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Patho > Week 6: Neuro > Flashcards

Week 6: Neuro Flashcards

1
Q

What are the major functions of each of the four major regions of the brain?

A

Frontal lobe: primary motor cortex
Parietal lobe: primary somatosensory cortex
Temporal: primary auditory cortex
Occipital: primary visual cortex + visual association cortex to interpret the meaning of visual experiences

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2
Q

What is the primary role of the primary motor cortex?

A

important for precise movement of hands, feet and phonation (speech)

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3
Q

What is the primary role of the somatosensory cortex?

A

perceives meaningfulness of integrated sensory inputs

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4
Q

What is the role of the hypothalamus?

A

controls homeostatic processes in the body - water balance, hunger-satiety cycle, metabolism, temperature

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5
Q

Major functions of the brain stem?

A

respiratory control center, cardiovascular control center, vasomotor center

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6
Q

What is the role of the reticular activating system (RAS)?

A

maintains behavioral arousal, consciousness, and motivation

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7
Q

What is the role of the cerebellum?

A

skeletal muscle activity; balance & equilibrium

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8
Q

How does bone function to protect the CNS?

A

brain and spinal cord are enclosed in the skull and vertebral column that offer protection

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9
Q

How do the meninges protect the CNS?

A

three connective tissue membranes that protect CNS structures

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10
Q

What are the three meningeal layers?

A

Dura mater: double layer membrane surrounding the brain
Arachnoid mater: threadlike extensions span subarachnoid space and attach to the pia mater
Pia mater: clings tightly to the surface of brain and spinal cord

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11
Q

How does CSF protect the CNS?

A

watery broth in ventricles that provides a cushion

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12
Q

How does the blood brain barrier protect the CNS?

A

provides separation between blood and neurons - relatively impermeable capillaries
Allows for passage of key nutrients: water, glucose, essential amino acids; excludes unwanted molecules

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13
Q

General organization of nerves in the spinal cord

A

cervical (C1-C5), brachial (C5-T1), thoracic (T1-T12), lumbar (L1-L4), sacral (L4-S5)

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14
Q

Where do we sample CSF?

A

L3/L4

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15
Q

Posterior region of the spinal cord contains which tract(s)?

A

ascending/sensory tracts

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16
Q

Anterolateral sections of the spinal cord contains which tract(s)?

A

ascending/sensory & descending/motor information

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17
Q

Definition, causes and symptoms of TBI

A

Head injury and subsequent damage to brain, possibly cranial nerves
Causes: falls, vehicular accidents, violence
Symptoms: dependent on if it is diffuse or local, the severity and the part of the brain involved

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18
Q

Definition and causes of cerebrovascular disease

A

vascular injuries such as stroke that may present with similar clinical manifestations as TBI
Causes: hypertension and hyperlipidemia

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19
Q

What is the role of the Circle of Willis?

A

protective circulation system that facilitates blood flow to the brain, allows collateral flow if a portion of the brain is disrupted

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20
Q

Define spinal cord injury

A

injuries to cranial nerves that often accompany TBIs

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21
Q

What conditions do seizures accompany?

A

many neuro conditions including TBIs and CVD

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22
Q

Define consciousness

A

state of awareness and orientation to surroundings, ability to respond to stimuli
determined by the RAS

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23
Q

What tool is used to determine level of consciousness?

A

Glasgow Coma Scale

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24
Q

Define concussion - injury severity and reversibility, symptoms (5)

A

caused by sudden movement of brain, most common form of TBI
Severity: Diffuse
Reversibility: Typically reversible
Symptoms: Associated with temporary LOC, change in resp, hypotension, bradycardia and amnesia

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25
Q

What is a contusion and is it reversible?

A

bruising of brain tissue, small petechial hemorrhages that leak into brain tissue
Reversibility: Partially reversible, depending on severity of injury

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26
Q

Define closed vs. open injury

A

Closed injury: skull intact

Open injury: skull fracture

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27
Q

Define primary vs. secondary brain injury

A

Primary brain injury: structural damage at the moment of trauma to neurons, glial cells, blood vessels
Secondary brain injury: consequence of response to injury: changes to blood flow, edema and subsequent ICP which can lead to cell death or herniation - worsens the primary injury

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28
Q

Definition and major consequence: hypoxia and ischemic injury

A

result from decreased oxygen availability in the brain tissue
Consequence: reduces availability of glucose and removal of waste products

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29
Q

Cerebral edema: definition and causes (2)

