Nervous System Flashcards
(186 cards)
1
Q
Cerebello/o
A
cerebellum
2
Q
Cerebr/o
A
cerebrum
3
Q
Dur/o
A
dura mater
4
Q
Encephal/o
A
brain
5
Q
Gli/o
A
glial cells
6
Q
Lept/o
A
thin, slender
7
Q
Mening/o Meningi/o
A
membranes, meninges
8
Q
My/o
A
muscle
9
Q
Myel/o
A
spinal cord, means bone marrow in other contexts
10
Q
Neur/o
A
nerve
11
Q
Pont/o
A
pons
12
Q
Radicul/o
A
nerve root (of spinal nerves)
13
Q
Thalam/o
A
thalamus
14
Q
Thec/o
A
sheath (refers to the meninges)
15
Q
Vag/o
A
vagus nerve (CN X)
16
Q
Alges/o
A
excessive sensitivity to pain
17
Q
-algesia
A
excessive sensitivity to pain
18
Q
-algia
A
pain
19
Q
Caus/o
A
burning
20
Q
Comat/o
A
deep sleep (coma)
21
Q
Esthesi/o
A
feeling, nervous sensation
22
Q
-esthesia
A
feeling, nervous sensation
23
Q
Kines/o Kinsesi/o
A
movement
24
Q
-kinesia -kinesis -kinetic
A
movement
25
-lepsy
seizure
26
Lex/o
word, phrase
27
-paresis
weakness
28
-phasia
speech
29
-plegia
paralysis (loss or impairment of the ability to move parts of the body)
30
-praxia
action
31
-sthenia
strength
32
Syncop/o
to cut off, cut short
33
Tax/o
order, coordination
34
Afferent nerve
carries message toward the brain (sensory)
35
Efferent nerve
carries message away from the brain (motor)
36
Arachnoid membrane
middle layer of the three membranes (meninges) that surround the brain and spinal cord
37
Astrocyte
type of glial cell that transports water and salts from capillaries
38
Autonomic nervous system (ANS)
nerves that control involuntary body functions
39
Blood-brain barrier
protective separation between the blood and brain cells, made up of endothelial cells and astrocytes
40
Cerebellum
posterior part of the brain that coordinates muscle movements and maintains balance
41
Cerebral cortex
outer region of the cerebrum containing sheets of nerve cells; gray matter of the brain
42
Cerebrum
Largest part of the brain; responsible for voluntary muscular activity, vision, speech, taste, hearing, thought, and memory
43
Dendrite
Microscopic branching fiber of a nerve cell that is the first part to receive the nervous impulse
44
Dura mater
Thick, outermost layer of the meninges, surrounding and protecting the brain/spinal cord
45
Ependymal cell
Glial cell that lines membranes within the brain and spinal cord and helps to form CSF
46
Glial cell
supportive and connective nerve cell that does not carry nervous impulses; they CAN reproduce. (ex. astrocytes, ependymal cells)
47
Gyrus (pl. gyri)
sheet of nerve cells that produces a rounded ridge on the surface of the cerebral cortex (convolution)
48
Hypothalamus
portion of the brain beneath the thalamus; controls sleep, appetite, body temp, emotions, and secretions from the pituitary
49
Medulla oblongata
Part of the brain just above the spinal cord; controls breathing, heartbeat, and the size of blood vessels (Life center). Site of nerve fiber crossover.
50
Microglial cell
phagocytic glial cell that removes waste products from the CNS
51
Oligodendroglial cell (oligodendrocyte)
Glial cell that forms the myelin sheath covering axons
52
Parasympathetic nerve
Involuntary autonomic nerves that balance sympathetic stimulation; lower heart rate & bp, stimulate intestinal contractions
53
Parenchyma
essential, distinguishing tissue of any organ or system. Parenchyma of nervous system includes neurons & nerves
54
Pia mater
thin, delicate inner membrane of the meninges
55
Pons
part of the brain anterior to the cerebellum and between the medulla and the rest of the midbrain; a bridge connecting various parts
56
Sciatic nerve
nerve extending from the base of the spine through the thigh, lower leg and foot.
