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Patho > Topic 8.1 - General and Acute Neurological Dysfunction > Flashcards

Topic 8.1 - General and Acute Neurological Dysfunction Flashcards

1
Q

What structures are in the brainstem?

A

Medulla, pons, midbrain

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2
Q

What structures are in the diencephalon?

A

The thalamus and hypothalamus

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3
Q

What structures are found in the cereberum?

A

The basal ganglia and cerebral cortex

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4
Q

Which spaces does CSF flow through?

A

Through ventricles and subarachnoid space

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5
Q

What are some early signs of increase intracranial pressure?

A

–> LoC changes
–> Decreased PERRLA Reflex
-> Severe headache due to stretching of dura and blood vessels
–> Vomiting due to stimulation of emetic center in medulla
–> Papilledema due to swelling on optic disk

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6
Q

What is papilledema?

A

Swelling of the optic disks
–> Blurred vision, double vision, or complete loss of vision

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7
Q

How and why do the vitals change during increase in ICP?

A

ICF leads to cerebral ischemia:
Systemic vasoconstriction tries to provide more blood to the brain –> systemic BP rise
Baroreceptors respond to increase BP by slowing heart
Chemoreceptors respond to low CO2 levels by reducing RR.

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8
Q

How are issues with ICF diagnosed?

A

Specimen taken from lumbar puncture
–> Test for increased pressure
–> Presence of blood (pink)
–> Presence of WBCs (yellow)
–> Abnormal proteins (Neoplasm)

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9
Q

What is transtentorial hernia?

A

The movement of brain tissue from one intracranial compartment to another.

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10
Q

What is an uncal herniation?

A

Rising intracranial pressure due to herniation of uncus.

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11
Q

What are space occupying lesions?

A

Neurological diseases/masses/lesions that cause secondary damage by occupying space at the expense of the brain tissues and its blood supply.

Can lead to herniation

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12
Q

What kinds of issues can cause space occupying lesions?

A

Intracranial hemorrhage, increased CSF, edema, Intracranial abscess and tumors.

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13
Q

What is the most common brain tumour in children? How is it graded?

A

Astrocytoma - in cerebellum, occurs in childhood
Graded from type I-IV

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14
Q

What kind of brain tumors are commons in young children?

A

Cerebellar and brainstem tumors

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15
Q

What kind of brain tumors are most common in adults and emerge in mid-life?

A

Gliomas

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16
Q

What are the most aggressive and common primary tumors in the adult brain?

A

Glioblastoma

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17
Q

Where do glioblastomas usually develop? What symptoms’ do they cause? What is the prognosis?

A

Usually develop in the cerebral white matter - cause seizures, nausea, vomiting, headache

Infiltrates into other brain tissues, very difficult to operate on. Poor prognosis.

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18
Q

Why are brain tumors so difficult to treat?

A

–> They are resistant to conventional radiation and chemo
–> They are difficult to remove by surgery
–> At time of diagnosis they are already quite large, and have likely migrated.

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19
Q

Brain tumors are difficult to treat. What methods an be effective?

A

–> Angiogenesis inhibitors
–> Emergence of tumor treatment fields (electrical fields to disrupt tumor cell division)
–> Neutralize tumor with immune system

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20
Q

What percentage of cardiac output does the brain use at rest?

A

20%

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21
Q

What vessel circuit can compensate for a blocked internal carotid artery and prevent stroke?

A

The arterial circle of Willis

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22
Q

What causes Transient Ischemic Attack?

A

Temporary localized reduction of blood flow to brain
–> Patrial occlusion of artery
–> Atherosclerosis
–> Small embolus
–> Vascular spasm

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23
Q

What are the symptoms of a TIA?

A

Symptoms may be directly related to location of ischemia
–> Muscle weakness in arm/leg
–> Visual disturbances
–> Numbness
–> Transient aphasia or confusion

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24
Q

How are TIAs treated?

A

Thrombolytic agents

25
Q

What is CVA?

A

A cerebrovascular accident is an infarction in the brain tissue that results in a lack of blood (stroke)

26
Q

_ minutes of ischemia can lead to irreversible nerve cell damage.

A

5

27
Q

What are the three kinds of strokes?

A

–> Occlusion by atheroma in large artery
–> Sudden obstruction caused by embolus lodged in a cerebral artery
–> Intracerebral hemorrhage due to severe HTN

28
Q

What kinds of conditions can predispose an individual to CVA?

A

Diabetes, hypertension, atherosclerosis, history is TIAs, aging, heart disease

29
Q

What lifestyle factors can predispose an individual to CVA?

