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Neuro Diseases / Disorders > Week 1 - Neuro Diseases / Disorders > Flashcards

Week 1 - Neuro Diseases / Disorders Flashcards

1
Q

epidural hemorrhage / hematoma

A

traumatic vascular injury, between dura and bone, ruptured meningeal artery, appears lens shaped and clear on CT scan, person often experiences blow to head with momentary loss of consciousness and then acts normal only to go into a coma hours later, blow to the temple

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2
Q

subdural hemorrhage / hematoma

A

traumatic vascular injury, between dura and arachnoid layer, rupture of cerebral vein where it joins sinus, result of deacceleration injury in which the skull comes to a stop but the brain keeps moving, appears more blurred and follows curve of skull on CT scan, elderly falls

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3
Q

subarachnoid hemorrhage / hematoma

A

traumatic vascular injury, between arachnoid and pia, rupture of cerebral artery, caused by aneurysm, blood will be found in CSF, worst headache ever, possible berry aneurysm rupture

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4
Q

Babinski sign

A

plantar extensor response with fanning of toes when dorsal lateral foot is stroked, present in very young/old or with neurological defect because brain is not able to override reflex

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5
Q

Waaredenberg syndrome

A

neural crest cells fail to differentiate properly, white hair patch, pale skin, pale blue eyes, deafness, constipation

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6
Q

Hirschsprung disease or congenital megacolon

A

neural crest cells fail to migrate to rectum and sigmoid colon, normal peristalsis does not occur, fecal retention with ballooning, surgically repaired

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7
Q

craniorachischisis

A

neural tube defect, failure of the neural tube to close leaving exposed spinal cord

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8
Q

anencephaly or meroanencephaly

A

exposed brain or no brain, failure or rostral neuropore to close

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9
Q

spina bifida variations

A

failure of caudal neuropore to close

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10
Q

occipital encephalocele

A

anterior neural tube defect, brain and meninges protrude in occipital area

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11
Q

spina bifida

A

posterior neural tube defect, failure of vertebral arch formation, tuft of hair in lumbar region

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12
Q

meningocele

A

posterior neural tube defect, failure of vertebral arch formation, protruding meninges and CSF

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13
Q

myelomeningocele

A

posterior neural tube defect, failure of vertebral arch formation, meninges and CSF and spinal cord protuding

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14
Q

syringomyelia

A

non-NTD, cavitation of spinal cord in cervical or thoracic region, loss of pain and temp sensation in thoracic and cervical area

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15
Q

holoprosencephaly

A

non-NTD, forebrain does not divide into two hemispheres

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16
Q

hydrocephalus

A

non-NTD, CSF overproduction dilates ventricles, skull enlarges before sutures fuse

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17
Q

Dandy-Walker malformation

A

non-NTD, partial or complete absence of cerebellar vermis

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18
Q

Arnold-Chiari malformation

A

non-NTD, bone blocking normal passageway in skull, surgery required

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19
Q

Arnold-Chiari malformation type 1

A

asymptomatic until 30s

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20
Q

Arnold-Chiari malformation type 2

A

herniation in foramen magnum, myelomeningocele

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21
Q

Arnold-Chiari malformation type 3

A

occipital encephalocele, syringomelia

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22
Q

Arnold-Chiari malformation type 4

A

lack of cerebellar development

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23
Q

fetal alcohol syndrome

A

underdeveloped corpus collosum, very toxic to synpatogenesis 6months - 2 years, underdeveloped cortex

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24
Q

testing CN I olfactory (smell)

A

pass odors

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25
Q

testing CN II optic (acuity, fields, pupils)

A

chart, confrontation, eyes individually

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26
Q

testing CN III occulomotor (pupils, eye movements)

A

direct, conjugate, consensual, flash light, MR, IR, SR, IO

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27
Q

testing CN IV trochlear (superior oblique)

A

conjugate

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28
Q

testing CN VI abducens (lateral rectus)

