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PSYC 351B > Neurological Disorders > Flashcards

Neurological Disorders Flashcards

1
Q

Why is oxygen needed in the brain?

A
  • needed to break down glucose into carbon dioxide and water

- need a continuous feed of supply

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2
Q

What areas are particularly vulnerable to oxygen loss?

A
  • subcortical nuclei, limbic system, frontal lobes and cerebellum
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3
Q

What is anoxia and hypoxia?

A
  • an absence of oxygen

- a deficiency in oxygen

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4
Q

What is an ischemic accident?

A
  • loss of blood flow
  • can be transient
  • happen in the internal carotid, middle cerebral or the vertebral cerebral arteries
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5
Q

How do ischemic accidents affect stroke?

A
  • higher risk of stroke by 20-35%
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6
Q

What is a hemorrage?

A
  • escaping blood from a ruptured blood vessel
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7
Q

What is an embolism or embolic occlusion?

A
  • a temporary block that clears with pressure
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8
Q

What are the symptoms of a transient ischemic attack?

A
  • tingling or numbness in one side of the face
  • confusion
  • loss or impairment of speech
  • slurring of speech and dizziness
  • blurry or double vision
  • other cognitive changes
  • weakness on one side of body (arm or leg)
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9
Q

What is infarction?

A
  • (obstruction of blood flow)

- cell death caused by occlusion of a blood vessel

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10
Q

What are infarctions mostly caused by?

A
  • thrombotic or embolic vascular occlusion mostly caused by atherosclerosis
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11
Q

What artery is particularly vulnerable to infarction?

A
  • middle cerebral artery (left hemisphere)
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12
Q

What are infarctions in small vessels called?

A
  • lacunar infarctions
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13
Q

What is a thrombotic vascular occlusion?

A
  • full block of an artery
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14
Q

What is a hemorrage and what are they commonly caused by?

A
  • rupture of the vessel producing hematomas

- can be caused by aneursyms

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15
Q

What is a hematoma?

A
  • collection of blood outside of blood vessels
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16
Q

What is an aneurysm?

A
  • an abnormal enlargement in a blood vessel

- causing thinning in the walls

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17
Q

What areas are particularly vulnerable to hemorrhages?

A
  • putamen, white matter, thalamus, pons, cerebellum, and caudate nucleus
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18
Q

What are the types of aneurysms?

A
  • saccular aneurysm

- fusiform aneurysm

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19
Q

What is coiling?

A
  • insert microcatheter into femoral artery and feed wire up to aneursym
  • fill aneursym with coiled wire
  • decreases chances of rupture
  • but risk of embolism during procedure
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20
Q

What is a intracerebral hemorrhage stroke?

A
  • vessel rupture
  • increased intracranial pressure (ICP)
  • neuronal death
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21
Q

What is a subarachnoid hemorrhage stroke?

A
  • rupture occurs within the subarachnoid space

- increased intracranial pressure (ICP)

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22
Q

What is arteriovenous malformation?

A
  • too much branching of capillaries producing thin and weak walls
  • tangle of abnormal blood vessels
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23
Q

What are the neuropsychological effects (of stroke)?

A
  • impaired inhibitory control
  • impaired attention and attentional control
  • motor and sensory impairments
  • memory impairments
  • deficits in abstract reasoning
  • emotional and behavioural changes
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24
Q

What are characteristics of brain tumors?

A
  • atypical, uncontrolled growth of cells
  • cells do not serve a functional purpose
  • tumor grows at the expense of healthy cells
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25
Q

What are infiltrating tumors?

A
  • take over and “invade” neighbouring areas of the brain and destroy surrounding tissue
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26
Q

What are non-infiltrating tumors?

A
  • encapsulated, well differentiated and non-invasive
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27
Q

What are malignant tumors?

A
  • indicates that the properties of the tumor cells invade other tissue and that there is a propensity for regrowth
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28
Q

What are benign tumors?

A
  • describes abnormal cell growth that is usually surrounded by a fibrous capsule and is non-infiltrative
  • a much smaller probability for regrowth
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29
Q

What is grading?

A
  • a classification system of tumor growth

- grading is in order of increasing malignancy from Grades 1 to 4

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30
Q

What types of brain tumors are infiltrating?

A
  • gliomas
  • glioblastoma multiforme
  • astrocytomas
  • oligodendrogliomas
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31
Q

What types of brain tumors are non-infiltrating?

A
  • meningiomas
32
Q

What are gliomas?

A
  • a malignant tumour of glial tissue
33
Q

What is a neuroma?

A
  • begnign growth of nerve tissue between the toes
34
Q

Why are traumatic brain injuries a big deal?

A
  • number one killer of young Canadians
  • annual cost about 3 billion
  • 50, 000 Canadians annually
  • high correlation with homelessness and prison
35
Q

What are the leading causes of TBI?

A
  • motor vehicle accidents
  • sports injuries
  • falls
  • alcohol involved in 1/3 of all TBIs
36
Q

Why is the brain vulnerable to TBIs?

A
  • brain is consistency of congealed oatmeal
  • skull is roughly as thick as 3 pennies
  • technology has advanced faster than evolution
37
Q

What are the different types of trauma?

A
  • penetrating
  • crush
  • open
  • closed
38
Q

How does a penetrating trauma occur?

