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Pathophysiology > Test 5 > Flashcards

Test 5 Flashcards

1
Q

What is the most common cause of neurological disability?

A

Cerebrovascular disease

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2
Q

What are the three categories cerebral vascular disease can be dividied into?

A
  1. Ischemia stroke
  2. Transient ischemic attack
  3. Hemorrhagic stroke
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3
Q

What type of stroke results from an obstruction by a thrombus or embolus?

A

Ischemic

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4
Q

In an area of ischemia, cells are not given proper oxygen/nutrition which leads to _______.

A

Infarction

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5
Q

What are 3 causes of ischemic stroke?

A
  1. Cerebral arteriosclerosis
  2. Atrial fibrillation
  3. Carotid stenosis
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6
Q

What is the treatment of ischemic stroke?

A

Thrombolysis

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7
Q

How soon after an ischemic stroke should thrombolysis occur?

A

Within the first 4 1/2 hours

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8
Q

In a _________, an embolus occludes blood flow, but the body’s fibrinolytic system works quickly to dissolve in.

A

Transient Ischemic Attack (TIA)

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9
Q

What percent of TIA progress to stroke?

A

20%

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10
Q

In a _______ stroke, an artery ruptures which induces bleeding in the brain.

A

Hemorrhagic

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11
Q

Besides bleeding in the brain, what else can a hemorrhagic stroke cause?

A

Cerebral edema

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12
Q

What is the treatment of hemorrhagic stroke?

A
  • Hemodynamic stabilization
  • Clot forming agents
  • Surgical procedures
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13
Q

What are five symptoms of stroke?

A
  1. Weakness on one side of body
  2. Loss of gag reflex
  3. Facial droop
  4. Slurred speech
  5. Aphasia
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14
Q

True or False: No reliable clinical presentation exists to differentiate between ischemic and hemorrhagic strokes.

A

True

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15
Q

How can you differentiate between stroke types?

A
  1. Computed Tomography

2. Magnetic Resonance Angiography

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16
Q

A condition characterized by recurring seizures

A

Epilepsy

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17
Q

A sudden discharge of electrical activity in the brain

A

Seizure

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18
Q

What are 4 contributors to seizures?

A
  1. Genetic disposition
  2. Head Trauma
  3. Brain tumors
  4. Infections
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19
Q

What are the two main types of seizures?

A

Focal Seizures

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20
Q

A seizure that begins in one hemisphere and quickly spreads to the other.

A

Generalized seizure

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21
Q

Seizures can be categorized based on what?

A

Symptoms and EEG results

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22
Q

What are 4 symptoms of seizures

A
  1. Disruption of senses
  2. Loss of consciousness
  3. Muscle spasms
  4. Repetitive convulsions
    (some may report auras)
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23
Q

What is the most common type of headache?

A

Tension

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24
Q

What are the three types of headaches?

A
  1. Tension
  2. Migraine
  3. Trigeminal Autonomic Cephalagias (TAC)
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25
Q

What is one type of Trigeminal Autonomic Cephalagia?

A

Cluster headache

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26
Q

This type of headache appears bilaterally with mild to moderate pain, it may be accompanied with neck stiffness

A

Tension headache

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27
Q

This type of headache is described as throbbing, usually one-sided headache, worsens with movement and photophobia/phonophobia is present.

A

Migraine headache

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28
Q

These types of headaches are described as excruciating and stabbing, worsens with movement, typically appears on one side and can be accompanied with redness in the eyes and congestion.

A

Trigeminal Autonomic Cephalagia (TAC)

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29
Q

Slowly progressive disorders that affect motor or sensory neurons

A

Degenerative neurological disorders

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30
Q
  • Also known as Lou Gehrig’s disease
  • Affects upper and lower motor neurons
  • Cognition and Sensation are left in tact
  • No cure exists
A

Amyotrophic Lateral Sclerosis (ALS)

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31
Q
  • Triads of symptoms: tremors, bradykinesia, and muscle rigidity
  • Result of disrupted dopamine production by the basal ganglia
  • Tx required: dopamine replacement
A

Parkinson’s disease

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32
Q
  • Usually arises from post-infection
  • Progressive, symmetric, and peripheral neuropathy
  • Patients often recover w/supportive therapy
A

Guillain-Barre Syndrome

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33
Q
  • Antibodies attack the myelin surrounding axons

- Causes sensory and motor dysfunction

A

Multiple sclerosis

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34
Q
  • Acetylcholine receptors on skeletal muscle are attacked

- Treatment includes: Acetylcholinesterase inhibitors

A

Myasthenia gravis

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35
Q

What are the four ways Traumatic Brain injuries can happen?

