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PT 680 Clinical Medicine > Intro to CNS Disorders > Flashcards

Intro to CNS Disorders Flashcards

(70 cards)

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1
Q

what does the CNS control

A

behavior, thought, motor function

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2
Q

changes in ____ in the nucleus of the cell body alters gene expression resulting in abnormal production of harmful proteins that make the CNS more vulnerable to disease

A

DNA

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3
Q

give examples of how DNA can be altered, causing CNS disease

A
  • genetic predisposition
  • toxicity due to drug/alcohol abuse
  • environmental triggers
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4
Q

tissue death that occurs with severe injury or disease

A

necrosis

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5
Q

sets off cascade of inflammatory actions; leads to excitoxicity and release or free radicals; contributes to damage of surrounding tissues; cell is destroyed (membranes and structures)

A

necrosis

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6
Q

genetically programmed degradation of DNA

A

apoptosis

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7
Q

seen in development as neuronal pruning; does not lead to inflammatory action; may be triggered by free radicals resulting in cell death; may be pathologic (cancer cells); cell membranes generally intact

A

apoptosis

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8
Q

what are the two types of glial cell

A

macroglia and microglia

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9
Q

give examples of macroglia cells

A

astrocytes, oligodendrocytes, schwann cells

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10
Q

the connective tissue of CNS; support and maintain neuronal plasticity; most populous in CNS

A

macroglia cells

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11
Q

most numerous on all CNS cells (supporting cells)

A

astrocytes

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12
Q

associated with CNS deymylemination and what is a disease example

A

olgiodendrocytes
MS

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13
Q

associated with PNS demyelination and what is a disease example

A

schwann cells
diabetic peripheral neuropathy

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14
Q

the immune system of the CNS; 10% of glial population; respond when CNS tissue is damaged; act as phagocytes and can trigger astrocytes

A

microglia cells

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15
Q

when microglia are triggered, what s/s do they produce

A

fever, sleep, decreased appetite, lethargy, swelling

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16
Q

are usually transient, but aging cells are not deactivated by apoptosis and may contribute to pathogenesis of neurologic disease

A

microglia

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17
Q

made of epithelial cells that form a tight matrix that block diffusion between cells

A

blood brain barrier

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18
Q

how does glucose and amino acids cross the blood brain barrier

A

protein transport

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19
Q

give some examples of pathogens that are able to penetrate the blood brain barrier and lead to disease

A

meningitis
encephalitis
some metabolic disorders

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20
Q

cells that line the ventricles and spinal canal; produce CSF

A

ependymal cells

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21
Q

what can ependymal cells be implicated by

A

infectious diseases
stroke
TBI

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22
Q

shunt that drains CSF from the ventricles to the perineum (gut) to decrease ICP

A

ventriculoperitoneal shunt

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23
Q

what are the 3 main ways axons can be injured

A

shearing, compression, traction

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24
Q

damage to axons that occurs in TBI due to shearing forces during coup-countercoup injury (due to increased velocity)

A

diffuse axonal injury (DAI)

