Physio Final Flashcards
Tumor
- A mass of cells whose growth is uncontrolled and that serves no useful function
Tumors damage brain tissue by:
- Compression
- Infiltration
- Malignant can compress and infiltrate
- Benign tend to only compress
Primary Brain Tumors
- Start in the CNS
- Most commonly seen in those under 15 and above 65 y/o
Secondary Brain Tumors
- Metastasize to brain
- Most common brain metastases are from lung and breast cancer
Grading of CNS Tumors
- Grade 1: low proliferative potential
- Grade 2: Infiltrative, but low proliferative potential
- Grade 3: Histological evidence of malignancy
- Grade 4: Mitotically active, prone to necrosis, fatal outcomes
Gliomas
- MOST common primary brain tumor type
- Tumor of the glial cells
Astrocytoma
- Tumor of the astrocytes
- Can be low grade or high grade
Glioblastoma Multiforme
- Grade 4 Astrocytoma
- Most aggressive tumor form
- Average survival rate from diagnoses approx. 2 years
- Higher incidence in white individuals
Meningioma
- Tumor of the meninges, usually benign and slow growing
- Encapsulated
Main Brain Tumor Treatments
- Surgical resection
- Radiation
- Chemotherapy
Seizure
- A period of sudden, excessive activity of cerebral neurons
- Can be partial/focal or generalized
Partial/Focal Types of Seizures
- Simple partial: no major change in consciousness
- Complex partial: cause of loss consciousness
Generalized Types of Seizures
- Tonic-clonic (aka Grand Mal)
- Absence (aka petit-mal)
- Atonic
Tonic-Clonic/Grand Mal Seizures
- Most severe form of seizure
- include convulsions
- Tonic phase: stiffening of muscles
- Clonic phase: jerking or twitching
Typical Stages of Tonic-Clonic/Grand Mal Seizures
- Aura stage
- Tonic stage
- Clonic stage
- Postictal stage
Absence “Petit Mal” Seizures
- Sudden lapse in consciousness
- Staring blankly into space
- Eyelid fluttering
- Lip smacking
- Involuntary hand movements
- Lasts less than 15 seconds
Atonic Seizures
- Aka “drop seizures”
- Sudden loss of muscle control = collapse or fall
Seizure Challenges
- 50% of those with seizure disorder show damage to the hippocampus
- Falling
-Drowning
-Car accidents: unable to drive for 1 year post seizure - Pregnancy complications
- Emotional health issues
Seizure First Aid
- STAY (stay with the person until they are awake and alert after the seizure)
- SAFE (keep the person safe)
- SIDE (turn the person onto their side if they are not awake and aware)
When to Call 911 during a Seizure
- Seizure lasts longer than 5 minutes
- Person does not return to their usual state
- Person is injured, pregnant, or sick
- Repeated seizures
- First time seizure
- Difficulty breathing
- Seizure occurs in water
Prion Disease
- Occurs when prion protein, found throughout the body, begins folding into an abnormal three-dimensional shape
- Damaged prion protein destroys brain cells, leading to a rapid decline in thinking and reasoning
- AKA transmissible spongiform encephalopathies
Creutzfeldt-Jakob Disease
- “Mad Cow Disease” epidemic of the 1980s and 1990s
- Can be sporadic or familial
- Causes severe mental deterioration and dementia - 8 month average
Kuru Disease
- From eating contaminated human brain tissue
- Traditional practice of Fore people of Papa New Guinea
- 10-50 year incubation period
Parkinson’s Disease
- Caused by the degeneration of dopamine-secreting neurons in the substantia nigra that send axon to the basal ganglia –> a deficiency of automatic, habitual motor responses
- 95% of cases are sporadic
Parkinson’s Disease Symptoms
- Dystonia = rigidity –> cog wheel test
- Bradykinesia and slowed reaction times = falls
- Shuffling gait
- Face masking
- Tremors = pill rolling tremor (75%)
Parkinson’s Disease Treatments
- L-Dopa: time limited, side effects of hallucinations and delusions
- Deprenyl: slows Parkinson’s progression
