midterm Flashcards
(174 cards)
1
Q
which type of cells filter CSF out of blood
A
ependymal cells
2
Q
name the functions of the CSF
A
- protects the brain nervous system
- pH balance
- mechanicall cushin
- gravity/flotation
- nutrient/ waste exchange
3
Q
what is the normal volume of CSF and how much per hour
A
150 cc
20 cc per hour
4
Q
what is considered as a common neurological symptom
A
headaches
5
Q
T/F
benign headaches are not serious
A
False
it may also may be bad
6
Q
list the nerves that involved with headaches
A
V, IX, X and C1- C3
7
Q
List the vascular type of headaches
A
- classic migraine
- complicated migraine
- cluster headache
8
Q
Cervicogenic/ subluxation is classified as what type of headache?
A
tension
9
Q
what are some other type of headaches other than tension and vascular
A
intracranial pressure or inflammation
10
Q
young women comes in with unilateral severe throbbing, intolerance to noise and light and experiences an aura …. what type of headache would you diagnose?
A
classic migraine
11
Q
T/F
young women with unilateral serve throbbing, intolerance to noise and light, an aura and difficulty with vision … this indicates she is experiencing a classic migraine
A
False
complicated migraine
same signs and gender as classic except signs will also have neurological defects
12
Q
T/F
young women with unilateral serve throbbing, intolerance to noise and light, an aura and difficulty with vision … this indicates she is experiencing a classic migraine
A
False
complicated migraine
same signs and gender as classic except signs will also have neurological defects
13
Q
Middle aged man comes in office with an intense, stabbing, tearing pain behind one eye and pt describes headache that it lasts for a few minutes and goes away then comes back off and on ……. what type of headache would diagnose this pt
A
cluster headache
14
Q
what type of pain would a pt experience with a cervicogenic headache
A
most common ,,, sueezig sensation and describe as hat band bilateral
15
Q
Temporal Arteritis (giant cell) aka?
A
circumnodule arteritis
16
Q
Temporal Arteritis (giant cell) aka?
A
circumnodule arteritis
17
Q
what are the classic signs of temporal arteritis
A
elderly
- inflammation of temporal arteries
- superficial scalp pain
18
Q
what are the signs and symptoms of increased intracranial pressure
A
- cushing’s triad ( increase BP, decreased HR , arrhythmia/ respiratory
19
Q
what are the signs and symptoms of increased intracranial pressure
A
- cushing’s triad ( increase BP, decreased HR , arrhythmia/ respiratory
20
Q
what does contra coup mean in increased intracranial pressure
A
brain injury on opposite side of impact
21
Q
T/F
concussion trauma may lead to leaking blood into the brain with permanent neurological deficits
A
False
this is describing a contusion
22
Q
list the different types of intracranial hemmorage
A
- epidural
- subdural
- sub arachnoid
- intracerebral
23
Q
T/F
an edpidural hemmorage injury can have a sign of sheer force, or a trivial forgotten injury
A
False
this is from a subdural injury
epidural injury can be from a whiplash injury
24
Q
epidural bleeds occurs from what artery
A
meningeal artery
due to fracture of temporal artery
25
T/F
| subdural injury can overtime calcify
false
26
subdural bleeding can occur where
bridging veins
| between dura and arachnoid mater
27
subarachnoid injury occurs where
leaking of the basilar or anterior, medial or posterior cerebral artery
28
T/F
| subarachnoid injury can time of pain can lasts days to months
false
| time of pain is immediate
29
T/F
| subarachnoid injury can time of pain can lasts days to months
false
| time of pain is immediate
30
"worst headache ever" sign usually occurs in which intracranial hemmorage
subarachnoid
31
T/F
| epidural injury occurs deep within the brain
false
| this is intracerebral
32
which injury occurs with tiny distal arteries rupturing and the common signs are high BP and berry aneurysm
intracerebral hemmorage
33
increased intracranial pressure, herniation, Arnold Chiari malformation occurs in which type of patients
Adults with hydrocephalus
34
what obstructs CSF flow
Hydrocephalus
35
T/F
| METS is the most common malignant intracranial tumor
FAlse
| the most common is a Glioma with astrocytes the most common glioma
36
T/F
| Meninigioma is a benign tumor
True
37
T/F
