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Flashcards in CNS Deck (57):
1

What are the order of layers of the brain from outside in?

dura mater
arachnoid
pia mater

2

What regulates the blood supply to the brain?

circle of willis
- often a site for aneurysms and bleeds

3

What does the brain not have that the rest of the body does?

lymphatic system - tumours can not metastasize to the brain this way

4

The skull is a bony box that can not expand. Therefore if the volume of tissue of fluid inside the skull increases what happens?

- intracranial pressure rises
- results in herniation(abnormal protrusion) where part of the brain moves from one compartment of the skull to another

5

What do the neurons do compared to the glial cells?

- Neurons - the processors
- Glial cells - supporting functions (includes schwann cells, astrocytes & oligodendrocytes)

6

Frontal lobe is responsible for ...

planning

7

parental lobe which is responsible for ...

movement

8

occipital lobe responsible for ...

vision

9

cerebellum which is responsible for..

co-ordinating movement and balance

10

Brain stem is responsible for...

vital functions like regulation BP, resp rate ect.

11

pre central and post central gyrus are responsible for ...

pre - motor cortex
post - sensory cortex

12

Frontal and temporal lobe are responsible for ...

speech and language
includes brocas area in frontal lobe
includes wernickes area in temporal lobe

13

What is the brain stem composed of (3 areas)?

midbrain
pons
medulla

14

What is focal neurological signs?

a set of symptoms or signs in which causation can be localized to an anatomic site in the central nervous system

15

What is generalised neurological abnormalities?

Essentially an alteration in level of consciousness

16

If you have damage to the frontal lobe what are the likely signs?

Anosmia (inability to smell)
Inappropriate emotions
Expressive dysphasia (cant get words out )
Motor impairment

17

If you have damage to the parietal lobe what are the likely signs?

Receptive dysphasia ( not understanding language)
Sensory impairment

18

If you have damage to the temporal lobe what is the likely signs ?

- cortical deafness
- Receptive dysphasia

19

Diffuse neurological injury is usually manifest as impairment of consciousness. Most often due to what?

- increased intracranial pressure
- may occur as a primary response
- or as a secondary to response to a focal injury (injury to specific area)

20

What are the 2 main pathologies types of strokes?

- ischaemic (as result of blockage, atheroma or thrombosis or emboli)
- haemorrhagic (as a result of berry aneurysm or hypertension related)

21

What is the only difference between a stoke and a TIA

- the duration in which the symptoms last (TIA resolves within 24 hours)

22

In cerebrovascular disease survival depends on what 3 things ?

- duration of ischaemia
- what collateral circulation available
- how much reduction of flow and quickly it happens

23

What are the treatments for TIA's?

- antiplatelet therapy (aspirin or clopidogrel)
- control BP
- lower cholesterol

24

What are the risk factors for strokes?

- hypertension
- diabetes
- heart disease
- Previous transient ischaemic attacks
- hyperlipidaemia

25

What are causes of haemorrhagic events (strokes ect.)?

- hypertension
- vascular malformation (berry aneurysm )
- neoplasia
- trauma
- drug abuse
- iatrogenic

26

What are the management of strokes?

- thrombolysis (break up blood clot)
- aspirin/ clopidogrel
- physiotherapy
- occupational therapy
- SALT
- supportive treatment

27

intracerebral haemorrhage (haemorrhagic stroke) presents as what symptoms?

- headache
- rapid or gradual decrease in conscious level
- localises depending on site of bleed

28

Subarachnoid haemorrhage normally occur ?

- spontaneous
- when berry aneurysm ruptures

29

What are the symptoms of a subarachnoid haemorrhage?

- thunderclap headache (bad!)
- meningitis like signs (photophobia ect.)
- requires neurosurgical input

30

where does a subdural haemorrhage occur?

- bleeding from bridging veins between cortex and venous sinuses
- blood between dura and arachnoid

31

What may cause a subdural haemorrhage?

- often on anticoagulants
- often minor trauma in the elderly
- common in alcoholics

32

Symptoms of subdural haemorrhage normally take days, weeks or months to present as it involves veins. What are the symptoms?

- fluctuant conscience level

33

What is an extradural haemorrhage ?

haemorrhage outside the dura
typically affecting the middle meningeal artery

34

What may cause an extradural haemorrhage?

post head injury
often with fractured temporal or parietal bone

35

What are the symptoms of extradural haemorrhage?

- slowly falling conscious level
possibly with lucid periods

36

What should a dementia assessment include?

TSH – ensure thyroid function is normal
CT scan (Not all cases) to check for intracranial pathology
Vitamin B12, thiamine – alcoholism

37

What is Alzheimer's disease due to?

- accumulation of AB amyloid, tau-neurofibrillary tangles and plaques
- loss of neurones and synapses

38

What does the accumulation in amyloid, tau-neurofibrillary tangles and plaques in Alzheimer's disease lead to ?

- defects of visual-spatial skills (gets lost)
- memory loss
- decreasing cognotion
- ansognosia (lack of awareness)

39

What is the treatment for Alzheimer's disease?

-MDT
- cholinesterase inhibitors (rivastigmine)

40

What is epilepsy ?

A recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifest as seizures

41

What can epilepsy be due to?

- space occupying lesions
- stroke
- alcohol withdrawal

42

What is treatment of epilepsy?

- avoid triggers
- drugs such as sodium valproate, carmazepine, phenytoin, lamotrigine

43

There are two types of infection in the brain these are diffuse or focal infection. Give an example of each.

diffuse infection - meningitis
focal infection - abscess

44

What are the early symptoms of meningitis?

- headache
- cold hands and feet
- pyrexial (fever)

45

What are the late stages of meningitis?

- neck stiffness
- photophobia
- kernigs sign (extension of knee causes pain in the neck)
- non-blanching rash
- seizures

46

What are the 3 main examples of bacteria causing meningitis?

Neisseria meningitidis
Pneumococcus
Meningococcus

47

What can a brain abscess symptoms present as?

- headaches
- seizures
- temperature

48

What does ring enhancing lesion in radiology suggest ?

- brain abscess

49

How can brain abscess occur?

via blood
- embolus from bacterial endocarditis
- IV drug users at risk
direct
- from inner ear infection

50

What is parkinsons disease?

- movement disorder
- sporadic or familial
- can be drug induced

51

What are the symptoms of parkinsons?

- rigidity
- bradykinesis (slowness of movement)
- resting tremor
- postural instability (prone to falls, start with difficulty)

52

What is parkinsons a results of ?

- decreased dopamine with the brain (in substantia nigra, which is decreased also )

53

What are the presentations of a tumour in the brain?

- headaches
- seizures
- cognitive or behavioural change
- vomiting
- altered consciousness

54

Most tumours in the brain are secondary deposits from somewhere else. Where might these include?

breast
small cell lung carcinoma

55

What are the two most common primary benign brain tumours?

meningiomas
astrocytomas

56

A meningioma is a slow growing tumour where do they arise from?

derived from menigothelial cells

57

Pituitary tumours can cause..

compression
hormonally active