57
Spinal nerves
31 pairs of nerves arising from the spinal cord
58
Stroma
connective and supporting tissue of an organ, glial cells are the stromal tissue of the brain
59
Sympathetic nerves
stimulate body involuntarily in times of crisis; increase heart rate & bp, dilate airways, slow digestion
60
Thalamus
Main relay center of the brain; conducts impulses between the spinal cord and the cerebrum, control of awareness and consciousness
61
Vagus nerve
CN X; it's branches reach the larynx, trachea, bronchi, lungs, aorta, esophagus & stomach.
62
Ventricles of the brain
Canals in the brain that contain CSF
63
Hydrocephalus
-abnormal accumulation of CSF in the brain, enlarged head & small face -ventriculoperitoneal shunt is placed to remove pressure on brain -can occur as an adult from infection or tumors
64
Spina bifida
-incomplete closure of the lumbar vertebral column during embryogenesis resulting in exposure of meninges & spinal cord -different types; occulta (posterior vertebrae have not fused, mole dimple or patch of hair over area), cystica w/ meningocele (external protruding sac containing meninges & CSF), cystica w/ myelomeningocele (external protruding sac w/ meninges, CSF & spinal cord, often associated w/ paralysis & hydrocephalus) -Spina bifida is just one type of neural tube defect (congenital anomaly of nervous system occurring during first 4 weeks of gestation), folic acid deficiency is strongly associated w/ these
65
Alzheimer's disease (AD)
-chronic disorder that accounts for \>50% of dementia cases, usually in persons \>65yo -progressive impairment of intellectual function, may compromise language and memory, visuospatial skill, behavior and personality & cognition -unknown cause, but associated w/ plaques and neurofibrillary tangles w/ amyloid deposits -signs/symptoms; short term memory loss, loss of expression, aphasia (language comprehension difficulties), problem-solving difficulties, thought disorders, difficulties w/ ADLs, problems w/ concentration, social withdrawal
66
Amyotrophic lateral sclerosis (ALS/Lou Gehrig disease)
-degenerative disease which affects the upper & lower motor neurons -signs/symtoms; unexplained weight loss, focal wasting of muscle groups, limb weakness w/ variable symmetry & distribution, difficulty walking, difficulty swallowing, slurring of speech, inability to control affect, atrophy, fasciculations (small muscle twitches), hyperactive deep tension reflexes, SPARES COGNITIVE, OCULOMOTOR, SENSORY & AUTONOMIC FUNCTIONS
67
Epilepsy
-chronic brain disorder characterized by recurrent seizure activity; mostly idiopathic. -seizure; abnormal paroxysmal neuronal discharge of the brain, which may cause a transient disturbance of cerebral function, may be partial (limited to part of a cerebral hemisphere; simple & complex seizures) or generalized (petit mal/absence, febrile, tonic-clonic/grand mal, or status epilepticus). Complex partial is most common, followed by tonic-clonic. -Pt's often have weakness & confusion post-seizures (postictal) -May have Todd's paralysis, contralateral postictal paralysis & persistent weakness
68
Huntington disease (Huntington chorea)
-autosomal dominant disorder on chromosome 4 characterized by dementia and chorea; gradual onset & slow progress -symptoms generally appear after 30yo; chorea (abnormal, involuntary muscle movement), dysphagia, dysarthria, impaired recent memory, impaired judgement, intellectual decline, emotional disturbances, depression, anxiety, delusion, aggressiveness, urinary incontinence, bowel incontinence... -no cure & diagnosis is often after pt has reproduced
69
Multiple sclerosis (MS)
-inflammatory, progressive demyelination of the white matter of the brain and spinal cord resulting in multiple neurological signs and symptoms -unknown cause, pt usually
70
Myasthenia gravis (MG)
-autoimmune disorder of neuromuscular junction resulting in a pure motor syndrome (antibodies block Ach transmission) -males in 5th decade and females in 3rd decade -signs/symptoms; ptosis (drooping eyelids), diplopia (double vision), facial weakness, fatigue on chewing, dysphagia, dysarthria, dysphonia. neck, proximal limb, respiratory, and generalized weakness