A

conjugate

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29
Q

testing CN V trigeminal (facial sensation, corneal response, mastication)

A

bite down, cotton, pin, tuning fork, compare sides

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30
Q

testing CN VII facial (facial movement)

A

observe, squeeze eyes shut, smile, puff out cheeks, forehead muscle spared with a CNS lesion (stroke)

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31
Q

CNS lesion - facial appearance

A

forehead spared, wrinkles evenly

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32
Q

CNS lesion - facial appearance

A

forehead affected, wrinkles unevenly

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33
Q

testing CN VIII vestibulocochlear (hearing, balance)

A

dizziness, vertigo, finger rubbing, weber, rinne

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34
Q

testing CN IX glossopharyngeal

A

swallow, horseness, palate elevation

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35
Q

testing CN X vagus

A

swallow, horseness, palate elevation

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36
Q

neuronal storage diseases

A

autosomal recessive enzyme deficiency, substrate accumulates, loss of cognitive function, seizures

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37
Q

leukodystrophies

A

myelin abnormality, autosomal recessive, problem with lysosomal or peroxisomal enzymes, loss of motor, spasticity, hypotonia, ataxia, less cognitive problems

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38
Q

neuronal ceroid lipofuscinoses

A

deficient enzymes for protein modification, lipofuscin accumulates, blindness, mental and motor problems, seizures, childhood to adulthood

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39
Q

Tay-Sachs disease

A

hexosaminidase A deficiency, accumulation of gangliosides, Ash. Jews, early infancy, developmental delays, paralysis, blind, deaf, death, born normal, bulging lysosomes, cherry red spot on retina

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40
Q

Krabbe Disease

A

deficiency in galactosylceramidase, galactocerebrosides accumulate, converted to galactosylsphingosine, toxic to oligodendrocytes, loss of myelin and oligodendrocytes in CNS and PNS, fat globoid macrophages in brain, 3-6 months onset, muscle stiffness, weakness, stumbling, trouble swallowing, stiff hand change

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41
Q

B1 - thiamine deficiency

A

chronic, Wernicke encephalopathy, Korsakoff syndrome

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42
Q

Wernicke encephalopathy

A

alcoholism, acute, reversible, hemorrhage and necrosis in mammillary bodies, confusion, ophthalmoplegia, ataxia, nystagmus

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43
Q

Korsakoff syndrome

A

alcoholism, thalamic lesions, prolonged, irreversible, memory problems, confabulation, cystic spaces and hemosiderin macrophages in mammillary bodies

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44
Q

B12 deficiency

A

anemia, reversible, B12 administration

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45
Q

B12 deficiency

A

subacute spinal cord degeneration, numbness, axatia, weakness, reversible until paraplegia, myelin swelling, vacuolization, ascending and descending tracts

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46
Q

hypoglycemia

A

pyramidal neurons most vulnerable = pseudolaminar necrosis, hippocampus and cerebellum vulnerable

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47
Q

hyperglycemia

A

diabetes mellitus, ketoacidosis or hyperosmolar coma, dehydration, confusion, stupor, coma

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48
Q

carbon monoxide

A

hypoxia, forms carboxyhemoglobin preventing O2 from bonding, cortex / hippocampus / Purkinje cells vulnerable, demyellination of tracts, looks pink upon death

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49
Q

methanol (antifreeze)

A

retina, degeneration of ganglion cells, blindness, only 10ml to kill

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50
Q

ethanol (alcohol)

A

acute = reversible, chronic = irreversible, affect cerebellum on midline, truncal ataxia, unsteady gait, nystagmus, Bergmann gliosis - lot of astrocytes

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51
Q

Guillain-Barre syndrome

A

PNS, life threatening, inflammatory, flu-like, acute symmetric ascending paralysis over a week, loss of tendon reflexes and sensation, elevated CSF proteins, immune mediated demyelination (T cells and macrophages) especially in spinal / cranial nerve motor roots, loss of respiratory kills, remyelination follows

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52
Q

leprosy (Hansen Disease)

