Ex1 / Ch5 Brain and Environs Flashcards
Ex1 (131 cards)
1
Q
3 cranial fossae
A
anterior
middle
posterior
2
Q
3 layers of meninges
A
- Dura
- Arachnoid
- Pia
3
Q
Cerebrospinal fluid: Made by
A
by ependymal cells in the 2 lateral ventricles
4
Q
CSF function
A
- mechanical protection (makes brain floating/absorb impact)
- Chemical protection (act as a buffer)
- nutrients waist transfer
5
Q
CSF Volume
A
150 cc
6
Q
CSF filtration rate
A
20 cc per Hour
7
Q
3 spaces (meninges)
A
epidural
subdural
subarachnoid
8
Q
_____ is a Common neurological symptom: benign, maybe bad
A
Headache
9
Q
Brain has nociceptors (true/false)
A
false
10
Q
which nerves are Intracranial sensory
A
V
IX
X
11
Q
Headeach + neck stiffness + fever =
A
meningitis
12
Q
Sudden explosive headache (worst headache ever) =
A
subarachnoid hemorrhage
13
Q
Types of headaches
A
Vascular
Inflammatory
Tension type
Increased ICP
Fatigue
Traumatic
Toxic/metabolic
Infectious
Referred
Low pressure
14
Q
Types of Vascular Headache
A
Migraine
Cluster
Dissection
15
Q
Migraine is most common in (men/women)?
A
women
16
Q
Type of migraine:
unilateral and throbbing, lasts a few hours, bright light and loud sound makes it worse, prodrome (aura)
A
Classic migraine
17
Q
Type of migraine:
same as classic + other neuro finding (blinding in 1 eye, tingling, weakness)
A
Complicated migraine
18
Q
Type of migraine:
doesn’t give a headache, causes nausea and other debilitating symptoms.
A
Atypical migraine
19
Q
Type of a vascular headaches:
middle aged men, unilateral behind 1 eye, last minutes, short and intense, alcohol and stress make it worse
A
Cluster
20
Q
Intracranial tumors causes
A
- increased ICP
- Focal deficit (also global deficit)
21
Q
Dissection (neurologic) causes damage to
A
the tunica intima
22
Q
Damage to the tunica intima leads to
A
blood flowing into the false lumen
23
Q
Dissection (neurologic) results in
A
thrombus or embolism formation at this site resulting in ischemia
24
Q
Tension Type Headache aka
A
Cervicogenic/ subluxation
25
Tension Caused by
dehydration
stress
psychological
26
Tension Described as
squeezing (hatband)
27
Fatigue Headache is related to:
sleep deprivation
eye strain
28
Causes of Toxic/Metabolic Headachea
1. dehydration (hangover)
2. chemical exposure
3. rebound (withdrawal ie: caffeine)
29
Cuases of Referred Headache
1. dental
2. eye strain
3. sinus irritation (frontal or maxillary sinus)
4. neck pain suboccipital
30
Inflammatory Headache (Temporal) aka
giant cell arteritis
31
Inflammatory Headache common in (who)
elderly patients
32
Inflammatory Headache risks
inflammation of temporal aa
ophthalmic aa
33
Inflammatory cells invade tunica \_\_\_\_
media
34
Fibrotic change results in the tunica \_\_\_\_\_
intima
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Fibrotic change due to Inflammatory Headache leads to the closur of the \_\_\_\_
lumen
36
Inflammatory Headache Signs and symptoms:
Swelling of the superficial temporal artery
Will be hard and palpable
Scalp pain
37
Causes of neurological deficits?
