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Patho II > E3: acute adult neuro > Flashcards

E3: acute adult neuro Flashcards

(55 cards)

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1
Q

intracranial adaptive capacity

A

the ability of any of the 3 components of the brain to adapt to changes in size

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2
Q

increased intracranial pressure

A

increased pressure inside cranium, can lead to brain cell injury and death

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3
Q

brain cells are

A

voracious consumers of o2 and glucose

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4
Q

if the brain cells are deprived of o2 and glucose, what happens

A

irreversible damage in minutes

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5
Q

brain tissue %

A

80%

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6
Q

blood %

A

10%

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7
Q

CSF %

A

10%

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8
Q

cerebral perfusion pressure

A

required to perfuse brain cells

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9
Q

normal CPP

A

60-90 mm/hg

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10
Q

how much of the cardiac output does the brain require

A

15-20%

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11
Q

formula for CPP

A

CCP=MAP minus ICP

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12
Q

normal ICP

A

5-15 mm/Hg

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13
Q

etiology in increased ICP

A
  1. swelling of brain
  2. increased blood volume
  3. increased CSF
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14
Q

early clinical mani of increased ICP in LOC

A

confusion
restlessness
lethargy

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15
Q

late clinical mani of increased ICP in loc

A

loss of consciousness

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16
Q

early clinical mani of increased icp in pupil

A

subtle, sluggish reaction

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17
Q

late clinical mani of increased ICP in pupils

A

dialating, fixed

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18
Q

Cushing triad

A

late signs of VERY HIGH increased ICP

  1. widening pulse pressure (S increases, d decreases)
  2. bradycardia
  3. respirations decrease and are irregular
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19
Q

other signs of increased icp

A
  1. severe headache
  2. projectile vomiting
  3. seizures
  4. papilledema (edema of optic disc/nerve)
  5. altered motor function
    (extremity strength and movement,
    abnormal posturing
    -decorticate
    -decerebrate)
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20
Q

decorticate

A

abnormal flexion in increased ICP

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21
Q

decerebrate

A

abnormal extension in increased ICP

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22
Q

herniation of the brain

A
  • sever increased ICP
  • shifting of brain from one compartment to another
  • places pressure on cerebral blood vessels and vital centers (medulla)
  • death
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23
Q

traumatic brain injury (TBI)

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A

damaged brain tissue swells

24
Q

contrecoup

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A

injury on opposite side of brain in TBI

front of head hits, slams against cranium (coup), then flies back and hits back of cranium (contrecoup)

25
types of skull fracture
- linear - compound - depressed - basilar
26
what can happen with skull fracture
bleeding and CSF leak can happen | look for CSF out of the nose or ear
27
concussion
mild injury to head, reversible, some swelling
28
s/s of concussion
headache, confusion, difficulty concentrating
29
contusion
bruising of brain (worse than concussion)
30
s/s of contusion
same as concussion and may see s/s of increased ICP
31
epidural hematoma
1. bleeding between skull and dura (furthest out) 2. ARTERIAL bleed (meningeal artery) 3. medical emergency 4. bleeding compresses brain toward opposite side
32
subdural hematomas
1. bleeding between dura and arachnoid matter | 2. VENOUS bleed
33
s/s of subdural hematomas
same as increased ICP
34
types of subdural hematomas
1. acute 2. subacute 3. chronic
35
acute subdural hematoma time
symptoms within 48 hrs
36
subacute subdural hematoma time
symptoms 2 days-2 weeks (slow bleed)
37
chronic subdural hematoma time
symptoms 2 weeks-several months (very slow bleed)
38
subarachnoid hemorrhage (SAH)
- bleeding into subarachnoid space - ARTERIAL source - poor prognosis
39
clinical mani of subarachnoid hemorrhage
- increased ICP - blood mixing with CSG irritates meninges - --nuchal rigidity (stiff neck) - --photophobia (sensitivity to light) - --diplopia (double vison)
40
brain tumors
- benign or malignant - primary or metastasized (breast or lung) - occupies space (increased ICP, necrosis)
41
clinical mani of brain tumors
- headache (early) - seizures (early) - increased ICP
42
intracerebral hemorrhage
- farthest IN all four types of bleed - similar to SAH but further in - usually produces a hemorrhagic stroke - POOR PROGNOSIS
43
stroke etiology
rupture of cerebral artery or occlusion of cerebral artery
44
anoxia
lack of o2 and cerebral edema occurs in area of CVA
45
TIA
temporary interruption of arterial blood flow in the brain caused by platelet clumps OR blood vessel spasm (little stroke, warns of stroke, s/s gone in 24 hrs)
46
risk factors for stroke
- hypertension - heart failure - hyperlipidemia - diabetes - smoking - chronic A. fib without anticoag - obesity - physical inactivity
47
clinical mani of TIA
- blurred vision - slurred speech - weakness/numbness on one side of body - decreased LOC
48
occlusive stroke
cerebral thrombosis - mot common 85% - atherosclerosis of artery causes occlusion (clot) - leads to brain necrosis - scar tissue remains
49
hemorrhagic stroke
- sudden onset - blood vessels ruptures - bleeding into cranium - necrosis and scar tissue result
50
cerebral emoblus
- clot breaks loose (heart) travels to brain - occludes cerebral artery - causes tissue death - onset is sudden
51
clinical mani of stroke
- headache - dizziness - confusion - aphasia - symptoms of increased ICP - hemiparesis (paralysis) on opposite side of stroke
52
aphasia
change in speech- symptom of stroke
53
expressie aphasia
cant express self but can understand
54
receptive aphasia
cant receive messages
55
global aphasia
both expressive and receptive

Patho II (23 decks)

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