Unit 7 Patho Flashcards
Dopamine is an important neurotransmitter. Which disease or disorder results when the neurons in the brain that produce dopamine die?
1) Multiple Sclerosis (MS)
2) Gianne-Barre Syndrome
3) Parkinson’s disease
4) Poliomyelitis
3) Parkinson’s Disease
The nervous system is divided into two parts, what are they?
CNS- Brain and Spinal cord
PNS- Afferent and Efferent divisions
Failure of the neural tube to close during embryonic development is called?
Neural tube defects
What are two most common types of neural tube defects?
Anencephaly- The upper part of the neural tube fails to close causing the fetus to develop missing large parts of the brain
Spina Bifida- The lower part of the neural tube does not close during the first weeks of embryonic development
Dendrites and axons in the CNS form the ____ matter in the CNS and run in clusters called ______.
Gray matter ; nuclei
Brain and spinal cord support come from:
1)Bone- skull and vertebral column
2) Meninges- Pia mater, Anachnoid mater, and Dura mater
3) Fluid- Blood and Cerebrospinal Fluid
What secretes Cerebrospinal fluid (CSF)?
Choroid Plexus secretes CSF and transports ions and nutrients from plasma into ventricles.
The CSF provides a physical and chemical protection for the brain. What are their roles?
Physical protection
-increases buoyancy and -protective padding.
(This protects the brain from injury when jolted or hit).
Chemical protection
-regulates the extracellular environment,
-exchanges solutes with interstitial fluid and
-provides route to removal waste . (Allows for homeostatic regulation)
What are three infections of the Central Nervous System?
Meningitis
Encephalitis
Myelitis
What is Meningitis? What are some potential signs and symptoms?
Inflammation of the meninges of the brain and spinal cord. (Can be bacterial or viral infection)
S&S: Headaches, vomiting, vision loss, focal neuro signs, neck stiffness and increase intracranial pressure (ICP)
Causes vision loss due to increased pressure of the optic nerve.
Neck stiffness is an important sign, when the neck is flexed, the inflamed nerve root and meninges of cervical region get stretched.
What is Encephalitis? What are some potential signs and symptoms?
An acute inflammatory disease of the brain. (Viral infection)
S&S: Headache, vomiting, altered consciousness, focal neuro signs.
Altered consciousness refers to a change in a patients state of awareness and arousal.
What is Myelitis? What are the signs and symptoms?
Inflammation of the spinal cord (Viral infection)
Signs and symptoms may include pain, abnormal sensation, weakness/paralysis of extremities, bowel and bladder dysfunction.
What are the neural tissue metabolic requirements?
Neurons need oxygen and glucose.
With this oxygen can cross blood brain barrier freely
Glucose requires membrane transporters.
The brain receives 15% of oxygen and is responsible for about 50% of glucose consumption.
How can hypoglycemia affect the body?
It can lead to confusion, unconsciousness, and death.
What are the functions of the cerebrum? (Cerebral cortex, Basal ganglion, and limbic system)
Cerebral cortex-Process sensory information and coordination the execution of movement.
Basal Ganglion- controls the body’s ability to move.
Limbic system- learning and memory (Part of gray matter)
What are the functions of the basal ganglion?
Controls the body’s ability to move
What are the functions of the brain stem? (Midbrain, pons and medulla oblongata)
Midbrain- eye movement
Pons- coordination of breathing
Medulla Oblongata- control of involuntary functions
Also deals with sleep, arousal, pain modulation and muscle tone.
What is the function of Diencephalon and what does it consist of?
It consist of the thalamus, pineal gland, hypothalamus, and pituitary gland.
Thalamus- integrating and relay station for sensory and motor information.
Pineal gland- Melatonin secretion
Hypothalamus- Homeostasis and behavioral drives
Pituitary gland- Hormone secretion.
What is the function of the cerebellum?
Cerebellums main function is movement coordination.