A

PNS, infectious, slow progressive infection of skin and nerves, mycobacterium leprae, forms granulomas, transmitted by respiratory droplet, tropical countries, deformities

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53
Q

Mycobacterium leprae

A

acid fast (does not gram stain), obligate intracellular bacteria, hard to kill, body forms granulomas around it

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54
Q

tuberculoid leprosy

A

PNS, localized - less severe, dry, scaly skin lesions, nerve degeneration, T-cell response with granulomas

55
Q

lepromatous leprosy

A

PNS, serve, widespread, skin, nerves, eyes, mouth, testes, hands, feet, no immune response, leonine face, autoamputation of toes, foamy histiocytes

56
Q

varicella-zoster virus

A

PNS, chickenpox dormant on sensory ganglia, reactivation = painful vesicular rash, neuronal destruction, multinucleate giant cell

57
Q

hereditary neuropathy

A

progressive, disabling, motor, sensory, or autonomic, possible amyloid deposition or metabolic disorders

58
Q

neuropathy type 1 (Charcot-Marie-Tooth disease)

A

demyelinating / remyelinating, muscle and sensation loss, pain intact, childhood / early adulthood, high arches, hammer toes, foot drop, legs with inverted bottle appearance, nerves with onion bulb appearance

59
Q

diabetic peripheral neuropathy

A

common, distal nerves, stocking - glove, symmetric sensory and motor neuropathy, decreased pain sensation in distal extremities, ulcers on ball of foot

60
Q

malignancy related neuropathy

A

mononeuropathy on one side of body common, ex: brachial plexus = lung neoplasm, obturator palsy = pelvic neoplasm, cranial nerve = brain tumor

61
Q

paraneoplastic effect

A

polyneuropathy, collection of symptoms with cancer, small cell lung cancer, plasma cell malignancy

62
Q

vasogenic cerebral edema

A

increased vascular permeability, intercellular spaces, localized or generalized

63
Q

cytotoxic cerebral edema

A

cell membrane injury, intracellular fluid increased = big cells, hypoxia or metabolic damage, Tx mannitol

64
Q

hydrocephalus

A

excessive CSF in ventricular system, infancy = head enlarged, after infancy = increased cranial pressure, five kinds: communicating / non-communicating / ex vacuo / increased CSF production / normal pressure

65
Q

noncommunicating hydrocephalus

A

block in ventricular system (tumor, abcess, malformation), only part of ventricular system enlarged, CSF is not able to leave part of ventricular system and circulate in subarachniod space

66
Q

communicating hydrocephalus

A

block in subarachnoid space, entire ventricular system enlarged, meningitis, hemorrhage, dural thrombosis

67
Q

hydrocephalus ex vacuo

A

no ventricular block, ventricular system dilates due brain atrophy, Alzheimer’s Pick disease, massive hypoxia

68
Q

hydrocephalus due to increased CSF

A

uncommon, choroid plexus papilloma

69
Q

normal pressure hydrocephalus

A

elderly, gait problems, incontinence, dementia, large ventricles, no cortical atrophy, reversible, like communicating hydrocephalus, misdiagnosed as Alzheimer’s

70
Q

increased intracranial pressure

A

brain volume increases, mass effect, compromised blood flow, herniation

71
Q

brain herniation

A

part of brain gets pushed into another compartment, headache, vomiting, decreased consciousness, papilledema, fatal, tumor, abscess, hematoma, edema, encephalitis, hemorrhage, types - subfalcine, transtentorial, tonsilar

72
Q

subfalcine herniation

A

cingulate gyrus under falx, compression of anterior cerebral artery, limb weakness, aphasia, speech problems

73
Q

transtentorial herniation

A

uncinate, temporal lobe against tentorium, CN III - pupil dilation and ocular movement, brainstem - impaired consciousness, posterior cerebral artery - ischemia to visual cortex, contralateral cerebral peduncle

74
Q

case - football player knocked out, normal CT scan, headaches all week, collapsed Friday night