- Intentional lesioning of the pathway
- Deep Brain Stimulation
Huntington’s Disease
- Inherited disease resulting in degeneration of the basal ganglia
- Typical onset between 30-50
- Results in: Chorea (involuntary jerking movements), Dystonia, Slurred speech and swallow difficulties
Amyotrophic Lateral Sclerosis (ALS)
- Degenerative disorder that attacks spinal cord and cranial nerve motor neurons –> brain and muscle connection loss
- Average onset late 50s
- 10% inherited
ALS Symptoms
- Progressive weakness and muscular atrophy: eventual loss of speech, swallow with paralysis
- Eye movements spared
- Death typically caused by respiratory failure (typically within 24 months)
Multiple Sclerosis (MS)
- An autoimmune demyelinating disease
- At scattered locations within the CNS, the person’s immune system attacks myelin sheaths, leaving behind hard patches of debris called sclerotic plaques
- onset late 20s to 30s
- Damage occurs in white matter
MS Risk Factors
- Females > Males
- Living far from the equator
- Black or white race
- Smoking
MS Symptoms
- Fatigue
- Vision problems
- Bladder/bowel dysfunction
- Spasms
- Slowed processing speeds
Meningitis
- Inflammation of the meninges caused by viruses or bacteria
Meningitis Causes
- Virus
- Bacteria
- Fungus
- Parasite
Meningitis Symptoms
- Stiff neck
- Headache
- AMS
Meningitis Etiology
- Spread of middle-ear infection to the brain
- Head injury
- Embolus that has dislodged from bacterial infection in the heart
- IV drug use
Dementia
- Umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life
Alzheimer’s Disease
- Neuritic plaques and neurofibrillary tangles
- Beta amyloid is abnormal in Alzheimer’s
- Treatment with anti-inflammatory drugs results in lower risk
Vascular Dementia
- Associated with brain damage due to ischemic injury, anoxia
- Risk factors same as stroke
- “Mini strokes” aka lacunar infarcts
- typical age of onset 65
Dementia with Lewy Body Disease
- Characterized by the abnormal build up of alpha-synuclein proteins into masses i.e., lewy bodies
Dementia with Lewy Body Disease Symptoms
- Visual hallucinations (80% of individuals early on in condition)
- Falls and dysautonomia
- Movement issues
- Sleep problems
- Fluctuating cognition
- Mood and behavior changes
Frontotemporal Dementia
- Umbrella term for a group of brain diseases known as frontotemporal lobar degeneration
- Accumulation of Tau protein (overwhelms the brain and causes tissue death)
3 Types of Frontotemporal Dementia
- Behavioral Variant (most common)
- Primary Progressive Aphasia
- Movement disorders
Schizophrenia Risk and Development
- 46% concordance rate
- 10x risk of African and Caribbean migrants
- Men > Women
- Mutation in 21 of the 23 chromosomes
- Older paternal age
- Atypical prenatal development
- Poor social adjustment and academic performance
- Deficient psychomotor functioning
Schizophrenia Minor Physical Anomalies
- High-steepled palate
- Partial webbing of two middle toes
- Especially wide or narrow-set eyes
Schizophrenia Disease Burden
- 20% Reduction in life expectancy
- 40% of deaths attributable to suicide
Antipsychotic Side Effects: Extrapyramidal
- Impairment in motor functions NOT related to the pyramids
- Tardive dyskinesia
- Akathisia
- Pseudo-Parkinsonism
- Acute dystonia
Antipsychotic Side Effects: Anti-cholinergic
- Dry mouth
- Urinary retention
- Blurred vision
- Constipation
Antipsychotic Treatment resistant
- Failing of at least 2 antipsychotic medication trials = Clozapine
Depression Heritability
- Families of persons with affective disorders are 10x more likely to develop MDD or Bipolar disorder
Depression Neuropathology
- Hedonic tone/responsiveness: trait or genetic predisposition underlying one’s baseline range and lifelong ability to feel pleasure
- Dysfunction of mesolimbic and mesocortical pathways
- Hippocampal neurogenesis