| Meninigioma is a benign tumor
True
38
what is Bebinski's sign
tumour in the frontal lobe
39
T/F
| METS is the most common malignant intracranial tumor
False
| the most common is a Glioma with astrocytes the most common glioma
40
what is Bebinski's sign
tumour in the frontal lobe
41
what type of disease of spreads comes from deer ticks
Borella burdoferri
42
Lyme disease stages:
- stage 1
- stage 2
- stage 3
Stage 1 - target erythmeia migraines / located thigh, groin, axilla ( appears days to weeks after infection )
stage 2 - mild meningitis sign / unilateral facial paralysis
- weeks to months after infection
stage 3- chronic lyme arthritis--- bouts of pain and swelling in one or more in large joints (knees)
43
Lyme disease stages:
- stage 1
- stage 2
- stage 3
Stage 1 - target erythmeia migraines / located thigh, groin, axilla ( appears days to weeks after infection )
stage 2 - mild meningitis sign / unilateral facial paralysis
- weeks to months after infection
stage 3- chronic lyme arthritis--- bouts of pain and swelling in one or more in large joints (knees)
44
T/F
| Viral meningitis is considered fatal
False
45
Pain in every joint and muscle, CSF has no pus or bacteria and has normal glucose levels, patient feels bed then gets better, headache and low fever ... what is this i am describing
Viral Meningitis
46
Low fever, gradual over months , slow developing, rare, regional/ geographic predominance, leaves brain sandy (calcified cysts)
Fungal / parasitic
47
pus filled pocket, focal deficits, 100 % fatal with no treatment , 20-30% survive
Brain Abscess
48
Borelia burdoferris , deer tick , joint and muscle pain , target rash ( erythema migraines) slow developing meningioencephalitis
Lyme disease
49
Inflammation of the brain, severe headache, fever, depressed consciousness ( sleeps for days) ex- prions, west nile, elderly and immune compromised at risk for death
encephalitis
50
Kreutzfield jacob aka Mad cow, protein fragments get into brain , causes encephalitis
Prions
51
Kreutzfield jacob aka Mad cow, protein fragments get into brain , causes encephalitis
Prions
52
what is the most common cause of viral encephalitis
herpes simplex virus
53
Which encephalitis is associated with a slow progressive encephalitis associated with measles
subacute sclerosing panencephalitis
54
protein- based infections are called ____
prions
55
protein- based infections are called ____
prions
56
lists some signs and symptoms of creutzfeldt - jakob disease
- breakdown of nervous system
- rapid progressive dementia, ataxia, hallucination, startle response, myoclonus
- incubation period 2-25 years
- transmission from organ transplant
transmission from beef
- death occurs 6-12 months
57
decreased csf can be a cause of a cause from from
a bad spinal tap
58
can be a the result of a bad spinal tap
decreased csf - cause of low pressure headache, nervous system will shut down
59
list the different types of intracranial hemorrhage
- Epidural
- Subdural
- Subarachnoid
- intracerebral
60
Name this type of hemorrhage
- bleeding on the outside
- blood collects in the epidual space
- between dura mater and skull
- middle meningeal artery rupture
- blood does not contact the brain
Epidural
61
list the characteristics of subdural hematoma
- between the dura and arachnoid mater
- where the CSF is
- will find blood in the csf
- rupture of bridging veins
- Trauma - then headache that will get worst
62
list the characteristics of subarachnoid hematoma
- inside arachnoid mater
- explosive bad headache
- rupture of the cerebral artery - anterior/ middle/ posterior ( circle of willis)
- usually fatal
- headache subsides followed by loss of consciousness
- Berry aneurisms - causes subarachnoid hematoma- after a couple of days the next berry will appear
63
list the characteristics of subarachnoid hematoma
- inside arachnoid mater
- explosive bad headache
- rupture of the cerebral artery - anterior/ middle/ posterior ( circle of willis)
- usually fatal
- headache subsides followed by loss of consciousness
- Berry aneurisms - causes subarachnoid hematoma- after a couple of days the next berry will appear
64
_____ hemorrhage occurs deep within the brain most common symptom is high BP, diabetes and rupture of smallest of terminal branches
Intracranial
65
T/F
| Coup is injury ipsilateral
False
| coup is injury on same site