A
  1. Blunt trauma
  2. Penetrating Trauma
  3. Acceleration/Deacceleration
  4. Blast trauma
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36
Q

What are the two pathophysiological alterations that result from a TBI?

A
  1. Change in intercranial pressure (ICP)

2. Change in level of consciousness (LOC)

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37
Q

Movement of the brain that results in rapid stretch and damage to the axons.

A

Diffuse axonal injury

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38
Q

What happens immediately in diffuse axonal injury?

A

Loss of consciousness

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39
Q

What type of TBI does a person normally remain in a coma?

A

Diffuse axonal injury

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40
Q

What type of mild TBI usually results from a blow to the head?

A

Concussion

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41
Q

How long do the symptoms of a concussion usually resolve?

A

10-14 days

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42
Q

Symptoms of a concussion

A
  1. Dizziness
  2. Seeing “stars”
  3. Amnesia
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43
Q

What are the three types of intercranial bleeding?

A
  1. Epidural
  2. Subdural
  3. Subarachnoid
    (Named for their location)
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44
Q

What are the two types of spinal cord injuries?

A
  1. Complete

2. Incomplete

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45
Q

What type of spinal cord injury does a patient lose all sensory and motor function below the level of injury?

A

Complete

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46
Q

Any significant injury to the spinal cord can result in what?

A

Spinal shock

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47
Q

What is the lack of reflexes during spinal shock called?

A

Bulbocavernosus reflex

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48
Q

A spinal cord injury at or above C4 affects what?

A

Respiration

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49
Q

A spinal cord injury at or above T6 may result in what?

A

Neurogenic shock

causes SNS depression, decrease cardiac output and hypotension

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50
Q

Injury to ascending tracts leads to loss of ______

A

sensation

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51
Q

Injury to descending tracts leads to loss of _____

A

motor function

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52
Q

If anything happens to the ________, condition is nearly incompatible with life.

A

brainstem

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53
Q

What area of the brain will extensive damage happen if the brain bleed occurs there?

A

Circle of Wills

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54
Q

Area around an infarct is called _______

A

Ischemic penumbra (damaged not dead)

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55
Q

What is the pathophysiology of an ischemic stroke?

A
  1. Occlusion of a cerebral artery
  2. Loss of perfusion
  3. Ischemia
  4. Release of glutamate outside of cell (Increase of Ca+ inside cell)
  5. Infarcation
  6. Perimeter cells hypo perfused= ischemic penumbra
  7. Cerebral edema
  8. Anoxic Encephalopathy
  9. Can lead to herniation of brain stem
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56
Q

What is elevated pressure in the brain called?

A

Anoxic Encephalopathy

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57
Q

In a TIA, how long do clots typically dissolve?

A

Within 24 hours

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58
Q

If a clot in a TIA takes longer than 24, but still reverse, the disorder is called ________

A

Reversible Ischemic Neurological Deficits (RINDs)

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59
Q

What are some risk factors for CVAs?

A
  • HTN
  • Hormonal contraception
  • Obesity
  • Inactivity
  • Binge drinking/substance abuse
  • Smoking
  • Previous stroke or TIA
  • Age
  • Family hx or ethnicity
  • Heart disease and AF
  • High cholesterol
  • Diabetes
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60
Q

What type of aphasia is damage to the broca area of the left hemisphere?

A

Expressive aphasia

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61
Q

What type of aphasia is damage to the Wernicke’s area of the left hemisphere?

A

Receptive Aphasia

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62
Q

A stroke where symptoms occur on the same side

A

Ipsylateral

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63
Q

A stroke where symptoms occur on opposite sides

A

Contralateral

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64
Q

Mnemonic for stroke symptoms

A 
Balance
Eyes
Face
Arms
Speech
Time
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65
Q

The movement during a seizure is called

A

tonic clonic

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66
Q

After a seizure, a person is in the _____ stage

A

ictal

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67
Q

What are the two types of seizures?