71
Palsy
paralysis (partial or complete loss of motor function) -cerebral palsy; damage to cerebrum during gestation or birth -bell's palsy; unilateral facial paralysis secondary to facial nerve (CN VII) problem (viral infection usually), complete recovery possible
72
Parkinson disease (parkinsonism/paralysis agitans)
-chronic, degenerative disease of basal ganglia w/ an unknown cause (possible toxin exposure). associated w/ dopamine depletion -signs/symptoms; expressionless facies (mask face), infrequent blinking, positive myerson sign (repetitive tapping over bridge of nose produces sustained blink), fine slowly spreading tremor, pill-rolling resting tremor, muscular rigidity and weakness, shuffling gait w/o arm swing, bradykinesia w/ postural instability, possible decreased intellectual function
73
Tourette syndrome
-Hereditary chronic neuromuscular disorder consisting of various motor/vocal tics (sudden involuntary, brief & repetitive motor movements) -Symptoms begin in childhood & location, number, frequency & complexity of tics changes over time -Signs/symptoms; tics occur many times a day & change over time (may only have one at a time). Motor tics include facial grimacing, blinking, head or neck twitching, tongue protruding, sniffing, touching. Vocal tics include grunts, snorts, throat clearing, barking & complex tics w/ echolalia (repeating words of others), palilalia (repeating one's own words), coprolalia (use of obscenities), copraxia or copropraxia (use of obscene gestures)
74
Meningitis
-inflammation of membranes of the brain/spinal cord usually caused by viral (aseptic) or bacterial (more serious, pyogenic) sources but sometimes fungal -signs/symptoms; headache, fever, sensorial disturbances, neck & back stiffness, photophobia -diagnosed by CBC, blood cultures, CXR, LP (lumbar puncture). CT usually done before LP if space-occupying lesion is suspected
75
Shingles (herpes zoster)
-reactivation of varicella-zoster (chickenpox) virus that has been dormant in the dorsal root ganglia; usually presents as painful unilateral dermatomal eruption -Signs/symptoms; prodromal phase, tingling, itching, boring/knife-like pain -Acute phase presents w/ constitutional symptoms (affecting many body systems), fatigue, malaise, headache, fever, weakness, and a dermatomal rash that is initially erythematous and maculopapular which evolves rapidly to grouped vesicles
76
HIV encephalopathy
-neurologic complications arising from HIV (or opportunistic infections, tumors, or drug-related complications) -Other neurologic complications that arise from HIV infection include vacuolar myelopathy, peripheral neuropathies, polymyositis (inflammatory muscular disease) and AIDS dimentia complex (ADC).
77
Brain tumors
-abnormal growth of brain tissue/meninges -glioblastoma is the most common type of brain tumor in adults, also the most common cause of new onset seizure in middle age. 1 year. Signs/symptoms; hemiparesis, vision changes, seizures, confusion, obtundation (less than full consciousness), headache. Diagnosed by CT or MRI; "ring-enhancing lesion" -Meningiomas are benign tumors arising from arachnoid cells, usually asymptomatic but they can cause symptoms by compression (including hemiparesis, seizures, headache, sphincter disorders). These generally do not produce bone erosion and are also diagnosed by CT or MRI. -If brain tumors are from metastatic growth they generally originated in lung, breast, skin, kidney, or GI tract.
78
CNS trauma (cerebral concussion/contusion)
-traumatic damage to brain; pt's w/ loss of consciousness \>2 minutes should be evaluated for neurological symptoms as these may cause increased ICP, seizures, cerebral edema , or intracranial hematoma -concussion; no structural damage to brain -contusion; bruising of brain usually associated w/ skull fracture, cerebral edema, and increased ICP. Hematomas may lead to permanent brain injury
79
Skull fractures
-Basilar skull fracture leads to raccoon signs (bruising around orbit), battle signs (blood in external auditory meatus), CSF leakage from ear/nose, cranial nerve palsies.