66
Contra - coupe is a ____ lobe injury
| impact in the ___ and injury at the ____
Frontal
- front
- back
67
Contra - coupe is a ____ lobe injury
| impact in the ___ and injury at the ____
Frontal
- front
- back
68
CSF is made by ____
ependymal cells
69
T/F
| CSF is more dense than H20
False
| it is less dense
70
What are the intracranial sensory nerves
V, IX, 5 ( 5,9,10) and C1- C3
71
Transient, neurological deficit - arm, leg
| what type of migraine is this
Complicated
72
Describe what an Atypical Migraine is
Pain in the opthalmic artery and blurry vision
73
Explain what Dissection is
it is a vascular headache that is damage to the tunica intima leads to blood flowing past into the false lumen. May also be a result in thrombus or embolism formation
74
what is the classic sign in Giant cell arteritis
is a superficial scalp pain --- inflammatory cells invade the tunica media
75
Temporal Arteritis is most common in what type of patients
Elderly patients
76
in increased intracranial pressure the neurological deficits follow :
1. compression
2. Destruction
3. Herniation
77
in increased intracranial pressure the neurological deficits follow :
1. compression
2. Destruction
3. Herniation
78
Increased Intracranial Pressure- Signs and symptoms
Cushing triad-
Global symptoms-
Focal symptoms-
- increases BP, Decrease HR , abnormal respiration
- cannot be pinpointed, headaches, changing levels of consciousness, personality changes
- can be tracked to one area of the brain ( lesion in left brain = right arm) - lack of peripheral vision = optic chiasm, papilledema
79
Increased Intracranial Pressure- Signs and symptoms
Cushing triad-
Global symptoms-
Focal symptoms-
- increases BP, Decrease HR , abnormal respiration
- cannot be pinpointed, headaches, changing levels of consciousness, personality changes
- can be tracked to one area of the brain ( lesion in left brain = right arm) - lack of peripheral vision = optic chiasm, papilledema
80
papilledema is engorgment and elevation of the __-__
optic disc
81
T/F
| 40% of tumor types are metastatic
False metastatic is 23%
| glioma
82
List the percentages of Tumor Types
23% metastic covers
40% glioma
17% meningioma
15% pituitary Tumor
83
List the percentages of Tumor Types
23% metastic covers
40% glioma
17% meningioma
15% pituitary Tumor
84
what are the characteristic for Hydrocephalus in Adults and Infants
Infants
- Head growth - frontal may bulge
- high pitched scream
- setting sun sign - eyes roll down
- Trans- illumination of skull - light shines through
Adults
- headache
- Changes in consciousness
- Papilledema
- could herniated cerebellum
85
Central Nervous System Infection spreads via _____
- blood
- CSF
- by bacteria, fungi , parasites
86
T/F
| infections occur in blood
False in CSF
87
List the Symptoms of a Central Nervous System Infection
- can be gradual - over months
- fever
- headache
- stiff neck
88
List the Symptoms of a Central Nervous System Infection
- can be gradual - over months
- fever
- headache
- stiff neck
89
What are the signs of Bacterial meningitis
- fever, headache, nuchal rigidity , photophobia
- decreases glucose- the bacteria feed on glucose
- positive- leagues and kernigs
90
What are the signs of Bacterial meningitis
- fever, headache, nuchal rigidity , photophobia
- decreases glucose- the bacteria feed on glucose
- positive- leagues and kernigs
91
T/F
| Viral meningitis is considered fatal
False
| CSF is normal
92
T/F
| Primary viral meningitis is hepatic rash
false
| that is secondary , primary is west nile
93
T/F
| Primary viral meningitis is hepatic rash
false
| that is secondary , primary is west nile
94
Corticospinal tract is _____
voluntary control of distal extremities
95
Pathway of the motor pathway
1. cerebral cortex
2. Basal Ganglia
3. Cerebellum
4. Pons
5. Medulla
6. brainstem
96
T/F
| Basal ganglia motor planning- smooth, unconscious co-ordination
False
| Cerebellum
97
The Corticobulbar tract begins ____
in the primary motor cortex
98
The corticobulbar tract projects to ____ where the ___ ___ are located
brainstem
| cranial nuclei
99
The autonomic system is always a ___ neuron pathway
2
100
in the autonomic system ....
neuron #1= ____ to ____ = ___
neuron #2 = in the ______ = ___
brainstem to spinal cord = UMN
| peripheral ganglia = LMN
101
in the autonomic system ....
