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Wk12 CNS > Brain Injurys > Flashcards

Brain Injurys Flashcards

1
Q

Define Stroke and TIA

A
  • A disturbance of cerebral function lasting more then 24hrs or leading to death with no apparent cause other then vascular origin
  • Stroke symptoms that resolve themselves in under 24hrs
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2
Q

What is a Ischemic stroke

A
  • Occlusion are embolic or atherosclerotic

- Brain tissue becomes hypoxic, ischemic tisue releases Free Radicals

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3
Q

What si the cause of Cerebral Emboli

A
  • Carotid stenosis
  • Decreased or occluded blood flow to the brain due to emboli or atherosclerosis in the carotid artery resulting in a stroke
  • AF = Cardiac emboli
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4
Q

Management of stroke

A
  • FAST test
  • O2 only if hypoxic (to much o2 is bad)
  • Treat Hypoglycemia
  • Carefully consider ECG12 but think about time on scene
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5
Q

Signs and symptoms of a posterior stroke

A
  • Persistant Vertigo even when holding head still
  • Gate Ataxia
  • Trunk ataxia
  • Nystagmus
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6
Q

What is a Haemorrhagic stroke

A
  • Arteriovenous Malformation (AVM)
  • Malformation of the brains blood vessels at birth taht causes the artery walls to become weak and at increased risk of hemorrhagic stroke
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7
Q

What is the Monroe Kellie Hypothesis

A
  • Cranial cavity contains
    Blood 10%
    Brain Tissue 80%
    CSF 10%
  • The cranial compartment is incompressible and that the volume inside the cranium is fixed. The cranium and its constituents (blood, CSF, and brain tissue) create a state of volume equilibrium, such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another.
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8
Q

What are the layers of the brain

A
  • Skin
  • Periosteim
  • Bone
  • Dura mater (tough outer layer)
  • Arachnoid mater (delicate middle layer)
  • Pia mater (innermost layer)
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9
Q

What is Cerebral Edema, Vasogenic Edema and Cytoxic edema

A
  • Cerebral edema
    Increase in tissue volume secondary to fluid accumulation
  • Vasogenic Edema
    Occurs in TBI with impairment of the blood brain barrier function
  • Cytoxic Edema
    Involves an increase in intracellular fluid. Seen in “water intoxication” or impaired function across the sodium-potassium pump.
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10
Q

What are some of the risk factors for a stroke

A
  • High BP
  • High cholesterole
  • Smoking
  • DM
  • Older age
  • MI
  • Previous stroke
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11
Q

Define a Seizure

A
  • Abnormal behaviour caused by an electrical discharge from neutrons in the cerebral cortex
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12
Q

Causes of Seizures

A
  • Any serious injury or illness affecting the brain
  • Infection
  • Tumours
  • Drug abuse
  • Vascular Lesions
  • Brain Injury
  • Systematic Metabolic Disturbances
  • Hypoxia
  • Hypoglycaemia
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13
Q

Explain the Aetiology of a seizure

A
  • Alterations in cell membrane permeability
  • Alterarions in distribution of ions
  • Decrease inhibition of cortical or thalamic neuronal activity
  • Imbalance of neurotransmitters
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14
Q

Name the types of seizure

A
  • Epilepsy
  • Eclampsia
  • Pyrexia
  • Toxin (drugs, alcohol)
  • Syncopal
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15
Q

Sub section of seizures

A
  • Generalised
  • Partial Seizure
  • Pseudoseizure
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16
Q

What are the s+s of a Generalised Tonic Chlonic

A
  • Aura (warning that a seizure will happen)
  • LOC
  • Tonic Phase (Body becomes rigid)
  • Hypertonic Phase
  • Chlonic Phase (uncontrolled jerking)
  • Post seizure
  • Postictal
17
Q

Generilised Absence seizure

A
  • Presents with 10/30sec LOC
  • Eye or muscle fluttering
  • Occasional loss of muscle tone
  • LOC
  • Rarely after the age of 20yr
18
Q

Why do bystanders often describe the onset of cardiac arrest as a seizure?

A
  • People in sudden cardiac arrest can begin posturing and displaying the kind of movements that we often associate with seizures. Even as they begin CPR his arms are still moving, he is in cardiac arrest. Even through the first and second defibrillation he maintains his posturing and agonal respirations.
  • It is surprisingly difficult to differentiate seizures from early cardiac arrest.
  • It is nearly impossible to distinguish benign syncope from cardiac arrest until the patient recovers and a thorough history, examination, and workup can be performed.
    Any patient presenting with syncope or seizure needs, at the minimum, an EKG.
19
Q

Pharmacodynamics of Benzodiazepines

A
  • Binds to GABA receptor complex and antagonises the effect, opens up the chlorine channels, thus repolerising it and making it less likely to fire
  • GABA neurotransmitters bind to GABA receptors this causes a inhibition of impulse traffic across the synapse reducing anxiety and wakefulness.
20
Q

What is Status Epileptic

A
  • A series of seizures of two or more generalised motor seizures without an intervening return of consciousness
  • 30mins of continuous seizures
21
Q

Signs and symptoms of meningitis

A
  • Fever
  • Vomitting
  • Pain
  • Rash
  • Photophobia
  • Stiff neck
  • Increase HR
  • Cold peripheries
  • Decrease in SPO2
22
Q

What is the cause of Meningitis

A
  • A pathogen that can migrate across the Blood brain barrier

- A inflammatory response will happen in the meninges

23
Q

What are the unique signs of Meningococal Meningitis

A
  • Photophobia
  • Meningism (neck stiffness, irritibility of nerves passinh throught the meninges)
  • Brundzinski and Kerrings sign

Brundzinski sign is where if you flex the neck his knees would bend towards the chest

Kerrings sign is if the hips are flexed and knees bent there will be pain on movement

24
Q

Meningococal septiceamia

A
  • Activation of the inflammatory response and prothrombin activators, increase the permibility of the skin not to dissimilar to Sepsis
  • Cause a rash due to the capilleries losing there permibility and blood is begining to leak out causing the tissue to become ischemic
25
Q

Management of meningitis

A
  • High flow O2
  • Fluids
  • Benzylpenicillin

Wk12 CNS (2 decks)

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