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Phase 2 4. Neurology > PBL 6 > Flashcards

PBL 6 Flashcards

1
Q

What is the function of the frontal lobe?

A

movement
decision making
problem solving
planning

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2
Q

What are the three main divisions of the frontal lobes?

A
  • prefrontal cortex
  • premotor cortex
  • primary motor cortex
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3
Q

What is the function of the prefrontal cortex?

A

personality expression, planning of complex cognitive behaviours

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4
Q

What is the function of the premotor cortex?

A

voluntary muscle movement

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5
Q

What is the function of the primary motor cortex?

A

voluntary muscle movement

motor homunculus

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6
Q

What is the function of the parietal lobe?

A

processing tactile sensory information such as pressure, touch and pain

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7
Q

Which portion of the brain is involved in processing the body’s senses?

A

somatosensory cortex

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8
Q

What is the function of the somatosensory cortex?

A

allows co-ordination of movements in response to the objects in our environment (situational/spatial awareness)

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9
Q

What is the function of the occipital lobe?

A

main centre for visual processing

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10
Q

Which lobes are involved in visual perception

A

occipital lobes in addition to posterior portions of the parietal and temporal lobes

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11
Q

What main structure is found within the occipital lobe?

A

The primary visual cortex

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12
Q

What is the function of the primary visual cortex?

A

receives visual input from the retina via the optic nerve

these visual signals are interpreted in the occipital lobes

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13
Q

Describe the function of the temporal lobe

A

organising sensory input, auditory perception, language, and speech production

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14
Q

What structures are found within the temporal lobe?

A
  • limbic system
  • olfactory cortex
  • amygdala
  • hippocampus
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15
Q

what is wernicke’s area?

A

sensory language understanding, lexical processing (words and sentances)

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16
Q

What symptoms will occur if the wernicke’s area is damaged?

A
  • receptive aphasia and extremely poor comprehension
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17
Q

What is Broca’s area?

A

motor aspect of speech, damage to this area will result in expressive aphasia, non-fluent and slow speech

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18
Q

What is the primary auditory cortex?

A

area where processing of auditory (sound) information occurs

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19
Q

What is the basal ganglia

A

a collection of nuclei that are strongly connected to the cerebrum, brainstem and cerebral cortex

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20
Q

What is the basal ganglia involved in?

A

influencing motor activity and motor control

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21
Q

What are the three parts of the basal ganglia?

A
  • corpus striatum
  • subthalamic nuclei
  • substantia nigra
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22
Q

What is the corpus striatum?

A

structure made up of caudate nucleus, putamen and globus pallidus

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23
Q

What is the subthalamic nuclei?

A

produces the excitatory neurotransmitter glutamate

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24
Q

what is the substantia nigra?

A

produces the neurotransmitter dopamine, which is involved in the nigro-striatial pathway

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25
Q

What is the medulla oblongata’s function?

A

deals with autonomic/involuntary functions

carries out life-sustaining functions:

  • breathing
  • HR
  • BP
  • swallowing
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26
Q

What is the function of the pons?

A

connects the cerebral cortex with the medulla oblongata

serves as a communications and coordinations centre between the two hemispheres of the brain

helps in transferring of messages between various parts of the brain and the spinal cord

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27
Q

What is the function of the thalamus?

A
  • relay station

receives auditory, visual sensory and somatosensory signals and relays them to the cortex

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28
Q

Describe the thalamus

A

dual lobed mass of gret matter burried under the cerebral cortex

location of the cell bodies of the 3rd order neurones in ascending pathways

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29
Q

Describe the hypothalamus

A

control centre for many autonomic functions of the PNS

  • hunger
  • thirst
  • body temp maintenance
  • homeostasis
  • influences the pituitary gland
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30
Q

Describe the cerebellum

A

controls motor movement coordination, balance, equilibrium and muscle tone

relays information between body muscles and areas of the cerebral cortex that are involved in motor control

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31
Q

Describe the amygdala

A

almond shaped group of neurons located deep within the medial temporal lobes

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32
Q

What is the role of the amygdala?

A

primary role in processing and memory of emotional reactions

part of the limbic system that supports emotion, behaviour and long-term memory

33
Q

What is the role of the hippocampus?

A

forming, organising and storing memories

limbic system structure involved in forming new memories and connecting emotions and senses (smell and sound) to memories

memory ‘indexer’ - sends memories for long-term storage and retrieves them when necessary

34
Q

Name the two dural reflexions in the cranial cavity

A
  • tentorium cerebelli

- falx cerebri

35
Q

Where is the tentorium cerebelli found?

A

between occipital lobes and cerebellum

36
Q

Where is the falx cerebri found?

A

between the cerebral hemispheres in the longitudinal cerebral fissure

37
Q

What is a primary brain injury?

A

the result of initial trauma on neural tissue

described as:

  • focal
  • polar
  • diffuse
38
Q

What are focal injuries?

A
  • injuries localised to the site of impact on the skull

- damage is variable

39
Q

What symptoms would arise from damage to the motor cortex?

A

contralateral weakness of the face and arm

40
Q

What are the symptoms of space occupying lesions?

A
  • raised ICP
  • brain shifting
  • herniation
41
Q

What can cause a space ooccupying lesion?

A
  • haematoma

- significant oedema

42
Q

What are the three main types of haematomas that can occur?

A
  • epidural haematoma
  • subdural haematoma
  • intracerebral haematoma
43
Q

Describe an epidural haematoma

A

collections of blood in the epidural space between the cranium and teh dura mater

44
Q

How do epidural haematomas occur?

