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Patho: neuro, pain, fluid balance > Neurological Patho > Flashcards

Neurological Patho Flashcards

1
Q

Fever

  • what it is
  • benefits
A

-temporary resetting of the hypothalamic thermostat

  • kills many pathogenic microorganisms
  • increases reactions and pathways in cells than may increase defense mechanisms
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2
Q

Pyrogens

A

fever inducing substances released during the inflammatory respponce

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3
Q

Hyperthermia

  • what it is
  • symptoms
  • cause
A
  • elevation of the body temp w/o an increase in the hypothalamic set point
  • nerve damage, coagulation of cell proteins, death
  • therapeutic, accidental (heat exposure), associated with stroke or head trauma
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4
Q

Malignant Hyperthermia

A

a rare inherited muscular disorder

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5
Q

Hypothermia

  • what it is
  • symptoms
  • cause
A
  • body temo less than 35C resulting in the formation of ice crystals inside cells causing them to rupture and die
  • slows rate of metabolism, increases blood viscosity, slows blood, blood coagulation, vasoconstriction
  • therapeutic: slow metabolism and preserve ischemic tissue during surgery
  • Accidental: sudden immersion in cold water or prolonged exposure to cold
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6
Q

NREM vs REM Sleep

A

NREM: 75-80% of sleep time, deep sleep, processing and compartmentalizing, parasympathetic activity increased

REM (rapid eye movement): 20-25% of sleep time, occurs every 90 min beginning after 1-2hr sleep

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7
Q

Obstructive Sleep Apnea Syndrome

  • what it is
  • cause
A
  • respiratory condition

- caused by total or partial upper airway collapse

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8
Q

Narcolepsy

  • what it is
  • cause
A
  • primary hypersomnia, A chronic sleep disorder that causes overwhelming daytime drowsiness.
  • Associated with immune-mediated destruction of hypocretin-secreting cells in the hypothalamus
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9
Q

Visual Dysfunctions

-cause

A

damage to cranial nerve II, IV, VI
II- Optic
IV- Trochlear
VI- Abducens

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10
Q

Strabismus

  • what it is
  • symptoms
A
  • deviation of the eye (lazy eye)

- results in decreased focal vision

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11
Q

Nystagmus

  • what it is
  • cause
A
  • one or both eyes are shaky

- genetic, alcohol intoxication

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12
Q

Glaucoma

  • what it is
  • cause
A
  • increased intraocular pressure

- damage to rods and cones

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13
Q

Myopia

A

-nearsighted, can see things near

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14
Q

Hyperopia

A

farsighted, can see things far away

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15
Q

Astigmatism

A

uneven cornea surface resulting in multi focal points

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16
Q

Meniere Disease

  • what it is
  • cause
  • symptoms
A
  • Disruption in both vestibular (inner ear, balance) and hearing function
  • unknown
  • periods of vertigo (spinning sensation), hearing loss, tinnitus (ringing), fullness in ears
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17
Q

Otitis Externa

  • what it is
  • cause
  • symptoms
A
  • Infection of the outer ear
  • prolonged moisture
  • earache
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18
Q

Otitis Media

  • what it is
  • who it effects
A
  • infection of the middle ear

- pediatric patients

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19
Q

Vestibular Nystagmus

A

eyeball inflammation resulting in eyeball shakiness

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20
Q

Vertigo

  • cause
  • symptoms
A

-inflammation, build up in inner ear

  • spinning sensation
  • NO hearing loss
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21
Q

Reticular Activating System (RAS)

-what it does

A

responsible for overall level of consciousness.

