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Pathology SEM 2 > Neuro Pathologies > Flashcards

Neuro Pathologies Flashcards

(72 cards)

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1
Q

What does the Medial Cerebral Artery Supply?

A
  • Most Outer Surface
  • Sensorimotor Cortex
  • Basal Ganglia
  • Internal Capsule
  • Brocas Area ( on left)
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2
Q

What does the Anterior Cerebral Artery Supply?

A
  • Frontal Lobe

- Medial part of sensorimotor cortex

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3
Q

What does the Posterior Cerebral Artery supply?

A
  • Occipital lobe
  • Temporal Lobe
  • Thalamus - Sensory lobe
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4
Q

What does the Basillar Artery supply?

A
  • All of the Brain stem
  • Cerebellum
  • Nuclei of Cranial Nerve , facial nerve and Vagus nerve.
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5
Q

Give the 4 Types of Hemorrhagic Stroke

A
  • Intracerebral
  • Subarachnoid
  • Subdural
  • Extradural
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6
Q

What is Haemorrhage?

A

Bleeding due to rupture of congenital aneurysm. AVM or Trauma. Leading to sudden intense vomiting ( Vestibular Disturbance), stiff neck and loss of consciousness.

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7
Q

Give the background pathology of a Intracerebral Haemorrhage

A
  • Deep bleed
    -Associated with Hypertension
    -Arterial wall weaken = Micro aneurysm , leading to rupture and bleed
    = Severe headache and Vomiting.
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8
Q

Give the background pathology of a Subdural Haemorrhage

A

-Subdural space
-Trauma
Headache,Drowsiness,Stupor
(Unconsciousness ), Hemiparesis, Coma

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9
Q

Give the background pathology of a Subarachnoid Haemorrhage

A

A subarachnoid hemorrhage is bleeding from a damaged artery at the surface of the brain. This bleeding often causes a sudden, severe headache

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10
Q

Give the background pathology of a Extradural Haemorrhage

A
  • Trauma

- Tearing of Meningeal Artery

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11
Q

How are strokes treated?

A
  • Medical emergency
  • MRI/CT
  • SAH , surgery
  • SDH,EDH,IDH = Treat Hypertension
  • Osmotic agents
  • Other tests,Blood tests , echo-cardiology.
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12
Q

What is Hemiplegia?

A
  • Paralysis of 1 side
  • Right CVA - Left hemiplegia
  • Left CVA- right hemiplegia
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13
Q

Give the Motor Pathway

A
  • Motor Cortex
  • Cortico-spinal tract
  • 80% fibres cross
  • Synapses w/alpha motor neurone
  • Peripheral motor nerve
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14
Q

Give the Motor Symptoms associated with a Stroke

A
  • Low tone
  • High tone
  • Weakness
  • Hemiplegia/Asymmetry
  • Decrease in normal movement patterns
  • Decrease balance
  • Ataxia - Uncoordinated movement - Compensatory movements used to counterbalance
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15
Q

State the incidence rate of Hypo and Hypertonicity

A
  • 5% in the first 10 ten days

- 8/10 experience weakness

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16
Q

Give the Sensory Pathway

A
  • Sensory receptors
  • Sensory peripheral nerves
  • Dorsal tracts
  • Thalamus
  • Sensory cortex - front of the parietal lobe
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17
Q

Give the Sensory symptoms associated with a Stroke

A
  • Impaired cutaneous sensation
  • Stereognosis - objects and depth perception
  • Proprioceptive impairment
  • Homonygous hemianopia
  • Visual field loss
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18
Q

What is Expressive Dysphasia ?

A
  • Decreased ability to produce speech

- Brocas area

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19
Q

What is Receptive Dysphasia?