A

left subdural hematoma, midline brain shift, decreased vision in right eye, limited left ocular motility, ptosis of left eye, caused a tentorial herniation with compression of CN III and posterior cerebral artery

75
Q

tonsillar herniation

A

cerebellar tonsils through foramen magnum, compressed medulla, compromised vitals, life threatening

76
Q

linear skull fracture

A

common, straight, not serious, heals

77
Q

depressed skull fracture

A

inward, comminuted, damage brain

78
Q

diastatis skull fracture

A

across a suture, suture widens, children

79
Q

basal skull fracture

A

more force, distant hematoma, CSF from ear or nose, raccoon eyes, battle sign bruise behind ear, ex: temporal bone fracture in petrous part

80
Q

concussion

A

parenchymal injury, altered consciousness, change in momentum, amnesia, confusion, headache, nausea, vomiting, dizziness, Grade 1 - 15 min, Grade 3 - LOC

81
Q

direct parenchymal injury

A

tearing or bruising of parenchymal tissue, ex: laceration from bullet, contusion, coup injury, countercoup injury

82
Q

diffuse axonal injury

A

twisting / shearing of axons in deep white matter of brain, angular acceleration / deceleration, persistent deficits or coma, shaken baby, boxers, can cause small hemorrhages and axonal spheroids

83
Q

second-impact syndrome

A

second concussion before first one heals, brain swells rapidly, young athletes

84
Q

chronic traumatic encephalopathy

A

killed Derek Boogard, progressive, degenerative, repetitive brain trauma, behavior and personality changes, dementia, tau proteins deposited

85
Q

coup injury

A

contusion on brain at point of contact with fixed object, happens second

86
Q

countercoup injury

A

contusion opposite point of impact with fixed object, often worse, happens first becaause brain remains suspended in CSF when skull deaccelerates into object

87
Q

berry aneurysm

A

aneurysm at branch point in circle of Willis, most anterior cerebral artery, some middle cerebral artery, few posterior cerebral artery, Tx with coils

88
Q

ischemia

A

local anemia due to lack of blood flow

89
Q

infarction

A

severe ischemia leading to cell death and necrosis

90
Q

thrombus

A

clot that blocks blood flow, can lead to ischemia or infarction, often extracranial

91
Q

embolus

A

clot that forms in another location and travels to the brain and blocks blood flow, can lead to ischemia or infarction, often intracranial

92
Q

hemorrhage

A

bleeding from blood vessel, can be associated with hypertension, can be intracerebral or aneuryism

93
Q

middle cerebral artery syndrome

A

affects supratentorial structures supplied by middle cerebral artery

94
Q

anterior cerebral artery syndrome

A

affects supratentorial structures supplied by anterior cerebral artery

95
Q

lateral medullary syndrome (PICA)

A

effects infratentorial structures supplied by the inferior posterior cerebellar artery

96
Q

medial medullary syndrome

A

effects infratentorial structures supplied by the anterior spinal artery and penetrating branches of the vertebral arteries

97
Q

Weber’s syndrome

A

effects infratentorial structures

98
Q

multiple sclerosis presentation

A

white female, 30s, light-headed, problems concentrating, forgetful, symptoms worse in summer (channels closer faster), problems typing, numb fingers, dizziness, depression

99
Q

multiple sclerosis physical exam findings

A

normal EKG, orthostatic hypotension (BP lower and HR higher when standing), hyperreflexive 3+ = CNS problem (hyporeflexive = PNS), positive Babinski (CNS no longer inhibits reflex - extensor plantar reflex), struggle with rapid hand movement

100
Q

multiple sclerosis lab results

A

normal - WBC, Hb, platelets, ESR, B12, folate, syphilis, TSH, electrolytes; lumbar puncture CSF - normal pressure, color, protein con, RBC, WBC - abnormal high IgG, high albumin, oligoclonal bands (shows IgG presence), abnormal visual evoked potential (slower and weaker), plaques on MRI

