Neurological system Flashcards
1
Q
what percentage of CO does the brain recieve
A
15-20%
2
Q
what are the 3 components of the brain
A
- forebrain
- midbrain
- hindbrain
3
Q
what comprises the brain stem
A
midbrain, medulla and pons
4
Q
reticular formation
A
the collection of nerve cell bodies within the the brainstem that connect the brainstem to the cortex that control the vital reflexes
5
Q
spinal cord
A
lies within the vertebral column
6
Q
upper motor neurons
A
- completely contained within the CNS
- control fine motor movement influences spinal reflex arcs
7
Q
lower motor neurons
A
- project into periphery
- directly influence muscles
- cell body is in the grey matter of the spinal column and brainstem , but extend to the PNS
8
Q
damage to the upper neurons results in
A
intital paralysis followed by partial recovery
9
Q
damage to the lower neurons results in
A
paralysis unless peripheral nerve damage is followed by nerve regeneration
10
Q
frontal lobe functions
A
- problem solving
- emotional traits
- reasoning
- speaking
- voluntary motor activity
11
Q
temporal lobe function
A
- understanding language
- behaviour
- memory
- hearing
12
Q
brain stem functions
A
- breathing
- body tempurature
- digestion
- alertness/sleep
- swallowing
13
Q
cerebellum functions
A
- balance
- coordination and control of voluntary movements
- fine muscle control
14
Q
occipital lobe function
A
- vision
- color perception
15
Q
parietal lobe function
A
- knowing right from left
- sensation
- reading
- body orientation
16
Q
what are the 3 components of the neuron
A
cell body
dendrites
axon
17
Q
dendrites
A
carry nerve impulses towards the cell body
18
Q
axon
A
carry nerve impulses away from the cell body
19
Q
myelin sheath
A
- wraps around the axon
- speeds up impulse propagation
20
Q
schwann cells
A
form myelin sheath around axon
21
Q
which injuries will heal faster: crushing or cut injuries
A
crush
22
Q
effect of scaring on nerve regeneration
A
block or slow
23
Q
cranium
A
protects brain and associated structures
24
Q
meninges
A
- 3 protective membranes
25
subarachoid space
- lies between the arachnoid and pia layers
- contains cerebrospinal fluid
26
cerebralspinal fluid
- intercranial and spinal structures float in the CSF
- protect from injury
27
____ ml of CSF is circulating in the subarachnoid space and ventricles
150 ml
28
___ml of CSF produced daily
600
29
where is CSF formed
in the ventricles
30
how many cervical vertebrae are there
8
31
how many thoracic vertebrae are there
12
32
how many lumbar vertebrae are there
5
33
how many sacral vertebrae are there
5
34
how many coccygeal vertebrae are there
1
35
what is the primary regulator for blood flow in the CNS
carbon dioxide
36
carbon dioxide
- primary regulator for blood flow in the CNS
- potent vasodialator
37
circle of Willis
- provides an alternative route for collateral blood flow if one of the contributing arteries is occluded
- saftey valve for the brain
38
blood brain barrier
- cellular structures that selectively inhibit potentially harmful substance from entering the interstitial spaces of the brain or CSF
39
what kind of alterations are there
- structural
- metabolic
- psychogenic
40
structural alterations
- infection, vascular alterations, neoplasms, traumatic injury, congenital degenerative and polygenic traits, and metabolic disorders
41
metabolic alterations
- alterations in the delivery of energy
- hypoxia, electrolyte disturbances, or hypoglycemia, disorders causes by renal or liver
- alter neuron excitability as medications and toxins are not properly cleared
42
psychogenic alterations
- psychiatric disorders
- appear unconciousness but are actually awake
- unrespnsiveness
43
level of conciousness is tested with
glasgow coma scale
44
if LOC decreases the brain relies on _____ to regulate respiration
carbon dioxide levels
45
confusion
loss of ability to think rapidly and clearly; impaired judgement and decision making
46
disorientation
the person may exhibit restlessness, anxiety, and irritation; disorientation to time occurs followed by disorientation to place and familar others and impaired memory; recognition of self is lost last
47
lethargy
- limited spontaneous movement or speech; easy arousal with normal speech or touch; orientation to time, place, or person may or may not occur
48
obtundation
- mild to moderate reduction in arousal (awakeness) with limited response to enviorment; falls asleep unless stimulated verbally or tactiley; answers questions with minimal response
49
stupor
- condition of deep sleep or unresponsiveness from which person may be aroused or caused to open eyes only by vigorous and repeated stimulation; response is often withdrawn or grabbing at stimulus
