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Exam 4 Pathophysiology > Neurological System Disorders > Flashcards

Neurological System Disorders Flashcards

1
Q

Pressure required to get oxygen into brain to perfuse cells of brain

A

Cerebral Perfusion Pressure (CPP)

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2
Q

Decreased CPP are caused by?

A
  • Hypovolemia
  • Hypotension
  • Hypertension
  • Blockage of arterial flow into brain
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3
Q

Increased ICP is caused by?

A
  • Head injury
  • Brain tumor
  • Brain Attack (Stroke)
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4
Q

Abnormal CPP resulting in IICP

A

Hypotension, Hypovolemia, atherosclerosis of carotid arteries -> Ischemia & hypoxia of brain -> Cerebral edema => increased ICP

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5
Q

Caused of Increased ICP

A

Hemorrhage, infection, acidosis -> Cerebral edema -> Increased ICP => Decreased oxygenated blood going into brain arteries (CPP decreases)

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6
Q

General sequela (S/s of IICP)

A
  • Change of LOC
  • Pressure on respiratory centers (Cheyne stokes) -> Pressures other parts of brain stem -> Decerebrate & Decorticate posturing (Only Comatose pt’s)
  • Affected reflexes (Babinski - plantar reflex)
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7
Q

Autonomic, LOC, Mental status manifestation as a result of brain/brain stem stroke

A
  • Diminished LOC
  • HR & BP changes due to (pressure on medulla)
  • Breathing changes (Apnea or Cheyne-stroke)
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8
Q

Sensorimotor Manifestations seen as a result of brain/brain stem abnormalities

A
  • Sensations, muscle tones, movement & strength weakness
  • Pt’s are often comatose (Abnormal motor responses to stimuli) (Decerebrate & Decorticate posturing)
  • Mixed degree of CN abnormalities (Both pupils either fixed or dilated, fixed, or pinpoint)
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9
Q

Reflex Manifestations seen as a result of Brain/Brain Stem Abnormalities

A
  • Protective reflexes (Sneezing, coughing, gagging, & Swallowing) diminished or lost
  • Reflexes weaker (Symmetrically)
  • Bilateral (Postive Babinski)
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10
Q

Left hemispheric CVA (S/s)

A
  • Dysphasia or aphasia (Speech)
  • Inability to comprehend, integrate, & express language
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11
Q

Right hemispheric CVA (S/s)

A
  • Left-sided neglect (Completely ignores the environment on left side)
  • Seat of insight (Creativity, face recognition, muscle ability, etc)
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12
Q

Expected Level of Consciousness (LOC)

A
  • Being alert or arousable to alertness if asleep
  • Being oriented x4 (self, time, place, events)
  • Following command
  • Normal speech
  • Conversing appropriately
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13
Q

Focal cerebral edema around right CN 7 that innervates a smile
- What would you expect to see?

A

Facial drooping on left side of mouth

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14
Q

Focal cerebral edema around right CN 2 that transmits visual image to brain
- What would you expect to see?

A

Visual defects in two left halves of both eyes (Homonymous hemianopia)

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15
Q

When assessing pupillary response (CN 2 & CN 3) what would you expect to see?

A
  • Both pupils should equally respond to light
  • Both pupils should constrict to the same size
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16
Q

Pyramidal tracts carrying impulses that produces voluntary movements of purpose & skill from brain (via: Spinal cord)
- (Descending Tract)

A

Corticospinal tracts

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17
Q

Carries sensation of pain, temperature, crude & light touch from body to brain (thalamus) for processing
- (Ascending tract)

A

Spinothalamic tracts

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18
Q

If there is a focal/lesion related to corticospinal or spinothalamic tract in the brain
- What would you expect to see?

A
  • Asymmetric sensorimotor changes
  • Unilateral on (Contralateral side) due to decussation
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19
Q

Stroking plantar surface of foot makes the big toe flex (“Upgoing toe”)

A

Postive Babinski

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20
Q

If there is focal pressure (Lesion, edema, etc) on motor tracts, what would likely occur?

A
  • Paresis (Reflex changes) on contralateral side of body below the neck (Opposite of where the brain lesion is
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21
Q

If there is focal pressure on cranial nerves, what would likely occur?

A
  • Abnormalities in facial movement, visual disturbance and pupillary response to light
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22
Q

Treatments for Brain disorders

A
  • Keep head of bed up @ (30 degrees)
  • Keeping BP not too high or too low
  • Giving diuretics (to decrease cerebral edema)
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23
Q

Hemorrhagic brain attack (S/s)

A
  • Intense headache
  • Neck pain
  • Light intolerance
  • Nausea & Vomiting
  • High mortality rate
24
Q

Dx & Tx for Brain attack (Stroke) BA

A

BEFAST
B- Balance (sudden loss of balance
E- Eyes (Vision loss)
F- Face (uneven smile)
A- Arms (one arm weaker)
S- Speech (Slurred speech)
T- Time (Call 911 ASAP)

25
Q

Pupil Dilation
- Sympathetic response occurs upon exposure to darkness

A

Mydriasis

26
Q

Pupil Constriction
- Parasympathetic response occurs upon exposure to light

A

Miosis

27
Q

Abnormal finding of pupillary assessment, such as a lack of constriction to light, would be what finding?

