1st Flashcards
(105 cards)
1
Q
fosse of cranium
A
anterior, middle, posterior fossae
2
Q
three layers of meninges
A
dura, arachnoid, pia matter
3
Q
3 spaces
A
epidural, subdural, subarachnoid
4
Q
between dura mater and arachnoid
A
subdural
5
Q
what makes CSF?
A
ependymal cells
6
Q
where is CSF made?
A
Ventricles
7
Q
functions of CSF
A
nutrition, mechanical protection, chemical protection
8
Q
myelin is made of these;
less dense than water; floats in CSF
A
hydro carbons
9
Q
CSF covers what?
A
entire nervous system
10
Q
this is a buffer CSF protects the brain from pH changes
A
amphoteric
11
Q
how much CSF is in system?
A
150cc’s
12
Q
how quickly is CSF recycled?
A
20cc/hour
13
Q
most common neurological sign
A
headache
14
Q
does brain have nociceptors?
A
no but everything else in brain does
15
Q
sensory nerves in head (head pain)
A
CN V, IX, X, AND C1-C3
16
Q
migraines do this
A
throb
17
Q
are migraines unilateral or bilateral?
A
unilateral:
-sometimes hard to say where it is though
18
Q
what makes migraines worse?
A
bright light and loud sounds
19
Q
timing on migraines usually measured in…
A
hours (generally less than 12)
20
Q
See an aura/ prodrone before onset
A
classic migraine
21
Q
upset stomach, woozy, flashing lights in eye
A
prodrone signs of migraine
22
Q
migraines usually occur in these
A
young woman in early 20’s
23
Q
migraines usually onset during this time
A
onset of puberty (hormone related)
24
Q
red wine, wheat (allergies), chemical induction
A
migraine triggers
25
classic migraine + transient neurological deficits:
| blindness in one eye , loss of feeling, eat.
complicated migraine
26
squeezing headache
| hatband headache
tension headache
27
these last days to weeks
caused by cevical and cranial muscle spasm
tension headaches
28
two most common forms of headaches
vascular and tension
29
headache with neck stiffness and fever
suggestive meningitis
30
sudden explosive headache
suggestive of subarachnoid hemorrhage
31
usually artery
inflammation of temporal arteries and others going to eye
superficial scalp pain
treatment prevents loss of vision
temporal arteritis/ giant cell
32
classic sign of temporal arteritis
superficial scalp pain
33
elderly + scalp pain+ vision loss
temporal arteritis
34
artery responsible for vision loss in temporal arteritis
ophthalmic artery
35
arterial dissection is a form of this causes headache
stroke
36
this can cause a headache only ever comes after a lumbar puncture
low CSF pressure
37
increased intracranial pressure results in (3)...
compression, destruction, herniation
38
headache, changes in consciousness level
global effects of increased ICP
39
run a pinwheel down a specific area of body and they can't feel it
focal symptoms of increased ICP
40
increased BP
| decreased heart rate
cusings triad for ICP
41
subfalcene herniation
subfalcene herniation
42
where inferior medial temporal lobe is pushed under tentorium cerebelli
midbrain signs (CN III and IV)
also issues with smell and short term memory
CSF collects in brain
tentorial herniation
43
herniate cerebellum through foramen magnum
produces hydrocephalous
compresses lower medulla producing autonomic symptoms
chiari malformation
44
obstructed CSF flow
symptoms are general increased intracranial pressure
hydrocephalus
45
most common type of trauma
no apparent damage to brain/cord
must be kept awake
concussion
46
multiple concussions have cumulative effect
not sen on PET scan CAT scan, EEG, or MRI
post concussive syndrome
47
does individual concussion leave a neurological deficit?
no
48
head trauma on one side of the head is brain injury on other side
contracoup injury
49
bruise, bleeding
may leave neurological deficit
contusion
50
ripping or tearing of brain/ nervous tissue
results in permanent neurological deficits (due to permanent brain damage)
laceration
51
four types of intracranial hemorrhage
epidural, subdural, subarachnoid, intracerebral
52
this type of intracranial hemorrhage gets worse over a course of hours
worst possible location is right on top of the head
epidural intracranial hemorrhage
53
why do symptoms of epidural intracranial hemorrhage develop so quickly?
because meningeal arteries are injured. they're under pressure and leak fast
54
survival rate of metastatic brain cancer?