(Increased Intracranial Pressure)
1. compression
2. destruction
3. herniation
38
Increased Intracranial Pressure-
Signs and symptoms (Cushing triad)
**increase bp** (pressure in skull)
**decrease HR** (due to the coratid receptor, dorsal nucleus of vagus)
**irregular respiration**
39
Increased Intracranial Pressure- Global symptoms
headache
changes in mental status
40
Increased Intracranial Pressure - Focal symptoms
specific to the area of brain preforming that function
41
Def: optic disc gets swollen and puffy (due to increased ICP)
Papilledema
42
Nervous System Herniation Locations:
1. cingulate gyrus
2. inferior media temporal lobe
3. cerebellar tonsil
4. new opening
43
Hydrocephalus happens due to
obstructed CSF flow
44
Hydrocephalus symptoms (adults)
increased ICP
Dementia
Urinary incontinence
Gait impairment
loss of forward and back ward stability
45
Hydrocephalus symptoms (children)
**increased ICP**
**big head** (skull is not fused)
**setting sun sign** (rolling down eye)
**high pitch** scream
**poor head control** (weight of water)
**transillumination** (shine a light on one side, and be visible on the other)
46
Intracranial tumors causes
1. increased ICP
2. Focal deficit (also global deficit
47
What do benign tumors do to the surrounding tissue?
push the tissue away
48
What do malignant tumors do to the surrounding tissue?
invade the surrounding tissue
49
is the benign tumor encapsulated?
if yes, what is the capsule made of?
Yes, with fiber/calcium
50
is the malignant tumor encapsulated?
if yes, what is the capsule made of?
No
51
benign tumor growth rate
slow
52
malignant tumor growth rate
fast
53
Benign tumor recurrence
less likely
54
Malignant tumor recurrence
more likely
55
Tumor types
mets (metastatic)
glioma
meningioma (benign)
pituitary tumor
Schwannoma
56
metastatic precentage of all tumors
23%
57
glioma precentage of all tumors
40%
58
what's the ratio of benign to malignant glioma
1:1
59
meningioma precentage of all tumors
17%
60
is meningioma benign or malignant
benign
61
pituitary tumor percentage out of all tumors
5%
62
Schwannoma percentage out of all tumors
5%
63
Trauma injury sites
Linear impact coup
Rebound impact Contrecoup
64
Rotational Shear Damage
1. Rotational component of injury affect the lower parts of brain
2. Basal ganglia and thalamus
3. Corpus callosum
65
the Cause of concussion
Mild head trauma
66
concussion symptoms
loss of consciousness
headache
vomiting
amnesia
disorientation
seizure
focal neurological deficit
fatigue
67
concussion Signs
oculomotor difficulties
vistibulo-ocular disturbance
balance and postural instability
68
# Define:
Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)
computerized baseline compared to post injury
69
ImPACT measures
1. attention span
2. working memory
3. sustained and selective attention time
4. response variability
5. nonverbal problems solving
6. reaction time
70
SCAT5 characteristic
* **Sport concussion** assessment tool
* Has **immediate** on field assessment
* Also has office assessment
71
On field assessment includes
* Red flags
* Observable neurologic signs
* Memory assessment
* Glasgow coma scale and cervical examination
72
Off Field assessment includes
* History of injury
* Symptoms scale
* Cognitive assessment
* Neurological and balance exam
* Delayed recall – short term memory
* Decision making – problem solving
73
Guidelines for Concussion Management
1. removal from contest following signs and symptoms of concussion
2. no return to play in current game
3. medical evaluation following injury
4. rule out more serious intracranial pathology
74
Step wise to return to play
* No activity rest until asymptomatic
* Light aerobic excersise
* Sport specific training
* Non-contract drills
* Full contract drills
* Game play
Generally about 24 hours per step
75
Post Concussive Syndrome can last
days to weeks after injury
76
Post Concussive Syndrome
sign & symptoms
* Fatigue
* difficulty concentrating
* irritability
* light sensitivity
* noise sensitivity
* emotional lability
* dizziness
* headache
* neck pain
* nausea
* vomiting
77
Contusion aka
Traumatic Intracerebral or Intraparenchymal Hemorrhage
78
Epidural Hematoma location
between dura mater and skull
79
Epidural Hematoma gets worse over the course of (time)