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25
traction on a peripheral N that causes degeneration of the distal end of axon
wallerian degeneration
26
amines
serotonin, dopamine, acetycholine, norepinephrine
27
amino acids
GABA, glycine, glutamate
28
neuroactive peptides
enkephalins, endorphins, substance P
29
gaseous neurotransmitters
nitrous oxide, carbon monoxide
30
how can pathology develop due to neurotransmitters
- changes in the synthesis/availability of neurotransmitters - changes in target cells can cause abnormal responses to normal levels of transmitters
31
nerve growth factor, BDNF, and other _______ contribute to maintenance and survival functions of neurons known as ______
neurotrophic factors neuroprotective
32
best way to increase neurotrophic factors
aerobic exercise
33
aging
senescene
34
nerve conduction velocity decreases by 15% in myelinated fibers by
8th decade (80 y/o)
35
what can develop in the brain with aging
neurotic plaques, glial scar tissue, neurofibrillary tangles
36
by how much does blood supply decrease to brain with aging and what does this mean
10-15% decreased glucose and decreased brain metabolism
37
changes in PNS associated with age
diminished vestibular, vision, and somatosensation
38
changes in ANS due to age
decreased ANS reactivity alterations in BP, RR, HR, blood flow, organ function
39
by 60 y/o, we lose what percent of hair cells in vestibular system
40%
40
neurological disorders associated with age
muscular dystrophy down syndrome parkinson's alzheimer's
41
neurological disorders associated with race/ethnicity
tay-sachs neural tube defects
42
neurological disorders associated with genetic history
duchenne's muscular dystrophy huntington's chorea spinal muscle atrophy
43
neurological disorders associated with familial history
DM charcot marie tooth
44
CT markers placed for tracking dopamine uptake
DaTScan
45
used to identify disruption of white matter
diffusion tensor imaging
46
evaluates function of CN 8 - auditory component and integrity of brainstem in coma
brainstem auditory evoked potentials (BAEP)
47
determines O2 saturation in brain tissue
near-infrared spectroscopy
48
how/where is CSF analysis taken
- via percutaneous puncture in subarachnoid space - between L3-4 or L4-5
49
why would a CSF analysis be performed
- evaluate inflammatory diseases of CSF - rule out CNS infection - confirm otherwise undiagnosed CNS conditions
50
what does pink/clear/yellow/cloudy CSF each indicate
clear = normal yellow = old RBC pink = active bleeding cloudy = infection
51
example of diseases for evaluation of CSF
meningitis, encephalitis, MS, parasitic/fungal infections, rabies, syphyilis
52
when is CSF analysis contraindicated
ICP is elevated or presence of focal neurologic signs --> brain would leak into back
53
evaluates changes in glucose, proteins, WBC, or identified bacteria in blood samples which may indicated infectious pathologies
CBC and diff, cytology, bacteriology
54
most common ordered lab test; provides info on size, availability, # of blood cells in peripheral circulation; ratio of RBC, WBC, plasma
CBC
55
measures relative volume of RBC's; quick screen of anemia/polycythemia
hematocrit
56
normal hematocrit values for M and F
M 42-52% F 37-47%
57
measures oxygen carrying capacity of RBC
hemaglobin
58
normal hemoglobin levels for M and F
M: 14-18 F: 12-16
59
____ level changes cause brain/nerve tissue to shrink/swell which may alter consciousness, induce coma, or intracranial hemorrhage
sodium
60
must have ____ and ____ levels WNL for neuromuscular transmission of action potentials
potassium and calcium
61
high or low levels of _____ may result in diabetic ketoacidosis, insulin shock, or diabetic coma
glucose
62
normal adult values and critical values for sodium, potassium, calcium, fasting glucose
- Sodium: 134-142; 110 - Potassium: 3.7-5.1; <3.2 or >5.1 - Calcium: 8.6-10.3; <7 = tetany; >12 = coma - Fasting Glucose: 70-100; over 60 y/o 90-130
63
sedative-hypnotic drugs and side effects they can cause
barbituates, benzodiazepines - drowsiness, changes in motor performance the next day, antegrade anmesia, physical dependance, sleeping while driving, GI discomfort
64
anti-anxiety, anti-depressant, affective disorder drugs and side effects they can cause
xanax, buspar, ativan, klonopin, elavil, cymbalta, prozac - dizziness, HA, nausea, drowsiness, addiction, abuse, orthostatic hypotension, cardiac arrhythmias, seizures
65
anti-epiletic drugs and aide effects they can cause
pehnobartial, valium, ativan, tegretol, neurontin (gabapentin) - usually take across the lifespan - withdrawal has to be gradual and controlled by physician
66
anti-coagulation medications (stoke) and side effects
coumadin, herparin, asprin (ASA) - hemorrhage most common negative effect, easily bruised
67
drugs to tx: parkinsons seizures/spasticity spasticity and side effects
- PD: levadopa/sinemet - Seizures/spasticity: neurontin/gabapentin - Spasticity: balcofen sedation, dizziness, nausea, ataxia, fatigue
68
initial period of neural shock and disruption of neural connectivity in undamaged areas of brain due to connection to damaged portions of brain
diaschisis
69
cortical reorganization via collateral sprouting; regenerative synaptogenesis via pharmacological, novel tasks, and aerobic activity
neuroplasticity
70
3 main interventions to help improve neuroprotection
exercise diet sleep

PT 680 Clinical Medicine (18 decks)

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