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Patho Exam 2 > Patho CH 10: Altered Neural Function > Flashcards

Patho CH 10: Altered Neural Function Flashcards

1
Q

fundamental functional unit of the cell

A

neuron

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2
Q

filled with cytoplasm and contains organelles, including the nucleus, that support the metabolic demands of the cell.

A

cell body/soma

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3
Q

multiple, branched extensions of the cell body that transmit impulses to the cell body

A

dendrites

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4
Q

carries impulses away from the cell body

A

axon

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5
Q

carry impulses from receptors in the periphery to the central nervous system (brain and spinal cord)

A

Sensory neurons/afferent neurons

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6
Q

carry signals away from the brain and spinal cord to targets in the body that regulate activity.

A

Motor neurons/efferent neurons

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7
Q

most abundant neuron type
provide connections between neurons, transmitting signals between afferent and efferent neurons.

A

interneuron

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8
Q

has insulating properties to increase speed of nerve impulses

A

myelin

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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

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10
Q

the difference in electrical charge between the inside and outside of the cell.

A

membrane potential

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11
Q

3 components of action potential in the neuron

A
  1. resting membrane potential
  2. depolarization phase
  3. repolarization phase
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12
Q

transmit impulses by passing current-carrying ions through small openings known as gap junctions.

A

electrical synapses

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13
Q

involve specific structures important for impulses stimulated by neurotransmitters, chemicals affecting the function of nearby cells.

A

chemical synapses

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14
Q

contain neurotransmitters packaged in vesicles, mitochondria, and other cellular organelles

A

Presynaptic terminals

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15
Q

3 major types of neurotransmitters

A
  1. Amino acids (e.g., glutamic acid and gamma-aminobutyric acid [GABA])
  2. Peptides (e.g., endorphins, enkephalins, substance P)
  3. Monoamines (e.g., serotonin, dopamine, norepinephrine
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16
Q

components of the CNS

A

brain and spinal cord

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17
Q

mechanisms of injury to the CNS:

A

trauma
ischemia
excitatory response to neurotransmitters
pressure

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18
Q

possible causes of TBIs

A

automobile accidents
falls
sports
‘shaken baby syndrome’

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19
Q

demographic at highest risk for TBI

A

65 and up
children 5-24 = ATV
children 0-4 = assault

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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

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21
Q

TBI may lead to what complications:

A

seizure
concussion
contusion
hematoma
edema
skull fracture

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22
Q

leading causes of SCIs

A

MTV accidents
acts of violence

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23
Q

most common SCIs happen in what parts of spinal cord

A

C5-C7
T12
L1

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24
Q

SCI responses

A

paresthesia - abnormal sensation
quadriplegia - paralysis of all four extremities

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25
Q

main excitatory neurotransmitter in the body

A

glutamate

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26
Q

abnormal extension

A

decerebrate posturing

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27
Q

abnormal flexion

A

decorticate posturing

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28
Q

common symptoms of increased ICP

A

HA
V
papilledema (swelling of optic nerve)
mental deterioration

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29
Q

A catheter is inserted into the left lateral ventricle and passed through the internal jugular vein into the peritoneal cavity

A

(ventriculoperitoneal shunt)

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30
Q

A catheter is inserted into the right atrium and passed through the internal jugular vein into the peritoneal cavity

A

(ventriculoatrial shunt) (

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31
Q

components of PNS

A

somatic nervous system
autonomic nervous system

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32
Q

The interconnected circulatory systems confer neurologic protection for the CNS via the __ and ____

A

blood–brain barrier (BBB) and cerebrospinal fluid (CSF).

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33
Q

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.

A

The circle of Willis/ cerebral arterial circle

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34
Q

The brain is protected from potentially hazardous substances by reduced
permeability in capillaries that supply the brain)

A

the blood–brain barrier (BBB)

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35
Q

The BBB functions include:

A

 Protection of the brain from foreign substances
 Protection of the brain from hormones and neurotransmitters in the
systemic circulation
 Protection against drastic environmental fluctuations

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36
Q

The meninges are three protective membranes that surround CSF surfaces.

A

 Dura mater (outer layer)
 Arachnoid mater (middle layer)
 Pia mater (inner layer)

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37
Q

flows from four fluid-filled interconnecting
cavities of the brain, known as the ventricles.