What is Parkinson’s disease?
The degeneration of dopamine producing cells in basal ganglion.
Also the decreased initiation and inhibition of movement.
What are the clinical manifestations (symptoms) of Parkinson’s disease?
For primary signs think (T.R.A.P):
T- tremor
R- rigidity
A- akinesia/bradykinesia [slowness of movements]
P- postural instability
Secondary Motor symptoms
-Stooped posture
-Decreased strength in extensor muscles and decreased flexibility in flexor muscles
-Shuffling gait, freezing of gait
What are some non-motor symptoms of Parkinson’s?
Depression
Dementia
Sleep disturbances
Difficulty smelling
What is the difference between a Cerebrovascular Accident (CVA) and a Transient Ischemic Attack (TIA)?
CVA is sudden loss of neurological function due to impaired blood flow for more than 24 hours
TIA is the interruption of blood flow to the brain for less than 24 hours
How might a patient present with a CVA?
They may present with:
—contralateral hemiparesis
—Contralateral sensory deficits
— Gait and balance deficits
— Speech and cognitive deficits
IMPORTANT Remember (FAST)
F- Face Drooping
A- Arm Weakness
S- Speech Difficulty
T- Time to call 911
Describe how the brain functions as an integration system to modulate the sensory system.
The sensory system monitors the internal and external environments and initiates a reflex response.
Describe how the brain functions as an integration system to modulate the cognitive system.
The cognitive system in the cerebral cortex is able to initiate voluntary thought, understanding, perception,and language
Describe how the brain functions as an integration system to modulate the behavior state system.
The behavior state system in the brain governs sleep-wake cycles, learning, memory, pain,and other intrinsic factors.
What is Alzheimer’s Disease?
A progressive brain disorder that causes Dementia.
Caused by atrophy of the cerebral cortex and the disruption in major neurotransmitters including Acetylcholine.
—A genetic predisposition.
What are the early and late symptoms of Alzheimer’s?
Early
— Psychological and personality changes
—(First symptom) inability to learn new information.
—Difficulty with judgment, language, and safety.
Late
—Loss of smell and taste [leads to decrease in appetite]
—Lack of neuromuscular coordination.
— Delusion, agitation, and disorders of sleep
What are the 2 sensory stimuli divided into?
Special Senses and Somatic senses
What is associated with special senses?
Vision, hearing, taste, smell, and equilibrium.
What is associated with somatic senses?
Touch, temperature, pain, itch, proprioception
What are the 4 different types of sensory receptors?
Chemoreceptors: For ex. Oxygen, pH and glucose.
Mechanoreceptors: For ex. Pressure, cell stretch, vibration, sound and acceleration
Photoreceptors: For ex. Photons of light
Thermoreceptors: For ex. Varying degrees of heat
What is the sensory pathway (Spinothalamic tract)?
It begin in the dorsal root ganglion, it extends to the dorsal horn where they synapse with the second neuron. (This second neuron has the cell body in the GRAY MATTER and connects to the thalamus). ➡️These second neurons intersect with the spinal cord and ascend to the brain and enter the thalamus. ➡️Lastly they synapse in the post-central gyrus in the cerebral cortex
What are the four distinguishing properties of a stimulus in the CNS?
—Modality: which sensory neuron are activated
—Location: which receptive fields are activated
—Intensity: Number of receptors activated and frequency of action potentials from those receptors.
—Duration: Durations of action potentials in the sensory neuron
What is a peripheral nerve that provides sensory information to the skin?
Cutaneous nerve
What is the cutaneous area supplied by one dorsal root?
Dermatome
Which somatosensory fibers sense burning pain and hot temperatures?
Non myelinated fibers (Type C)
Which somatosensory fiber sense sharp pain, gross touch and cold temperatures?
Small myelinated fibers (Type A-Delta) [Faster]
Which somatosensory fiber sense proprioception p, vibration, and fine touch?
