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Patho Exam 3 > Neuro > Flashcards

Neuro Flashcards

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1
Q

Neurons

A

Generate action potentials

Transmitter cells

Carry messages to and from the brain and spinal cord.

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2
Q

Glial Cells

A

Support and protect neurons.

Do not generate action potentials but have a resting potential

CNS: Astrocytes, Microglia, Oligodendroglia, Ependymal cells.

PNS: Schwann Cells (myelin), Satellite cells

Produce cerebral spinal fluid.

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3
Q

Neurons can synapse with

A

neurons, muscle, glands

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4
Q

Synaptic Transmission

A

A small burst of neurotransmitters is released

The neurotransmitters stimulate or inhibit action potentials

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5
Q

Neurotransmitters

A

either destroyed by enzymes or reabsorbed

recycled for the next transmission

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6
Q

Electrical impulses

A

Info passed between neurons by chemicals

Can be excitatory or inhibitory

Along the axons, the information passes electrically

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7
Q

Neurons cont

A

Do not have the ability to divide

Losses due to aging or injury cannot be replaced

Not all cell death results in loss of functioning

Undamaged neurons in the brain will assume functions of damaged neurons (“plasticity”)

require constant oxygen and glucose supply

vulnerable to hypoxia and hypoglycemia

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8
Q

Myelin

A

Lipoprotein

Increases speed of conduction, large axons:

  • Are “insulation”
  • Prevent leakage of electric current
  • Layers w/spaces (nodes of Ranvier) between cells
  • Impulse “jumps” from node to node

“Unmyelinated” axons – smaller, slower

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9
Q

The Neurological System Consists of three main components

A

spinal cord, brain, peripheral nerves

Central Nervous system: Brain and spinal cord

Peripheral nervous system: nerves

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10
Q

Peripheral nervous system

A

Autonomic nervous system: sympathetic (fight or flight) nervous system and parasympathetic (rest and digest)

Somatic nervous system: sensory nerves and motor nerves

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11
Q

Cerebrum

A 
includes lobes
Frontal
Parietal
Occipital lobe
Temporal lobe
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12
Q

Diencephalon

A

thalamus

hypothalamus

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13
Q

Cerebellum

A

balance and coordination

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14
Q

Brain stem

A

midbrain, pons, medulla oblongata

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15
Q

3 meninges

A

Dura mater, arachnoid mater, pia mater

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16
Q

Dura mater

A

outer, lines skull

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17
Q

Arachnoid mater

A

middle, contains blood vessels

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18
Q

Pia mater

A

inner, covers brain

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19
Q

3 potential spaces

A

epidural, subdural, subarachnoid

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20
Q

epidural

A

outside dura

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21
Q

subdural

A

between dura and arachnoid

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22
Q

subarachnoid

A

deep to arachnoid, filled with CSF

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23
Q

Cerebrospinal Fluid (CSF)

A

Made in choroid plexuses (roofs of ventricles)
Filtration of plasma from capillaries through ependymal cells (electrolytes, glucose)

Cushions and nourishes brain

Useful for diagnosing meningitis, bleeds, MS

Hydrocephalus: excessive accumulation of CSF

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24
Q

Blood supply to the brain

A

Supplied by the internal carotid and vertebral arteries

Arterial circle (circle of Willis) helps ensure flow

800 to 1000 mL per minute

CO2 level affects CNS blood flow

Increases in CO2 will increase cerebral blood flow & arterial blood pressure.