A

Ipsilateral finding (Increased ICP causing ipsilateral cranial nerve to behave abnormally

28
Q

Thrombus forms in arteries going to brain or within brain itself & causes ischemia to distal tissues

A

Thrombotic

29
Q

Clot breaks off from a thrombus & lodges somewhere else in cerebral artery & causing ischemia

A

Embolic

30
Q

Not a true stroke
- last 10 mins to <24 hours

A

Transient ischemic attack (TIA)

31
Q

Intracranial bleeding from head injury, burst aneurysm, HTN, coagulation disorders, etc

A

Hemorrhagic

32
Q
  • Paresis on Contralateral side below neck & shoulders (Due to decussation of corticospinal tract)
  • Facial drooping & visual defects contralateral to the lesion
  • Hemispheric-specific problem
    What kind of stoke is this?
A

Hemispheric stroke

33
Q

Vertigo, nystagmus, loss of balance
What kind of stroke is this?

A

Cerebellar stroke

34
Q

Tx for Ischemic stroke

A
  • Clot-busting drugs
  • Anti-coagulants (Heparin)
35
Q

Tx for Hemorrhagic stroke

A
  • Surgery to fix aneurysm
36
Q

Tx for any kind of stroke

A
  • Any intervention to decrease hypoxia & IICP
  • HOB up (30 degrees)
  • give O2
  • BP management
37
Q

(S/s): Severe memory, behavioral, & motor changes
- abnormal accumulation of amyloid in brain tissue & neurofibrillary tangles inside cell bodies of neurons of brain
What is this degenerative brain disease?

A

Alzheimer’s

38
Q

(S/s): (Cog-wheel rigidity), Slow movement (hypokinesia), pill-rolling tremors (dyskinesia), shuffling gait (Parkinsonian gait, basal ganglion gait)
- Decrease in dopamine, acetylcholine bombards receptors cells with excitatory impulses

A

Parkinsons

39
Q

Tx for Parkinson’s Disease

A
  • Give dopamine (L-lopa)
    -Give Anticholinergic meds (Benadryl)
40
Q
  • Overall rigidity (Mask-like face)
  • “Cog-wheel rigidity” of forearm
  • Dysarthria (Diff. forming words)
  • Dysphagia (Diff. Swallowing)
    What is the manifestation?
A

Hypertonia

41
Q
  • Involuntary facial & trunk movement
  • Inability to make appropriate posture adjustment (tipping & falling)
  • Stopped, shuffling posture, decrease arm swing
    What is the manifestation?
A

Dyskinesia

42
Q

Autoimmune disorder our own T-cells attack myelin sheaths of random axons in brain (Deterioration of axons)
- Causes demyelination (Scarring & Sclerosing of myelin sheath cells)
- Transmits nerve impulses 10x slower
What is this disease?

A

Multiple Sclerosis

43
Q

(S/s): Asymmetric, weakness of an extremity, bladder problem, ataxia, vision problems (Double vision)
- Cerebellum affected (Vertigo, incoordination)
What is this disease?

A

Multiple Sclerosis

44
Q

Headache syndrome thought to be a disorder of blood flow to brain + hyperactivity of certain neural pain-information tracts (Red wine, chocolate, certain cheese)
- Vasodilation, increased capillary permeability, pulsating one-sided throbbing headache
- (Prodrome) : Visual or sound aura
- (Headache): Photo/phono phobia
- (Postdrome): Tired & weak

A

Migrane

45
Q

Tx for Migrane

A
  • Trigger avoidance (NSAIDS)
  • Abortive drugs (Immitrex) @ first sign of headache (Prodrome)
46
Q

Sudden, Chaotic discharge of neurons in brain

A

Seizures

47
Q

Continued unbated seizures

A

Epilepticus

48
Q

Patient is always unconscious, tonic-clonic movement

A

General Seizures

49
Q

Varied degree of consciousness & motor involvement; local)

A

Partial Seizures

50
Q

Post-seizures state of re-organization of brain signals
- Pt is groggy & confused

A

Post-ictal

51
Q

Inflammation causes increased permeability of meningeal structure -> edema -> nerve endings pf spinal meninges irritated => Cerebral edema

A

Meningitis

52
Q

(S/s):
- Photophobia, headache, irritability, restlessness, confusion
- Neck stiffness, Positive Brudzinski’s & Kernig’s signs
- CSF - High protein, High WBC, & low glucose

A

Meningitis

53
Q

Virulent endotoxin that cause petechiae & purpura

A

Meningococcal

54
Q

Dx for Bacterial Meningits

A
  • Lumbar puncture
  • CSF lab report (High WBC & Protein count) & Low glucose levels
55
Q

PNS disorder (Neuromuscular junction disorder)
- Caused by autoantibodies that destroy acetylcholine receptors at the distal end of neuromuscular junction

A

Myasthenia Gravis

56
Q

(S/s): Weakness of muscle (Control eye & eyelid movement), facial expressions, chewing, talking, swallowing, & neck & limb movement

A

Myasthenia Gravis

57
Q

(S/s): Muscle weakness + breathing is affected

A

Myasthenia Crisis

Exam 4 Pathophysiology (2 decks)

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