Patho CH 10: Altered Neural Function Flashcards
1
Q
fundamental functional unit of the cell
A
neuron
2
Q
filled with cytoplasm and contains organelles, including the nucleus, that support the metabolic demands of the cell.
A
cell body/soma
3
Q
multiple, branched extensions of the cell body that transmit impulses to the cell body
A
dendrites
4
Q
carries impulses away from the cell body
A
axon
5
Q
carry impulses from receptors in the periphery to the central nervous system (brain and spinal cord)
A
Sensory neurons/afferent neurons
6
Q
carry signals away from the brain and spinal cord to targets in the body that regulate activity.
A
Motor neurons/efferent neurons
7
Q
most abundant neuron type
provide connections between neurons, transmitting signals between afferent and efferent neurons.
A
interneuron
8
Q
has insulating properties to increase speed of nerve impulses
A
myelin
9
Q
electrical events that travel along the entire neuron by allowing charged ions to flood through channels in the semipermeable membrane around the neuron.
A
action potential
10
Q
the difference in electrical charge between the inside and outside of the cell.
A
membrane potential
11
Q
3 components of action potential in the neuron
A
- resting membrane potential
- depolarization phase
- repolarization phase
12
Q
transmit impulses by passing current-carrying ions through small openings known as gap junctions.
A
electrical synapses
13
Q
involve specific structures important for impulses stimulated by neurotransmitters, chemicals affecting the function of nearby cells.
A
chemical synapses
14
Q
contain neurotransmitters packaged in vesicles, mitochondria, and other cellular organelles
A
Presynaptic terminals
15
Q
3 major types of neurotransmitters
A
- Amino acids (e.g., glutamic acid and gamma-aminobutyric acid [GABA])
- Peptides (e.g., endorphins, enkephalins, substance P)
- Monoamines (e.g., serotonin, dopamine, norepinephrine
16
Q
components of the CNS
A
brain and spinal cord
17
Q
mechanisms of injury to the CNS:
A
trauma
ischemia
excitatory response to neurotransmitters
pressure
18
Q
possible causes of TBIs
A
automobile accidents
falls
sports
‘shaken baby syndrome’
19
Q
demographic at highest risk for TBI
A
65 and up
children 5-24 = ATV
children 0-4 = assault
20
Q
the force of the acceleration impact causes injury to the tissue in the local area, and the deceleration impact leads to injury on the opposite side of the skull
A
coup–contrecoup injuries
21
Q
TBI may lead to what complications:
A
seizure
concussion
contusion
hematoma
edema
skull fracture
22
Q
leading causes of SCIs
A
MTV accidents
acts of violence
23
Q
most common SCIs happen in what parts of spinal cord
A
C5-C7
T12
L1
24
Q
SCI responses
A
paresthesia - abnormal sensation
quadriplegia - paralysis of all four extremities
25
main excitatory neurotransmitter in the body
glutamate
26
abnormal extension
decerebrate posturing
27
abnormal flexion
decorticate posturing
28
common symptoms of increased ICP
HA
V
papilledema (swelling of optic nerve)
mental deterioration
29
A catheter is inserted into the left lateral ventricle and passed through the internal jugular vein into the peritoneal cavity
(ventriculoperitoneal shunt)
30
A catheter is inserted into the right atrium and passed through the internal jugular vein into the peritoneal cavity
(ventriculoatrial shunt) (
31
components of PNS
somatic nervous system
autonomic nervous system
32
The interconnected circulatory systems confer neurologic protection for the CNS via the __ and ____
blood–brain barrier (BBB) and cerebrospinal fluid (CSF).
33
a cerebral arterial structure that connects the vertebral and carotid circulations.
This structure is essential as a route of collateral circulation in case
perfusion is impaired in another arterial system.
The circle of Willis/ cerebral arterial circle
34
The brain is protected from potentially hazardous substances by reduced
permeability in capillaries that supply the brain)
the blood–brain barrier (BBB)
35
The BBB functions include:
Protection of the brain from foreign substances
Protection of the brain from hormones and neurotransmitters in the
systemic circulation
Protection against drastic environmental fluctuations
36
The meninges are three protective membranes that surround CSF surfaces.
Dura mater (outer layer)
Arachnoid mater (middle layer)
Pia mater (inner layer)
37
flows from four fluid-filled interconnecting
cavities of the brain, known as the ventricles.
cerebrospinal fluid (CSF)
38
CSF protects the CNS by:
Providing a cushion for brain structures
Reducing the pressure on brain structures
Removing harmful substances
Transporting hormones to remote sites in the brain
39
The total volume of CSF in the CNS at any one time is approximately
125 to 150 mL.