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25
Circle of Willis
Anterior Cerebral Artery, middle cerebral artery, posterior cerebral artery, lenticulostriate arteries
26
Anterior Cerebral artery
supplies frontal lobes
27
Middle Cerebral Artery
Artery-frontal lobe & the lateral surface of the temporal and parietal lobe (includes motor, sensory, speech) *Most frequently occluded artery in a stroke.
28
Posterior Cerebral Artery
temporal & occipital lobes of cerebral hemispheres.
29
Lenticulostriate arteries
small, deep penetrating arteries known as the lenticulostriate arteries branch from the middle cerebral artery
30
How does autoregulation of cerebral blood flow work?
The arteries that comprise the circle of Willis in the brain normally maintain a constant flow of blood within the brain
31
Autoregulation
means that the cerebral arteries constrict or dilate to keep the CPP between 50-150mmHg
32
CPP (cerebral perfusion pressure)
the pressure required to perfuse the brain with blood
33
MAP (mean arterial pressure)
it is the average blood pressure in the arteries. MAP is a more accurate way to measure “blood pressure” in the vessels.
34
ICP
intracranial pressure
35
Autoregulation is achieved by
combination of 4 factors: 1. BP (MAP) 2. Metabolic-- CO2, others 3. Autonomic receptors (smaller role) 4. Arterial oxygen level
36
BP (MAP)
the cerebral arteries constrict or dilate in response to changes in BP (ie. MAP) or intracranial pressure (ICP)
37
Metabolic--CO2
CO2 is a potent vasodilator | increased CO2/decreased BP --> vasodilation decreased CO2/increased BP--> vasoconstriction
38
Arterial oxygen level
low arterial oxygen tension has profound effects on cerebral blood flow. When PO2 falls below 50 mmHg there is a rapid increase in cerebral blood flow (CBF) and arterial blood volume.
39
Cranial nerves
12 of cranial nerves branch directly from the base of the brain. some carry sensory fibers, others only carry motor fibers some carry both each nerve travels from the brain through the foramen ovale to its destination
40
On old olympus towering tops, a finn and german viewed some hops
Some say marry money but my brother says bad business marry money
41
white matter
comprised of nerve fiber tracts/ pathways
42
Gray matter
neurons
43
ascending fibers/afferent tracts
carry sensory information the body back to the brain
44
descending fibers/efferent tracts
carry motor impulses from the brain to the PNS
45
nerves
bundles of nerve fibers. Each fiber is part of the neuron works like an information highway
46
31 spinal nerve pairs
8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal
47
ganglia
collections of nerve cell bodies outside the CNS
48
Spinal nerves
arise from dorsal and ventral surfaces of the spinal cord
49
Spinal nerve
comprised of a dorsal root adn a ventral root. Each root formed from 6-8 rootlets
50
Somatic
voluntary 31 pairs of spinal nerves 12 pairs of cranial nerves
51
Automatic
involuntary smooth muscle cardiac muscle glands
52
Check and balance system
Sympathetic nervous system | Parasympathetic nervous system
53
Sensory nerves
afferent nerves input: sensory afferent: to brain
54
motor nerves
efferent nerves output: motor efferent: from brain
55
interneurons
connect the sensory and motor neurons in the spinal cord
56
Dermatome
area of the skin innervated by a given pair of spinal sensory nerves
57
What can be fixed in nervous system:
severed peripheral nerves: | - can regenerate to a point to reestablish connections
58
What cannot be fixed in the nervous system:
severed brain and spinal cord axons | - results in paralysis and loss of sensation below the area of damage
59
Autonomic nervous system
controls smooth muscles | unconscious response that affects such activities as heart rate, blood pressure, intestinal motility
60
sympathetic nervous
fight or flight response aided by adrenal medulla via epinephrine and norepinephrine secretion stimulates the adrenergic receptors
61
parasympathetic nervous system
rest and digest response stimulates the cholinergic receptors The two subdivisions have an antagonistic effect with each other
62
Adrenergic (SNS) & Cholinergic (PNS) receptors
These receptors are found in certain target organs: | The heart, lungs, gastrointestinal tract, the bladder, and the muscles.
63
Order of Neurological Assessment
``` Mental status cranial nerves motor system sensory system reflexes ```
64
Assessing Consciousness
alert, confused, delirious, lethargic, obtunded, stuporous, comatose
65
Glasgow Coma Scale (GCS)
Evaluates neurological functioning. Used after TBI or other neurological injuries. Looks at purposeful response to the environment in 3 areas: Eye opening Motor response Verbal response
66
Increased Intracranial Pressure (ICP)
Increased ICP is increased volume in the cranial. Skull: rigid, does not expand in adults. Brain occupies 80% of the skull. Monro-Kelli hypothesis Volume increase: compensated for by shifts in CSF & blood volume. Causes: traumatic brain injury, tumor, hydrocephalus, cerebral edema, and hemorrhage
67
Monro-Kelli hypothesis
increase in volume of one component must be compensated by a decrease in volume of another
68
Fontanelles
close by age 3 years usually
69
Increased ICP compensatory mechanisms
autoregulation, Cushing's reflex, Cushing's triad
70
Autoregulation (normal response)
the blood vessels dilate to increase blood flow and constrict if ICP increases. This acts up to a certain point.
71
Cushing's reflex (normal response)
the hypothalamus increases sympathetic stimulation when the mean arterial pressure drops below the ICP. Causes vasoconstriction, increased cardiac contractility, and increased cardiac output.
72
Cushing's triad (what you see when things go bad.....very very bad)
increased blood pressure, bradycardia, and Cheyne-Stokes respiratory pattern.
73
Cushing's Triad 3 primary signs that often indicate an increase in intracranial pressure (ICP)
increase systolic BP decrease in pulse decrease in respiration
74
Symptoms of increased ICP are opposite of SHOCK
decrease in BP increase in pulse increase in respiration
75
Cushing's syndrome
a disease state resulting from the elevated levels of blood cortisol
76
Herniation
Feared complication of increased ICP | Refers to displacement of brain tissue
77
transtentorial (central) herniation
cerebral blood flow, CSF, reticular activation system, and respirations are impaired
78
Uncal herniation
puts pressure on cranial nerve III, the posterior cerebral artery, and the reticular activation system
79
Cerebellar, or tonsillar (intrafratentorial), herniation
compresses the brain stem and vital centers, causing death
80
Manifestations of Increased ICP
``` Decreasing level of consciousness Vomiting (often projectile) Rising blood pressure Increasing pulse pressure Bradycardia Papilledema Fixed and dilated pupils Posturing ```
81
Increased ICP diagnosis
History & physical exam Glasgow Coma scale Head CT, MRI ICP monitoring
82
Increased ICP treatment
``` depends on cause (bleed, tumor, hydrocephalus, meningitis). Respiratory support Semi-Fowler’s positioning Decrease edema, swelling Prevent seizures Reduce brain metabolism No activities that increase ICP Control glucose level Stress ulcer prevention ```
83
Cerebral perfusion pressure | pressure in brain
the pressure required to “perfuse” all of the tissue of the brain with blood. Without sufficient blood perfusion any living tissue dies
84
Homeostasis in the Cranium
CCP= MAP-ICP Where, CPP is cerebral perfusion pressure MAP is mean arterial pressure ICP is intracranial pressure If MAP decreases then CPP decreases If ICP increases then CPP decreases we do not want CPP to decrease in most circumstances

Patho Exam 3 (2 decks)

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