A
  • by a hard object, such as bullet, scissors or knife
39
Q

What are the primary and secondary risk of penetrating trauma?

A
  • primary risk: depends on location

- secondary: infection and hemorrhaging

40
Q

What causes crush trauma?

A
  • skull and brain are crushed between two hard surfaces
41
Q

What is open trauma?

A
  • skull is fractured and there is an opening causing the brain to be exposed
42
Q

What is a closed head injury?

A
  • rapid acceleration and deceleration shake the brain in the skull (like jello)
  • no direct impact is needed
43
Q

What is acceleration and deceleration?

A
  • acceleration: significant physical force propels it quickly from stationary to moving
  • deceleration: brain is in motion then stopped abruptly
44
Q

What are the primary effects of a closed head injury?

A
  • coup: a contusion at the site of impact

- contra-coup: a contusion on the opposite site of impact

45
Q

What is diffuse axonal injury?

A
  • common and most likely at frontal lobes and temporal poles due to uneven “sandpaper-like” surface of the tentorial plates that hold them in place
  • physical forces shear, tear and rupture nerves, blood vessels and covering of the brain
46
Q

What are complications of diffuse effects?

A
  • neuronal disruption, ischemia, hemorrhaging and edema
47
Q

Why are frontal lobes vulnerable to TBI?

A
  • bone shape on top of skull

- result in anosmia (inability to smell)

48
Q

What is tensile strength?

A
  • minimum stress required to rupture axon
49
Q

What is retrograde degeneration?

A
  • axon degenerates back to cell body resulting in cell death
50
Q

What is anterograde degeneration?

A
  • damaged cell bod leads to axon fibre degeneration
51
Q

What is the Glasgow Coma Scale?

A
  • standard rapid, reliable measure of coma depth

- assesses language, consciousness, motor, etc.

52
Q

What do scores >13 say?

A
  • mild confusional state
53
Q

What do scores <5 say?

A
  • deep coma
54
Q

What scores mean the patient is in a coma state?

A
  • 8 or less

- can’t open eyes, make recognizable sounds or follow commands

55
Q

What scores predict good recovery?

A
  • > 8
56
Q

What secondary effects can there be with closed head injury?

A
  • edema
  • herniation
  • extradural and subdural hemorrhage
  • intracranial bleeding
  • skull fractures
  • post traumatic epilepsy
57
Q

What is edema?

A
  • swelling of the brain after trauma
  • main cause of death
  • brain swells and becomes compressed, blocking arteries
58
Q

What is herniation?

A
  • hemorrhages, tumours or infections displace and deform the brain
59
Q

What is transtentorial herniation?

A
  • swelling causes the brain stem to protrude through the opening at the base of the skull
  • called coning and is often fatal
  • compromises the brainstem which controls vital functions
60
Q

What treatment is done to monitor transtentorial herniation?

A
  • intracranial pressure monitored with catheter into ventricles or subarachnoid space
61
Q

How is intracranial pressure controlled?

A
  • blood pressure ca be reduced medically or with hyperventilation
  • extreme cases are put in a pharmacologically induced coma
  • last resort: sunt or removal of a lobe to make room
62
Q

What is subdural hematoma?

A
  • between dura and arachnoid space

- frequent and very dangerous but difficult to detect

63
Q

When can subdural hematoma occur?

A
  • 1 hour to 1 week after injury
64
Q

What exactly occurs during a subdural hematoma?

A
  • initial period of unconsciousness followed by normal conscious functioning
  • bleed enlarges and pushes brain laterally and downward causing herniation and consciousness deteriorates quickly
65
Q

What are the symtpoms of subdural hematoma?

A
  • contralateral hemiparesis, ipsilateral pupil dilation, changes in consciousness
66
Q

What is extradural hematoma (epidural hematoma?

A
  • between dura and skull
  • uncommon (1-3%)
  • usually caused by rupture of an artery
67
Q

How is a extradural hematoma treated?

A
  • by drilling burr holes over parieto-occipital and temporal regions to drain blood before it coagulates
68
Q

What is intracranial bleeding?

A
  • bleeding within the brain

- difficult to remove

69
Q

What occurs in 15% of fatal injuries (related to intracranial bleeding)?

A
  • space-occupying clots
70
Q

What is the most frequent cause of intracranial bleeding?

A
  • microscopic hemorrhages formed by torn blood vessels
71
Q

What may be required to treat intracranial bleeding?

A
  • surgery to relieve pressure caused by a clot
72
Q

What are the two types of skull fractures?

A
  • linear fracture: benign, distinct straight line

- depressed: fragments of skull driven into dura and brain

73
Q

What are the risks of skull fractures?

A
  • infection, CSF leaks, bleeding

- can rupture meningeal arteries or venous sinuses resulting in epidural and subdural hematomas

74
Q

When are post-traumatic epilepsy symptoms more likely?

A
  • after penetrating head injuries (40%) than closed head wounds (10%) because they are related to presence of scar tissue
  • onset can be delayed for up to 2 years
75
Q

What precaution is taken against post-traumatic epilepsy?

A
  • patients given anticonvulsant medication to control for possibility
76
Q

What are acute treatments of TBI?

A
  • ABCs (airways, breathing, circulation)
  • control ICP with ventilation/diuretics
  • steroid therapy to prevent edema
  • temperature control to control metabolic rate

PSYC 351B (14 decks)

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