A
  • vessels within the dura susceptible to injury with skull fractures
  • fracture of the temporal bone can affect the middle meningeal artery
45
Q

What is the most common source of epidural haematomas?

A

arterial source - can expand rapidly

46
Q

Describe a subdural haematoma

A

Form in the space between the dura and the arachnoid mater

  • stretched and sheared apart
  • slower rate of formation
47
Q

Which vessels are usually affected in subdural haematomas?

A

bridging veins which drain venous blood from the surface of the brain, coursing the arachnoid and subdural spaces before emptying into the venous sinuses

48
Q

Describe an intracerebra haematoma

A
  • single or multiple
  • commonly in the frontal or temporal lobes
  • may occur in association with severe motion or a contusion can coalesce into a haematoma
49
Q

What are polar injuries?

A

cerebral contusions that occurs when the brain moves within the cranial cavity causing the brain to be crushed by violent contact with the skull or dura mater

50
Q

Where are polar injuries found?

A

occur adjacent to the site of impact (coup lesions) and diagonally opposite (contrecoup lesions)

most common site is the underside of the frontal lobes, inferior aspects of the temporal lobes, the occipital poles and the cerebellum

51
Q

What is a concussion?

A

a temporary distrubance in brain function as a result of trauma

52
Q

What are the symptoms of concussion?

A
  • headache
  • dizziness
  • memory disturbance
  • balance problems
  • loss of consciousness
  • seizure activity
  • poor performance
53
Q

What are diffuse injuries?

A

occur when movement of the brain within the cranial cavity causes widespread neuronal damage

54
Q

What causes diffuse axonal injury?

A

brain is subjected to shifting and rotational forces during injury

  • causes stretching and shearing of axonal white matter
55
Q

What are the signs of diffuse axonal injury?

A
  • frequently comatose at time of injury

- coma is a consequence of damage in the cerebral cortex

56
Q

What is a secondary injury?

A

The development of further neurological damage subsequent to the primary injury

often secondary injuries cause more damage than primary injuries

57
Q

What are resulting symptoms of secondary brain injury?

A
  • ischaemia
  • increased ICP
  • altered vascular regulation (hypoxia)
  • cerebral sweeping
  • infection
58
Q

How does ischaemia affect the brain?

A
  • failure in supply of energy sources
  • neurons have small metabolic reserves and are extremely sensitive to energy deprivation
  • failure of energy supply results in death of neurones, with sparing of vessels and support cells which are robust
59
Q

Which event in ischaemic damage leads to cell death?

A

-excitotoxicity

activation of glutamate receptors which causes uncontrolled entry of calcium ions into neurons = death

60
Q

What is intrcranial pressure?

A

The pressure exerted by the contents of the cranium.

ranges from 0-15mmHg

61
Q

what components make up the volume of the cranium?

A
  • brain tissue
  • CSF
  • blood
62
Q

What is the monro-kellie hypothesis

A

a description of the compensatory responses to a change in volume by any of the 3 components (compliance)

increase in one can be offset by decreases in the other two

63
Q

How can blood volume be reduced in the cranium?

A
  • vasoconstriction can reduce blood vessel volume
64
Q

How can CSF volume be reduced in the cranium?

A

by moving into the spinal cord from the cranium

65
Q

How can brain tissue volime be reduced in the cranium?

A

In young children, head circumference will slightly increase

66
Q

Name the serious complication that can result from elevated ICP?

A

compression and herniation

  • causes rapid neurological dysfunction
67
Q

What structures can e affected by a midline shift?

A
  • reticular activating system (RAS) which is necessary for maintaining consciousness, and vital cardiorespiratory centres
68
Q

How is consciousness clinically assessed?

A
  • Glasgow coma scale (GCS)
  • Cranial nerve reflexes

GCS alone in not sufficient

69
Q

What is consciousness?

A

A state of alertness and attentiveness to one’s environment and situation

A fully conscious person is awake, alert and orientated to time, person, place and current circumstances

70
Q

What is the acute management of head injury?

A

1 - cardiopulmonary stabilisation (ABC, airway vital)
2 - Disability (GCS)
3 - Radiology -
4 - surgical intervention - for depressed skull fractures, bleeding vessels, and haematomas

Management of ICP

71
Q

What is cerebral perfusion pressure?

A

the net pressure gradient causing cerebral blood flow to the brain (perfusion)

must be maintained in narrow limits as too little can cause ischaemia and too much can raise ICP

72
Q

Describe CNS regeneration

A

adult CNS neurons have limited ability to regenerate in contrast to PNS neurones due to lack of factors that facilitate growth in the cns and to the presence of factors which actively inhibit growth

73
Q

Describe recovery of function in the CNS

A

Due to neural plasticity despite limited CNS regeneration

adaption of uninjured tissue to undertake some of the functions of previously subserved tissue which has been irreversibly damaged

74
Q

Describe neural plasticity

A

the potential for brain to change its structure and function

75
Q

What does neural plasticity involve?

A
  • rewiring of existing neurons into new functional networks, and the addition of new formed neurones
76
Q

What is neural plasticity used for?

A

to train different areas of the brain to assume new functions

77
Q

How does neural plasticity occur?

A

Greater exposure to a particular stimulus prompts the brain to dedicate more neurones to that stimulus (and a lack of stimulation allows the brain to reassign neurones to a different function)

78
Q

What is the outcome of head injuries?

A

major causes of morbidity and disability

severe psychosocial factors

79
Q

What are the possible long-term sequelae of head injury?

A
  • cognitive impairment
  • hemiparesis
  • epilepsy
  • chronic subdural haematoma
  • hydrocephalus
  • chronic traumatic encephalopathy

Phase 2 4. Neurology (29 decks)

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