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BSNC 2000 > CNS Regulation > Flashcards

CNS Regulation Flashcards

(94 cards)

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1
Q

Four functional brain areas

A

Cerebrum
Diencephalon
Brainstem
Cerebellum

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2
Q

Diencephalon components

A

Thalamus

Hypothalamus

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3
Q

Brainstem components

A

Midbrain
Pons
Medulla Oblongata

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4
Q

Cerebrum function

A

thinking, consciousness
sensory perception
movement, emotions, memory

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5
Q

Cerebellum function

A

balance, muscle coordination, posture

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6
Q

Diencephalon function

A

sensory relay, emotions, alert mechanism, regulation of body temp, fluid balance, sleep, appetite

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7
Q

Brainstem function

A

conduction pathway between PNS and CNS

cardiac, respiratory, vasomotor control (medulla/pons)

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8
Q

Intracranial Pressure

A

sum of pressure within the intracranial cavity

brain tissue + blood + CSF

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9
Q

Layers of the meninges

A

Dura mater
Arachnoid
Pia mater

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10
Q

Blood Brain Barrier components

A

endothelial cells with tight junctions

astrocytes

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11
Q

Where is CSF located

A

within the subarachnoid space

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12
Q

Normal ICP

A

0-15 mm Hg

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13
Q

Pathological ICP

A

sustained at > equal to 20 mm Hg

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14
Q

Anterior Cerebral Artery blood Supply

A

medial surface of cerebrum

frontal, parietal lobes + prefrontal cortex

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15
Q

Middle Cerebral Artery Blood Supply

A

lateral surface of cerebrum
frontal, parietal, temporal lobes + basal nuclei
broca’s & wernicke’s area
delivers 80% of blood to brain

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16
Q

Brain Cellular Metabolism

A

Brain cannot engage in anaerobic metabolism so it requires a constant supply of O2
otherwise, lactic acid/pyruvic acid builds up lowering pH

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17
Q

Factors causing cerebral vasodilation

A

Low O2
Decreased pH (increase in lactic/pyruvic acid)
Increased CO2

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18
Q

FAST

A 
F = facial droop
A = arm drift
S = slurred speech
T = time
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19
Q