A
  1. Grand mal

2. Petit mal (absent seizures)

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68
Q

Guillain-Barre is characterized by what kind of paralysis?

A

Ascending (starts from feet and moves upwards)

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69
Q

The _______ on the spinal cord, the greater the injury.

A

Higher

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70
Q

How much mass of the brain does brain tissue take up?

A

80%

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71
Q

How much mass of the brain does cerebrospinal fluid (CSF) take up?

A

10%

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72
Q

How much mass of the brain does blood take up?

A

10%

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73
Q

Self-awareness and ability to react with the environment

A

Level of consciousness

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74
Q

What are the four levels of consciousness?

A
  1. alert
  2. lethargic
  3. obtunded (stupor)– difficult to arouse
  4. coma
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75
Q

What is Cushing’s Triad?

A

Hypertension, Apnea, and Bradycardia

*Usually a sign of impending death

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76
Q

What type of coma posturing happens when the feet are plantar flexed, legs are internally rotated, elbows flexed, arms adducted, and wrist and fingers flexed?

A

Decorticate posturing

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77
Q

What type of coma are the feet plantar flexed, wrist and arms flexed, forearms pronated, elbows extended, and arms adducted?

A

Decerebrate posturing

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78
Q

What type of TBI is where the brain hits the front of the skull then hits the back of skull (whiplash/ shaken baby syndrome) ?

A

Coup-Contrecoup Injury

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79
Q

What type of TBI is a result of vibrating trauma?

A

Blast injury

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80
Q

What type of TBI occurs when a bullet goes through a brain?

A

Penetrating trauma

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81
Q

What type of TBI happens when hit on the head with an object?

A

Blunt trauma

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82
Q

In a diffuse axonal injury, the injury happens to the _____ matter of brain.

A

White

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83
Q

What type of spinal cord injury happens as a result of twisting?

A

Rotational

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84
Q

What type of spinal cord injury happens as a result of a person hitting a chin on rock and head neck goes backwards?

A

Hyperextension

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85
Q

What type of spinal cord injury is caused by a downward force on top of head?

A

Vertical compression

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86
Q

What type of spinal cord injury happens when chin gets forced to chest?

A

Hyperflexion

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87
Q

The immediate damage to neurons and the trauma stretches or tears the spinal cord.

A

Primary Injury

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88
Q

What type of spinal cord injury can worsen primary injury and potentially cause cytotoxic edema?

A

Secondary injury

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89
Q

Skin area innervated by the sensory fibers of a single nerve root

A

Dematome

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90
Q

A group of muscles primarily innervated by the motor fibers of a single nerve root

A

Myotome

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91
Q

Spinal ______ can make estimating the extent of a permanent spinal injury difficult to assess

A

Shock

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92
Q

Neurogenic shock occurs when injury is located above ____.

A

T6

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93
Q

What does the musculoskeletal system include?

A
  • bones
  • cartilage
  • tendons
  • muscles
  • ligaments
94
Q

Name three things that can cause MSK trauma

A
  1. motor vehicle accidents
  2. work-related accidents
  3. sports injuries
95
Q

What 5 common traumas of the MSK?

A
  1. Bone fractures
  2. Nerve trauma
  3. Sprains
  4. Strains
  5. Dislocations
96
Q

Any disruption, either complete or incomplete, in the continuity of the bone.

A

Bone fracture

97
Q

The type of bone fracture that occurs from repetitive or cumulative trauma

A

Stress fracture

98
Q

What is the primary risk factor for a hip fracture?

A

Osteoporosis

99
Q

What is the strongest bone in the body?

A

The femur

100
Q

How can a femur break?

A

With significant traumatic force (MVAs, high-impact sports, ect)

101
Q

What are the three types of femoral fractures?

A

Type 1: Spiral or Transverse
Type 2: Comminuted
Type 3: Open/Compound

102
Q

A common fracture that occurs in the vertebrae that can lead to kyphosis

A

Compression fracture

103
Q

What is the most common type of fracture in childhood?

A

Clavicle

104
Q

What type of fractures are Colles and Smiths fractures?

A

Distal radius

105
Q

What type of nerve complication effects the median nerve in the wrist?

A

Carpal tunnel syndrome

106
Q

What type of nerve complication happens when a person experiences numbness and tingling?

