FINAL Flashcards
(183 cards)
what are meningitis signs?
HA photophobia neck stiffness Brudzinski’s sign Kernig’s sign
what are signs of intra cranial pressure signs?
- CUSHING TRIAD (hypertension + bradycardia + abnormal respiration)
-projectile vomiting
-unilatral change of sensation a/o muscle weakness
-severe HA, uneven pupils
as mental status is declined
neurological examination includes?
- identification of mental status
- cranial nerves
- muscle strength
- gait
- stance
- coordination
- dermatomes
- spinal reflexes
- comparison of pulses (central and peripheral
pupillary and accommodation reflex
sensory CN 2 / optic
motor CN 3 / oculomotor - constrict pupil and lense accommodation for near vision (consensual reflex)
corneal reflex
sensory CN 5 /trigeminal - feeling that cornea is being touched
motor CN 7 / facial - blinking
gag reflex
sensory CN 9 / glossopharagneal
motor CN 10 / vagus - gagging
what are two major arteries, as the branches of the brachia-cephalic aortic trunk on both sides, that serves as origin of circle of willis?
vertebral and common carotid
which part of circle of willis supply blood to occipital lobes of cerebrum, brain stem, cerebellum? and what are these areas of brain responsible for?
posterior cerebral arteries
for vision, vital centers, and maintenance of equilibrium (respectively)
which part of circle of willis is responsible for supplying lateral parts of cerebrum?
what are these areas of brain responsible for?
*middle cerebral arteries
brain cortex are responsible for functioning of upper part of trunk and upper extremities + speech
what is most commonly affected arteries in stroke (CVA)?
middle cerebral arteries
why does fracture or other types of injuries to the face (eye, nose) may compromise brain circulation?
because internal carotid arteries, which are origin of middle cerebral arteries, climb to the circle of willis via the cavernous sinuses
which part of circle of willis is responsible for supplying blood to superior parts of the brain and the diencephalon? and injury to this reflects?
anterior cerebral arteries
reflected on dysfunction of lower trunk/lower extremities and diencephalon
what are 2 types of stroke or cerebra-vascular accident (CVA)? what percentages do they make up?
ischemic (embolic) - 90%
hemorrhagic
major etiology of ischemic stroke is?
systemic arterial hypertension + atherosclerosis and thrombosis
*usually from heart –> brain
[different from DVT, leg –> Lung]
major etiology of hemorrhagic stroke
malignant arterial hypertensions associated with aneurysm within circle of willis (for ex ADPKD) or trauma
in which neuron injury, will you see exaggerated spinal reflexes? what other signs will you see in this injury?
upper motor nuron (bc brain damage, spinal loop…)
- Baginski’s reflex present
- spastic muscle on affected (central-lateral) side
- muscle fasciculation (isolated muscle contraction)
in lower motor neuron injury, you will see?
- spinal reflex diminished or absent
- weakness of muscle on contra-lateral side of body
upper motor neurons are presented by what?
motor area neurons of brain and cortico-spinal (pyramidal) tract, composed of their axons before they synapse with LMN, situated in ventral horns of spinal cord.
which is the “Talk or Die” hemorrhage? why is it called this?
-where is it an injury to?
epidural (extra-dura) hemorrhage/hematoma
- trauma to meningeal arteries, which are superficially locked in grooves of skull above dura
- person will lose consciousness briefly due to shaking of reticular formation of brain stem, then gain consciousness for a short while and again lose consciousness due to accumulation of hematoma and herniation of brain as result of blood clot gravity
injured veins of brain within subdural space (also called the bridging veins) causes, what type of hemorrhage?
what are red flags for this condition
subdural hemorrhage
bridging veins have low pressure, the hemorrhage, originated from them could be acute, sub-acute, or even chronic.
RED FLAG - patient present with chronic increasing in severity HA
the “worse HA of one’s life” can result from which brain hemorrhage?
causes?
subarachnoid hemorrhage
can be trauma or spontaneous bleeding from circle of willis arteries and their branches (stroke, aneurysm rupture)
what is hydrocephalus, it can result in?
accumulation of cerebra-spinal fluid within system of circulation
regardless of etiology, can result in motor, sensory deficit, demential in adults, and neurological/mental retardation in newborn
what is non-communicating hydrocephalus?\most common in?
due to obstruction as per blockages such as adhesions, malformation of CSF system
- congenital malformation (rebulla during pregnancy, fetal irradiation), or adhesion due to meningitis or menage-encepalitis
what is communicating hydrocephalus?
most common in?
atrophy of arachnoid granulations (villi) of arachnoid membrane (meninx)
-geriatrics
arachnoid villa returns CSF to venous sinus