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Medical Conditions 2 > CNS disorders > Flashcards

CNS disorders Flashcards

1
Q

what are the two main sources of blood into the circle of willis

A
  • internal carotid
  • vertebral artery
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2
Q

ACA- anterior cerebral artery

A
  • branches from internal carotid
  • had many superficial and deep branches and anastomosis
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3
Q

MCA - middle cerebral artery

A
  • branches from internal carotid
  • 4 main branches
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4
Q

PCA - posterior cerebral artery

A
  • branch from the basilar artery near the pituitary stalk at the ponotmesencephalic junction

supplies

  • occipital lobe,
  • inferomedial temporal lobe,
  • a large portion of the thalamus
  • upper brain stem,
  • midbrain,
  • lateral geniculate body
  • hippocampus
  • parahyippocampal gryus
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5
Q

CNS cells:

A
  • neurons
  • macroglia:
  • microglia
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6
Q

What are macroglia and describe

A

derived from nerve cell linage

  • astrocytes: provide structure
  • oligodendrocytes: myleinate
  • Schwann: mylinate in PNS
  • ependymal cells: help produce CSF
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7
Q

Microglia

A
  • derived from monocyte cell lineage
  • immune cell of brain
  • 10% of CNS cells
  • clean foreign bodies
  • are times where microglia stay active and cause damage
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8
Q

Cellular dysfunction: neural cell death

A
  • apoptosis: programmed but can cause damage if it outside normal range of occurring
  • necrosis: unplanned usually caused by an external factor, cell membrane gets disrupted and the insides affect other cells when they leak out
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9
Q

Cellular dysfunction: excitotoxicity

A
  • free radicals: can be dangerous or harmful
  • released during exercise but that helps the body understand how to deal with them
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10
Q

What regulates the extracellular environment of the CNS

A
  • blood brain barrier: tightly joined endothelial cells; block diffusion
  • ependymal cells: line ventricles and spinal canal and regulate metabolism
  • regulate the extracellular environment and protect the nervous system structures
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11
Q

Amino acid Neurotransmitters

A
  • glutamate: excitation
  • GABA & Glycine: inhibitory
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12
Q

Amines Neurotransmitters

A
  • cholinergic = acetylcholine
  • biogenic: catecholamines, serotonin
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13
Q
  • neuopeptides Neurotransmitters
A
  • enkephalins
  • b-endorphins
  • substance P
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14
Q

gaseous Neurotransmitters

A
  • nitrous oxide NO
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15
Q

Sympathetic NS neurotransmitters and what they cause as well as receptor types

A
  • adrenergic stimulate sympathetic NS
  • can have a positive effect meaning it increases sympathetic response or a negative effect meaning that it decreases sympathetic response
  • receptor types: alpha and beta
  • nicotinic receptor at preganglioic neuron
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16
Q

parasympathetic Neurotransmitters

A
  • cholinergics for both pre and post ganglionic
  • only positive effects
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17
Q
  1. adrenergics
  2. cholinergincs
A
  • stimulate sympathetic NS
  • stimulate parasympatheic NS
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18
Q

beta blockers
vs
alpha blockers

A
  • inhibit sympathetic (beta receptors mostly)
  • inhibit sympathetic (alpha receptors mostly)
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19
Q

anticholinergics

A

inhibit parasympathetic NS

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20
Q

what are side effects of increase in parasympathetic function

A
  • GI distress: nausea, vomiting, diarrhea,
  • abdominal cramping,
  • bronchoconstriction,
  • increase salivation
  • bradycardia
  • pupils constricted
  • impacts vision
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21
Q

Biogenic amines

A
  • norepinephrine
  • Dopamine
  • serotonin
  • work together to regulate attention and alertness
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22
Q

Norepinephrine effects with Mental health regulation

A
  • attention
  • motivation
  • pleasure
  • reward
  • mood
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23
Q

Dopamine

A
  • alertness
  • energy
  • Anxiety
  • involved in movement quality
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24
Q

Serotonin

A
  • obsession
  • compulsions
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25
Q

CNS disorders

A

Infections
neoplasm
vascular
trauma
degenerative

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26
Q

Infectious disorders of the CNS

A
  • Meningitis (viral, tuberculous, bacterial)
  • encephalitis
  • brain abscess
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27
Q