A

Sedentary lifestyle, oral contraceptives, nicotine/tobacco

30
Q

What kind of cerebral aneurism is most common?

A

Berry Aneurism
–> At bifurcation point of circle o Willis

31
Q

How are cerebral aneurisms treated?

A

Surgical treatment - high risk procedure, required early screening

32
Q

What might cause cerebral edema? What are the biggest concerns with this kind of edema?

A

–> Infectious agents are often to blame
–> Increased pressure, disruptions in BBB and ischemic stroke are main concerns.

33
Q

What is meningitis?

A

Infection that results in swelling on the meninges.

34
Q

How can meningitis be detected in an CSF specimen?

A

Exudate from infection contains cell proteins, and other abnormal solid materials.

35
Q

Different age groups are susceptible to meningitis due to different causative organisms. What usually causes meningitis in neonates?

A

E. Coli

36
Q

Different age groups are susceptible to meningitis due to different causative organisms. What usually causes meningitis in young children?

A

H. influenzae

37
Q

Different age groups are susceptible to meningitis due to different causative organisms. What usually causes meningitis in children and young adults?

A

N. meningitides or meningococcus

38
Q

Different age groups are susceptible to meningitis due to different causative organisms. What usually causes meningitis in older adults?

A

S. pneumoniae

39
Q

What are some symptoms of meningitis?

A

–> Severe headache
–> Back pain
–> Photophobia
–> Nuchal (neck) rigidity
–> Vomiting, irritability, lethargy, fever, chills
–> Progression of fever
–> Kernig and Brudzinski’s signs

40
Q

What might cause brain abscesses? Where might they spread to?

A

Localized infection area of necrosis surrounded by edema, or the site of injury or surgery.
May spread to ear, throat, lung, or sinuses

41
Q

What kind of infection usually causes encephalitis?

A

Usually one of viral origin

42
Q

What is encephalitis?

A

infection of parenchymal or connective tissue in the brain and spinal cord, which leads to necrosis and inflammation.

43
Q

What are the early signs of encephalitis?

A

Headache, neck stiffness, lethargy, vomiting, seizures, and fever

44
Q

Western Equine Encephalitis:
How is it spread?
When is it more frequent?
Who does it usually affect?

A

Spread by mosquitos - more common in summer months
Common in young children

45
Q

St. Louis Encephalitis - which demographic does it affect most?

A

More serious for elders than for younger individuals

46
Q

What causes and spreads West Nile Fever?

A

A kind of encephalitis caused by flavivirus and spread by mosquitos

47
Q

Lyme Disease:
Caused by which bacterium?
Transmitted by what?
Symptoms?

A

Spread by ticks carrying Borrelia burgdorferi.
Symptoms include sore throat, dry cough, fever, headache, cardiac arrythmias, and neurological abnormities. Also causes encephalitis.

48
Q

What kind of HSV causes encephalitis?

A

Herpes Simplex I can cause encephalitis and extensive necrosis and hemorrhage in the brain.

49
Q

Ameobic Meningeocephalitis:
Caused by which microorganism?
Where is this found?
Prognosis?

A

Caused by Naegleria flowleri amoeba, often found in warm water habitats.
Rare but fatal.

50
Q

How does rabies reach the CNS?

A

By travelling up the neuron

51
Q

What are are the symptoms of rabies?

A

Headache, fever, respiratory failure, death. The virus also causes issues swallowing.

52
Q

Concussion:
Cause?
Symptoms?

A

Caused by sudden excessive movement of the brain from blow to head or whiplash type injury
Can lead to amnesia and headaches, but usually recover within 24 hours.

53
Q

What is a contrecoup injury?

A

Bruising contralateral to primary concussion injury - may be secondary to accelerating or deceleration accidents.

54
Q

What is an epidural hematoma? When do symptoms usually arise?

A

Bleeding between the dura and the skull - symptoms arise within a few hours of injury

55
Q

What is a subdural hematoma?

A

Bleeding between the dura and arachnoid mater.
A tear in the arachnoid will results in ICP

56
Q

What is a subarachnoid hemorrhage?

A

Bleeding between the arachnoid and pia mater - blood mixes with CSF

57
Q

What kind of hematoma is associated with traumatic bleeding from BVs at the base of the brain?

A

A Subarachnoid hemorrhage.

58
Q

What causes intracerebral hematoma?

A

Results from contusion or shearing injuries - may develop days after injury.

59
Q

What are some common causes for hematomas?

A

Automobile or motorcycle accidents, sports injuries, falls.

Patho (14 decks)

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