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NSB Lectures > Global Brain Activity > Flashcards

Global Brain Activity Flashcards

1
Q

Does plasma and CSF have similar ionic compositions?

A

No. CSF - less protein + K+.
Similar Na+, HCO3- and osmolarity.

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2
Q

Is the osmolarity of plasma and CSF the same?

A

Yes

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3
Q

Does K+ directly affect the brain?

A

No, usually affects heart first then a secondary affect on brain.

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4
Q

Which ion is fundamental for osmolarity?

A

Na+

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5
Q

Which ions can affect the brain?

A

Na+, Ca2+, Mg+, P

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6
Q

What is the normal range for Na+?

A

135-145mmol/L

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7
Q

What happens to a cell in hyponatraemia?

A

Too much water outside of the cell with Na+, so water moves in + swells cell

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8
Q

How does hyponatraemia affect the brain?

A

Cells in brain swell due to water moving into cell to (cerebral oedema), which causes decreased blood flow and cerebral compression.

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9
Q

How does the brain compensate in acute hyponatraemia?

A

Shifts out CSF into systemic circulation, then pushes K+ out to try and also draw water out of cell.
It also pushes other molecules out to shift water + stop cells continuing to expand.

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10
Q

What is beer potomania?

A

Drink large amounts of beer cause dilutional hyponatraemia, no time for compensation mechanisms

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11
Q

What common anti-epileptic medication causes hyponatraemia?

A

Carbamazepine

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12
Q

What does it mean when the brain herniates?

A

Tissue is displaced in the brain to where it shouldn’t be

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13
Q

What are some common symptoms of cerebral oedema?

A

Nausea
Vomiting
Anorexia
Headaches
Lethargy
Disorientation
Muscle cramps

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14
Q

What are some common signs of cerebral oedema?

A

Seizures
Coma
Hyporeflexia
Cheyenne-stoking
Respiratory depression
Hypothermia

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15
Q

What system in the brain stem affects our consciousness level?

A

Reticular activating system

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16
Q

When treating chronic hyponatraemia, what should you be careful of?

A

Raising Na+ too quickly, can cause Central Pontine Myelinolysis (Osmotic Demyelination Syndrome)

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17
Q

If you over correct hyponatraemia, instead of drawing water out and having a normal sized cell, what happens to the cell?

A

It shrivels + damages the cytoskeleton.
Can also get demyelination

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18
Q

What can Central Pontine Myelinolysis cause?

A

Quadriplegia
Pseudobulbar Palsy
Seizures
Coma
Death

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19
Q

What happens to a cell in hypernatraemia?

A

Too little water outside cell, water moves out of cell + cell shrinks

20
Q

How does hypernatraemia affect the brain?

A

Cells shrink which can cause haemorrhage from tears in veins or arteries

21
Q

How does the brain compensate in hypernatraemia?

A

Uptake K+ into cell
Uptake of osmolytes into cells (glutamine, glutamate + taurine) which are protective against cell damage

22
Q

What can an overcorrection of hypernatraemia cause?

A

Cerebral oedema

23
Q

What is the normal serum pH?

A

7.35-7.45

24
Q

What respiratory mechanism helps correct a metabolic disorder?

A

Increase or decrease in ventilation

25
Q

Can Co2 cross the BBB?

A

Yes

26
Q

How does Co2 affect cerebral blood flow?

A

Co2 regulates cerebral blood flow.
More Co2 = more blood flow
Less Co2 = less blood flow

27
Q

Would hyperventilation cause acidosis or alkalosis?

A

alkalosis

28
Q

Would hypoventilation cause acidosis or alkalosis?

A

Acidosis

29
Q

What are some symptoms as a result of hyperventilation?

A

Lightheadedness
Syncope
Seizures
Hypocalcaemia

30
Q

What are some symptoms as a result of hypoventilation?

A

Morning headaches
Visual disturbances
Confusion

31
Q
A
32
Q

How is a pneumocephalogram done?

A

Inject air into spinal cord via lumbar puncture + then rotate patient.

33
Q
A
34
Q
A
35
Q

What do you need to change when looking at CT images, in order to look at different components of the brain?

A

Grey scale

36
Q

What are some benefits to CT scans?

A

Quick
Metal compatible
Cheap

37
Q

What are some downsides to CT scans?

A

Low resolution especially in the posterior fossa
Radiation

38
Q

Is an MRI high or low resolution?

A

High

39
Q

What are some pro’s of MRI’s?

A

Detailed
Wide range of imaging possibilities
No ionising radiation

40
Q

What are some cons of MRI’s?

A

Metal can be a problem e.g. PPM
Claustrophobia
Time consuming (prone to motion artefact)
Loud
Can heat up body

41
Q

What is an fMRI?

A

Functional MRI
Brain requires glucose to be transported in, causing arterioles to dilate.
Measures characteristic difference of deoxy-Hb + oxy-Hb, indirectly measuring neuronal activity based on vascular response.
Poor spatial and temporal resolution.

42
Q

What is meant by default mode network?

A

Activity of the brain when doing nothing. Consists of the medial prefrontal cortex, medial parietal cortex and medial temporal lobes.
Can be affected by ADHA, schizophrenia, autism + Alzheimers.

43
Q

What does nuclear medicine involve?

A

Radioactive isotope attached to a drug that can bind to an area of interest.
Radioactive emissions are measured and imaged with a gamma camera.
PET (Positron Emission Tomography); Inject with radioactive substance emitting positrons. Positrons collide with tissue electrons, emitting gamma rays in opposite directions.

44
Q

When might a PET scan be used?

A

Pre-surgical assessment of complex seizures where MR normal
Evaluate memory loss + differentiate types of dementia

45
Q

What is a SPECT?

A

Single Photon Emission Computed Tomography
2D images from multiple angles, reconstructed into 3D. Can use isotopes with single gamma ray.
Worse spatial resolution + more radiation than PET (but cheaper)

46
Q

What scan is most common to determine whether tremors are from Parkinsons?

A

DaTscan - Dopamine Transporter to ioflupane 123

NSB Lectures (48 decks)

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