Neoplasms

A
  • tumor
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28
Q

Vascular- CNS disorder

A

TIA
stroke

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29
Q

Trauma- CNS disorder

A

TBI

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30
Q

Degenerative disorders - CNS disorders

A
  • get progressively worse
  • ALS
  • Alzheimer’s
  • huntington disease
  • MS
  • Parkinson
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31
Q

Examples of the variety of clinical manifestations of CNS disorders

A
  • Sensory disturbances
  • Movement disorders
  • disorders of coordination movement
  • deficits of higher brain function
  • altered states of consciousness
  • emotional instability
  • memory problems
  • brainstem dysfunction
  • autonomic system dysfunction
  • aging and the CNS
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32
Q

Sensory disturbances: spinal cord lesion

A
  • decreased pain on CL side and decreased touch on ipsilateral side
33
Q

Lesion above medulla

A
  • decreased pain and touch on contralateral side
34
Q

Spinal cord lesions DCML

A
  • sensations ipsilateral deficits
35
Q

Anterolateral spinal cord lesions

A
  • contralateral deficits
36
Q

Motor system pathways

A
  • Anterior corticospinal tract
  • lateral cortiocospinal
37
Q

Hypotonicity vs hypertonicity

A

describing resting tone

38
Q

Spasticity

A
  • type of hypertonia that is velocity dependent
39
Q

Dysmetria

A
  • dysfunction with moving certain distance
  • proximation
40
Q

Dysdiadochokinesia

A

-Inability to preform rapid reciprocal movement
- coordination

41
Q

Ataxia vs apraxia

A
  • (1). Difficulty controlling movement
  • (2). difficulty initiating movement
42
Q

Gaze-evoked nystagmus

A
  • eyes don’t stop after rapid head movement don’t stop once head stops
43
Q
  1. Aphasia
  2. Agnosia
  3. dysarthria
  4. anarthria
A
  1. trouble with expression and reception of language
  2. unable to recognize objects/people
  3. trouble generating speech
  4. without speech
44
Q

Higher brain function deficits in CNS disorders

A
  • language vs speech
  • perception
  • abstract thinking
  • movement
  • adaptive response
  • frontal lobe damage
  • right hemisphere syndrome
  • Alexia: difficulty with reading
45
Q

Disorders of consciousness and emotion

A
  • Reticular activating system: arousal and attention
  • orbital prefrontal region: selective attention to facial expression
  • limbic system: orbitofrontal cortex, hippocampus, parahippocampal gyrus, cingulate gyrus, cingulate gyrus,hippocampus
  • amygdala: integrates emotion and context in stress response
46
Q

Diagnosis of CNS disorders

A
  • clinical localization
  • computed tomography
  • MRI: typical first done
  • fMRI
  • PET
  • DaTSCAN
  • Diffusion Tensor imaging
  • EEG
  • Brainstem auditory evoked potentials
  • transcranial doppler ultrasound
  • near-infrared spectroscopy
  • transcranial magnetic stimulate
47
Q

Treatment for CNS disorders

A

Pharmacologic:

  • modulate neurotransmitter synthesis, release, reuptake or degradation (can be used to enhanced movement not just mental health)
  • antioxidant therapies to prevent free radicals from penetrating membrane
  • pharmacology for movement disorders
  • antipsychotic and antidepressants
  • opioid analgesics

Stem cells

48
Q

Meningitis

A
  • inflammation
  • viral aseptic infection vs bacterial infection
49
Q

Meningitis: risk factors

A
  • immunodeficiency
  • crowded living spaces
  • spleen dysfunction
50
Q

Pathogenesis of bacterial meningitis

A
  • depends on insulting agent
  • typicall gets into the blood stream and can go throug BBB by way of a WBC
51
Q

Clinical manifestations: meningitis

Also what is the only way to diangosis

A
  • cardinal signs: headache
  • stiff neck
  • non-balancing rash
  • septicemia
  • red flags signs: cold hands/feet, limb pain; pale mottled skin
  • nausea and vomiting
  • lumbar puncture= spinal tap for diagnosis
52
Q

Treatment: meningitis

A
  • bacterial Meningitis: antimicrobials and steroids
  • viral meningitis
53
Q

Encephalitis:

