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NURS 2514 > Week 8 - Brain Injury & Damage > Flashcards

Week 8 - Brain Injury & Damage Flashcards

1
Q

what 3 mechanisms can cause neuron damage & death

A
  • ischemia
  • excitotoxicity
  • cerebral edema
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2
Q

how does the brain generate ATP

A
  • largely from aerobic metabolism (requires O2) of glucose
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3
Q

how much hypoxia & hypoglycemia can the brain tolerat?

A
  • can tolerate short term without too much neural death
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4
Q

at what point does the hypoxia result in severe damge

A
  • severe ischemia rapdily results in irreversible neuron destruction within 4-6 min
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5
Q

what is the most abudant excitatory nt in the brain?

A
  • the amino acid glutamine
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6
Q

describe the normal function of glutamate in the brain

A
  • binds predominately to a receptor called NMDA, allowing Na and Ca to enter the cell
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7
Q

how is glutamate neutralized & removed from the synapse after binding to NMDA

A
  • removed from the synapse by a secondary active Na+ co-transporter
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8
Q

how can the neutralization of glutamate become impaired?

A
  • since the removal of glutamate required a secondary active transporter (requires ATP)
  • when ATP is unavailable, it cannot be removed
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9
Q

what does the impairement of removal of glutamate cause

A
  • causes intracellular Ca++ to accumulate

- this accumulation accelerates neural cell death

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10
Q

what can cause cerebral edema?

A
  • inhibition of the Na/K+ pump
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11
Q

what does the Na/K pump do

A
  • pumps 2 K+ into the cell

- and 3 Na out of the cell

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12
Q

how does inhibition of the Na/K pump cause cerebral edema? what does this lead to?

A
  • causes Na and water to accumulate in neurons

= increased ICP

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13
Q

how does neuron death & damage effect K+? what does this predispose to

A
  • neural death causes the release of K+ = elevated K+ lvla

- predisposes to seizures

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14
Q

how are lesions to the brain categorized

A

where they occur

  1. supratentorial lesions
  2. infratentorial lesion
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15
Q

what is a supratentorial lesion

A
  • lesions that occurs superior to the tentorium cerebell (remember the tentorium cerebelli separates the cerebrum & cerebellum)
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16
Q

what is an infratentorial lesion

A
  • lesions that occur inferior to the tentorium
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17
Q

what do supratentorial lesions often result ikn?

A
  • location specific dysfunction

- must be quite large to effect consciousness

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18
Q

what do infratentorial lesions often result in?

A
  • easily disrupt the closely bundled motor & sensory tracts

- effect consciousness, resp, and circulatory function

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19
Q

what is the function of the frontal lobe (6)

A
  • intellect
  • personality
  • abstract thinking & reasoning
  • spatial ability
  • judging
  • planning
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20
Q

what is the premotor cortex? what does it control?

A
  • found in front of the motor cortex

- controls skilled movement

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21
Q

what is the central sulcus

A
  • fissure that separates the motor cortex from the sensory cortex
  • also the frontal lobe from the parietal
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22
Q

what is the function of the sensory cortex

A
  • processes incoming sensations

ex. touch, pressure, temp, taste, etc.

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23
Q

how is the sensory & motor cortex organized? list

A
  • specific parts correlate to different body parts
  • from top of brain down:
  • foot
  • leg
  • trunk
  • arm
  • hand
  • face
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24
Q

what is the function of the parietal lobe

A
  • contains the sensory cortex

- plays a role in processing sensory info

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25
Q

what is the function of the occipital lobe

A
  • visual area
26
Q

what is the function of the temporal lobe

A
  • auditory area
27
Q

what is the function of the cerebellum

A
  • balance
  • equilibrium
  • coordination
28
Q

what is broca’s area

A

speech area

  • plays role in speech production
  • motor control of speech
  • expression of language
29
Q

what is wernickes area

A
  • important for interpreting & understanding language
30
Q

what can damage to motor areas cause?