80
Subdural hematoma
-tearing the veins between dura & arachnoid membrane due to blunt trauma -signs/symptoms; progressive change in mental status, focal neurological signs w/ or w/o LOC, H/A (headache), hemiparesis, unreactive pupil w/ ophthalmoplegia, and possible seizure
81
Epidural hematoma
-caused by a tear of the middle meningeal artery or venous sinus between skull & dura usually after skull fracture -lethal if untreated -Signs/symptoms; transient recovery of consciousness followed by progressive obtundation, gradual decline of neurological status ultimately producing coma -concave blood clot shown on CT/MRI
82
Cerebrovascular accident (CVA)
-A suddenly developing neurological deficit usually related to impaired cerebral blood flow; stroke -3rd leading cause of death in the US -Risk factors; 7th/8th decade of life, HTN, cardiac arrhythmia, DM, hypercoagulable, history of smoking, family history, oral contraceptives, carotid atherosclerosis, drugs (cocain/amphetamines) -Types; thrombotic, embolic, hemorrhagic -Signs/symptoms depend on location of CVA
83
Transient Cerebral Ischemia (TIA)
-neurological deficits caused by ischemia lasting between 2 and 24 hours; related to CVA so same risk factors -Causes; embolus, rheumatic heart disease, mitral valve disease, cardiac arrhythmia, atrial myxoma, polythcemia vera, hyperviscosity syndromes, sickle cell anemia -Signs/symptoms; abrupt onset w/o warning, rapid recovery
84
Migraine headache
-severe, reoccuring, unilateral, vascular headache -POUND; Pulsatile, Onset (abrupt), Unilateral, N/V, Duration (4-72 hours) -Types; classic, common, basilar -may be preceded by aura
85
CSF analysis
-normally CSF is clear, colorless fluid formed by choroid plexus and reabsorbed by arachnoid villi. About 90-150mL present at any time although 500mL produced/day. It acts in shock absorption, ICP regulation, nutrient supply & waste removal. -CSF is removed via lumbar puncture & analyzed for protein, glucose, RBC & WBC, and chemical levels. -diagnose meningitis, subarachnoid hemorrhage, infections, CNS malignancy, autoimmune disease and MS.
86
Lumbar puncture
-CSF fluid is withdrawn from between 2 lumbar vertebrae -AKA "spinal tap" -Used for CSF analysis as well as measuring CSF pressure and introduction of anesthetics/medications/contrast media
87
Cerebral angiography
-X-ray imaging of the arterial blood vessels in the brain w/ contrast. -Used to diagnose hemorrhage, aneurysm & occlusions
88
CT of the brain
-CT\>MRI of brain for acute hemorrhage in the brain and subarachnoid space, therefore it's best for the 1-3 days following trauma (since it's better at demonstrating hemorrhage/fracture)
89
MRI of brain
-MRI\>CT of brain for posterior fossa tumors and brain stem glioma (in fact it's better for tumors in general); also bets for spinal cord
90
Positron emission tomography (PET) scan
-Radioactive glucose is injected and then detected in the brain to image the metabolic activity of cells (reconstructed by computer analysis often in modern scanners aided by results from a CT/X-ray scan performed at the same time) -Detect malignancy, alzheimer's, stroke, schizophrenia, & epilepsy
91
Doppler ultrasound studies
-Sound waves detect blood flow in the carotid and intracranial arteries
92
Electroencephalogram (EEG)
-recording of the electrical activity of the brain as recorded from electrodes placed on the scalp -used to demonstrate seizure activity resulting from brain tumors, other diseases, and injury to the brain
93
Stereotactic radiosurgery
-use of a specialized instrument to locate & treat targets in the brain -Stereotactic instrument guides insertion of a needle into the brain for the use of a gamma knife to treat inaccessible brain tumors & abnormal blood vessel masses -Proton stereotactic radiosurgery (PSRS) delivers a uniform dose of proton radiation to a target and spares surrounding normal tissue