A

swelling of the brain due to accumulation of fluids

Causes: damage to BBB or inadequate waste removal

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30
Q

Definition and major consequence: increased ICP

A

results from fluid accumulation due to inflammatory or edematous processes

resultant reduction in tissue perfusion can lead to hypoxia and neuronal death, can lead to herniation (often into brain stem area)

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31
Q

Define epidural hemorrhage

A

arterial bleed into extradural space between skull and outermost brain layer

32
Q

Define subdural hemorrhage, common causes

A

most common meningeal hemorrhage, blood accumulates between dura mater and arachnoid mater
causes: trauma, coagulopathy, alcoholism

33
Q

Define intracerebral hemorrhage

A

disruption of cerebral vessels within the parenchyma resulting in neuro deficits, commonly found in frontal and temporal lobes

34
Q

Define intracerebral hematoma

A

focal injury involving collection of blood in or around the brain, often caused by hemorrhage

35
Q

Define transient ischemic attacks, what they are a risk factor for, the causes and s/s (4)

A

neuro events due to ischemia that are short-lived and resolve completely
Risk factor for stroke
Causes: embolus or thrombus involving any cerebral artery
S/s: transient episodes of contralateral weakness, sensory deficits, visual impairments, aphasia

36
Q

Define stroke, causes

A

sudden focal neuro deficit due to vascular disorder. Nontraumatic disruption of blood flow
causes: occlusion of cerebral arteries by ischemia or hemorrhage

37
Q

Define ischemic stroke

A

results from obstructed blood flow or systemic hypoperfusion, leading to ischemia, potentially irreversible necrotic process and cerebral infarction

38
Q

Define hemorrhagic stroke

A

results from intracranial hemorrhage, deep in the parenchyma or near surface of the brain, often has HTN as underlying cause

39
Q

Define aneurysm, a defect in ____ can lead to it, major consequence

A

localized dilation in a blood vessel wall that can rupture and lead to hemorrhage

  • tunica media
  • rupture can cause aneurysmal subarachnoid hemorrhage, s/s range from mild headache to coma and death
40
Q

Causes and symptoms of spinal cord injury

A

Causes: any injury caused by trauma - vehicle accidents, falls, sports injuries, violence
Symptoms: vary depending on site of injury and if nerve roots are damaged

41
Q

What is the result of a spinal cord transection?

A

loss of motor, sensory, reflex and autonomic function below the level of injury; can be complete or partial

42
Q

Differentiate between primary vs. secondary spinal cord injury

A

Primary SCI: occurs at time of accident and is irreversible

Secondary SCI: follows primary injury and spreads damage

43
Q

Define meningitis, what are common causes (specific strains)?

A

infection of the meninges
bacteria: strep pneumonia, Neisseria meningitidis, hameophilus influenzae
Virus: enteroviruses, coxsackie virus, adenovirus, herpes, HIV, Epstein Barr virus, CMV

44
Q

Define encephalitis, what are common causes (7)

A

infection and inflammation of brain tissue or spinal cord

Causes: equine encephalitis, west nile, herpes, HIV, cytomegalovirus, rabies, prion diseases (mad cow disease)

45
Q

Define Parkinson Disease, what is the common cause and s/s

A

degenerative disease of CNS characterized by movement disorder
Cause: death of dopamine-producing cells in substantia nigra of the basal ganglia
S/s: movement related symptoms (tremor, bradykinesia, rigidity, postural instability), neuropsychiatric sx (dementia & depression)

46
Q

What is the characteristic of cells death in Parkinson Disease?

A

Development of alpha-synuclein protein in the brain (Lewy bodies)

47
Q

Define MS, s/s (5), Tx

A

autoimmune attack on myelin of CNS neurons that causes formation of plaques and destruction of myelin
S/S: visual changes, muscle weakness, loss of coordination, numbness, mild cognitive impairments
Tx: anti-inflammatory agents (corticosteroids)

48
Q

Define ALS, S/S, Tx

A

condition characterized by loss of motor neurons
S/S: Progressive weakness and muscle wasting, death usually within 5 years of dx
Tx: supportive measures only - drugs (riluzole) can suppress glutamate and ameliorate sx

49
Q

What is usually the cause of mortality in ALS?

A

Failure of respiratory muscles

50
Q

What are two pathologic associations with ALS?

A

May involve excess glutamate in synapses

Mutations in superoxide dismutase gene associated, suggesting oxidative stress may contribute to cell death

51
Q

What are the basic divisions of the PNS?

A

Afferent (sensory): detects, transmits and processes environmental information from internal/external sources through a variety of receptors
Efferent (motor): initiates voluntary and involuntary movement

52
Q

What are the levels of afferent neurons?