A

Ulnar nerve damage

107
Q

What type of nerve involvement happens in brachial plexus injury (violent pull of arm or shoulder)?

A

Multiple nerve involvement

108
Q

Results from small tears in the muscle or tendon

A

Strain

109
Q

Results from injury to a ligament

A

Sprain

110
Q

Where do meniscus injuries occur?

A

In the knee

111
Q

What is the most commonly dislocated join in the body?

A

Shoulder dislocation

112
Q

Shoulder dislocation happens when the humeral separates from the scapula’s _________ cavity.

A

Glenoid

113
Q

A type of degenerative MSK disorder that is specific to bones

A

Osteoporosis

114
Q

A type of degenerative MSK disorder that is specific to joints.

A

Osteoarthritis

115
Q

A condition of low bone density and structural deterioration of the bone; caused by an imbalance of the normal process of bone breakdown

A

Osteoporosis

116
Q

Bone breakdown is caused by

A

Osteoclasts

117
Q

Bone formation is caused by

A

Osteoblasts

118
Q

Net bone loss occurs after what age?

A

30

119
Q

What are the risk factors for osteoporosis?

A

-Postmenopausal woman and elderly men

Lack of estrogen; estrogen normally inhibits osteoclasts

120
Q

A condition of the degeneration in joints (usually gets worse over time)

A

Osteoarthritis

121
Q

What three nutrients are associated with degenerative diseases of the bone?

A

Vitamin D, Calcium, and Phosphorus

122
Q

A disease in malnourished growing children characterized by the lack of Vitamin D, Calcium, or Phosphorus

A

Rickets

123
Q

What are some symptoms of Rickets?

A
  • Child’s femur develops bow-shaped
  • Child’s thoracic cage develops asymmetrically
  • Tooth development is delayed
124
Q

What is the condition that is similar to Rickets, but happens in adults?

A

Osteomalacia

125
Q

What are some causes for Osteomalacia?

A
  • Cancer
  • Liver and Malabsorption disorders
  • Medications
126
Q

What condition is characterized by the intervertebral discs flattening and collapsing?

A

Degenerative disc disease

127
Q

Narrowing of the spinal column caused by degenerative disc disease

A

Spinal stenosis

128
Q

Severe spinal stenosis in the lumbar or sacral area that may result in bladder and bowel dysfunction

A

Cauda Equina Syndrome

129
Q

Bone that is more solid and dense

A

Cortical bone

130
Q

Bone that is more porous and spongy

A

Trabecular bone

131
Q

Attaches muscles to bones

A

Tendons

132
Q

Attaches bones to bones

A

Ligaments

133
Q

A fractur in which the bone fragments separates completely; and the fractured bone stays in place

A

Complete non-displaced closed fracture

134
Q

An incomplete break of the bone where the intact side of the bone flexes (usually seen in children)

A

Greenstick fracture

135
Q

A fracture with more than one fracture line and more than two bone fragments that may be shattered or crushed

A

Comminuted fracture

136
Q

______ is typically associated with comminuted fractures

A

Trauma

137
Q

Stress fractures are most common in what body part?

A

Feet

138
Q

A type of fracture that is generally displaced, often results from trauma, carries a HIGH risk for infection, long bones are most at risk, requires surgical intervention.

(goes through the skin)

A

Open/Compound Fracture

139
Q

Crushing of the bone due to pressure (Generally occurs in the vertebrae)

A

Compression

140
Q

Occurs from a shearing, rotational force (Occurs when the body is in motion while one extremity is planted)

A

Spiral fracture

141
Q

Occurs when one part of the fracture is compressed into the adjacent bone (occurs with impact)

A

Impacted fracture

142
Q

Separation of bone fragments where ligaments or tendons attach

A

Avulsion fracture

143
Q

Smith fracture of the wrist is related to _____

A

flexion

144
Q

Colles fracture of the wrist is related to _______

A

extension

145
Q

Fracture of the ________ can result in excessive blood loss

A

Femur

146
Q

Only ___ of people with a hip fracture will make a full recovery

A

25%

147
Q

What are the risk factors for bone fractures?