40
diagnostics of TBIs
: CT, MRI, EEG, LP
41
PATHO of spinal shock
loss of autonomic, reflex, motor, and sensory activity below the injury
42
patho of autonomic dysreflexia
occurs after resolution of spinal shock
associated with injuries at or above T6
stimulated by noxious stimuli (distended bowel or bladder, skin lesion)
43
patho of neurogenic shock
altered vasomotor response secondary to impaired sympathetic impulse transmission from brainstem to the thoracolumbar region
most common with cervical spinal cord injury
44
pathology underlying ischemic injury
related to oxygen and nutrient deprivation to neural tissue. Impaired blood flow for longer than a few
minutes results in tissue infarction in brain tissue with high metabolic demands.
Cellular function ceases because of the inability to use anaerobic metabolic processes or take up glucose and glycogen.
Infarction stimulates an inflammatory response and edema development, leading to increased ICP - local water and electrolyte imbalance and acidosis.
45
Tumors may obstruct CSF flow and promote brain displacement to an area of lower pressure
brain herniation.
46
clinical manifestations of peripheral nerve damage
peripheral neuropathy
47
causes for diabetic neuropathy
Over time, high blood glucose (sugar) levels can damage the small blood
vessels that supply the nerves in your body. This stops essential nutrients
reaching the nerves. As a result, the nerve fibers can become damaged, and
they may disappear
48
Traumatic peripheral nerve injury can occur because of the crushing or
cutting of neurons causing:
o Numbness
o Paresthesia
o Pain
49
polyneuropathy
Peripheral nerve damage involving multiple axons
50
Polyneuropathy can occur secondary to disease
processes such as:
multiple sclerosis (MS)
diabetes mellitus
nutrient deficiency
toxic agents (arsenic).
51
causes of PNS pressure injury
trauma and edema
52
PNS pressure injuries can cause
pain and paresthesia
53
causes of PNS motor dysfunction
neuromuscular junction abnormalities
damage in skeletal muscle fibers
spinal cord injury with damage to the corticospinal system or spinal nerve roots.
54
inability to coordinate muscle activity
ataxia
55
involuntary movements of flexion and extension, pronation and supination of hands, toes, and feet; slow; writing-type movements
athetosis
56
jerking, swinging, sweeping motions of the proximal limbs
ballismus
57
decrease in spontaneity and movement
bradykinesia/hypokinesia
58
irregular, spasmodic, involuntary movements of the limbs or facial muscles with hypotonia
chorea
59
resistance to movement; rigidity decreasing to stiffness after movement begins
cogwheel rigidity
60
abnormal tonicity; difficulty maintaining posture
dystonia
61
excessive motor activity
hyperkinesis
62
repeated, habitual muscle contractions; movements that can be voluntarily suppressed for a short period of time
tic
63
oscillating, repetitive movements of the whole muscle; irregular, involuntary contractions of the opposing muscle
tremor
64
alterations in mental stats may include these symptoms:
altered consciousness
confusion
depression
anxiety
psychosis
inattentiveness
loss of rational thought
impaired memory
poor judgment
65
alterations in coordination lead to these symptoms:
poor balance
injury from falls
difficulty in performing the activities of daily living (ADL)
movement disorders.
66
sensory deficits include:
blindness
deafness
pain
loss of smell or taste
lack of sensation.
67
manifestations of motor deficits
paralysis
impaired voluntary movements
enhanced involuntary movement
68
seizures are limited to the originating hemisphere and can involve either motor or sensory brain components.
Symptoms:
Simple partial seizures
sensory and autonomic without promoting an altered state of consciousness
69
seizures that involve both hemispheres and result in loss of consciousness and lack of memory about events during and after seizure
short lived
Complex partial seizures
70
seizures caused by a more generalized electrical transmission.
Generalized seizures
71
seizures characterized by a brief change in level of consciousness (LOC) and eye and mouth movements, can occur up to 100 times a day
Absence seizures
72
characterized by involuntary muscle movements of the extremities or body, and they are not associated with LOC.