94
-severe, reoccuring, unilateral, vascular headache -POUND; Pulsatile, Onset (abrupt), Unilateral, N/V, Duration (4-72 hours) -Types; classic, common, basilar -may be preceded by aura
Migraine headache
95
cerebellum
Cerebello/o
96
cerebrum
Cerebr/o
97
dura mater
Dur/o
98
brain
Encephal/o
99
glial cells
Gli/o
100
thin, slender
Lept/o
101
membranes, meninges
Mening/o Meningi/o
102
muscle
My/o
103
spinal cord, means bone marrow in other contexts
Myel/o
104
nerve
Neur/o
105
pons
Pont/o
106
nerve root (of spinal nerves)
Radicul/o
107
thalamus
Thalam/o
108
sheath (refers to the meninges)
Thec/o
109
vagus nerve (CN X)
Vag/o
110
excessive sensitivity to pain
Alges/o
111
excessive sensitivity to pain
-algesia
112
pain
-algia
113
burning
Caus/o
114
deep sleep (coma)
Comat/o
115
feeling, nervous sensation
Esthesi/o
116
feeling, nervous sensation
-esthesia
117
movement
Kines/o Kinsesi/o
118
movement
-kinesia -kinesis -kinetic
119
seizure
-lepsy
120
word, phrase
Lex/o
121
weakness
-paresis
122
speech
-phasia
123
paralysis (loss or impairment of the ability to move parts of the body)
-plegia
124
action
-praxia
125
strength
-sthenia
126
to cut off, cut short
Syncop/o
127
order, coordination
Tax/o
128
carries message toward the brain (sensory)
Afferent nerve
129
carries message away from the brain (motor)
Efferent nerve
130
middle layer of the three membranes (meninges) that surround the brain and spinal cord
Arachnoid membrane
131
type of glial cell that transports water and salts from capillaries
Astrocyte
132
nerves that control involuntary body functions
Autonomic nervous system (ANS)
133
protective separation between the blood and brain cells, made up of endothelial cells and astrocytes
Blood-brain barrier
134
posterior part of the brain that coordinates muscle movements and maintains balance
Cerebellum
135
outer region of the cerebrum containing sheets of nerve cells; gray matter of the brain
Cerebral cortex
136
Largest part of the brain; responsible for voluntary muscular activity, vision, speech, taste, hearing, thought, and memory
Cerebrum
137
Microscopic branching fiber of a nerve cell that is the first part to receive the nervous impulse
Dendrite
138
Thick, outermost layer of the meninges, surrounding and protecting the brain/spinal cord
Dura mater
139
Glial cell that lines membranes within the brain and spinal cord and helps to form CSF
Ependymal cell
140
supportive and connective nerve cell that does not carry nervous impulses; they CAN reproduce. (ex. astrocytes, ependymal cells)
Glial cell
141
sheet of nerve cells that produces a rounded ridge on the surface of the cerebral cortex (convolution)
Gyrus (pl. gyri)
142
portion of the brain beneath the thalamus; controls sleep, appetite, body temp, emotions, and secretions from the pituitary
Hypothalamus
143
Part of the brain just above the spinal cord; controls breathing, heartbeat, and the size of blood vessels (Life center). Site of nerve fiber crossover.
Medulla oblongata
144
phagocytic glial cell that removes waste products from the CNS
Microglial cell
145
Glial cell that forms the myelin sheath covering axons
Oligodendroglial cell (oligodendrocyte)
146
Involuntary autonomic nerves that balance sympathetic stimulation; lower heart rate & bp, stimulate intestinal contractions
Parasympathetic nerve
147
essential, distinguishing tissue of any organ or system. Parenchyma of nervous system includes neurons & nerves
Parenchyma
148
thin, delicate inner membrane of the meninges
Pia mater
149
part of the brain anterior to the cerebellum and between the medulla and the rest of the midbrain; a bridge connecting various parts
Pons
150
nerve extending from the base of the spine through the thigh, lower leg and foot.