A
  1. Age
  2. Bone pathology
  3. Post menopausal
  4. Low Ca++ and Vitamin D
  5. Activity
  6. Medications
148
Q
  • Can accompany closed MSK injury in any compartment

- Increased pressure leads to decrease vascularization

A

Compartment syndrome

149
Q

Toxins that increase in the blood which can lead to renal failure (as seen in compartment syndrome)

A

Rhabdomyolysis

150
Q

Spinal curvature seen more commonly in the elderly

A

Kyphosis

151
Q

Spinal curvature that can be seen in pregnancy

A

Lordosis

152
Q

Spinal curvature that is a deviation from being midline

A

Scoliosis

153
Q

Cervical strains and sprains most commonly occur from?

A
  • Acceleration/Deceleration Injury

- Repetitive stress or posturing/positioning

154
Q

Why are lumbar injuries the most common?

A

Because lumbar carries the heaviest load of back

155
Q

What are the three types of shoulder injuries?

A
  1. rotator cuff injury (1 of 4 mucles)
  2. dislocation
  3. frozen
156
Q

Neonates are at risk for what type of MSK injury?

A

Brachial plexus injury (Erb’s Palsy)

157
Q

What type of MSK injury happens mainly in women, happens with inflammation in the plantar fascia, and is due to high impact on the feet?

A

Plantar Fasciitis

158
Q

What two types of knee injuries are common in athletes?

A
  • Rupture of the Anterior Cruciate Ligament (ACL)

- Tear of the Meniscus

159
Q

A mass of cells showing an uncoordinated and proliferative growth

A

Cancer

160
Q

Cancer cells take on what appearance?

A

Abnormal appearance and lack differentiation

161
Q

Specific immune (WBC) cells that function to destroy abnormally appearing cells

A

Natural Killer (NK) cells

162
Q

If a cancer has spread, it has _____

A

metastasized

163
Q

Cancer Grade I

A

Cells are well-differentiated

164
Q

Cancer Grade III

A

Cells or poorly differentiated (anaplastic)

165
Q

How is cancer staged?

A

By TNM Classification

Tumor size, node involvement, and metastasis

166
Q

ALL cancers arise from what?

A

Genetic defect

167
Q

What gene mutation causes 50% of cancer cases?

A

TP53 (Tumor suppression gene)

168
Q

When mutated, proto-oncogenes become what?

A

Oncogenes

169
Q

Programmed cell death

A

Apoptosis

170
Q

Failure of what two things can cause cause?

A

Apoptosis or NK cells

171
Q

Regulates cell replication

A

Proto-oncogenes

172
Q

Promotes uncontrolled cellular proliferation

A

Oncogenes

173
Q

What can cause genes to mutate?

A
  • Genetics
  • Environment
  • Diet and activity
  • Viruses
174
Q

Which Viruses are linked to cancer?

A
  • HPV
  • EBV
  • Hep B and C
175
Q

_____ insert genes into the host DNA to replicate and can inhibit tumor suppression

A

Viruses

176
Q

Growth of abnormal cells (stays in the membrane)

A

Benign

177
Q

Growth of abnormal cells that proliferates and moves (no membrane)

A

Malignant

178
Q

Spread of cancer

A

Metastasis

179
Q

The ability to tell cells appart

A

Differentiation

180
Q

Lack of differentiation in cells

A

Anaplasia

181
Q

The formation of blood vessels

A

Angiogenesis

182
Q

Loss of a lot of weight (including muscle mass and fat)

A

Cachexia

183
Q

Using new blood vessels as pathways to spread cancer

A

Vascular Endothelial Growth Factor (VEGF)

184
Q

What type of cancer arises from endothelial cells?

A

Carcinomas

185
Q

What type of cancer arises from blood and lymph?

A

Lymphomas and Leukemias

186
Q

What type of cancer arises from connective tissue?

A

Sarcomas

187
Q

What type of cancer arises from the muscles?

A

Myomas

188
Q

What type of cancer arises from the lining of of the breast glandular tissue?

A

Adenomas

189
Q

Cancer Grade II

A

Moderately differentiated

190
Q

Which cancer stage is the worst?

A

Stage V: Includes distal metastasis

191
Q

What is the common site of metastasis for lung cancer?

A

Bone and Brain

192
Q

What is the common site of metastasis for colon cancer?

A

Liver, Peritoneum, Ovary, Lungs

193
Q

What is the common site of metastasis for Breast Cancer?

A

Bone, Brain, Liver, and Lungs

194
Q

What is the common site of metastasis for Prostate cancer

A

Vertebrae, Bone, Liver, Lungs

195
Q

What is the common site of metastasis for Melanma?