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22
Q

Arousal

  • what it is
  • what it is controlled by
A
  • state of awakeness

- controlled by the RAS

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23
Q

Awareness

A

encompasses all cognitive functions and mood

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24
Q

Decorticate

A

Abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight.
Extreme rigidity
Symptoms will be contralateral to lesion

This type of posturing is a sign of CNS damage in the brain

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25
Q

Decerebrate

A

Abnormal body posture where the arms and legs are held straight out, the toes are pointed downward, and the head and neck are arched backward.
Extreme rigidity
Symptoms will be ipsillateral (same side) to lesion

This type of posturing usually means there has been severe damage to the brain stem (thus WORSE PROGNOSIS b/c the brain stem controls vital function)

26
Q

Brain Death (total brain death)

  • what it is
  • Symptoms
A
  • irreversible loss of entire brain (including brain stem and cerebellum)
  • the brain can no longer maintain internal homeostasis
  • unresponsive coma, apnea, pupils dilated; fixed; no reflext, flat EEG (electroencephalogram: a test used to find electrical activity of the brain), no ocular response.
27
Q

Cerebral Death

  • what it is
  • Symptoms
A
  • irreversible coma due to death of the entire cerebral hemispheres (excluding the brain stem and cerebellum)
  • the brain continues to maintain internal homeostasis
  • no behavioral response
  • some patients progress through, remain in coma, enter a vegetative state, progress to a minimally conscious state (MCS), locked-in syndrome
28
Q

what can cause alterations in awareness?

A
  • ischemia
  • compression or effects of toxins
  • chemicals
  • metabolic disorders
29
Q

Seizures

  • what they are
  • cause
A
  • excessive discharges of cortical neurons.

- The electrical impulse short circuits and explodes across the synapse

30
Q

Convulsion

A

tonic-clonic (jerky, contract-relax) movements

31
Q

Partial Seizure

A

only part of the brain surface is affected during seizure. Focal and unilateral

32
Q

Generalized seizure

A

the entire brain surface is affected.

bilateral

33
Q

What is postictal state?

what is the main concern?

A

the period post seizure when the brain has been depleted of ATP.
Potential of passing out

34
Q

Cerebral Edema

A
  • increased fluid in the brain
  • maybe caused by inflammation from injury
  • can lead to ICP
35
Q

Increased intracranial pressure (ICP)

A

caused by increase in intracranial content (tumor, edema, excessive CSF, hemorrhage)

36
Q

Hydrocephalus

  • what is it
  • cause
A
  • excess fluid w/i the cerebral ventricles, subarachnoid space, or both
  • caused by interference in the CSF flow
37
Q

Traumatic brain injury (TBI)

A

alteration of brain function caused by external force

38
Q

focal brain injury

open vs closed

A
  • Focal: local, contusion, brain bleed
  • open: penetrating trauma, breaks the dura, exposes cranial contents, typically loss of consciousness
  • closed: blunt trauma, dura remains intact, coup or countercoup, impact of brain on on skull causes contusions
39
Q

diffuse brain injury

A

-diffused: general

40
Q

Coup vs countercoup (focal brain injury)

A
  • coup: brain impacts the front of the skull
  • countercoup: brain impacts the back of the skull

side impact: coup is when the head hits the blunt force, countercoup is when it snaps back and hits the opposite side of the skull

41
Q

Contusions (focal brain injury)

A

brain bruising/ bleeding from broken blood vessels

42
Q

Epidural, subdural and intracerebral hematomas (focal brain injury)

A

Epidural: blood between skull and dura. can be a fast bleed, loss of consciousness, easiest to treat

Subdural: blood between the dura and the arachnoid. **can be the most fatal b/c pt. may not know that they have a brain bleed (may feel like a bad headache)

Intracerebral: (aneurysm) blood bellow the archnoid and pia (inside brain tissue).

43
Q

Axonal Damage (diffused brain injury)

A

acceleration/ deceleration or rotational force.
shearing, stretching, tearing nerve fibers.
cannot be repaired in CNS.

44
Q

concussion vs diffuse axonal injury (DAI)

A

concussion: blow to the head, either with or without loss of consciousness and can lead to temporary cognitive symptoms.

