Neuro01 Flashcards
(Circulatory Disorders and Traumatic Injury to the CNS)
(2)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Raised Intracranial Pressure)
- why so susc?
- four causes?
- limited potential for expansion
- focally expanding mass
CSF accumulation
vascular congestion
brain edema
(3)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Consequence of the intracranial expanding lesion)
- local deformity, distortion of brain and reduced volume of what?
- Internal herniation - results in what?
- Ischemic Brain Necrosis
what happens here?
- CSF
- hemorrhagic infarction of herniated segment or compressed tissue
- compression of small vessels (esp those from meningeal surfaces) –> if severe get endothelial damage
even if severe is treated, reperfusion causes vasogenic edema (point of no return)
greater degrees of compression –> ischemic brain necrosis
(4)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Herniation)
- supracallosal subfalcine = ?
- transtentorial = ?
- foraminal = ?
- transcalvaris
- which is most commoon?
- cingulate gyrus slips beneath
- occipital cortex slips beneath (compresses midbrain)
- herniation of cerebellum, compress resp centers in brainstem
- foraminal
(5)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Brain Swelling)
(6)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Congestive Brain Swelling)
- enlargement of the brain resulting in elevated intracranial pressure caused by what?
- cause?
- local or generalized?
- increased of the blood-contating vasculature (cerebrovascular dilation)
- trauma
- either
(7)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Brain Edema)
- is an increased brain tissue water content within what?
- What types (4)?
- what one is most common?
- the cell and intercellular space
- vasogenic, cytotoxic, hypo-osmotic, hydrostatic
- vasogenic
(7)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Brain Edema)
(Maybe due to opening of BBB)
1-3. what three things can cause?
- tight junction separation
- ^ vesicular transport (^transendothelial channels)
- change in structure of endo membrane –> ^ perm
(8)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Brain Edema)
(Vasogenic Edema (Vascular leakage))
- most common
- loss of function of what?
- distribution of edema depends on distribution of affected vessels (ex tumor = localized vs. gen = toxins)
(Cytotoxic Edema)
- what is it?
- results from damaged what?
- BBB
- intracellular fluid accumulation w/ normal vascular perm
- ATP-dependent ion pumps
(from hypoxia/exotoxin (perfringens))
(9)
(11)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Brain Edema)
(hypo-osmotic edema - rapid osmolarity shifts)
1-2. from what two?
(Hydrostatic Edema - interstitial Edema)
- elevated intraventricular hydrostatic pressure that accompanies what?
- water intoxication
- salt toxicity (swine, bovine)
- hydrocephalus
(12)
(Circulatory Disorders and Traumatic Injury to the CNS)
(Edema)
eck…
(13)
(Intramyelinic Edema (maple syrup urine disease))
- uncommon, reflecting toxic insult to what?
- fluid accumulation within what?
- oligodendrocytes
- myelin lamella (vacuoles sharply demarcated)
(14)
(Hemorrhage)
- look at pic
- major consequence due to what?
- space occupying nature of lesion
(15)
(Ischemia)
- what is it?
- pathophysiology sim to other tissues
- What system particularly affected?
why?
regional differences by measuring blood rate - white vs grey?
why else?
most susc neurons?
- reduction of blood flow to a region
- nerve system
high metabolic rate
gray higher than white (.65-1.8 vs. .2)
more vulnerable to ischemia (neurons more than glia/vascular)
pyramidal cells in cerebral cortex/hippocampus, purkinje cells in cerebellum (diff in neonate - more brain stem insult)