Types of Stroke

A

Ischemic

Hemorrhagic

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20
Q

Hemiplegia

A

one sided paralysis

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21
Q

Posterior Cerebral Artery blood supply

A

posterior surface of cerebrum

occipital lobe + medial/inferior temporal lobe

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22
Q

Penumbra

A

ischemic brain tissue surrounding a central necrotic core

penumbra represents salvable brain tissue during the evolution of as stroke

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23
Q

Time period before infarction

A

3 minutes

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24
Q

Modifiable Risk Factors

A 
Hypertension
Diabetes
Hyperlipidemia / Dyslipidemia 
Heart conditions (dysrhythmia, inflammation, heart failure)
Atherosclerosis 
Obstructive sleep apnea 
Alcoholism
Cocaine 
Smoking
Hormone Replace Therapy
Oral contraceptives
Injury
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25
Non-Modifiable Risk Factors
``` Age Gender Race (African-Americans) Family History/Genetics Stroke History ```
26
Common vessels of ischemic stroke
internal carotid arteries vertebral arteries basilar artery
27
Conditions for Thrombosis
``` Atrial fibrillation Valvular disorders Cardiogenic embolism Dilated left ventricle Atherosclerosis ```
28
Transient Ischemic Attacks
ischemic brain tissue without infarction symptoms same as stroke without long-term damage resolve within 24 hours elevated risk of stroke for next 3 months
29
Agnosia
inability to recognize familiar persons/objects
30
Ataxia
uncoordinated muscle activity
31
Apraxia
inability to perform learned, motor tasks
32
Dysarthria
inarticulate/slurred speech due to neuromuscular impairment
33
Agraphria
inability to write
34
Alexia
inability to understand written words
35
Hemiplegia
one sided paralysis
36
Homonymous Hemianopia
loss of half of one's vision field
37
Cerebral Perfusion Pressure equation
MAP - ICP
38
Medication management
anticoagulation reperfusion antiplatelet function neuroprotective function
39
Primary Motor Cortex location
Frontal Lobe before central sulcus
40
Somatosensory Cortex Location
Parietal lobe behind central sulcus
41
Broca's area
located in frontal lobe on the left side near motor cortex | involved in speech formation/articulation
42
Wernicke's area
located in temporal lobe on left side near auditory cortex | involved in language comprehension
43
Visual cortex location
located in occipital lobe
44
Auditory cortex location
located in temporal lobe
45
Gustatory cortex location
located in the insular lobe
46
Middle Cerebral Artery Homunculus
hand, arm, face
47
Anterior Cerebral Artery Homunculus
feet, legs | prefrontal cortex
48
Prefrontal cortex Function
higher-order thinking | reasoning, planning, decision-making, problem-solving
49
Hemiparesis
one-sided weakness
50
Metabolic demand of brain
20% oxygen 15% CO Adequate perfusion --> brain does not store glycogen or engage in anaerobic metabolism
51
Types of Ischemic Stroke
Thrombotic Embolus (fat, air bubble, traveling blood clot) Lacunar (very small strokes, small arteries) Watershed
52
Stroke Medication Treatment
thrombolytics | antithrombotics
53
tPA
thrombolytic aka tissue plasminogen activator dissolves fibrin fibers of blood clots used to treat ischemic strokes --> DO NOT USE for hemorrhagic stroke
54
tPA criteria
``` > 18 years old onset of stroke <4.5 hours ischemic stroke no bleeding conditions controlled HTN <185/110 normal glucose >50 mg/dL ```
55
Common causes of thrombi/emboli
``` cardiogenic emboli atrial fibrillation mitral valvular disease left ventricular thrombi carotid plaque right-left shunting polycythemia sickle cell disease ```
56
Alcohol and blood
risk factor for HTN hypercoaguability of blood decrease cerebral blood flow increase risk of atrial fibrillation
57
Lacunar Stroke
<15 mm wide affects smaller arteries located in the subcortical region
58
Types of Hemorrhagic Stroke
Intracerebral | Subarachnoid
59
Hemostasis Stages
1) Vascular Spasm 2) Platelet plug 3) Coagulation
60
Plasmin
enzyme that dissolves blood clots by breaking up fibrin
61
Plasmin chemical equation
tissue plasminogen activator (tPA) + plasminogen --> plasmin
62
Antithrombotic classes
anticoagulants | antiplatelet
63
Factors increasing ICP
increase in SpCO2 (causes vasodilation)
64
Dysphagia Liquid Thickening
Thin Mild (Nectar) Moderate (Honey) Extremely thick (Spoon)
65
Cushing's Triad
late signs of ICP bradycardia decreased respiratory rate increasing blood pressure
66
Frontal lobe function
emotional control center personality executive function, problem-solving, planning, behavior
67
Temporal lobe function
memory (hippocampus) learning hearing managing emotions, recognizing faces
68
Parietal lobe function
somatosensory sensation visuospatial processing math, spelling, hand-eye coordination, fine motor movement
69
Occipital lobe function
vision
70
S/S of Increased ICP
``` nausea/vomiting headache blurred vision cushing's triad widened pulse pressure ```
71
Ischemic Stroke Treatment
thrombolytics | endovascular thrombectomy
72
Hemorrhage Stroke Treatment
surgery | manage ICP
73
NIHSS Stroke
lower the score the better | national stroke assessment tool
74
tPA drug info
Onset: 30 min Peak: 60 min Half life: 35 min initial bolus dose then infusion
75
Hemorrhagic Stroke S/S
headache vomiting d/t increased ICP rapid onset
76
BP Management
extreme BP >220/120 should be treated by lowering 15% but not more than 25% over 24 hours
77
Hemorrhagic Stroke Diagnosis
CT scan | blood in CSF
78
How long can you prescribe antiplatelet and anticoagulants together
30 days
79
Antiplatelet drugs
aspirin | clopidogrel
80
Anticoagulant drugs
warfarin apixaban (XA drugs) heparin (prodrug)
81
Warfarin
anticoagulant mechanism: interferes with vitamin K synthesis, interrupt clotting cascade monitor for blooding frequent INR checks
82
Ischemic Stroke & A-fib
Anticoagulant
83
Ischemic Stroke & No A-fib
Antiplatelet
84
Anticoagulant mechanism
interrupts the coagulation cascade to prevent the formation of clotting factors
85
Antiplatelet mechanism
prevents platelet aggregation by interrupting the enzymatic cascade
86
Coagulation pathways
intrinsic (ends at factor 10) extrinsic (ends at factor 10) common (factor 10 --> thrombin)
87
Impaired CNS Regulation Mechanisms
``` Reduced Perfusion Altered Neurotransmission Insufficient Glucose Infection Degeneration Neoplasm Developmental defects ```
88
Arteriovenous malformation
capillary bed fails to form between arterioles and venules | blood shunts from arteries (high pressure) --> venules (low pressure) causing venules to expand/weaken
89
Somatic Sensation
touch pain temperature proprioception
90
Stroke Definition
brain tissue infarction secondary to ischemic or hemorrhagic damage. results in focal neurological deficits.
91
Virchow's Triad
three factors that predispose clot formation 1) hypercoagulability 2) blood stasis 3) endothelial injury
92
INR
used to monitor anticoagulant therapy measures intrinsic & common pathway of vitamin-k clotting factors therapeutic range = 1.5-2.5x normal
93
Origin of Embolic Stroke
atherosclerotic plaques in the internal carotid artery | left side of heart
94
GCS Scores
Mild 13-14 Moderate 6-12 Severe 5-8

BSNC 2000 (9 decks)

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