Sciatic nerve
151
31 pairs of nerves arising from the spinal cord
Spinal nerves
152
connective and supporting tissue of an organ, glial cells are the stromal tissue of the brain
Stroma
153
stimulate body involuntarily in times of crisis; increase heart rate & bp, dilate airways, slow digestion
Sympathetic nerves
154
Main relay center of the brain; conducts impulses between the spinal cord and the cerebrum, control of awareness and consciousness
Thalamus
155
CN X; it's branches reach the larynx, trachea, bronchi, lungs, aorta, esophagus & stomach.
Vagus nerve
156
Canals in the brain that contain CSF
Ventricles of the brain
157
-abnormal accumulation of CSF in the brain, enlarged head & small face -ventriculoperitoneal shunt is placed to remove pressure on brain -can occur as an adult from infection or tumors
Hydrocephalus
158
-incomplete closure of the lumbar vertebral column during embryogenesis resulting in exposure of meninges & spinal cord -different types; occulta (posterior vertebrae have not fused, mole dimple or patch of hair over area), cystica w/ meningocele (external protruding sac containing meninges & CSF), cystica w/ myelomeningocele (external protruding sac w/ meninges, CSF & spinal cord, often associated w/ paralysis & hydrocephalus) -Spina bifida is just one type of neural tube defect (congenital anomaly of nervous system occurring during first 4 weeks of gestation), folic acid deficiency is strongly associated w/ these
Spina bifida
159
-chronic disorder that accounts for \>50% of dementia cases, usually in persons \>65yo -progressive impairment of intellectual function, may compromise language and memory, visuospatial skill, behavior and personality & cognition -unknown cause, but associated w/ plaques and neurofibrillary tangles w/ amyloid deposits -signs/symptoms; short term memory loss, loss of expression, aphasia (language comprehension difficulties), problem-solving difficulties, thought disorders, difficulties w/ ADLs, problems w/ concentration, social withdrawal
Alzheimer's disease (AD)
160
-degenerative disease which affects the upper & lower motor neurons -signs/symtoms; unexplained weight loss, focal wasting of muscle groups, limb weakness w/ variable symmetry & distribution, difficulty walking, difficulty swallowing, slurring of speech, inability to control affect, atrophy, fasciculations (small muscle twitches), hyperactive deep tension reflexes, SPARES COGNITIVE, OCULOMOTOR, SENSORY & AUTONOMIC FUNCTIONS
Amyotrophic lateral sclerosis (ALS/Lou Gehrig disease)
161
-chronic brain disorder characterized by recurrent seizure activity; mostly idiopathic. -seizure; abnormal paroxysmal neuronal discharge of the brain, which may cause a transient disturbance of cerebral function, may be partial (limited to part of a cerebral hemisphere; simple & complex seizures) or generalized (petit mal/absence, febrile, tonic-clonic/grand mal, or status epilepticus). Complex partial is most common, followed by tonic-clonic. -Pt's often have weakness & confusion post-seizures (postictal) -May have Todd's paralysis, contralateral postictal paralysis & persistent weakness
Epilepsy
162
-autosomal dominant disorder on chromosome 4 characterized by dementia and chorea; gradual onset & slow progress -symptoms generally appear after 30yo; chorea (abnormal, involuntary muscle movement), dysphagia, dysarthria, impaired recent memory, impaired judgement, intellectual decline, emotional disturbances, depression, anxiety, delusion, aggressiveness, urinary incontinence, bowel incontinence... -no cure & diagnosis is often after pt has reproduced
Huntington disease (Huntington chorea)
163
-inflammatory, progressive demyelination of the white matter of the brain and spinal cord resulting in multiple neurological signs and symptoms -unknown cause, pt usually
Multiple sclerosis (MS)
164
-autoimmune disorder of neuromuscular junction resulting in a pure motor syndrome (antibodies block Ach transmission) -males in 5th decade and females in 3rd decade -signs/symptoms; ptosis (drooping eyelids), diplopia (double vision), facial weakness, fatigue on chewing, dysphagia, dysarthria, dysphonia. neck, proximal limb, respiratory, and generalized weakness