A
  • Decreased ability to understand speech

- Wernikes area in the temporal lobe

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20
Q

Give the Cognitive Symptoms associated with Stroke

A
  • Agnosia - inability to recognise objects
  • Astereognosis - Inability to recognise objected using active hand touch without sensory input
  • Visual and Auditory Agnosia - can bring up safety issues
  • Depth perception
  • Apraxia - Out of order
  • Anosagnosia- Not recognising that they have had a stroke
  • Inattention and neglect
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21
Q

Why is it important to identify neglect in a stroke patient/

A
  • Can be Cog , Sensory or Visual
  • Poor Prognosis
  • Left hemiplegia
  • Fails to attend stimuli from functional problems
  • Left side = Self care , eating , dressing , walking
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22
Q

Give Other related problems with Stroke

A
  • Disorder of emotion
  • Dysphasia - x swallow
  • Incontinence
  • Secondary musculoskeletal problem
  • Balance/gait problems
  • Functional difficulties
  • Social problems
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23
Q

Factors affecting Stroke recovery

A
  • Extend and nature of lesion
  • Integrity of collateral circulation
  • Pre-morbidity
  • Age
  • Capacity of nervous system to reorganise
  • Environment
  • Motivation and attitude
  • Patient participation
  • Patient experience
  • Co-existing conditions
  • Nutrition/Hydration
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24
Q

What is a Stroke?