A
  • acute inflammatory disease of the parenchyma or tissue of the brain
54
Q

causes of encephalitis

A
  • direct viral invasion or hypersensitivity initiated by a virus herpes simplex virus
  • autoimmune
  • bacterial
  • insects bites
55
Q

Pathogenesis of encephalitis

A
  • destruction of cell membrane
  • gliosis and scarring
  • white matter destruction
56
Q

Clinical manifestations: encephalitis

A
  • headahce, weakness, UMN signs
  • can combine with meningitis and become meningoencephalitis
  • altered mental status
  • movement disorders
  • ataxia
  • cranial nerve defects
57
Q

Medical management: encephalitis

Diagnosis, treament,

A
  • Dx: IgM antibodies in serum or CSF
  • Treatment: varies with the infectious agent; antiviral if causes by herpes simplex virus
58
Q

Brain abscess

A
  • uncommon
  • focal infection
59
Q

brain abscess: risk factors

A
  • compromised immune system receiving steroid
  • immunosuppressants or cytotoxic chemotherapy
  • systemic illness such as HIV infections
60
Q

Clinical manifestations; brain abscess

A
  • headache, disturbed consciousness, and fever
61
Q

Zika

A
  • RNA virus transmitted by specific mosquito bite
  • usually asymptomatic
  • fever, rash, jt pain, conjunctivitis
  • affects fetus
62
Q
  • Prions disease
A
  • genetic or acquired
  • creutzfeld-joakob disease
  • 50-80 years old
  • cognitive impairment/confusion/movement disorders
  • fatal
63
Q

Degenerative CNS disorders

A
  • ALS - amyotrophic lateral scleosis
  • dementia
  • huntington disease
  • MS
  • parkinson
64
Q

ALS: classifications

A
  • pseudobulbar
  • progressive bulbar palsy
  • primary lateral sclerosis
  • progressive spinal muscular atrophy

*bulbar = cranial nerve

65
Q

ALS symtpoms

A
  • depend on whether it is UMN or LMN
  • typically musucle weakness and atrophy
  • extremities affected first with progression to respiratory muscles
66
Q

Types of dementia

A
  • alzheimers disease
  • lewy body dementia
  • vascular dementia
  • Frontotemportal disorder
67
Q

Dementia

Alzheimers disease

A
  • memory loss
  • language problems
  • unpredictable behavior
  • amyloid plaques
  • tau tangles
68
Q

Dementia

Lewy Body Dementia

A
  • difficulty with thinkng, movement, behavior, mood
  • abnormal deposits of a protein (alpha-synuclein)
  • affects acetylcholine and dopamine in the brain
69
Q

Dementia

  • Vascular dementia
A
  • disruption in blood flow
70
Q

Dementia

Frontotemporal disorder

A
  • when nerve cells in the frontal and temporal lobes of the brain are lost
  • behaviors
  • emotions
  • communication
  • walking
  • rare and affects younger people (45-64)
71
Q

Huntington disease

A
  • progressive genetic disorder
  • usually beginning in 30s-40s
72
Q

huntington’s disease

signs and symtoms

A
  • movement: choreic movement (ataxic) and rigid/difficulty moving
  • cognition: may be detected before motor deficits
  • psychiatric disorders
  • atrophy of caudate nucleus and putamen of basal ganglia
  • white matter deterioation in frontal lobe
73
Q

Multiple sclerosis

-what causes it, what occurs, when is it dx, and risk facotrs

A
  • scleotic plaques throught the brain and spinal cord
  • inflammation, demyleination, axon loss and gliosis
  • typically dx between 20-50 years
  • infection from epstein-barr, herpes, immune response, environment, genetics
74
Q

Symptoms of MS`

A
  • sensory
  • motor
  • bowel
  • bladder
  • affect
  • coordintion
75
Q

Treatment of MS

A
  • disease modifying agents
  • immunomodulating/immunosupressives
  • monoclonal antibodies
  • steriods
76
Q

Parkinson disease

A
  • degeneration of basal ganglia neurons
  • stop producing dopamine (symptoms occur when it is down 70-80%)
  • disrupts communication with cortex
  • chronic, progresisve disease
77
Q

hallmark traits of parkinsons

A
  • rigidity
  • tremor
  • bradykinesia
  • postural instability
78
Q

risk factors for parkinsons

A
  • genetic
  • toxic or infectious exposures

Medical Conditions 2 (22 decks)

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