CNS disorders Flashcards
(78 cards)
1
Q
what are the two main sources of blood into the circle of willis
A
- internal carotid
- vertebral artery
2
Q
ACA- anterior cerebral artery
A
- branches from internal carotid
- had many superficial and deep branches and anastomosis
3
Q
MCA - middle cerebral artery
A
- branches from internal carotid
- 4 main branches
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
5
Q
CNS cells:
A
- neurons
- macroglia:
- microglia
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
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
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
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
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
11
Q
Amino acid Neurotransmitters
A
- glutamate: excitation
- GABA & Glycine: inhibitory
12
Q
Amines Neurotransmitters
A
- cholinergic = acetylcholine
- biogenic: catecholamines, serotonin
13
Q
- neuopeptides Neurotransmitters
A
- enkephalins
- b-endorphins
- substance P
14
Q
gaseous Neurotransmitters
A
- nitrous oxide NO
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
16
Q
parasympathetic Neurotransmitters
A
- cholinergics for both pre and post ganglionic
- only positive effects
17
Q
- adrenergics
- cholinergincs
A
- stimulate sympathetic NS
- stimulate parasympatheic NS
18
Q
beta blockers
vs
alpha blockers
A
- inhibit sympathetic (beta receptors mostly)
- inhibit sympathetic (alpha receptors mostly)
19
Q
anticholinergics
A
inhibit parasympathetic NS
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
21
Q
Biogenic amines
A
- norepinephrine
- Dopamine
- serotonin
- work together to regulate attention and alertness
22
Q
Norepinephrine effects with Mental health regulation
A
- attention
- motivation
- pleasure
- reward
- mood
23
Q
Dopamine
A
- alertness
- energy
- Anxiety
- involved in movement quality
24
Q
Serotonin
A
- obsession
- compulsions
25
CNS disorders
Infections
neoplasm
vascular
trauma
degenerative
26
Infectious disorders of the CNS
- Meningitis (viral, tuberculous, bacterial)
- encephalitis
- brain abscess
27
Neoplasms
- tumor
28
Vascular- CNS disorder
TIA
stroke
29
Trauma- CNS disorder
TBI
30
Degenerative disorders - CNS disorders
- get progressively worse
- ALS
- Alzheimer's
- huntington disease
- MS
- Parkinson
31
Examples of the variety of clinical manifestations of CNS disorders
- 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
32
Sensory disturbances: spinal cord lesion
- decreased pain on CL side and decreased touch on ipsilateral side
33
Lesion above medulla
- decreased pain and touch on contralateral side
34
Spinal cord lesions DCML
- sensations ipsilateral deficits
35
Anterolateral spinal cord lesions
- contralateral deficits
36
Motor system pathways
- Anterior corticospinal tract
- lateral cortiocospinal
37
Hypotonicity vs hypertonicity
describing resting tone
38
Spasticity
- type of hypertonia that is velocity dependent
39
Dysmetria
- dysfunction with moving certain distance
- proximation
40
Dysdiadochokinesia
-Inability to preform rapid reciprocal movement
- coordination
41
Ataxia vs apraxia
- (1). Difficulty controlling movement
- (2). difficulty initiating movement
42
Gaze-evoked nystagmus
- eyes don't stop after rapid head movement don't stop once head stops
43
1. Aphasia
2. Agnosia
3. dysarthria
4. anarthria
1. trouble with expression and reception of language
2. unable to recognize objects/people
3. trouble generating speech
4. without speech
44
Higher brain function deficits in CNS disorders
- language vs speech
- perception
- abstract thinking
- movement
- adaptive response
- frontal lobe damage
- right hemisphere syndrome
- Alexia: difficulty with reading
45
Disorders of consciousness and emotion
- 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
Diagnosis of CNS disorders
- 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
Treatment for CNS disorders
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
Meningitis
- inflammation
- viral aseptic infection vs bacterial infection
49
Meningitis: risk factors
- immunodeficiency
- crowded living spaces
- spleen dysfunction
50
Pathogenesis of bacterial meningitis
- depends on insulting agent
- typicall gets into the blood stream and can go throug BBB by way of a WBC
51
Clinical manifestations: meningitis
| Also what is the only way to diangosis
- 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
Treatment: meningitis
- bacterial Meningitis: antimicrobials and steroids
- viral meningitis
53
Encephalitis:
- acute inflammatory disease of the parenchyma or tissue of the brain
54
causes of encephalitis
- direct viral invasion or hypersensitivity initiated by a virus herpes simplex virus
- autoimmune
- bacterial
- insects bites
55
Pathogenesis of encephalitis
- destruction of cell membrane
- gliosis and scarring
- white matter destruction
56
Clinical manifestations: encephalitis
- headahce, weakness, UMN signs
- can combine with meningitis and become meningoencephalitis
- altered mental status
- movement disorders
- ataxia
- cranial nerve defects
57
Medical management: encephalitis
| Diagnosis, treament,
- Dx: IgM antibodies in serum or CSF
- Treatment: varies with the infectious agent; antiviral if causes by herpes simplex virus
58
Brain abscess
- uncommon
- focal infection
59
brain abscess: risk factors
- compromised immune system receiving steroid
- immunosuppressants or cytotoxic chemotherapy
- systemic illness such as HIV infections
60
Clinical manifestations; brain abscess
- headache, disturbed consciousness, and fever
61
Zika
- RNA virus transmitted by specific mosquito bite
- usually asymptomatic
- fever, rash, jt pain, conjunctivitis
- affects fetus
62
- Prions disease
- genetic or acquired
- creutzfeld-joakob disease
- 50-80 years old
- cognitive impairment/confusion/movement disorders
- fatal
63
Degenerative CNS disorders
- ALS - amyotrophic lateral scleosis
- dementia
- huntington disease
- MS
- parkinson
64
ALS: classifications
- pseudobulbar
- progressive bulbar palsy
- primary lateral sclerosis
- progressive spinal muscular atrophy
| *bulbar = cranial nerve
65
ALS symtpoms
- depend on whether it is UMN or LMN
- typically musucle weakness and atrophy
- extremities affected first with progression to respiratory muscles
66
Types of dementia
- alzheimers disease
- lewy body dementia
- vascular dementia
- Frontotemportal disorder
67
# Dementia
Alzheimers disease
- memory loss
- language problems
- unpredictable behavior
- amyloid plaques
- tau tangles
68
# Dementia
Lewy Body Dementia
- difficulty with thinkng, movement, behavior, mood
- abnormal deposits of a protein (alpha-synuclein)
- affects acetylcholine and dopamine in the brain
69
# Dementia
- Vascular dementia
- disruption in blood flow
70
# Dementia
Frontotemporal disorder
- 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
Huntington disease
- progressive genetic disorder
- usually beginning in 30s-40s
72
# huntington's disease
signs and symtoms
- 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
Multiple sclerosis
| -what causes it, what occurs, when is it dx, and risk facotrs
- 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
Symptoms of MS`
- sensory
- motor
- bowel
- bladder
- affect
- coordintion
75
Treatment of MS
- disease modifying agents
- immunomodulating/immunosupressives
- monoclonal antibodies
- steriods
76
Parkinson disease
- degeneration of basal ganglia neurons
- stop producing dopamine (symptoms occur when it is down 70-80%)
- disrupts communication with cortex
- chronic, progresisve disease
77
hallmark traits of parkinsons
- rigidity
- tremor
- bradykinesia
- postural instability
78
risk factors for parkinsons
- genetic
- toxic or infectious exposures
