Nervous System Flashcards Preview

Medical Terminology > Nervous System > Flashcards

Flashcards in Nervous System Deck (186):
1

Cerebello/o

cerebellum

2

Cerebr/o

cerebrum

3

Dur/o

dura mater

4

Encephal/o

brain

5

Gli/o

glial cells

6

Lept/o

thin, slender

7

Mening/o Meningi/o

membranes, meninges

8

My/o

muscle

9

Myel/o

spinal cord, means bone marrow in other contexts

10

Neur/o

nerve

11

Pont/o

pons

12

Radicul/o

nerve root (of spinal nerves)

13

Thalam/o

thalamus

14

Thec/o

sheath (refers to the meninges)

15

Vag/o

vagus nerve (CN X)

16

Alges/o

excessive sensitivity to pain

17

-algesia

excessive sensitivity to pain

18

-algia

pain

19

Caus/o

burning

20

Comat/o

deep sleep (coma)

21

Esthesi/o

feeling, nervous sensation

22

-esthesia

feeling, nervous sensation

23

Kines/o Kinsesi/o

movement

24

-kinesia -kinesis -kinetic

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