0%
55
in this intracranial hemorrhage, there is shearing of veins
gets worse over a period of days, weeks, months
can happen without direct head trauma (whiplash)
often found incidentally
subdural hematoma
56
what are signs of epidural hematoma
rapid onset
57
the intracranial hemorrhage you don't want
major vessels of the brain (ACA,PCA,MCA) are ruptured
blood is very high pressure
complaint is sudden explosive
may lose consciousness, regain and be confused, then die
subarachnoid hemorrhage
58
associated with subarachnoid hemorrhage
patient passes out, comes around confused then dies
lucid interval
59
intracranial hemorrhage where small arteries in the brain calcify and rupture
often due to high BP
not usually a major issue
intracerebral hemorrhage
60
symptoms of hydrocephalus
generalized increased ICP
61
eyes roll down with infant hydrocephalus
setting sun sign
62
can shine light in one fontanelle and see it through another
transillumination
63
tumor growing in cerebellum =
coordination issues on same side of body
64
tumors in brain produce what?
focal deficits in where tumor is growing
65
what % of tumors are metastatic
23%
66
what % of brain tumors are gliomas?
40%
67
what percent of gliomas are glioblastoma multiformae/malignant astrocytoma?
20%
68
1 year survival rate of glioblastoma multiformae/ malignant astrocytoma?
20%
69
5 year survival rate of glioblastoma/malignant astrocytoma?
5%
70
what percent of tumors are deadly fairly fast?
50%
71
headache that is always present and that gets better over weeks and months
tumor
72
tumor in frontal lobe
motor weakness
73
tumor in parietal lobe
sensory signs
74
tension headaches different than tumors in that
no cushiness' triad or sensory deficits
75
what tells you that you have an infection as source of headache?
fever along with neurological deficits
76
CNS infections
Get in via blood
tip into CSF
lyme disease
77
headache
fungal or parasitic symptoms
positive koenig's sign
lyme disease
78
fatal within hours of onset
extremely high fever, headache, neck stiffness all come on at once
yellow pus in the sulk (pus-filled CSF)
bacterial meningitis
79
fevers tend to be higher with this type of infection
| 103,104+
bacterial
80
stretch bottom for pain at top
koenig's
81
stretch top for pain at bottom
Burzinsky's
82
pus-filled bacterial pocket in the brain
brain abscess
83
focal deficits, lack of sensation in one arm, lack of motor coordination (if in cerebellum)
symptoms of brain abscess
84
brain abscesses are this percent fatal with appropriate treatment
50%
85
spread by deer tick
| causes lyme disease
borelia burdoferri
86
acute stage/ phase 1 lyme disease
days to weeks
| general sign of infection and large rash
87
stage 2 of lyme disease
weeks to months
| meningitis signs
88
stage 3 of lyme disease
months to years
| arthritis and chronic CNS problems
89
target rash
| associated with lyme disease
erythema migrans
90
where is erythema migraines usually found?
thigh, groin, axilla
91
acute stage/ phase 1 of lyme disease
general sign of infection and target rash
92
signs of viral infection
meningitis. encephalitis
93
distinguishing between viral and bacterial infection
viral fever is lower, viral don't could up the CSF
94
how long to resolve viral meningitis?
1-2 weeks
95
bacterial meningitis resolves with patient death in how long?
2-3 days
96
west nile causes this type of encephalitis ( severe)
primary encephalitis
97
this type of encephalitis is not as server
herpetic (secondary) encephalitis
98
comes from vaccines (measles, mumps)
encephalitis gets gradually worse over time and eventually begins to deteriorate
causes neurological signs throughout the CNS
usually fatal (1-3 years)
subacute sclerosing panencephalitis
99
long term getting worse
subacute
100
leads to sleeping sickness
parasitic
african trypanosomiasis
101
protein fragments (not big enough to be a virus)
prion
102
memory loss, sleep disturbance, apraxia, right/left disorientation, local CNS signs
global inflammatory response from brain
often from organ transplant, transmission of beef with BSE (bovine spongiform encephalopathy)
creutzfeldt-Jakob Disease
103
where is puncture to find a CSF infection
l4/5 below the cord
104
aka for viral meningitis
aseptic meningitis
105
taking fluid too fast leads to what?
low pressure headache