101
Q

multiple sclerosis tx

A

prednisone, interferon B 1a (avonex); side effect immunosuppression

102
Q

multiple sclerosis cause

A

autoimmune demyelinating disease, blood brain barrier become more leaky, immune cells - macrophages - attack myelin in CNS

103
Q

multiple sclerosis areas affected

A

Cognitive function (esp. memory loss) - frontal and temporal lobes
Mood (especially depression) - limbic system
Sensory systems - vision occipital, hearing temporal, somatosensory postcentral
Motor control and coordination - precentral and cerebellum
Autonomic nervous system function (esp. cardiovascular system) - parasympathetic and sympathetic control of BP in heart and vessels

104
Q

myasthenia gravis

A

autoimmune attack of nicotinic ACh receptors

105
Q

trigeminal neuralgia

A

acute, excruciating, lightning like facial pain, near nose, lips, eyes, or ears, usually involves V2, pain caused by touch to lips or nose, nerve is compressed by superior cerebrellar artery, tx putting sponge between them

106
Q

bell palsy

A

paralysis of facial muscles on affected side, facial nerve in distal facial canal or stylomastoid foramen, drooping lips and lower eyelid, loss of facial expression

107
Q

craniosynostosis

A

premature closure of one or more sutures in the skull produces a misshapen skull

108
Q

craniosynostosis

A

premature closure of one or more sutures in the skull produces a misshapen skull

109
Q

brachycephaly

A

fusion of coronal suture, skull shortened front-to-back, flat head

110
Q

brachycephaly

A

fusion of coronal suture, skull shortened front-to-back, flat head

111
Q

oxycephaly, turricephaly, acrocephaly

A

fusion of coronal and lambdoidal sutures, tower skull

112
Q

oxycephaly, turricephaly, acrocephaly

A

fusion of coronal and lambdoidal sutures, tower skull

113
Q

plagiocephaly

A

fusion of coronal and lambdoidal sutures unilaterall, asymmetrical skull

114
Q

plagiocephaly

A

fusion of coronal and lambdoidal sutures unilaterall, asymmetrical skull

115
Q

scaphocephaly

A

fusion of sagittal suture, long skull front-to-back

116
Q

scaphocephaly

A

fusion of sagittal suture, long skull front-to-back

117
Q

trigonocephaly

A

premature fusion of metopic suture, forehead looks pointed

118
Q

lambdoidal suture positional flattening

A

back of skull flattens from baby sleeping on their back, will self correct

119
Q

microcephaly

A

small head due to brain that failed to grow, may be NTD, genetic, obstructed blood supply, prenatal drugs, maternal rubella / chicken pox

120
Q

cranioschisis

A

meninges and / or brain herniate through skull defect, more common in occipital bone

121
Q

meningocele

A

meninges only herniated

122
Q

meningoencephalocele

A

meninges plus brain herniated

123
Q

meningohydroencephalocele

A

meninges plus brain and ventricle herniated

124
Q

Apert syndrome

A

autosomal dominant, craniosynostosis plus other defects like syndactyly of hands/feet and retardation, mutation of fibroblast growth factor receptor 1 and 2

125
Q

acrania

A

no skull

126
Q

anencephaly

A

no brain

127
Q

meroanencephaly

A

poorly formed brainstem tissue present

128
Q

hydrocephalus

A

enlarged ventricles due to too much CSF, if before sutures close = large head

129
Q

congenital hydrocephalus

A

associated with spina bifida and Dandy-Walker malformation

130
Q

acquired hydrocephalus

A

associated with hemorrhage, stroke, infection, tumor, and TBI

131
Q

brachial cyst

A

form from remnants of brachial arch

132
Q

syncope

A

fainting, problem in intermedolateral cell column, can be seen with MS

133
Q

subarachnoid hemorrhage

A

image with axial CT, shows blood pooled in lateral ventricles and hemorrahge interhemispheric fissure

Neuro Diseases / Disorders (3 decks)

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