hours (rapidly)
80
Epidural Hematoma complications
* Rupture of middle meningeal artery
* Lens shaped convex hematoma
* Rapid progressing
* Displaces brain tissue
* Leads to herniation
81
Subdural hematoma complication
* rupture of bridging veins, slower in developing
* Shear force tear of bridging veins
* Crescent shaped bleed
82
Acute Subdural hematoma
within 24 hours severe neurologic deficits, 50% mortality
83
Subacute Subdural hematoma
1-14 days post injury with focal neurologic deficits
84
Chronic Subdural hematoma
2-6 weeks after injury
headache
balance problems
weakness
85
the worst type of hematoma
Subarachnoid hematoma
86
Subarachnoid hematoma complications
* Often from aneurysm
* Ticking time bomb
* **Worst headache of my life**
* Congenital aneurysms
* Blood fills subarachnoid space
* 40-50% mortality
87
Intracerebral hematoma caused by
high bp
diabetes
small vessels
88
Hypertensive hemorrhage
* High blood pressure threatens deep penetrating arteriols
* form micro aneurysms
* The micro aneurysms harden
* Continued pressure causes them to rupture
* Happens in basel ganglia pons cerebellum
89
Laceration
tearing of nervous system
90
Central Nervous System Infection can be caused by:
bacteria
viral
parasitic
prions
91
CNS infections Spread via
blood
92
the most common Symptoms with infections in the CSF
fever (bacterial & viral)
neck stiffness
headache
93
Bacterial meningitis may be fatal within \_\_\_\_\_
Hours of onset
94
the most fatal bacteria that cuause meningitis
Neisseria meningitis
Strep. pneumonia
Haemophilus influenzae
95
Bacterial meningitis signs and symptoms
1. headache
2. fever
3. neck stiffness
4. CSF cloudy full of puss
96
Def Brain abscess
pocket full of puss in the brain
97
Brain Abscess symptoms
headache
fever
neck stiffness
neurological signs specific to that area
98
Chances of survival with treatment (percentage)
80%
99
Lyme Disease is caused by
borelia burdoferri
100
Lyme Disease is transmitted by
deer tick
101
Lyme Disease stage 1 timing
Days to weeks after infection
102
Lyme Disease stage 1 symptoms
* Muscle + joint pain
* Swollen lymph nodes
* erythema migrans (thigh, groin, axilla)
103
Lyme Disease Stage 2 timing
Weeks to months
104
Lyme Disease Stage 2 symptoms
* Unilateral facial paralysis
* **Mild meningitis**
105
Lyme Disease Stage 3 timing
Months to years after untreated infection
106
Lyme Disease Stage 3 symptoms
* **Chronic Lyme arthritis** (MC knee)
* Nervous system problems: memory loss and difficulty concentrating
* chronic pain in muscles and unrestful sleep
107
describe lyme disease target rash
: pimple surrounded with a red ring
108
Viral meningitis aka
aseptic meningitis
109
what's a special sign about viral meningitis
Clear CSF
110
Defince Encephalitis
viral infections that involve the brain parenchyma
111
is Encephalitis (more/less) severe than typical viral meningitis?
more severe
112
encephalitis results in
meningoencephalitis
113
exapmle of primary viral infection
west nile
114
west nile is transmitted by
mosquito
115
example of secondary viral infection
herpetic rash
116
Subacute sclerosing panencephalitis is caused by
persistent measles infection
117
Subacute sclerosing panencephalitis symptoms
* Intellectual deterioration
* Forgetfulness
* Hallucination
* Seizures
* Neurological signs through CNS
118
Subacute sclerosing panencephalitis prognosis
Variable prognosis (recovery to death)
119
Sleeping Sickness aka
African trypanosoma
120
Sleeping Sickness stage 1 symptoms
fever
joint pain
headache
121
Sleeping Sickness stage 2 symptoms
sleep/wake cycle disruption
confusion
ataxia
tremor
122
Cysticercosis is caused by
tenia solium
123
Cysticercosis symptoms
* Headache
* Nausea
* Vomiting
* seizure
124
what are prions?
protein fragments
125
Creutzfeldt-Jakob disease symptoms
rapid progressive dementia
ataxia
hallucination
startle response
myoclonus
126
Prions Incubation period
2-25 years
127
prions are tramitted from
from organ transplant
beef with BSE
128
prions prognosis
death within 6-12 months
129
prions infections are differentiated using
lumbar puncture
spinal tap
130
lumbar puncture is taken at which level?
L4/L5 (below the spinal cord)
131
Too much fluid drawn or too fast during the lumbar puncture is the cause of
low pressure headache
