Neurological Disorders: Cortical Flashcards
What is the Monro-Kellie Doctrine?
equilibrium in cranial vault
What does an increase in CSF cause?
hydrocephalus
(in ventricles)
What does an increase in blood volume cause?
brain aneurysm
AV malformation (unneeded connection)
What does an increase in brain tissue volume cause?
inflammation
tumor
What is a simple partial seizure?
don’t lose consciousness
focal motor, focal sensory
What is a complex partial seizure?
some amnesia involved
psychomotor
What 3 things does the Glasgow Coma Scale assess?
- eye opening
- best motor response
- best verbal response
What is a normal score on the Glasgow Coma Scale?
15
What score is concerning on the Glasgow Coma Scale?
less than 7
What is a CVA (stroke)?
disruption of cerebral blood flow not related to trauma
What is the patho of a CVA?
- deprivation of normal perfusion
- cerebral infarction
- inflammation
What factors affect manifestations of a CVA?
area and extent
What are the 4 manifestations of a CVA?
- aphagia
- dysphagia
- paralysis on one side (facial droop)
- decreased cognitive ability
What is aphagia?
trouble understanding others
issues reading and writing
difficulty articulating speech
What things are affected with decreased cognitive ability?
memory
reasoning
personality changes
What is the patho of Transient Ischemic Attacks?
clot forms with spasms present around it
What are the 3 manifestations of Transient Ischemic Attacks?
- symptoms last less than 24 hours
- neuro deficits
- warning sign
What is the patho of Alzheimer’s Disease?
- cortical (brain tissue) atrophy
- ventricular dilation
- formation of plaques with cytoplasm which destroys nerve cells
- amyloid deposits around BVs which decreases volume of brain tissue
At what pressure is considered increased intracranial pressure?
greater than 15mmHg
What is the patho of IICP?
- increased blood volume, CSF, brain tissue
- an increase in BV pressure increases cerebral perfusion pressure
- herniation of brain
How is CPP calculated?
MAP-ICP
What is a normal cerebral perfusion pressure?
80-100mmHg at least 70
What happens with herniation of the brain?
brain forced into obscure places in skull
What are the 7 manifestations of IICP?
- headache
- changes in LOC
- changes in reflexes
- motor and visual changes
- abnormal posturing
- Cushing’s triad
- fixed and dilated pupils
What is decerebrate posturing?
severe
head is back
What is decorticate posturing?
less severe
arms brought to core
What is Cushing’s triad?
a late sign of IICP
1. bradycardia
2. slow and deep respirations
3. widening pulse pressure
What is the patho of Meningitis?
- bacteria or virus replicates in CSF and releases toxins
- inflammatory response that increases ICP
What are the 8 manifestations of Meningitis?
- headache
- nuchal rigidity
- ataxia
- visual disturbances, photophobia
- seizures
- cloudy CSF
- petechial rash
- increases in WBCs
What is nuchal rigidity?
neck becomes stiff
What is ataxia?
gait or coordination dysfunction
What is photophobia?
sensitivity to light
What is the patho of seizures?
progressive depolarization of cells which creates excessive electrical discharges
Where does a focal motor seizure occur?
locally and progresses distally
What are the manifestations of a focal motor seizure?
contraversive movement
(eyes and head turn to one side)
Where does a focal sensory seizure occur?
lesion in sensory cortex of parietal lobe
What are the manifestations of a focal sensory seizure?
simple, auditory, tactile, or visual disturbance
(numbness, tingling)
Where does a psychomotor seizure occur?
temporal lobe, medial surface of hemispheres, limbic system
What are the 4 manifestations of a psychomotor seizure?
- bizarre behavior
- exaggerated emotions
- automatisms
- no verbal response
What are automatisms?
actions without intention or conscious thoughts
What are examples of automatisms present in a psychomotor seizure?
lip smacking
grunting
chewing
What is the patho of a primary injury trauma?
- minimal disruption
(confusion, LOC, concussion) - extensive disruption
(sever motor, sensory deficits)
What is the patho of a secondary injury trauma?
inflammation
increased ICP
cerebral edema
What is the patho of head trauma?
intracranial bleed/hematoma
(clot forms after hemorrhage)
What are the 5 manifestations of head trauma?
- increased ICP
- seizures because of altered membrane transport
- abnormal bruising
- blood or CSF drainage through ears and nose
- altered motor and sensory function
What is periorbital ecchymosis?
black eye associated with head trauma
What is Battle’s sign?
bruising behind ear associated with head trauma
