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Pathophysiology > Week 2: Neuro > Flashcards

Week 2: Neuro Flashcards

1
Q

most common cause of brain trauma

A

mvc & falls

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2
Q

brain trauma severity measured by the

A

glasgow coma scale

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3
Q

glasgow coma scale

A

mild (gcs 13-15)
moderate (gcs 9-12)
severe (gcs 3-8)

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4
Q

blunt tbi types

A 
concussion
epidural
subdural
subarachnoid
intracerebral hemorrhage
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5
Q

penetrating tbi types

A

missiles

fractures

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6
Q

mild concussion characteristics

A

Immediate clinical manifestations with no LOC or LOC that is less than 30 min
GCS is 13-15
Mild retrograde amnesia may exist for <24 hours
May be no diagnostic imaging evidence
Headache, attention deficit, dizziness

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7
Q

moderate concussion characteristics

A

LOC >30 min
Amnesia lasting 24 hours or more
GCS 8-13
Basal skull fracture may be present but no brain stem injury
Transitory decerebration or decortication with unconc.
Confusion, may have permanent deficits, vision

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8
Q

severe concussion characteristics

A

GCS <8
Associated with brainstem injury (pupillary reaction, cardiac and resp symptoms)
LOC may last >24 hours
Immediate autonomic dysfunction that may last weeks
Increased ICP
Severe compromised coordination

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9
Q

physical consequences of DAI

A

spastic paralysis, peripheral nerve injury, dysphagia, dysarthria, hearing and vision, taste and smell

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10
Q

cognitive consequences of DAI

A

disorientation, confusion, dyspasia, poor judgement

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11
Q

behavioural consequences of DAI

A

agitation, blunted affect, impulsiveness, social withdrawal, depression

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12
Q

clinical manifestations of epidural hematomas

A

Loss of consciousness -> period of lucidity -> inc. headache, vomiting, drowsiness, seizure, hemiparesis, if temporal lobe herniation begins - ipsilateral pupillary dilation

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13
Q

spinal cord injury patho

A
  • Vertebral injuries d/t acceleration, deceleration, or deformation injuries
  • Injure tissues through compression, exerting tension or traction, or shearing tissues through hyperextension, hyperflexion vertical rotation of the spine
  • Classified into:
    simple fracture, compressed fracture, comminuted fracture (burst or shattered) or dislocation
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14
Q

spinal cord injuries occur mostly at

A

C1-2, C4-7, T1-L2

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15
Q

SCI Clinical Manifestations

A
  • All motor, sensory, reflex and autonomic functions cease below level of transected area and also may cease with concussive, contused, compressed or ischemic areas
  • Paraplegia, quadraplegia
  • Return of spinal neuron excitability occurs slowly
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16
Q

hyperrflexia occurs

A

any time after spinal shock ceases

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17
Q

hyperrflexia sx

A

Hypertension, pounding headache, blurred vision, sweating above level of lesion, nasal congestion, nausea, bradycardia

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18
Q

spinal cord injury dx and tx

A

dx made by physical, radiologic, and myelographic exam

tx includes immobolizing the spine, surgical decompression and stabilization, and corticosteroids

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19
Q

primary brain tumor types

A

intracerebral and extracerebral

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20
Q

intracerebral tumor types

A

astrocytoma
glioblastoma multiforme
pituitary adenoma

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21
Q

extracerebral tumor types

A

meningioma

neurofibroma

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22
Q

astrocytoma

A

arises from astrocytes

relatively slow growing

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23
Q

glioblastoma multiforme

A

from more mature glial cells

rapidly growing

24
Q

pituitary adenoma

A

from pituitary cells

resulting in secreting tumour

25
Q

meningioma

A

from arachnoid cells

problems due to location

26
Q

neurofibroma

A

arises from schwann cells

nerve sheath

27
Q

cva risk factors

A 
Arterial hypertension (   systolic & diastolic)
Smoking
Diabetes
Insulin resistance
Polycythemia and thrombocythemia
Impaired cardiac function
Atrial fibrillation
28
Q

ischemic stroke cause

A

arterial occlusions due to thrombi in the brain

29
Q

transient ischemic attacks

A

intermittent blockage - all neurologic deficits completely clear within 24 hours

30
Q

completed stroke

A

CVA that has reached its maximum destructiveness in producing neurologic deficits