A
  • contralateral weakness
  • complete loss of motor ability
  • loss of skilled movement
  • slow to initiate movements
31
Q

what does contralateral mean

A
  • occurring on the opposite side
32
Q

what is the fancy word for weakness

A
  • paresis
33
Q

what is the fancy word for complete loss of motor ability

A
  • paralysis
34
Q

what is the fancy word for loss of skilled movement

A
  • apraxia
35
Q

what is the fancy word for slow to initiate movements

A
  • ataxia
36
Q

what can damage to the somatosensory areas (sensory cortex, etc.) cause

A
  • numbness = parasthesia
37
Q

describe the visual field pathway using the L visual field as an example

A
  • L visual field info enters both eyes on the R side of the retinas
  • then goes thru the optic nerve
  • and crosses over in the optic chiasm = puts all the L field info together from both eyes into the R optic tract which travels to the occipital lobe
  • the occipital lobe them interprets the info
38
Q

what determines the characteristics of vision impairment

A
  • the location of the lesion in the visual pathway
39
Q

what does damage to one eye or optic nerve cause? why?

A

= blindness of the innervated eye

- bc there is no crossover yet, so it will only effect the info from that eye

40
Q

what does damage to the optic chiasm cause? why?

A
  • blindness in both eyes
  • the optic chiasm is the point of crossover, so info from both eyes is in the same spot
  • therefore damage to this spot will effect both eyes
41
Q

what does damage to the occipital lobe or optic tract cause

A
  • loss in the contralateral visual field
    ex. if damage was to the R occipital lobe, that lobe contains all the L visual field info = loss of left visual field (in both eyes bc half of each eye contains L visual field info)
42
Q

describe the pathway of sound transmission

A
  • sound transmissions cause vibrations of the ear drum & bones
  • the auditory info travels via the vestibulocochlear nerve to the brainstem
  • at the brainstem, the neurons split
  • 2 neurons go to the contralateral temporal lobe
  • 1 goes to the ipsilateral temporal lobe
43
Q

what can lesion in the temporal lobe cause

A
  • some hearing impairment in both ears, but more in the contralateral ear (since most of the info goes to that one)
  • failure to locate sounds
44
Q

where is broca’s and wernicke’s area found?

A
  • both on the L hemisphere
  • broca’s = L frontal lobe
  • wernicke’s = L temporal lobe
45
Q

what is aphasia

A
  • inability to express or comprehend language
46
Q

what are 2 types of aphasia

A
  1. expressive aphasia

2. receptive aphasia

47
Q

what causes expressive aphasia

A
  • damage to broca’s area when the L frontal lobe is damaged
48
Q

what does expressive aphasia result in

A
  • inability to speak or write fluently

- poor articulation

49
Q

what is the fancy word for poor articulation

A
  • dysarthria
50
Q

what causes receptive aphasia

A
  • damage to wernicke’s area when the L temporal lobe is damaged
51
Q

what does receptive aphasia result in

A
  • inability to read or understand spoken words
52
Q

what is dysaphasia

A
  • partial impairment in the ability to express or comprehend language
53
Q

what is global aphasia

A
  • damage to both broca’s and wernicke’s area

- combo of expressive & receptive aphasia

54
Q

what causes global aphasia

A
  • wide-spread L hemisphere damage

ex. stroke

55
Q

what 4 nerves are involved in spoken language

A
  • facial (5)
  • glossopharyngeal (tongue & pharynx) (9)
  • accessory (11)
  • hypoglossal (12)
56
Q

what is cerebral dominance

A
  • when some cerebral functions are isolated to one hemisphere
57
Q

what is the L hemisphere often dominant for?

A
  • language
  • logical thinking
  • analytical skills
58
Q

what is the R hemisphere often dominant for

A
  • artistic abilities

- spatial relationships

59
Q

what does wide-spread damage to the R hemisphere often cause

A
  • impairs artistic abiltiies & spatial relationships

- behavioral problems

60
Q

__% of right-handed individuals are L hemisphere dominant for language

A

99

61
Q

__% of left-handed people are R hemisphere dominant for language, __% left hemi dominant; what does this mean

A
  • 40%
  • 15%
    = in most left-handed individuals hemispheric dominance is incomplete
62
Q

what are the pros and cons to incomplete hemispheric dominance

A

pro =if have stroke, may not lose all language ability

con = greater risk of dyslexia or impairment of language ability

NURS 2514 (75 decks)

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