neuron #1= ____ to ____ = ___
neuron #2 = in the ______ = ___
brainstem to spinal cord = UMN
| peripheral ganglia = LMN
102
Name the lateral tracts of the spinal cord
1. lateral corticospinal tract = voluntary movement of distal extremities
2. Rubrospinal tract = voluntary movement proximal extremities- hip/ shoulder
103
Name the lateral tracts of the spinal cord
1. lateral corticospinal tract = voluntary movement of distal extremities
2. Rubrospinal tract = voluntary movement proximal extremities- hip/ shoulder
104
Name the medial tracts of the spinal cord
1. Anterior corticospinal tract - Bilateral axial muscle
2. Vestibulospinal tract - position of head
3. Reticulospinal tract - posture and gait
4. Tectospinal tract - coordination of head eye movement
105
```
Parasympathetic effects
Eyes-
Digestion-
Heart-
Lungs-
Peripheral capillaries-
Skeletal muscle-
```
- constrict pupil & lens
- absorption
- slow HR, decrease SV, decrease BP
- Dilate
- divert blood away toward organ
106
T/F
| Parasympathetic has long post ganglionic and short pre- ganglionic
False
107
name the cranial nerves involved with parasympathetic
III, VII, IX, X
| sacral spinal cord
108
name the cranial nerves involved with parasympathetic
III, VII, IX, X
| sacral spinal cord
109
name the cranial nerves involved with parasympathetic
III, VII, IX, X
| sacral spinal cord
110
Sympathetic origin
thoracolumbar T1-L3 lateral horn
111
Sympathetic second neuron is ___
Ne
112
T/F
| Sympathetic short preganglionic is norepinephrine receptor
False
AcH
Long post ganglionic is Ne
113
From spinal cord to sympathetic chain = synapse at ___
same level
114
from spinal cord up or down the spine = synapse at ___
applicable level
115
from spinal cored through sympathetic chain = synapses at ____
prevertebral ganglia ( superior and inferior mesenteric )
116
From spinal cord go directly to adrenal gland
acts as a secondary motor neuron - it secretes Ne and Epinephrine into bloodstream
117
From spinal cord go directly to adrenal gland
acts as a secondary motor neuron - it secretes Ne and Epinephrine into bloodstream
118
Sympathetic effects
- reduces blood supply to GI organs
- Increases blood to skeletal muscles
- Increases HR
- Increases respiration rate
- Dilate Pupils
- Lens thinner for far visions
119
Sympathetic effects
- reduces blood supply to GI organs
- Increases blood to skeletal muscles
- Increases HR
- Increases respiration rate
- Dilate Pupils
- Lens thinner for far visions
120
Myenteric plexus (Auerbach) controls _______
Muscle contraction
121
Submucosal Plexus (Meisner) controls _____ and ____
- blood vessel size
| - secretory function
122
Explain what Hirschprung Disease is
During development the migrating cells of the myenteric and submucosal plexuses do not continue to the distal colon
- the distal colon can't relax/ contract properly to allow stool to pass
123
what does Hirscgprung Disease result in
constipation
124
what does Hirscgprung Disease result in
constipation
125
T/F
| Neurological weakness usually presents distally
True
126
T/F Neurological weakness is usually proximal - becomes distal with progression
False Muscular weakness is usually proximal
127
T/F Neurological weakness is usually proximal - becomes distal with progression
False Muscular weakness is usually proximal
128
Section of colon that does not have myenteric plexus
Hirschprung Disease
129
T/F
| Paresis is muscle weakness all over
False that is Paralysis
| paresis is weaker in one specific muscle
130
List the characteristics of an UMNL Lesion
- Brain and Sprinal Cord
- Weakness
- No muscle atrophe
- No Fasciculations (twitches)
- Increased reflexes
- Increased tone
131
List the characteristics of an LMNL lesion
- Peripheral nerves from the spinal cord
- weakness
- muscle atrophe
- fasciclations
- decreased or absent reflexes
- decreased tone
132
What are these terms
- Paresis
- Plegia
- Paralysis
- Palsy
- weakness
- total weakness
- total weakness
- unspecified weakness
133
Location of terms :
- Hemi
- Para
- Mono
- Di
- Quadra or tetra
- one side of the body
- Lower extremities
- One extremity
- two of the same
- all four extremities
134
Location of terms :
- Hemi
- Para
- Mono
- Di
- Quadra or tetra
- one side of the body
- Lower extremities
- One extremity
- two of the same
- all four extremities
135
____ gait caused by a lesion of the upper motor neuron due to stroke, MS, degeneration , cerebral palsy
Spastic
136
Name the characteristics of spastic gait
stiff leg circumduction with decreased arm swing, scissoring of legs, unsteady, falling forward on spastic side
137
AKA of Front gait
Gait apraxia
138
___ gait is caused by lesion of frontal lobe due to hydrocephalus, tumor , anterior cerebral artery infarct, white matter disorder
Frontal