31
Q

embolic stroke

A

involves fragments of thrombi from outside the brain

32
Q

hemorrahagic stroke

A

from hypertension, ruptured aneurysms, bleeding into a. tumor, bleeding disorders, head trauma, illicit drug use

33
Q

subarachnoic hemorrahagic stroke

A

uncontrolled bleeding on surface of the brain

34
Q

intracerebral hemorrahagic stroke

A

an artery deep in the brain ruptures, usually due to increased BP

35
Q

cerebral infarction patho processes

A

global and focal

36
Q

global process

A

affects neurons most susceptible to ischemia

37
Q

focal process

A

central zone of cell loss surrounded by a zone of injured cells that could survive if reperfused in one hour

38
Q

hemorrhagic infarcts result from

A

reperfusion d/t resumption of blood flow

39
Q

cerebral hemorrhage primary cause

A

hypertension, bleeding precipitated by aneurysms in smaller vessles or arteriolar necrosis, mass of blood forms

40
Q

CVA dx and tx

A

dx through CT and CM
tx through drug therapy to prevent further thrombotic events, augments blood flow, reperfuses tissues and protects neurons

41
Q

thrombotic strokes tx

A

controlling cerebral edema and increasing ICP

42
Q

embolic strokes tx

A

preventing further emboli

43
Q

seizures description and characteristics

A

sudden explosive disorderly discharge of cerebral neurons characterized by sudden transient alteration in brain function

44
Q

conditions associated with seizures

A

cerebral lesions, biochemical disorders, cerebral trauma, epilepsy

45
Q

seizure triggers

A 
hypoglycemia
fatigue
emotional or physical stress
febrile illness
excess H2O ingestion
constipation
use of stimulant drugs
withdrawal from depressant drugs
hyperventilation
environmental stimuli
46
Q

generalized seizures

A

bilateral neuron involvement, general onset, originate from subcortical or deeper brain focus, impaired or lost consciousness

47
Q

partial seizures

A

unilateral neuron involvement, originate from cortical brain tissue, maintain consciousness if only unilateral, but may become generalized

48
Q

status epilepticus

A

multiple seizures without regaining consciousness or seizure lasting >30 minutes

49
Q

epileptogenic focus

A

group of neurons with more permeable plasma membranes that are hypersensitive to stimuli like hyperthermia, hypoxia, hypoglycemia

50
Q

seizures dx

A
  • health history
  • PE & lab tests to look for systemic diseases that can cause seizures
  • rule out neuro diseases
  • EEG to assess type of seizure and identify cause
51
Q

seizures tx

A

correct or control cause of seizure
Drugs to suppress seizure without intolerable side effects
Social stigma/family and client counselling

52
Q

meningitis

A

Infection of meninges caused by bacteria, virus, fungi, or parasites
In CSF through the subarachnoid space
Starts elsewhere in body and crosses blood brain barrier
Meningococcus and steptococcus most common
Fever chills, petechial rash, neck stiffness

53
Q

multiple sclerosis

A

Demyelinating disease with white matter plaques
Relapsing, remitting most common
Primary and secondary progressive types also
Steroids acutely, interferon chronically

54
Q

myasthenia gravis

A

Insidious onset with progressive muscle weakening
Diagnosed with Tensilon test and antibody assay
EMG is diagnostic
Steroids, anticholinesterase drugs, immunosuppressants such as azothiprine or cyclosporine used

55
Q

guillain barre syndrome

A

Acquired inflammatory disease that results in demyelination of peripheral nerves
Almost always preceded by viral illness, often mild
Starts with leg paralysis and goes to entire body
Treatment is supportive with ventilation common

56
Q

alzheimer’s disease

A

Dementia disease characterized by global progressive loss of cognitive mental function
Pathophysiology not understood but neurofibrillary tangles seen microscopically and neuritic plaques
Diagnosis is clinical

57
Q

parkinson’s disease

A

Degenerative disease of dopamine pathway in the substantia nigra
Primary and secondary
Secondary due to trauma, infection, or neoplasm
Usually after age 40, peaking in onset around 60

Pathophysiology (12 decks)

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