A

Sensory unit: afferent neuron and all receptors that send information along it
Dermatome: area of skin supplied by a single spinal nerve transmitting to a dorsal root ganglion and spinal cord segment
Receptive field: area that sends information along a single afferent neuron

53
Q

Which column do myelinated fibers travel along? Is it ipsilateral or contralateral? Where does it cross?

A
  1. Dorsal columns
  2. ipsilateral
  3. medulla
54
Q

Which column do unmyelinated fibers travel along? Is it ipsilateral or contralateral? Where does it cross?

A
  1. anterolateral system
  2. contralateral
  3. spinal cord at point of entry
55
Q

What sensory information is carried by fast vs. slow myelinated fibers?

A

Fast: touch, proprioception, pressure
Slow: touch, temperature, fast pain

56
Q

What sensory information is carried by unmyelinated fibers?

A

Slow pain, hot and cold, itch

57
Q

What are the basic steps in control of voluntary movement? (4)

A
  1. Commands initiated in association cortex
  2. Commands relayed to sensorimotor cortex, cerebellum, and subcortical nuclei
  3. Initial command broken down into series of smaller motor programs
  4. Motor programs transmitted through descending motor pathways to carry out commands
58
Q

Define pyramidal tracts, what are characteristics of diseases of these tracts?

A

originate in the sensorimotor cortex of the cerebral cortex, descend through the basal ganglia and brain stem, cross or remain uncrossed at the medulla from where they descend the spinal cord

Diseases (eg. Stroke) characterized by spasticity and paralysis

59
Q

Define extrapyramidal tracts, what are characteristics of diseases of these tracts?

A

remaining tracts that do not transverse the brainstem

Diseases (eg. Parkinson) result in involuntary movements, muscle rigidity, immobility without paralysis

60
Q

What is the major role of the ANS?

A

governs body processes without conscious effort

61
Q

What are the roles of the two divisions of the ANS?

A

Sympathetic: mobilizes the body
Parasympathetic: conserves body

62
Q

Which neurotransmitters are adrenergic?

A

epinephrine, norepinephrine

63
Q

Which neurons release norepinephrine?

A

most sympathetic postganglionic neurons

64
Q

Which neurotransmitter is cholinergic?

A

acetylcholine

65
Q

Which neurons release acetylcholine?

A

preganglionic neurons

parasympathetic postganglionic neurons

66
Q

What is the general response of adrenergic receptors?

A

Alpha-adrenergic: vasoconstriction of blood vessels in skin and viscera, not in airway smooth muscle

Beta-adrenergic: vasodilation of blood vessels in skeletal muscle, increase heart rate and contractility, relaxation of airway smooth muscle, blocked by propranolol

67
Q

Define pain

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage

68
Q

Define nociceptive pain, causes

A

cutaneous, deep somatic or visceral origins of pain

Causes: mechanical, thermal or chemical damage - trauma, burns, infection, exposure to toxins

69
Q

Which substance is released from nerve terminals? What is it’s major role?

A

Substance P
sensitizes nociceptors by causing release of histamine and serotonin from platelets and mast cells that contribute to inflammation

70
Q

Describe fast pain, which fibers carry it, localization, cutaneous or visceral?

A

prickling, stabbing
Carried on A-delta fibers (myelinated)
Good localization
Cutaneous: fast pain on the surface

71
Q

Describe slow pain, which fibers carry it, localization, cutaneous or visceral?

A

dull ache, burning
Carried by C fibers (unmyelinated)
Poor localization
Visceral: slow pain (chest pain due to myocardial infarction

72
Q

Define deep somatic pain

A

fast and slow pain (arthritis or sprained ankle)

73
Q

Define referred pain

A

localized to place other than the origin of the pain

74
Q

Describe Brown-Sequard Syndrome, S/S

A

SCI that alters functions of the PNS
S/S: loss of voluntary motor function from the corticospinal tract, proprioception loss from ipsilateral side of the body, contralateral loss of pain and temperature sensations from the lateral spinothalamic tracts for all levels below the lesion

75
Q

Describe Guillan-Barre Syndrome, S/S, causes, consequences

A

infection that initiates autoimmune destruction of peripheral nerves
s/s: ascending paralysis, weakness in extremities migrating toward the trunk, altered sensations, pain, dysfunction of ANS
Causes: infection with bacteria such as campylobacter jejuni or CMV
Consequences: damage to myelin and can result in paralysis as well as sensory and autonomic disturbances

Patho (14 decks)

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