Myoclonic seizures
73
convulsive and are associated with tonic (a state of continuous muscle contraction)
Tonic–clonic seizures
74
(rapid successions of alternating muscle contraction and relaxation) motions.
clonic seizures
75
Recovery from the seizure is manifested by:
This is called?
extreme fatigue, headache, muscle pain, and weakness
the postictal state
76
a potentially life-threatening condition characterized by a continuous tonic–clonic seizure, which leads to hypoxia.
seizure that doesn't stop
Status epilepticus
77
with seizures monitor for:
LOC
breathing
injury
78
MS patho
Central nervous system demyelination (any condition that causes damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, the nerves leading to the eyes (optic nerves) and spinal cord.)
both CNS and PNS
79
MS possible causes
o Genetics
o Environmental factors
o Triggering event
o Autoimmunity
o Regional variation
80
clinical manifestations of MS
relate to the slowing of nerve conduction impulses down the nerve axon.
fatigue!!
diplopia
dizziness
paresthesia
nystagmus
dystonia (posture)
dysphagia
heat imbalance
81
MS diagnostic criteria
o History
o Physical examination
Neurologic
o Imaging
MRI
o Laboratory
Lumbar puncture and CSF analysis
82
Incomplete Spinal Cord Transection Incomplete Spinal Cord Transection Patho
Spinal cord injury altering neuronal transmission (tear)
Categories
o Complete transection
o Partial transection
83
Incomplete Spinal Cord Transection Clinical Manifestations
Based on:
o Spinal segmental level
o Type of injury
o Degree of cord transection
84
Incomplete Spinal Cord Transection Diagnostic Criteria
Physical examination
o Cognitive function
o Motor function
o Sensory function
Imaging studies
85
Incomplete Spinal Cord Transection Treatment
Immobilization of the spine
o Traction
Surgery
o To correct fractures and decompress spinal cord
Promotion of functional abilities
86
Incomplete Spinal Cord Transection causes
Trauma to the spine (such as from a motor vehicle crash, fall, act of violence, or sport-related injury)
Compression of spinal cord
Ischemia from damage to spinal arteries
87
The four primary manifestations of overt PD
tremors, rigidity, bradykinesia, and postural instability
88
PD patho
Chronic, progressive neurologic condition
Degeneration of pigmented dopaminergic neurons of
the basal ganglia
Impaired transport of dopamine
Depletion of dopamine!!!
***imbalance of acetylcholine and dopamine***
89
PD diagnostic criteria
History and physical examination
bradykinesia, tremors, rigidity
90
PD treatment
Pharmacologic
o Dopamine replacement (levodopa)
o Anticholinergics
o Dopamine agonists
Surgical
o Pallidotomy
o Deep brain stimulation
91
PD is more common in ___ than ____
men than women
92
the disease affects appr ___ people in the US
1 million
93
arterial supply to the brain includes what arteries?
vertebral, basilar, carotid
94
primary vascular drainage of brain occurs via
jugular veins
95
ischemic injury clinical manifestations
• Loss of consciousness, weakness, difficulty speaking or swallowing, impaired vision, and paresthesia
96
increased ICP can lead to what brain issues
blood flow reduction
brain cell death
brain structure damage
97
epilepsy patho
•Seizure disorder
•result of impaired chemical and electrical neurotransmission.
•Impulses are spread in a disorderly way resulting from abnormal firing of neurons in the cerebral cortex.
98
possible symptoms of MS
fatigue
weakness
dizziness
diplopia
paresthesia
blurred vision
99
high injuries at level C1-C2 may result in:
loss of involuntary function
including sweating
blood pressure regulation
body temperature regulation
100
extrapyramidal system function
reduces erratic motions and maintaining muscle tone and stability of the trunk through BASAL GANGLIA
101
cerebrovascular circulation
protection via BBB
drugs that pass through make you sleepy
CSF
102
brain uses how much O2 and glucose?
O2 = 25%
glucose = 60%
103
peripheral neuropathy
sheath detereriates
degeneration
impulses cannot travel
remyelination
regenerate nerves
104
the brachial plexus provides innervation to what body parts?
shoulder, arm, forearm, wrist
105
axon injury and formation of demyelinated plaques predominantly in:
optic nerves
spinal cord
brainstem
cerebellum,
106
what is needed for spinal injuries above C4?
respiratory support
107
incidence of SCIs
•Approximately half of SCIs occur between the ages of 16-30.
•Approximately 78% of SCIs occur in males.
•Approximately 50% of SCIs involve the cervical spine.
•C4 and C5 are the most common levels of SCI.
107
incidence of SCIs
•Approximately half of SCIs occur between the ages of 16-30.
•Approximately 78% of SCIs occur in males.
•Approximately 50% of SCIs involve the cervical spine.
•C4 and C5 are the most common levels of SCI.
108
risk factors of PD
advanced age
more common in men than women
family history
109
complications of PD
falls
aspriration
UTI
mental health
sexual disfunction
constipation
hallucinations
110
history of PD
pill roll tremors*
rigidity
bradykinesia
cogwheel rigidity*