DAI: axons are sheared as the brain rapidly accelerates and decelerates.
loss of consciousness for >6hr

45
Q

Concussion Symptoms

A

headache, confusion, lack of coordination, amnesia, nausea, vomiting, dizziness, ringing in the ears (tinnitus), Dysarthria, fatigue, change in personality

46
Q

mild concussion vs Classic Cerebral Concussion

A

Mild: no loss of consciousness, confusion lasting minutes, possible amnesia

Cerebral: loss of consciousness >6hr
amnesia, confusion lasting hours to days

47
Q

what causes Spinal cord injury

A

traumatic injury of vertebral and neural tissues as a result of pulling, compressing, or shearing forces

48
Q

Paralysis:
quadriplegia
paraplegia
hemiplegia

A

Cervical injury

lumbar injury

contralateral injury (stroke)

49
Q

Cerebral Vascular Accidents (CVA)

  • what is it
  • 3 types
A

-Stroke: caused by interruption of good blood flow

  • Ischemic (clot leading to a lack of blood flow leading to hypoxia then narcosis)
  • hemorrhagic (blood leaks into brain tissue)
  • Associated with hypoperfusion
50
Q

Ischemic Stroke
thrombotic
embolic
hypoperfusion

A
  • thrombus (blood clot) that develops in the arteries supplying blood to the brain
  • Fragments that break from the thrombus (blood clot) formed outside the brain
  • inadequate blood supply to the brain
51
Q

Hemorrhagic Stroke

  • cause
  • what happens
A

-hypertension
-bleeding causes compressed brain tissue.
leads to ischemia, edema, increased ICP, necrosis

52
Q

Meningitis

  • what it is
  • symptoms
A
  • inflammation of the fluid and membranes (meninges) surrounding your brain and spinal cord.
  • swelling of the CNS

-headache, fever, a stiff neck

53
Q

Aseptic vs Bacterial Meningitis

A

Aseptic: “non-bacterial”, viral

Bacterial: more concerning

54
Q

Encephalitis

  • what it is
  • what causes is
A

infection (typically viral) of the brain and spinal cord.
Fever

Arthropod- borne (mosquito, tick), or herpes

55
Q

Alzheimer’s

  • what it is
  • what causes is
  • symptoms
A

Decrease axonal transmission, observable atrophying in the brain

  • Neurofilrillary (tau) tangles
  • Amyloid Plaques

1st- short term memory loss
2nd- loss of ability to speak
3rd- loss of ability to walk

56
Q

Parkinson’s

  • what it is
  • what causes is
  • symptoms
A

Degeneration of the basal ganglia.
decreased production of dopamine (leading to excessive ACH).
The lack of inhibition from dopamine leads to over stimulation of ACH.

Excessive ACH results in tremors, rigidity, bradykinesia (slowness of movement)

1st- tremor in hands, lack of balance
2nd- short term memory loss

57
Q

ALS

  • what it is
  • what causes is
  • symptoms
A

Amyotrophic lateral sclerosis

unknown etiology

1st- loss of ability to walk (muscle atrophy)
2nd- loss of ability to speak
3rd- respiratory failure
Retain normal intellectual and sensory function

Usually fatal within 3yr

58
Q

MS

  • what it is
  • what causes is
  • symptoms
A

Multiple Sclerosis
progressive, inflammatory, demylinating disorder of the CNS
Autoimmune of unknown origin
more common in women
Cytotoxic T cells kill myelinating glial cells

1st- loss of ability to walk
2nd- short term memory loss
3rd- visual disturbances and urinary incontinence

59
Q

GB

  • what it is
  • what causes is
  • symptoms
A

Guillain- Barre
demyelination of peripheral nerves (schwan cells).
Acute onset ascending motor paralysis from immunologic reaction

usually triggered by respiratory or GI infection.
recovery w/i weeks to months

Symptoms: fatigue, weakness

60
Q

MG

  • what it is
  • symptoms
A

Myasthenia Gravis
Chronic autoimmune disease attacking neuromuscular junctions.
An IgG antibody is produced against ACH receptors on skeletal muscle

Symptoms: weakness and fatigue of muscles, eyes, and throat.
Cause Diplopia (double vision), difficulty chewing, talking or swallowing
61
Q

Difference between meningitis and encephalitis

A
  • Meningitis: is an infection of the meninges, the membranes that surround the brain and spinal cord.
  • Encephalitis is inflammation of the brain itself

Patho: neuro, pain, fluid balance (4 decks)

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