139
Name the characteristics of frontal gait
- looks like pt is ice skating
- do not lift their legs
- slow shuffiling, narrow or wide based magnetic unsteady
- Pt can perform gait motion when lying
- supplemental motor area does not coordinate gait properly
140
_____ gait is Psychologically based , difficult to diagnose and despite unsteadiness and swaying patient does not fall
Functional gait disorder
141
Name the 3 Gait disorders
1. Spastic Gait
2. Frontal Gait ( aka gait apraxia)
3. Functional gait disorder
142
Name the 3 Gait disorders
1. Spastic Gait
2. Frontal Gait ( aka gait apraxia)
3. Functional gait disorder
143
Name the Patterns of weakness of a motor neuron lesion
1. proximal muscular dystrophy
2. Duchene is worst ( x chromosome disorder)
Gower sign ( no erector soinae strength )
144
Multpile Sclerosis is ______ of the CNS
demyelination
145
what is the classic sign of multiple sclerosis
- forst suspicion is 2 or more deficits separated anatomically and temporarily
146
List the definitive DX for MS
- based on MRI - bright white plaques -multiple bright scars
- decreased nerve coeducation
- oligoclonal bands ( immunoglobin) in the CSF
- Optic neuritis is the hallmark sign
147
Life expectancy for MS
25 - 35 years
148
what are the motor symptoms for MS
- weakness
- spasicity
- UMNL
149
Cerebellar signs of MS
- Nystagmus ( wobbly eyes)
- Ataxia - off be lance
- Dysarthria - difficulty speaking
150
Cerebellar signs of MS
- Nystagmus ( wobbly eyes)
- Ataxia - off be lance
- Dysarthria - difficulty speaking
151
Common Cranial nerve signs of MS
CN's V, VII, VIII- vision problems
152
Autonomic signs of MS
- Bowel Dysfunction
- Bladder Dysfunction
- Sexual Dysfunction
153
Name some Treatments for MS
- Anti - inflammatory diet - omega 3 fatty acids
| - Cool Baths - decreases signal dispersal
154
Name some Treatments for MS
- Anti - inflammatory diet - omega 3 fatty acids
| - Cool Baths - decreases signal dispersal
155
What is Lou Gehrig's disease
Amyotrophic lateral sclerosis ALS
156
What occurs in ALS (Lou Gehrig's disease)
Gradual degeneration of both upper and lower motor cell bodies
- leads to respiratory failure and death 3- 5 years ( phrenic n stops)
- Upper motor neuron lesion signs in lower extremity
- Lower motor neuron lesion signs in upper extremity
157
What is the first classic sign in ALS
Bulbar signs
158
what is Bulbar signs
- Dysarthria - difficulty speaking
- Dysphagia - difficulty swallowing
- respiratory weakness
159
What are some other DX based on the symptoms of ALS
- lead poisoning
- Dysproteinemia
- thyroid dysfunction
- Vit B12 Defieciency
- Vasculitis
- Neoplams
- Cervical Spne compression
160
Describe the differences of the two somatosensory pathways
| spinothalamic vs dorsal column
- spinothalamic = crude touch + pain + temp
161
Describe the differences of the two somatosensory pathways
| spinothalamic vs dorsal column
- spinothalamic = crude touch + pain + temp
| - dorsal columns= light touch + vibration + proprioception
162
T/F
| Posterior Dorsal Column= Medial lemniscal pathway
true
163
Posterior Dorsal Column Characteristics
- Large fibers = fast conduction - ipsilateral in spinal cord
- nucleus cuneatus and gracilis
- somatotropically higher levels add lateral
- signal ascends in the medial lemniscus
- thalamus
- posterior limb of internal capsule
- terminates in the sensory cortex
- also trigeminal lemniscus nucleus
164
- aplha delta fibers - fast conduction - specific projections
- sensation pf pain and temp
- discriminative pain - well localized
- temp sensation
- projects into intralaminar thalamus for distribution to cortex
Spinothalamic
165
Spinoreticular pathway characteristics
- Type C fibers - small , slow
- travels with spinothalamic tract
- terminates in reticular formation
- projects into intralaminar thalamus for distribution to cortex
166
In the Somatosensory Cortex... all _____ (___) ascend to parietal lobe
- thalamic
| - trigeminal
167
In the Somatosensory Cortex... all _____ (___) ascend to parietal lobe
- thalamic
| - trigeminal
168
_________ determines what the stimulus is
secondary somatosensory cortex
169
Anterior Spinothalamic terminates ____
in the reticular formation
170
Anterior Spinothalamic terminates ____
in the reticular formation
171
Spinal cord softening due to hemorrhage into cord or ischemia
Myelomalacia
172
T/F
| Myelomalacia is mainly caused by infections or Mutliple Sclerosis
False
| that is myelitis
173
Parietal lobe lesion is located ___ to side of sensory loss
- Contralateral
174
what occurs in a transverse cord lesion
- all function lost below level of lesion
| causes penetration trauma , MS , myelitis