50
coma
- associated with nonpurposeful movement only on stimulation
51
pupillary changes
- indicate level of brainstem dysfunction
- brainstem control of arousal is adjacent to area that control pupils
52
oculomotor responses
- resting spontaneous, and reflexive eye movements change with the level of consciousness of the patient
- medications should not change reflexes but destructive or compression injuries to the brainstem will cause specific abnormalities
53
dysconjugate movement
indication of brain injury
54
motor responses classifications
- purposeful
- inappropriate or not present
55
how to test motor responses
ask patient to squeeze finger
56
decorticate flexion
- bringing into the core
- assoicated with hemisphere damage above the midbrain
57
decerebrate posturing
- associated with severe damage involving the midbrain and upper pons
58
normal sized pupils
2-5mm
59
aneurysm
dilated pupils
60
cluster headache effect on the pupils
constricted pupils
61
glaucoma efffect on the pupils
mid dilated pupils
62
head trauma effect on the pupils
unequal sized pupils
63
syphilis effect on the pupils
small pupils that. constrict poorly to direct light
64
selective attention
- ability to focus
- choose what we are going to pay attention to
65
selective attention deficits may be caused by
seizures, contusions, subdural hematomias, stroke, neoplasms, alzheimers disease, dementia
66
memory
recording, retention, and retrial of information
67
amnesia
mild or severe is loss of memory
68
retrograde amnesia
- difficultly with past personal history or facts
69
anterograde amnesia
inability to form new memories
70
executive attention deficits
- inability to maintain sustained attention and working memeory deficit
71
ADHD
- ability to function is impaired by inattentiveness, hyperactivity impulsivity
72
agnosia
failure to recognize the form and nature of objects
73
agnosia types
- tactile
- visual
- auditory
74
agnosia is assoicated with
damage caused by cerebral accidents which cause damage to specific areas of the brain
75
dysphasia
impaired comprehension or production of language
76
aphasia
- most severe form of dysphasia
- inability to communicate using language
77
dysphasia in the brocas area
- cant create speach
78
dysphasia in the wernickes are
cant comprehend speech
79
aphasia ia caused by
injuries and disease
- vascular, neoplastic, traumatic, degenerative, metabolic, or infectious
80
primary injury
initial trauma
81
secondary injury
- result of the alteration in the cerebral blood slow, intercranial pressure, and oxygen delivery
- can occur within seconds or days
82
cerebral perfusion pressure (CPP) formula
MAP-ICP
83
increased intercranial pressure is due to
increased intercrainial content
- tumours, edema, excess CSF, or hemmorage
84
stage 1 of compensation
- brain is trying to compensate mainly through vasoconstricition
- patient may be asymptomatic
85
stage 2 of compensation
- intercranial pressure is increasing beyond the brains ability to compensate
- cellular hypoxia worsens
- body attempts to compensate through vasoconstriction
- patient will show signs of increased intercrainal pressure
86
sings of decreased level of conciousness
- widening pulse pressure, decreased heart rate, pupils small and sluggisn
87
signs of increased intercrainial pressure
confusion, restlessness, decreased level of conciousness
88
stage 3 of compensation
- inter cranial pressure is approaching arterial pressure
- cellular hypoxia worsens; patient becomes hypercapnia
- patient will decompensated quickly
- intervention is required quickly
- decreased level of consciousness, widened pulse pressure, decreased heart rate, pupils small and sluggish
89
stage 4 of compensation
- brain in herniating
- intercranial pressure equals arterial pressure which prevents cerebral perfusion, hypoxia lead to cellular dealth which will further increase ICP
- patient is past the point of receovery
- 'blown pupils"
- HR, BP, will decreased
- cheyne-stoke breathing
90
cushing triad
- occurs in the late stages of acute head injury
- indicates brain stem herniation is imminent
- increased BP, decreased Pulse rate, irregular breathing rate
91
cerebral edema
- type of dependent edema
- increase in the fluid content of the brain tissue
92
cerebral edema causes
- distortion of blood vessels, displacement of brain tissues, increase in ICP, and eventually herniation
93
cytotoxic or metabolic edema
- early stages; blood brain barrier stays intact
- failure of the active transport systems (cell lose potassium and gain sodium (water follows))
94
cytotoxic or metabolic edema is treated with
diuretics
95
interstitial edema
- caused by blockage of CSF pathways