A
  • Also know as a CVA
  • Rapid loss of brain function due to disturbance in the blood supply to the brain
  • Can be due to ischemia (lack of blood flow)caused by a blockage or Haemorrhage
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25
What is a Transient Ischaemic attack ( TIA)
- Part of the brain not receiving enough blood - Risk of more serious stroke in the future - Symptoms lasting less then 2 hours , any more = Stroke
26
What is Neuroplasticity?
- Primary recovery following stroke - Adaptive capacity of the CNS - Discovering new pathways - Phantom limb - Learning of new skills - Unmasking of dormant pathways to increase synaptic strength
27
What is the formations of New Synapses called
- Collateral Sprouting from intact nerve cells- Derivation
28
Risk Factors of Stroke
- Stroke - Hight Cholesterol - Age - Hypertension - AF - Diabetes - Hight salt diet - Contraceptive
29
What is Parkinson's disease?
- Degeneration of dopamine producing neurones in the Substantia basal ganglia
30
Give the Epidemiology of Parkinson's disease
- increase likelihood with age - men more than women - 15% genetic - influences by environmental factors
31
What does the Basal Ganglia do?
- Movement memory - Initiation and Planning - Regulation of muscle tone - Inhibit antagonistic/unnecessary movements
32
Explain the effect of Dopamine on Direct and indirect pathways
Direct = promotes movement Indirect =Inhibits movement Dopamine excites the direct pathway and inhibits the indirect pathway. - in Parkinson's a lack of dopamine = lack of movement.
33
Give the Primary Clinical features of Parkinson's Disease
Bradykinesia/Akinesia Resting Tremor - Pill rolling tremor Rigidity- Stiff inflexible , resistance to passive movement, lead pipe or cog wheel
34
Give 5 secondary features of Parkinson's Disease
- loss of facial expressions - Monotone speech - Problems w/swallowing - depression - Sleep disorders
35
What is Postural Instability in relation to Parkinson's disease
- Develops later - Flexed posture - Flexed hips and knees - Unable to access balance reactions
36
What medications are used in the management of Parkinson's Disease
``` Dopamine replacements - Sinemet -Madopar -Levadopar Dopamine copycats - Apomorphine -Dopamine Protectors -Anticholinergics ```
37
What surgeries are used in the treatment of Parkinson's
- Pallidotomy - Thalamotomy - Stem cell research.
38
What outcome measure is used in Parkinson's Disease
Hoehn and Yahr Scale | Measures from 0 - 5 ( including stages 1.5 and 2.5)
39
Give the background Epidemiology of Multiple Sclerosis
- Chronic demyelinating disease - 20-40s - 3 x as likely in females - no cure , medicines can help - more common in temperate climate, socioeconomic and caucasian
40
Give the background pathology of Multiple Sclerosis
- disruption of blood brain barrier - leakage of inflammatory cells - Destruction of Myelin sheath and Oligodendrocytes - Destruction of nerve signals , rate of conduction of nerves decreases - Plaques can then form through out CNS- no conduction
41
Signs and Symptoms of MS
- Visual problems - Weakness - Spasticity - Ataxia - Sensory loss - poor balance - Dizziness - Sexual Dysfunction - Fatigue - Limbic system
42
Give the four stages of MS
1 - Benign MS 2-Relapsing Remitting MS 3-Secondary Chronic MS 4-Primary Progressive
43
Give the features of a MS relapse
- Lasts 24hrs - Objective findings - 30 days after prior - Multiple Paroxysmal episode
44
What methods are used in the Diagnosis of MS?
- Lumbar puncture - MRI - plaque formation - nerve conduction
45
Give the initial symptoms of MS
- Limb weakness - 40% - Optic neuritis - Parasthaesia - Diplopia - Vertigo - Micturition problems
46
Give same of the medications used to treat MS
- IV methyl prednisolone - Ranitidine - Plasmapheresis
47
Give the overly prognosis for MS
- Highly variable - 50% walking unaided 15 years after diagnosis - 30% decreased quality of life - Suicide 7.5 time national average - Wide variation in impact on lifespan - risk of infection
48
What is the Spinothalamic tract? | Ascending
- Pain and Temperature
49
What is the dorsal columns? Cuneatus and Gracillis. | Ascending
- Touch , position sense , Vibration | - Cross in the medulla
50
What is the Spinocerebellar tract? | Ascending
- Proprioceptive information | - Most uncrossed
51
What is the Corticospinal Tract?
- lateral , motor info for limbs | - Anterior , motor info for axial muscles
52
What is the Vestibulospinal tract?
Integration of head and neck and trunk extremities | - Uncrossed
53
What is the Reticulospinal tract
- Lateral - facilities flexion and inhibits extension | - Medial - opposite
54
What is the Rubrospinal tract?
Control of fine movements
55
What is Tectospinal tract?
Controls muscles in response to visual stimuli
56
What results in a non-traumatic SCI
- Degenerative disc problems - infarct/bleed - Tumour - injection/inflammation - developmental/congenital problems
57
What are the vulnerable areas of the spine?
- Cervical spine - C5-7 -55% - Thoracolumbar - T12 - Mid thoracic T4-7
58
What are the 3 different mechanisms of a SCI
- Destruction from direct trauma - compression by bone fragmentation, hematoma or disc material. - Ischemia from damage or impingement on the spinal cord arteries
59
What is Tetraplegia?
- all 4 limbs - cervical
60
What is paraplegia?
- Trunk , legs , pelvis | - Thoracic/lumbar/sacral segments
61
What is an complete spinal cord injury
- Complete loss of function below point of injury | - outcome more predictable
62
What is an incomplete spinal cord injury?
- Some neural activity with a less predictable outcome | - now more common 55 - 65%
63
What will total complete lesion lead to?
- damage to descending - UMU - Damage to anterior motor neurone and LMU - Spinal shock - Flaccidity - Spasticity and spasms
64
What will total transection lead to?
- Impairment of deep and superficial sensation. - Autonomic dysfunction - Vasomotor control - postural hypotension - Autonomic Dysreflexia - sudden onset of high blood pressure - Problems with bladder and bowel function - Problems with sexual function
65
What is Central Cord Syndrome?
- Whip lash - Motor dysfunction in upper limb - Bladder dysfunction - Corticospinal and Spinothalamic tacts
66
What is Anterior Cord Syndrome?
- Disc herniation - Motor paralysis - decreased pain and temp - Retained proprioception and vibration
67
What is Brown-Sequard Syndrome ?
- Stab or Gun-shot wound - Motor deficit and Numbness - Loss of pain and temp sensation on opposite side.
68
What is ABI?
- Anoxic brain injury - Acquired - Trauma and non - traumatic , stroke, infections , tumours and seizures.
69
What is a TBI?
Traumatic Brain injury - Accidents , suicide , assault, shaken , strike to the head - Countercoup - affect side of the brain opposite to impact
70
What is an open-wound injury in relation to TBI
- Life threatening - Skull penetrating - Linear, diastatic , depressed , Basilar Skull fracture
71
What is a Closed head injury?
- Majority of head injuries - Demyelination - Diffuse axonal injury - Concussion - Intracranial haematoma - Cerebral contusion
72
What is the Crushing Injury?
- Compression | - Rare but most damaging

Pathology SEM 2 (3 decks)

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