Myasthenia gravis (MG)
165
paralysis (partial or complete loss of motor function) -cerebral palsy; damage to cerebrum during gestation or birth -bell's palsy; unilateral facial paralysis secondary to facial nerve (CN VII) problem (viral infection usually), complete recovery possible
Palsy
166
-chronic, degenerative disease of basal ganglia w/ an unknown cause (possible toxin exposure). associated w/ dopamine depletion -signs/symptoms; expressionless facies (mask face), infrequent blinking, positive myerson sign (repetitive tapping over bridge of nose produces sustained blink), fine slowly spreading tremor, pill-rolling resting tremor, muscular rigidity and weakness, shuffling gait w/o arm swing, bradykinesia w/ postural instability, possible decreased intellectual function
Parkinson disease (parkinsonism/paralysis agitans)
167
-Hereditary chronic neuromuscular disorder consisting of various motor/vocal tics (sudden involuntary, brief & repetitive motor movements) -Symptoms begin in childhood & location, number, frequency & complexity of tics changes over time -Signs/symptoms; tics occur many times a day & change over time (may only have one at a time). Motor tics include facial grimacing, blinking, head or neck twitching, tongue protruding, sniffing, touching. Vocal tics include grunts, snorts, throat clearing, barking & complex tics w/ echolalia (repeating words of others), palilalia (repeating one's own words), coprolalia (use of obscenities), copraxia or copropraxia (use of obscene gestures)
Tourette syndrome
168
-inflammation of membranes of the brain/spinal cord usually caused by viral (aseptic) or bacterial (more serious, pyogenic) sources but sometimes fungal -signs/symptoms; headache, fever, sensorial disturbances, neck & back stiffness, photophobia -diagnosed by CBC, blood cultures, CXR, LP (lumbar puncture). CT usually done before LP if space-occupying lesion is suspected
Meningitis
169
-reactivation of varicella-zoster (chickenpox) virus that has been dormant in the dorsal root ganglia; usually presents as painful unilateral dermatomal eruption -Signs/symptoms; prodromal phase, tingling, itching, boring/knife-like pain -Acute phase presents w/ constitutional symptoms (affecting many body systems), fatigue, malaise, headache, fever, weakness, and a dermatomal rash that is initially erythematous and maculopapular which evolves rapidly to grouped vesicles
Shingles (herpes zoster)
170
-neurologic complications arising from HIV (or opportunistic infections, tumors, or drug-related complications) -Other neurologic complications that arise from HIV infection include vacuolar myelopathy, peripheral neuropathies, polymyositis (inflammatory muscular disease) and AIDS dimentia complex (ADC).
HIV encephalopathy
171
-abnormal growth of brain tissue/meninges -glioblastoma is the most common type of brain tumor in adults, also the most common cause of new onset seizure in middle age. 1 year. Signs/symptoms; hemiparesis, vision changes, seizures, confusion, obtundation (less than full consciousness), headache. Diagnosed by CT or MRI; "ring-enhancing lesion" -Meningiomas are benign tumors arising from arachnoid cells, usually asymptomatic but they can cause symptoms by compression (including hemiparesis, seizures, headache, sphincter disorders). These generally do not produce bone erosion and are also diagnosed by CT or MRI. -If brain tumors are from metastatic growth they generally originated in lung, breast, skin, kidney, or GI tract.
Brain tumors
172
-traumatic damage to brain; pt's w/ loss of consciousness \>2 minutes should be evaluated for neurological symptoms as these may cause increased ICP, seizures, cerebral edema , or intracranial hematoma -concussion; no structural damage to brain -contusion; bruising of brain usually associated w/ skull fracture, cerebral edema, and increased ICP. Hematomas may lead to permanent brain injury
CNS trauma (cerebral concussion/contusion)
173
-Basilar skull fracture leads to raccoon signs (bruising around orbit), battle signs (blood in external auditory meatus), CSF leakage from ear/nose, cranial nerve palsies.