A

cerebrospinal fluid (CSF)

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38
Q

CSF protects the CNS by:

A

 Providing a cushion for brain structures
 Reducing the pressure on brain structures
 Removing harmful substances
 Transporting hormones to remote sites in the brain

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39
Q

The total volume of CSF in the CNS at any one time is approximately

A

125 to 150 mL.

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40
Q

diagnostics of TBIs

A

: CT, MRI, EEG, LP

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41
Q

PATHO of spinal shock

A

loss of autonomic, reflex, motor, and sensory activity below the injury

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42
Q

patho of autonomic dysreflexia

A

occurs after resolution of spinal shock

associated with injuries at or above T6

stimulated by noxious stimuli (distended bowel or bladder, skin lesion)

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43
Q

patho of neurogenic shock

A

altered vasomotor response secondary to impaired sympathetic impulse transmission from brainstem to the thoracolumbar region

most common with cervical spinal cord injury

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44
Q

pathology underlying ischemic injury

A

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.

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45
Q

Tumors may obstruct CSF flow and promote brain displacement to an area of lower pressure

A

brain herniation.

46
Q

clinical manifestations of peripheral nerve damage

A

peripheral neuropathy

47
Q

causes for diabetic neuropathy

A

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
Q

Traumatic peripheral nerve injury can occur because of the crushing or
cutting of neurons causing:

A

o Numbness
o Paresthesia
o Pain

49
Q

polyneuropathy

A

Peripheral nerve damage involving multiple axons

50
Q

Polyneuropathy can occur secondary to disease
processes such as:

A

multiple sclerosis (MS)
diabetes mellitus
nutrient deficiency
toxic agents (arsenic).

51
Q

causes of PNS pressure injury

A

trauma and edema

52
Q

PNS pressure injuries can cause

A

pain and paresthesia

53
Q

causes of PNS motor dysfunction

A

neuromuscular junction abnormalities
damage in skeletal muscle fibers
spinal cord injury with damage to the corticospinal system or spinal nerve roots.

54
Q

inability to coordinate muscle activity

A

ataxia

55
Q

involuntary movements of flexion and extension, pronation and supination of hands, toes, and feet; slow; writing-type movements

A

athetosis

56
Q

jerking, swinging, sweeping motions of the proximal limbs

A

ballismus

57
Q

decrease in spontaneity and movement

A

bradykinesia/hypokinesia

58
Q

irregular, spasmodic, involuntary movements of the limbs or facial muscles with hypotonia

A

chorea

59
Q

resistance to movement; rigidity decreasing to stiffness after movement begins

A

cogwheel rigidity

60
Q

abnormal tonicity; difficulty maintaining posture

A

dystonia

61
Q

excessive motor activity

A

hyperkinesis

62
Q

repeated, habitual muscle contractions; movements that can be voluntarily suppressed for a short period of time

A

tic

63
Q

oscillating, repetitive movements of the whole muscle; irregular, involuntary contractions of the opposing muscle

A

tremor

64
Q

alterations in mental stats may include these symptoms:

A

altered consciousness
confusion
depression
anxiety
psychosis
inattentiveness
loss of rational thought
impaired memory
poor judgment

65
Q

alterations in coordination lead to these symptoms:

A

poor balance
injury from falls
difficulty in performing the activities of daily living (ADL)
movement disorders.

66
Q

sensory deficits include:

A

blindness
deafness
pain
loss of smell or taste
lack of sensation.

67
Q

manifestations of motor deficits

A

paralysis
impaired voluntary movements
enhanced involuntary movement

68
Q

seizures are limited to the originating hemisphere and can involve either motor or sensory brain components.

Symptoms:

A

Simple partial seizures

sensory and autonomic without promoting an altered state of consciousness

69
Q

seizures that involve both hemispheres and result in loss of consciousness and lack of memory about events during and after seizure

short lived

A

Complex partial seizures

70
Q

seizures caused by a more generalized electrical transmission.

A

Generalized seizures

71
Q

seizures characterized by a brief change in level of consciousness (LOC) and eye and mouth movements, can occur up to 100 times a day

A

Absence seizures

72
Q

characterized by involuntary muscle movements of the extremities or body, and they are not associated with LOC.

A

Myoclonic seizures

73
Q

convulsive and are associated with tonic (a state of continuous muscle contraction)

A

Tonic–clonic seizures

74
Q

(rapid successions of alternating muscle contraction and relaxation) motions.