A

Brain

196
Q

An unexpected pathologic condition provoked by a secretion of hormones or substances secondary to the presence of cancer

A

Paraneoplastic syndrome

197
Q

What are 3 examples of a paraneoplastic syndrome?

A
  1. Increased ATCH
  2. Increased parathyroid like hormone
  3. Increased ADH
198
Q

What is the leading cancer death in the United States?

A

Lung cancer

199
Q

What are some risk factors to lung cancer?

A
  1. Environmental
  2. Smoking
  3. Family History
  4. Ethnicity
  5. COPD
200
Q

What is the number one risk factor for developing breast cancer?

A

Having breasts

201
Q

What age group is colon cancer usually found in?

A

The elderly population

202
Q

An overwhelming inflammation reaction initiated by a severe insult to the body

A

Systemic Inflammatory Response Syndrome (SIRS)

203
Q

What can SIRS be caused by?

A
  • Trauma
  • Elongated asthma attack (status asmaticus)
  • Surgical
204
Q

The initial body response in SIRS resembles which phase of the stress response

A

Alarm

205
Q

Why does SIRS often result in sepsis?

A

After initial injury, body’s immune system is exhausted from working hard and eventually immune system gets tired

206
Q

When a patient experiences SIRS, what type of infection generally causes sepsis?

A

Healthcare-Acquired

207
Q

What are the risk factors associated with sepsis?

A
  • Elderly
  • Infants
  • Immunosuppressed
  • Diabetes
208
Q

What is the pathophysiology of shock?

A
  1. Inadequate blood flow to tissue
  2. Leads to cellular hypoxia
  3. Anaerobic metabolism in cells
  4. Lactic acidosis
209
Q

What are the three main treatments for cancer?

A
  1. Surgery
  2. Radiation
  3. Chemotherapy
210
Q

What are the five types of shock?

A
  1. Neurogenic
  2. Anaphylactic
  3. Hypovolemic
  4. Septic
  5. Cardiogenic
211
Q

A life-threatening condition in which perfusion and oxygenation needs are not met

A

Shock

212
Q

Signs and symptoms of shock

A
  • Hypotension
  • Increased respiratory rate
  • Tachycardia
  • Oliguria
213
Q

What are the three stages of shock?

A
  1. Initial
  2. Progressive
  3. Irreversible
214
Q

This stage of shock involves the SNS and RAAS due to lack of perfusion

A

Initial

215
Q

This stage of shock is where the blood flow to the heart and brain are decreased

A

Irreversible

216
Q

This stage of shock is where vasoconstriction to the GI tract, liver, and kidneys occur

A

Progressive

217
Q

How does shock affect the liver and kidneys??

A
  • Leads to lactic acidosis (increased RR)

- Decreases urine output

218
Q

How does shock affect the GI tract?

A

GI mucosa breakdown

219
Q

How does shock affect the pancreas?

A

Pancreas does not provide enough insulin, glucose in the blood increases

220
Q

During shock, which hormones released by the adrenal gland exacerbates hyperglycemia?

A

Cortisol and epinephrine

221
Q

How does shock affect the blood?

A

Makes blood more susceptible to clot formation

222
Q

Shock that results when the heart is unable to meet the output demands requires (severe hypotension)

A

Cardiogenic

223
Q

What is the systolic blood pressure in someone suffering from cardiogenic shock?

A

Below 90 mm Hg

224
Q

Shock that occurs when blood volume is inadequate for tissue perfusion; usually caused by trauma

A

Hypovolemic

225
Q

What type of shock is IgE mediated, rapid, and systemic allergic reaction?

A

Anaphylactic Shock

226
Q

What happens during anaphylactic shock?

A

Massive vasodilation and bronchospasm

227
Q

What type of shock is caused by a disruption of the SNS?

A

Neurogenic shock

228
Q

What type of shock is the result of a severe infection?

A

Septic

229
Q

Septic shock is usually due to what?

A

Release of vasoactive toxins

230
Q

Viruses need what to survive?

A

Host cell

231
Q

What are the 5 P’s of compartment syndrome?

A
  • pain
  • pallor
  • paresthesia
  • pulselessness
  • paralysis

Pathophysiology (8 decks)

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