Large myelinated fibers (A-Alpha and A-Beta) [Fastest]
With the exception of olfaction, where do all sensory pathways first travel to for relay and processing?
Hypothalamus
Cerebellum
Cerebrum
Thalamus
Thalamus
What would be affected with an Anterior Cerebral Artery stroke?
The feet and legs
What would be affected with a Middle Cerebral Artery stroke?
The hands, feet, face and the language centers in the dominant hemisphere
What would be affected with a Posterior Cerebral Artery stroke?
The Visual Cortex
What is the most common clinical presentation after an anterior cerebral artery stroke?
1) Contralateral hemiparesis and sensory deficits; the leg more involved than the arm
2) Contralateral hemiparesis and sensory deficits; the arm more involved than the leg
3) Ipsilateral hemiparesis and sensory deficits; the leg more involved than the arm
4) Ipsilateral hemiparesis and sensory deficits; the arm more involved than the leg
1) Contralateral hemiparesis and sensory deficits; the leg more involved than the arm
What is local pain?
Pain located at the source of pain
What is acute pain?
A warming system that is expected to resolve
What is chronic/persistent pain?
Pain that is not resolving as aspected and there is a decreased threshold of neural excitability.
Discuss the pathway smell takes.
Smell (olfactory) is found in the nasal cavity ➡️ uses chemoreceptors and ➡️ is sent through limbic system
Discus the pathway taste takes.
Taste is found in the taste buds, ➡️ uses chemoreceptors ➡️ it’s then sent through CN 7, 9, and 10 in the brain stem.
Discuss the pathways for hearing.
Hearing (Auditory) is found in the ear and is carried by sound waves, fluid waves ➡️ chemical signals send action potentials and goes from CN 8 to brain stem and thalamus ➡️ ending in auditory cortex
Discuss the pathway for vision.
Vision is a translation of reflected light into a mental image ➡️ use’s photoreceptors ➡️ transduce light into an electrical signal that passes through the visual cortex in the occipital lobe.
Is a patient is having a stroke on the right side of the brain what would be affected?
The left side (Contralateral side)
If a patient is having a stroke in the brain stem what side would be affected?
Both the left and right side.
What is an intracranial Hemorrhage?
Bleeding within the skull
What are the Extra-Axial hemorrhages?
—Epidural: Bleeding between skull and dura mater
—Subdural: Bleeding below dura mater
—Subarachnoid: Bleeding below arachnoid space.
What are the Intra-Axial Hemorrhages?
—Intracerebral: Bleeding with the cerebrum (2nd most common form of stroke)
—Intraventricular: Bleeding in or around ventricles
A spinal cord injury in the neck will result in what?
It’ll result in paralysis from the shoulders down (Tetraplegia or Quadriplegia)
A quadriplegic person may present with what?
They may have feeling in the arms/hands; Depending on how high or low the injury occurred. The higher in the neck, you will be more impaired and even lose the ability to breath on your own.
A spinal cord injury on the chest or lower will result in?
It’ll result in Paraplegia
A person with paraplegia will present with what symptoms?
Loss of feeling in the legs and instability of abdominal area
What is the difference between a complete and an incomplete spinal cord injury?
Complete is when there is no communication between the brain and the body at the point of injury.
Incomplete is when there is still communication.
What is spina bifida?
A birth defect where the tissue on the left and right side of the back that normally come over the spinal cord to protect it, don’t completely meet to make a seal, leaving an opening in the back.
What are the three types of Spina Bifida?
— Myelomeningocele
— Meningocele
— Spina Bifida Occulta
Which is the most severe form of Spina Bifida?
Myelomeningocele
(When the spinal cord and surrounding meninges protrude out of the opening of the boney vertebrae)
Which is the most common form of Spina Bifida?
Spina Bifida Occulta
(The spinal cord and surrounding tissue don’t protrude, usually asymptomatic)