96
vasogenic edema
- late stages
- blood brain barrier compromised
97
vasogenic edema is caused by
increased permeability of the capillary endothelium of the brain
- injury of the vascular structures
98
vasogenic edema process
plasma proteins leak into the extracellular spaces, drae water to then; start in area of injury and spreads to white matter of the same side; edema promotes moe edema and ischemia
99
signs and symptoms for cerebral edema
- headache, stiffness, nausea and vomiting, vision loss, memory loss, loss of muscle coordination
100
hypotonia
- decreased muscle tone
- passive movement of a muscle
- has little resistance if any
101
hypotonia is caused by
- cerebral damage (causing ataxia and tremor)
- pained with exaggerated reflexes
'- spinal cord injury or cerebral vascular accident where nerve impulses are lost
102
hypotonia sings and symptoms
weak and tire easily, difficulty rising from seating, walking up the stairs, joints become hyperflexible, loss of muscle tone (look flabby and flat)
103
hypertonia
- increased muscle tone
- passice muscle movement with resistance to stretch
104
hypertonia is caused by
- upper neuron damage
- spasticity, paratonia, dystonia or rigidity
105
paratonia
inability to relax muscle during assesment
106
dystonia
contract uncontrollably
107
hypertonia signs and symptoms
- tire easily, weakness
- passive and active affected equally, can see either hypotrophy or hypertrophy dependent on decrease in muscle use or overstimulation of muscle fibres
108
hyperkinesia
- excessice purposeless movements
- could be tremors, or abnormal involuntary movements
109
dyskinesia
- abnormal movements that occur as spasms
- tardice dyskinesia is movements of the face
110
dyskinesia example
tourettes syndrome
111
hypokinesia
- loss of involuntary movement
- decrease of slowness in voluntary movements
- delay in time it takes to start to preform a movement
112
spinal shock
- temporary loss of all spinal cord function below the level of the lesion
- consequence of spinal cord injury
- destruction of efferent pathways) sending message down)
113
spinal shock initial symptoms
- complete paralysis, absence of reflexes, motor, sensory, autonomic function, including disturbances in bowel and bladder function
- can last hours
114
paresis
condition of muscle weakness caused by nerve damage or disease
115
paralysis
- loss of muscle function in part of your body
116
hemiparesis/hemiplegia
- one side
EXAMPLE: stroke
117
diplegia
- injuries of specific part of the brain
118
paraplegia
- lower extremities due to spinal cord injury
119
quadriplegia
- all four extremities due to spinal cord injury
120
brain death
- brain damage is beyond the point of recovery
- brainstem fucntions have stopped
- not reversible
121
brain death example
drug overdose
122
test to confirm brain death
dolls eyes, corneal reflex, ice in ears
123
cerebral dealth or irreversible coma
- dealth of the hemispheres - damage is permanent
- brain stem continues to maintain homeostasis
- person does not speak, open their eyes or have purposeful mevements, these individuals will not recover
- not candidates for organ donation
124
vegetative state
- unawareness of self or surrounding enviorment
- does not speak or understand speech, cannot follow commands, sleep-wake cycles present, spontaneous eye opening, BP and resps
125
a vegatative state lasts longer than __ _____ are considered permanent
12 months
126
locked-in syndrome
- complete paralysis of voluntary muscles (except eyes)
- fully conscious but unable to communicate except through eye movements
127
astrocytoma
- most common brain tumour across the lifespan (30-50%)
128
astrocytoma grade 1 and 2
slow growing
129
astrocytomas grade ____ are more common in children and younger people
1-3
130
grade 4 astrocytoma
- called glioblastoma
- most common type of lethal astrocytoma
131
extracerebral neoplasma
growth in the meninges outside the cerebrum
- usually originate from the meningeal cells in the dura mater
- slow growing
132
nerve sheath tumours
- autosomal dominant, disorder produces neurofibromas
- can occur peripherally (type1); or centrally (type 2)
- slow growing
- usually benign
133
nerve shealth signs and symptoms
muscle weakness, numbness, tingling
134
metastatic
- secondary tumours
135
primary sites for metastatic tumours
lung, breast, kidney, colon and skin
136
signs and symptoms of brain tumours
- diminished cognitive functioning (behavioural alteration), headache, vomiting, seizures, papilledema, unsteady gait, loss of sphincter control
137
metastatic brain tumors signs and symptoms
- headache, nervousness, depression, trembeling, confusion, forgetfulness, and gait disorders
