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PTH 606 Neuro disorders II > Exam 3 -TBI, concussion, basal ganglia, parkinson > Flashcards

Exam 3 -TBI, concussion, basal ganglia, parkinson Flashcards

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1
Q

Frontal lobe function and deficits

A

Function - emotional expression, thinking, problem solving, memory, language, personality

Deficits - ability to think, communicate, personality

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2
Q

Pre motor function and deficits

A

function - planning, spatial guidance

deficits - poor motor execution due to decreased planning

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3
Q

Prefrontal function and deficits

A

function - personality, decision making, social behavior

deficits - personality changes, poor decision making

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4
Q

Occipital lobe injury function and deficits

A

function - visual perception system, visuospatial processing, discrimination of movement and color

deficits - visual field deficits, scotomas (partial loss of vision), visual hallucinations/illusions

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5
Q

Thalamus function and deficits

A

function - relay center

deficits - sensory perception distortions

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6
Q

reticular formation function and deficits

A

function - maintain behavioral arousal and consciousness

deficits - irreversible coma

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7
Q

Temporal lobe function and deficits

A

function - sensory output into meanings for appropriate retention of visual memories, language comprehension, emotion association, auditory perception

deficits - speech, recalling visual stimuli, poor attention span, unable to recognize

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8
Q

Amygdala function and deficits

A

function - response and memory of emotions, especially fear, survival instinct

deficits - difficult with memory that is linked with emotion

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9
Q

hippocampus function and deficits

A

function - processing long term memory and emotional responses, behavioral inhibition

deficits - behavior, long term memory, emotional disturbances

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10
Q

What is the purpose of the CSF?

A
  • to surround and protect the brain
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11
Q

What are the 4 functions of the CSF?

A
  • protection: acts as cushion
  • buoyancy: reduces pressure at the base of the brain
  • excretion of waste products: one way flow from CSF to blood
  • endocrine medium for brain: transports hormones throughout brain
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12
Q

most TBIs that occur each year are what?

A

-75% concussions or other mild forms

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13
Q

TBI by age

A
  • kids 0-4 years
  • teens 15-19
  • adults 65+

= most likely to sustain one. over 75 y/o is highest rate of TBI related death.

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14
Q

TBI by gender

A

higher in males.

males aged 0-4 years have highest rates

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15
Q

What the the meninges?

A
  • a covering/protective layer of brain and spinal cord
Dura mater (superficial) "tough"
arachnoid - prevents permeability of toxins into brain.
pia mater (deep) - super thin
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16
Q

What layer of meninges prevents permeability of toxins into brain?

A

-arachnoid mater

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17
Q

gray matter vs white matter

A 
gray = cell bodies
white = axons
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18
Q

TBI - diffuse vs focal

A 
diffuse = axonal injury
focal = local injury
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19
Q

TBI - open vs closed

A
  • whether or not skull is fractured

- open = more risk of infection

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20
Q

TBI - high vs low velocity

A 
high = MVA
low = blow from blunt object or fall less than 6 feet
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21
Q

Glascow coma scale

A
  • 3-15 scale for acute brain injury
  • eye response, verbal response, motor response
  • lower score is worse.
  • mild, moderate, or severe
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22
Q

Pathophys of brain injury (flow chart thing)

A

injury to brain -> swelling or bleeding increase volume -> increases pressure -> causes blood flow to slow -> cerebral hypoxia and ischemia -> brain may herniate -> cerebral blood flow stops.

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23
Q

What is CT used to identify?

A
  • hematomas
  • ventricular enlargements
  • atrophy
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24
Q

What is MRI used to identify?

