Unit 26 Flashcards
Neurologist
A physician specializing in treatment of brain injury and dysfunction
Cerebral vascular accident
A.k.a. stroke
Infarct
Area of dead or dying tissue resulting from an obstruction of blood vessels
Most common types of vascular disorders affecting the CNS
Ischemia, migraine stroke, cerebral hemorrhage, angioma, arteriovenous aneurisms
Embolism
Clots or other plug brought through the blood from a larger vessel and forced into a smaller one, obstructing circulation
Area most affected by embolism
Middle cerebral artery of the left side
Thrombosis
Blood clot in a vessel that has remained at the place of its formation
Cerebral arteriosclerosis
Thickening and hardening of brains arteries
Cerebral vascular insufficiency/transient ischaemia
Passing attacks of ischemia. Experienced as fleeting giddiness or impaired consciousness
Migraine strokes
Due to spontaneous blood vessel constriction causing ischemia. Cause unknown
Causes of cerebral haemorrhage
High blood pressure, congenital defects in arteries, blood disorders, toxic chemicals, brain trauma
Angioma
Congenitally abnormal vessels forming masses (arteriovenous malformations). Causes abnormalities in blood flow patterns and are inherently weak. Can result in stroke
Aneurysms
Vascular dilation due to localize defect in a blood vessels elasticity. Usually congenital but may develop from hypertension, embolism, infection, arteriosclerosis
Metabolic syndrome
Combination of medical disorders including obesity and insulin abnormalities, increases risk of developing cardiovascular disease and diabetes
Contrecoup
Bruise from brain hitting the opposite end of the skull
Coup
Bruise from brain hitting the skull
Dementia pugilistica
Subsequent to repeated concussions and periods of unconsciousness. Common in boxers
Glasgow coma scale
Scale that provides an indicator of unconsciousness and potential recovery. Evaluate eye-opening, motor response, and verbal response, sums them
Time when brain is most epileptogenic
When inactive and person is still.
Three most common symptoms of epilepsy
Onset of aura, loss of consciousness, movement
Four common types of seizures
Focal seizures, generalized seizures, akinetic seizures, and myoclonic spasms
Focal seizures
Originate in a point in the near cortex representing a region of the body, or movement is first scene. Movement spreads
Complex partial seizure
Type of focal seizure originating usually in the temporal lobe. Characterized by subjective experiences prior to the attack, automatisms, and postural changes
Automatisms
Automatic, non-reflexive actions performed without conscious volition. E.g. lip smacking, chewing, undoing buttons
Generalized seizures
Bilaterally symmetrical and without focal on set. Includes loss of consciousness and stereotyped motor activity. Has three stages
Three stages of generalized seizures
Tonic- body stiffens and breathing stops
Clinic- rhythmic shaking
Postseizure- lack of affect and confusion
Akinetic seizures
Usually only in children. Very short duration, child usually falls down and gets up after a few seconds
Myoclonic seizures
Massive seizures consisting of sudden flexion or extension of the body
Encapsulated tumour
Brain tumour developing as a distinct entity, puts pressure on other parts of the brain. Maybe cystic
Infiltrating tumours
Not clearly distinct from surrounding tissue, may destroy healthy cells
Neoplasm
A.k.a. tumour
Glioma
45% of brain tumors. Arise from glial cells, infiltrate brain substance. Vary considerably
Meningioma
Tumour attached to the meninges. Grow outside the brain, well encapsulated, most benign. May develop between hemispheres and be difficult to remove. May erode skull.
Metastatic tumor
Has been transferred from elsewhere in the body. Usually multiple tumors, poor prognosis
Pain sensitive structures within the skull
Venous sinuses, Dura Mater, large arteries of the brain, branches of the fifth ninth and 10th cranial nerves, first and third cervical nerves
Types of headaches
Migraine, headache due to neurological disease, muscle contraction headache, and non-migrainous vascular headache
Classic migraine
12%. Preceded by aura during vasoconstriction, then pain during vasodilation.
Common migraine
80%. No aura, but gastrointestinal or other signal may precede an attack
Cluster headache
Unilateral pain in head or face, rarely lasts longer than two hours. Recurs repeatedly for weeks or months before disappearing.
Rarest types of migraine
Hemiplegic and ophthalmologic migraine. Loss of movement on one side of the body or of the eyes
Muscle contraction headache
Due to sustained attention in muscles of scalp and neck. Often due to poor posture or stress. Caffeine may exacerbate
Ergotamine compounds
Often given in conjunction with caffeine to construct cerebral arteries and alleviate migraine
Viral meningitis
Inflammation of the meninges due to infection. E.g. west Nile virus
Amebiasis
A.k.a. dysentery. Infection of a parasite causing encephalitis and brain abscesses
Malaria
Caused by a protozoan parasite. Plasmodia infects brains capillaries, producing haemorrhages and neuron degeneration
Myasthenia gravis
Auto immune disorder attacking muscle receptors for acetylcholines. Causes extreme muscular fatigue. Treatment includes acetylcholine therapy, immunosuppressants, and thymectomy
Poliomyelitis
Caused by a virus that attacks spinal cord motor neurons. Causes muscle wasting and eventually asphyxia. May interfere with acetylcholine synthesis
Multiple sclerosis
Motor fibre myelin is lost in scars called sclerotic plaques. May be generic or environmental
Paraplegia
Legs paralyzed due to complete transaction of spinal cord
Brown Sequard syndrome
Unilateral transaction through spinal cord. Contralateral side loses pain and temperature sensation. Ipsilateral side loses find touch and pressure sensation. Walking ability is recovered within days due to bilateral control
Hemiplegia
Loss of voluntary movements on one side, postural tone, summary flexes. Due to damage to neocortex and basal ganglia
Babinski sign
OK extensor plantar response. Stroking bottom of foot causes curling of toes. Hemiplegic people and infants extend foot
Abdominal reflex
Causes abdominal muscles to retract and stroked
Cremasteric reflex
Causes balls to retract when inner thigh stroked
Reflexes altered in hemiplegic patients
Babinski sign, abdominal reflex, cremasteric reflex
Components of examination in sleep laboratory
EEG, electromyogram, thermometer, electro-oculogram
Electromyogram
Records muscle activity
Electro-oculogram
Records eye-movement
Two major groups of sleep disorders
Narcolepsy and insomnia
Varieties of narcolepsy
Sleep attacks, cataplexy, sleep paralysis, and hypnagogic hallucinations
Sleep attacks
Brief episodes of an REM sleep for 15 minutes at any time.
Cataplexy
Complete loss of muscle tone and collapse. Person remains conscious. During times of excitement. May be an attack of REM sleep
Sleep paralysis
During transition from wakefulness to sleep. Can be aroused.
Hypnagogic hallucinations
Dreams a person has in sleep paralysis
Some reasons for insomnia
Nightmares and night terrors, sleep apnea, restless leg syndrome, myoclonus, drug use and brain damage
Restless leg syndrome
Unpleasant sensation in the legs that are relieved by moving them. Maybe due to iron deficiency, Parkinson’s, anemia, kidney failure, diabetes, etc. may have periodic limb movement in sleep
Obstructive sleep apnoea
Collapse of oral pharynx during paralysis of dreams sleep. Have history of loud snoring. Reduce their surgical intervention and wearable devices
Central sleep apnoea
Stems from a CNS disorder. Primarily affects males. Failure of the diaphragm and accessory muscles to move