A

clonic seizures

75
Q

Recovery from the seizure is manifested by:

This is called?

A

extreme fatigue, headache, muscle pain, and weakness

the postictal state

76
Q

a potentially life-threatening condition characterized by a continuous tonic–clonic seizure, which leads to hypoxia.
seizure that doesn’t stop

A

Status epilepticus

77
Q

with seizures monitor for:

A

LOC
breathing
injury

78
Q

MS patho

A

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
Q

MS possible causes

A

o Genetics
o Environmental factors
o Triggering event
o Autoimmunity
o Regional variation

80
Q

clinical manifestations of MS

A

relate to the slowing of nerve conduction impulses down the nerve axon.

fatigue!!
diplopia
dizziness
paresthesia
nystagmus
dystonia (posture)
dysphagia
heat imbalance

81
Q

MS diagnostic criteria

A

o History
o Physical examination
Neurologic
o Imaging
MRI
o Laboratory
Lumbar puncture and CSF analysis

82
Q

Incomplete Spinal Cord Transection Incomplete Spinal Cord Transection Patho

A

Spinal cord injury altering neuronal transmission (tear)
Categories
o Complete transection
o Partial transection

83
Q

Incomplete Spinal Cord Transection Clinical Manifestations

A

Based on:
o Spinal segmental level
o Type of injury
o Degree of cord transection

84
Q

Incomplete Spinal Cord Transection Diagnostic Criteria

A

Physical examination
o Cognitive function
o Motor function
o Sensory function
Imaging studies

85
Q

Incomplete Spinal Cord Transection Treatment

A

Immobilization of the spine
o Traction
Surgery
o To correct fractures and decompress spinal cord
Promotion of functional abilities

86
Q

Incomplete Spinal Cord Transection causes

A

 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
Q

The four primary manifestations of overt PD

A

tremors, rigidity, bradykinesia, and postural instability

88
Q

PD patho

A

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
Q

PD diagnostic criteria

A

History and physical examination
bradykinesia, tremors, rigidity

90
Q

PD treatment

A

Pharmacologic
o Dopamine replacement (levodopa)
o Anticholinergics
o Dopamine agonists
Surgical
o Pallidotomy
o Deep brain stimulation

91
Q

PD is more common in ___ than ____

A

men than women

92
Q

the disease affects appr ___ people in the US

A

1 million

93
Q

arterial supply to the brain includes what arteries?

A

vertebral, basilar, carotid

94
Q

primary vascular drainage of brain occurs via

A

jugular veins

95
Q

ischemic injury clinical manifestations

A

• Loss of consciousness, weakness, difficulty speaking or swallowing, impaired vision, and paresthesia

96
Q

increased ICP can lead to what brain issues

A

blood flow reduction
brain cell death
brain structure damage

97
Q

epilepsy patho

A

•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
Q

possible symptoms of MS

A

fatigue
weakness
dizziness
diplopia
paresthesia
blurred vision

99
Q

high injuries at level C1-C2 may result in:

A

loss of involuntary function
including sweating
blood pressure regulation
body temperature regulation

100
Q

extrapyramidal system function

A

reduces erratic motions and maintaining muscle tone and stability of the trunk through BASAL GANGLIA

101
Q

cerebrovascular circulation

A

protection via BBB
drugs that pass through make you sleepy
CSF

102
Q

brain uses how much O2 and glucose?

A

O2 = 25%
glucose = 60%

103
Q

peripheral neuropathy

A

sheath detereriates
degeneration
impulses cannot travel
remyelination
regenerate nerves

104
Q

the brachial plexus provides innervation to what body parts?

A

shoulder, arm, forearm, wrist

105
Q

axon injury and formation of demyelinated plaques predominantly in:

A

optic nerves
spinal cord
brainstem
cerebellum,

106
Q

what is needed for spinal injuries above C4?

A

respiratory support

107
Q

incidence of SCIs

A

•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
Q

incidence of SCIs

A

•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
Q

risk factors of PD

A

advanced age
more common in men than women
family history

109
Q

complications of PD

A

falls
aspriration
UTI
mental health
sexual disfunction
constipation
hallucinations

110
Q

history of PD

A

pill roll tremors*
rigidity
bradykinesia
cogwheel rigidity*

Patho Exam 2 (2 decks)

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