Skull fractures
174
-tearing the veins between dura & arachnoid membrane due to blunt trauma -signs/symptoms; progressive change in mental status, focal neurological signs w/ or w/o LOC, H/A (headache), hemiparesis, unreactive pupil w/ ophthalmoplegia, and possible seizure
Subdural hematoma
175
-caused by a tear of the middle meningeal artery or venous sinus between skull & dura usually after skull fracture -lethal if untreated -Signs/symptoms; transient recovery of consciousness followed by progressive obtundation, gradual decline of neurological status ultimately producing coma -concave blood clot shown on CT/MRI
Epidural hematoma
176
-A suddenly developing neurological deficit usually related to impaired cerebral blood flow; stroke -3rd leading cause of death in the US -Risk factors; 7th/8th decade of life, HTN, cardiac arrhythmia, DM, hypercoagulable, history of smoking, family history, oral contraceptives, carotid atherosclerosis, drugs (cocain/amphetamines) -Types; thrombotic, embolic, hemorrhagic -Signs/symptoms depend on location of CVA
Cerebrovascular accident (CVA)
177
-neurological deficits caused by ischemia lasting between 2 and 24 hours; related to CVA so same risk factors -Causes; embolus, rheumatic heart disease, mitral valve disease, cardiac arrhythmia, atrial myxoma, polythcemia vera, hyperviscosity syndromes, sickle cell anemia -Signs/symptoms; abrupt onset w/o warning, rapid recovery
Transient Cerebral Ischemia (TIA)
178
-normally CSF is clear, colorless fluid formed by choroid plexus and reabsorbed by arachnoid villi. About 90-150mL present at any time although 500mL produced/day. It acts in shock absorption, ICP regulation, nutrient supply & waste removal. -CSF is removed via lumbar puncture & analyzed for protein, glucose, RBC & WBC, and chemical levels. -diagnose meningitis, subarachnoid hemorrhage, infections, CNS malignancy, autoimmune disease and MS.
CSF analysis
179
-CSF fluid is withdrawn from between 2 lumbar vertebrae -AKA "spinal tap" -Used for CSF analysis as well as measuring CSF pressure and introduction of anesthetics/medications/contrast media
Lumbar puncture
180
-X-ray imaging of the arterial blood vessels in the brain w/ contrast. -Used to diagnose hemorrhage, aneurysm & occlusions
Cerebral angiography
181
-CT\>MRI of brain for acute hemorrhage in the brain and subarachnoid space, therefore it's best for the 1-3 days following trauma (since it's better at demonstrating hemorrhage/fracture)
CT of the brain
182
-MRI\>CT of brain for posterior fossa tumors and brain stem glioma (in fact it's better for tumors in general); also bets for spinal cord
MRI of brain
183
-Radioactive glucose is injected and then detected in the brain to image the metabolic activity of cells (reconstructed by computer analysis often in modern scanners aided by results from a CT/X-ray scan performed at the same time) -Detect malignancy, alzheimer's, stroke, schizophrenia, & epilepsy
Positron emission tomography (PET) scan
184
-Sound waves detect blood flow in the carotid and intracranial arteries
Doppler ultrasound studies
185
-recording of the electrical activity of the brain as recorded from electrodes placed on the scalp -used to demonstrate seizure activity resulting from brain tumors, other diseases, and injury to the brain
Electroencephalogram (EEG)
186
-use of a specialized instrument to locate & treat targets in the brain -Stereotactic instrument guides insertion of a needle into the brain for the use of a gamma knife to treat inaccessible brain tumors & abnormal blood vessel masses -Proton stereotactic radiosurgery (PSRS) delivers a uniform dose of proton radiation to a target and spares surrounding normal tissue
Stereotactic radiosurgery
