
what are some consequences of the depletion of available glucose and oxygen during seizures?
may produce secondary hypoxia and acidosis | may result in progressive brain tissue injury and destruction
56
epilepsy
to be seized by a force from without
57
two signals of seizure
aura | prodroma
58
aura
partial seizure prior to "real" seizure
59
prodroma
some sign like headache prior to seizure
60
treatment for seizure syndromes
fat-rich diet reduces seizure frequency
61
Cerebral edema caused by increased capillary permeability would be called:
Vasogenic
62
multiple sclerosis
destruction of the CNS due to inflammation of the vessels in the CNS and demyelination of nerve cells. A development of scars throughout the CNS
63
What is the cause of MS
interaction between autoimmune conditions, genetic make-up and viral infections of the brain. (herpes simples and epstein barr)
64
what are clinical manifestations of MS?
they are highly variable. It can attach any part of the CNS at any time. Which can cause problems with motor, sensory, cognitive, or autonomic system function.
65
how do you diagnose MS?
High IgGin CSF | multiple lesions throughout the CNS detected by MRI.
66
when does MS usually happen?
between 20-40 yrs old.
67
in which gender is MS more prevalent?
females (2:1)
68
where is MS more common?
the further away from the equator you are.
69
what type of disease is MS thought to be
autoimmune
70
What are the different types of MS
mixed (general) spinal cerebellar
71
Mixed MS (general)
commonly have central problems (vision disturbances, memory deficits, mood alterations) along with motor/sensory impairments
72
Spinal MS
mostly sensory and motor deficits
73
Cerebellar MS
mainly motor-loss of coordination
74
what are some treatments for MS?
prednisone (or other anti-inflammatory steroids) to decrease inflammation interferon beta 1b and beta 1a estrogen (clinical trials) for women
75
Acute confusion states
mental disorder with deficits in attention and coherence of thoughts and action -secondary to drug intoxication, metabolic disorder, or nervous system disease
76
dementia
progressive failure of cerebral functions not caused by an impaired level of consciousness
77
classifications of dementia
cortical | subcortical
78
cortical dementia
alzheimers disease
79
subcortical dementia
parkinson and huntington disease
80
Alzheimers disease
most common neurodegenerative disease worldwide
81
what causes alzheimer's disease
degeneration of the brain manifested by: -morphological changes -biochemical changes relates to genetic factors and poorly identified environmental factors.
82
Morphological changes in Alzheimer's disease
decreases surface area of the brain due to a decrease in size of the folds neurofibrillary tangles senile plaques decreased blood flow to the brain
83
neurofibrillary tangles
intracellular tangles of microtubules and microfilaments (detected upon autopsy)
84
senile plaques
areas of degenerated cells that coalesce around a fibrous core (detected upon autopsy) formed from a protein named beta amyloid
85
Clinical Manifestations of alzheimer's disease
slow and progressive change in memory (recent memory loss first) changes in mood changes in motor function (late)
86
Our results suggest that _________levels may be a risk factor for dementia, even among persons without diabetes
higher glucose
87
alzheimers disease is typifies by ______
amyloid plaques
88
_____ enhances breakdown of amyloid
ApoE | which then prevents plaques
89
how is insulin resistance related to alzheimer's disease?
insulin resistance reduces cognitive function
90
insulin resistance _____ risk of dementia
increases
91
ketones _____ cognitive function
improve
92
is there an approved test for early diagnosis of alzheimers disease?
No :(
93
how do we diagnose alzheimers disease?
by ruling out other diseases and following the course of the disease
94
what are some preventative measure for alzheimers'
``` diet rich in folate reduce refined carbs insulin-sensitizing meds increase essential fatty acids physical activity mental exercise ```
95
what is treatment for alzheimers?
there is no cure
96
Parkinson's disease
destruction of brain dopamine neurons in the striatum and substantia nigra
97
functional dopamine
coordinate the brain centers that monitor body position involved in neuronal circuits that permit pre-programmed movements (movements w/o thinking) inhibits the acetylcholine that cause muscle movement (reduces spontaneous, involuntary movements)
98
Clinical manifestations of parkinson's disease
``` tremor at rest rigidity akinesia (pill rolling) dementia, slow thought process, or depression shuffling gait frozen face postural abnormalities disorders of righting and equilibrium ```
99
Diagnosis for parkinsons
case history, course of disease, and brain scans
100
environmental factors relates to parkinsons:
``` head trauma exposure to anesthetics exposure to hydrocarbons pesticide exposure drinking well water working with wood or wood products with in janitorial services ```
101
Treatment of Parkinsons
Levodopa (Ldopa) precursor to DA. dopamine agonists inhibitor of monoamine oxidase (the enzyme taht degrades DA) electrode placed in basal ganglia of the brain
102
Huntington Disease is autosomal ____
dominant
103
Huntington disease
a type of chorea (family of dyskinesias) sever degeneration of the basal ganglia and frontal cerebral cortex disrupted thought process
104
clinical manifestations of huntington's
``` abnormal movement (hyperkinesia) dementia characterized by irritability (often becomes violent), apathy, inability to plan and organize, loss of short term memory, and slow thinking. euphoria or depression (bipolar, swing back and forth) changes in different parts of the bain (basal ganglia) detected by MRI ```
105
is there a treatment of huntington's
no

Pathohysiology (16 decks)

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