Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pathophysiology > 44 Acute Disorders of Brain Function > Flashcards

44 Acute Disorders of Brain Function Flashcards

1
Q

Mechanisms of Brain Injury

A 
1 Ischemia + Hypoxia
2 Cellular Energy Failure
3 Excitatory Amino Acids
4 Reperfusion Injury
5 Incr Intracranial Pressure [ICP]
6 Brain Compression + Herniation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ischemia

A
  • decr. blood flow
  • results in immediate neurologic dysfunction
  • —-due to inability of neurons to generate ATP needed for energy-requiring processes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ischemia + hypoxia

A
  • usually occurs together
  • isch is decr bf
  • hypox is decr O2 ay cell lvl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Neuronal Tissue

A
  • highly sensitive to O2 deprivation
  • has great ATP requirement
  • has limited capacity for anaerobic metab during ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cellular Energy Failure

A

after 5-10min w/o O2: irreversible brain damage

—bc neuronal tissue is dependent on glucose for ATP production + stores v little glycogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cellular Energy Failure

2 mechanisms

A

1 anaerobic metabolism

2 deterioration of ion gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

glutamate is an…

A

excitotoxin aka excitatory amino acid neurotransmitter

—important in learning/memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Excitatory Amino Acids

brain injury

A

excessive glutamate may be released bc of impaired membrane integrity
-reuptake mechanism fail to remove excess glutamate bc they are energy-dependant process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

excess glutamate/excitatory amino acid

effect

A

excess stimulates nearby neurons that then take up large amounts of injurious Ca ions
-causes Ca overload injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ca overload injury

A

cytotoxic edema + swelling

–due to excess glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Reperfusion Injury

A

when O2 re-enters cells, can produce reactive O2 products that act as free radicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

free radical examples

A

hydroxyl radicals
superoxide
peroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

in brain cell injury, ischemia leads to…

A

1 hypoxia>mitochondrial failure>decr ATP>Ca overload>free radical>cell death
2 reperfusion injury>immune cells> cell death
3 glutamate release> open NMDA channels> Ca overload> free rad> cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Volume of Cranium

3 components

A

1 brain tissue
2 cerebrospinal fluid [CSF]
3 blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

NORMAL Intracranial Pressure [ICP]

A

0-15 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Increased ICP can occur w…

A

1 space-occupying lesions
2 vasogenic or cytotoxic edema
3 obstruction of CSF
4 excessive production of CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 types of Increased ICP causes

A

1 INCR brain tissue vol
2 INCR CSF vol
3 INCR blood vol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

papilledema

A

edema of optic disk

-may occur due to INCR ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Increased ICP

s/s

A
  • headache
  • altered lvl of consciousness/drowsiness
  • vomit
  • blurry vision
  • papilledema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

as ICP rises…

A
  • compression of neural tissue + blood vessels
  • DECR lvl of consciousness
  • IMPAIRED pupil responsiveness to light
  • altered resp patterns
  • unresponsive to stimuli
  • unable to move, verbalize, or open eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Herniation

A

protrusion of brain tissue thry an opening in the supporting dura of the brain
–deadly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Level of Consciousness [LOC]

A

state of alertness + attentiveness to one’s enviro + situation

-change in LOC is most sensitive indicator of altered brain function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

most sensitive indicator of altered brain function

A

LOC

-may fluctuate so important to monitor + treat changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Coma