A

better at discriminating soft tissue trauma

-diffusion weighted imaging

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25
What is PET, SPECT, fMRI used for?
-can look at active areas and blood flow during a single activity
26
Subdural hematomas
- venous - brain starts to shrink after age 45, stretch or tear of bridging veins causes bleeding *watch ICP (nl=5-15 mmHg)
27
Epidural hematoma
- arterial - above dura - more deadly - progress a lot faster. - usually middle meningeal artery *watch ICP (nl=5-15 mmHg)
28
Subarachnoid hemorrhage
- acute bleeding under the arachnoid | - may occur spontaneously or as a result of trauma
29
Diffuse axonal injury - DAI
-widely scattered shearing of subcortical axons within their myelin sheaths. has cumulative effect.
30
if brain injury affects 3rd cranial nerve =
disruption of parasympathetic input | -"blown pupil????"
31
Anterograde amnesia
- unable to create new memories | - usually last to recover after coma
32
Post-traumatic amnesia
-cant remember events from injury to point of recovery
33
Retrograde amnesia
- inability to remember event prior to injury | - decreases with recovery
34
Decorticate rigidity
- corticospinal lesion at level of diencephalon - flexion of UE, ext of trunk and LE **flex UE up like praying they don't go to jail while in court.
35
Decerebrate rigidity
- cortical spinal lesion at level of brainstem - ext of trunk and all extremities (reminder of saying: **flex UE up like praying they don't go to jail while in court. = deCORTicate)
36
Emotional lability
- characteristic of R hemispheres lesion | - inability to control emotions with inappropriate laughing or crying
37
The chance of having a 2nd concussion after having one in an athlete is?
3-6 times greater chance of having another after having one
38
When to refer to ER after concussion
- any trouble with ABCs (airway, breathing, circulation) - unable, or unfamiliar with, assessing near function in all limbs - repeated vomiting - severe or worsening headache - seizure - unsteady gait - slurred speech - GCS
39
80-90% of concussions in adults will resolve in
7-10 days
40
return to play post concussion stages
``` 1-no activity 2- light aerobic 3 - sport-specific exercises 4- non-contract drills 5 - full contact practice 6- return to play ```
41
Pediatric Rancho scale
- levels 1-5 - level 1 is highest function - level 5 is no response.
42
Shaken baby syndrome
- 50% of the time it is from parents - age, median income, medicaid were strongly associated with occurrence ***Key sign = retinal hemorrhage. (bleeding in light sensitive area in back of eye)
43
Near Drowning
- survival for at least 24 hours following submersion incident - lose consciousness after 2 mins (child) - areas most susceptible to injury = CNS, kidney, heart. - good outcome (88%) if submerged for less than 6 mins. * *water temp not associated with outcome (time is)
44
Brain abscess (focal and multiple)
-microorganism reaches the brain tissue by a penetrating wound -Focal = impacted tooth Multiple = via bloodstream
45
Meningitis
-infection spread through CSF involving pia and arachnoid matters, subarachnoid space and the superficial layers of the brain and spinal cord.
46
Bacterial meningitis clinical features
- fever - severe headache - altered consciousness - convulsions - nuchal rigidity - blood cultures with inc protein and dec glucose level - memingism (triad): neck stiffness, photophobia, headache
47
Kernig's sign
- bend a knee up to 90/90 - ent knee - (+) = causes pain and restriction past 135 degrees
48
Brudzinski contralateral leg sign
- passive flexion of one extremity | - causes the opposite LE to have a reflex into flexion
49
Brudzinski neck sign
- passive flex neck | - reflexive flexion of hips and knees
50
Encephalitis
- inflammation of parenchyma and surrounding meninges | - viral (common)
51
seizures can be caused by?
-high fever, TBI, drugs, tumors, cardiac disorders, developmental disorders, metabolic
52
When is it considered epilepsy?
patient has 2 or more seizures
53
Epilepsy prognosis
- cannot be cured - most do not cause damage. If untreated it can - commonly have co-morbidities
54
Partial seizures - simple vs complex
simple = consciousness NOT impaired complex = conscious IS impaired
55
Generalized seizures
- indicate both hemispheres are initially involved | - consciousness is usually impaired
56
What is a ketogenic diet?
- high in fat - low in carbs - can help control seizures in some people
57
Function of basal ganglia
-purposeful motor activity -slow, sustained contractions -timing of movements -sequencing -resting/postural tone -problem solving -organizing behavior -procedural (motor) learning empathetic, socially appropriate behaviors
58
SMA function stuff
postural movement/learned automatic responses without visual input. (typing)
59
Premotor function stuff
-automatic experience which requires more coordination and visual input (throwing darts)
60
Limbic system main areas?
anterior cingulate cortex dorsal lateral prefrontal area orbitofrontal area
61
Anterior cingulate cortex
- part of limbic | - rationale cognitive functions, decision making, empathy and emotion, procedural learning
62
Dorsal lateral prefrontal areas
- part of limbic - integrating sensory - attention switching
63
Orbitofrontal areas
- part of limbic | - critical frontal region for memory formation
64
Parkinson's disease (what is it, and 4 signs)
-loss/decrease of dopamine neurons in SN (substantial nigra) =lose excitation on direct, and inhibition of indirect (increase inhibition of thalamus -> less movement) ****overactive indirect pathway - ***TRAP - Tremor - Rigidity - Akinesia/bradykinesia - postural instability
65
Huntington's disease (what does it do?)
- loss of indirect pathway (*overactive direct) - inhibits at level of GPe - degeneration of Striatum - loss of GABA secretion neurons. ****too much glutamate. Have excessive movements
66
Parkinson's vs Huntington's
PD = rigidity, resting tremor, bradykinesia/akinesia HD = involuntary mvmt, chorea, sensorimotor deficits, cognitive changes, psychiatric disorders
67
Hemiballismus
- injury to STN - decreased inhibition (indirect pathway) - **uncontrolled flinging (violent, uncontrolled mvmt) * * treat with dopamine antagonist
68
Pyramidal vs extrapyramidal signs and symptoms
Pyramidal - spasticity Extra - tramor, athetosis, dystonia, chorea
69
Hoehn and Yahr scale for parkinson's
Stage 1 = tremor, one side of body Stage 2 = both sides of body, "facial masking" Stage 3 = worse. problems with balance Stage 4 = need help with some or all ADLs Stage 5 = confined to w/c or bed. Need total assist.
70
What is the hallmark sign of parkinson's?
-bradykinesia
71
What is the gold standard to drug treatment in PD?
dopamine replacement. L-dopa/cabidopa (use dopamine agonists prior to using)
72
PD- anticholinergics help with treating
moderate tremor and dystonia only
73
LSVT LOUD - first and second half of session
- first = "ah" (sustained, high/low, phrases) | - second = core exercises
74
PWR Moves (4)
- posture (power up) - weight shift (power rock) - axial mobility (power twist) - transitions (power step)

PTH 606 Neuro disorders II (8 decks)

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