A

complete loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Glasgow Coma Scale
standardized tool for assessing LOC in acutely brain-injured persons -numeric scores given to arousal-directed responses of eye opening, verbal utterance, + motor rxn
26
Glasgow Coma Scale | mild, moderate, severe
mild: >12 mod: 9-12 sevr: <8
27
Glasgow Coma Scale | motor responses
``` -most powerful predictor of patient outcome based on: -decorticate posturing -abnormal flexor -decerebrate posturing -abnormal extension ```
28
Pupil Reflex
indicates function of brainstem + CN II + III -change in size, shape, + reactivity of pupil is early indicator of ICP + possible brain herniation
29
Oculovestibular Reflex
- doll's eyes maneuver entails rotating the patients head fr side to side - ---NORMALLY eyes turn in the opposite direction of head rotation - impaired reflex implies brainstem dysfunction
30
leading cause of death + disability in U.S.
traumatic brain injury [TBI]
31
how are most head injuries incurred?
- transportation-related accidents - falls - fire - arms - sports accidents
32
Types of Traumatic Brain Injuries [TBI]
1 PRIMARY INJURY ---focal, polar, diffuse 2 INTRACRANIAL HEMATOMAS ---epidural, subdural, subarachnoid
33
Primary Injury
type of TBI fr initial truma/injury on brain cells | 3 types: focal, polar, diffuse
34
Focal Primary Injury
coup: localized to sire of impact
35
Polar Primary Injury
coup contracoup - due to acceleration-deceleration mvmt of brain w/in skull - --results in double injury (usually opposite focal injury)
36
Diffuse Primary Injury
due to mvmt of brain w/in skull | -widespread axonal injury
37
Primary Injury | mechanisms
-CONCUSSION -CONTUSION INTRACRANIAL HEMATOMA
38
Concussion
- mild traumatic brain injury - alteration/loss of LOC (<30min) - ----but no evidence of brain damage on CT
39
Concussion | s/s
- headache - n/v - dizziness - fatigue - blurred vision - cognitiv + emo disturbances
40
most common military/athlete injury?
concussion
41
Contusion
CT or MRI reveals area of brain tissue damage | --necrosis, laceration, bruising
42
Intracranial Hematoma
localized collection of blood w/in cranium -disruption of vasculature can result in intracranial hemorrhage 3 types: epidural, subdural, or subarachnoid
43
Epidural Intracranial Hematoma
collection of blood bw DURA + SKULL - typically involved ARTERIAL INJURY - --thus RAPID ONSET OF SYMPTOMS
44
Subdural Hematoma
collection of blood bw DURA + OUTER LAYER OF ARACHNOID MEMBRANE - typically involves BRIDGING VEINS - -slower onset of symptoms -may be acute or subacute
45
Subdural Hematoma acute vs subacute
ACUTE: symptoms w/in 24hrs of injury SUBACUTE: incr ICP (headache, vomit, blurred vision) ----2-10 days later
46
Subarachnoid Hematoma
collection of blood bw ARACHNOID MEMBRANE + PIA MATER -due to rupture of bridging veins that pass the arachnoid space - more commonly assoc w rupture of cerebral aneurysms or arteriovenous malformations - --arterial origin
47
Traumatic Brain Injury [TBI] treatments
1 CardioPulmonary Stabilization | 2 maintnc of norm body temp/mild hypothermia, norm PaCO2, norm serum glucose lvl, + norm intravasc vol
48
TBI - base skull fracture
halo test: CSF can seep out as clear fluid fr ears/nose racoon sign: bilateral perioorbital hematomas: black eyes battle's sign: bruising under ear
49
treatment for open head injury
prophylatctic antibiotics
50
stroke
sudden onset of neurologic dysfunction due to cardiovascular disease that results in an area of brain infarction -3rd leading cause of death
51
most common form of stroke
ischemic stroke
52
cerebrovascular disease + stroke cause...
abnormalities of cerebral perfusion | - transient ischemic attacks (TIA), ischemic stroke, + hemorrhagic stroke
53
Ischemic Stroke
results fr sudden occlusion of cerebral artery secondary to thrombus formation or emboli
54
Thrombotic Strokes
type of ischemic stroke | *assoc w atherosclerosis + coagulopathies
55
Embolic Strokes
type of ischemic stroke | *assoc w cardiac dysfunction or dysrhythmias (atrial fibrillation)
56
Ischemic Stroke | s/s
* **ALL CONTRALATERAL - hemiplegia - hemisensory loss - visual field blindness
57
in an ischemic stroke, is a neurologic deficits completely resolve...
a Transient Ischemic Attack [TIA] occurs
58
Transient Ischemic Attack [TIA]
occurs when a neurologic deficit completely resolves in an ischemic stroke
59
Transient Ischemic Attack [TIA] | s/s
- neurologic symptoms typically last only minutes but they may last as long as 24 hours - symptoms resolve completely w/o evidence of neurologic dysfunction
60
Ischemic Stroke | treatment
``` aimed at minimizing infarct size + preserving neurologic function 1 thrombolytics 2 anticoagulant 3 antiplatelet 4 endarterectomy 5 angioplasty 6 stents ```
61
Motor Deficits
initially motor deficits occur as flaccidity or paralysis | -recovery of motor function occurs w onset of spasticity
62
Sensory Deficits
sensory disturbances occur in same locations as motor paralysis + may involve neglect or visual impairment - loss of visual field on paralyzed side also contributes to neglect - homonymous hemianopsia - assess fall risk
63
homonymous hemianopsia
contralateral field blindness - same side of retina in each eye is blinded - occurs in sensory deficits
64
Language Deficits
aphasia occurs w brain damage to the dominant cerebral hemisphere + can involve all language modalities
65
2 types of Aphasia/Language Deficit
1 Broca Aphasia | 2 Wernicke Aphasia
66
Broca Aphasia
verbal motor/expressive | -poor articulation + sparse vocab
67
Wernicke Aphasia
sensory, acoustic, + receptive | -impaired auditory comprehension + speech
68
Types of Stroke Sequelae
- cognitive deficit - language deficit - motor deficit - sensory deficit/diisturbances
69
most common causes of SubArachnoid Hemorrhage
Cerebral Aneurysm + Arteriovenous Malformation [AVMs]
70
Cerebral Aneurysm
lesion of an artery that results in dilation + ballooning of a segment of the vessel -60% will either die or suffer permanent disability -high blood pressure, acute alcohol intoxication, + recreational use (esp cocaine) implicated
71
Central Nervous System Infection
organisms may gain access to the CNS via 1 1 bloodstream 2 direct extension fr primary site 3 peripheral + cranial nerves 4 maternal-fetal exchange
72
...commonly assoc w bacterial infections
meningitis, cerebral abscess
73
...commonly assoc w viral infections
encephalitis
74
Meningitis
- streptococcus pneumoniae | - bacteria invade leptomeninges; accum of inflammatory exudate can result in obstructive hydrocephalus
75
Meningitis | s/s
- headache - fever - meningismus - cerebral dysfunction - ----confusion, delirium
76
meningismus
stiff neck fr meningitis
77
Meningitis | diagnosis
lumbar puncture
78
Meningitis | prevention
vaccination for Hib + N. meningitidis

Pathophysiology (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions