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Flashcards in Neurological Disorders Deck (105):
1

Blunt Brain trauma

Closed
Head strikes hard surface or a rapid moving object strikes the head.
Dura mater is intact and brain tissue is not exposed.

2

What kind of brain injury can Blunt trauma cause?

Focal (local) or diffuse (general) brain injuries.

3

Open Brain Trauma

Penetrating
injury breaks the dura and exposes the cranial contents to the environment.

4

what kind of injury does open trauma cause?

Causes primarily focal injuries.

5

What are types of injury caused by Bunt Trauma?

Coup injury and Contrecoup

6

Coup Injury

Injury directly at the point of impact

7

Contrecoup

Injury on the polar opposite of the site of impact

8

Focal Brain Injury

Observable brain lesion
force of impact typically produces contusion
-extradural hematoma
-subdural hematoma
-Intracerebral hematomas

9

What are different types of concussions?

Mild and classical

10

Mild concussion

temporary axonal disturbance causing attention and memory deficits but NO loss of consciousness

11

Type I mild concussion

confusion
disorientation
memory amnesia

12

Type II Mild concussion

momentary confusion
retrograde amnesia of prior minutes

13

Type III Mild concussion

confusion with retrograde (greater than a few minutes) and anterograde amnesia

14

Classic concussion

Grade IV
loss of consciousness (for more than 6 hrs)
physiological and neurologic dysfunction without substantial anatomic disruption
anterograde and retrograde amnesia

15

What causes the loss of consciousness in grade IV concussions?

Disconnection of cerebral systems from the brain stem and reticular activating system

16

Your friend takes a huge hit as he is running for the goal line playing “flag football”. He is slow to get up and unsteady on his feet. He goes over to the sidelines and can’t remember what day of the week it is. The next day, he still can’t remember what happened for several hours before or after the game. How severe was the concussion he just experienced?

Grade III

17

cerebrovascular Disorders

Any Abnormalities of he brain caused by a pathologic process in the blood vessels

18

Cerebral Infarction

loss of blood flow to brain area

19

Cerebral Hemorrhage

Bleeding within the brain

20

Transient Ischemic Attacks (TIA)

confusion
difficulty communicating
usually no long term dysfunction (<24hrs)
a warning sign of something more severe.

21

What are different types of cerebrovascular accidents?

Hemorrhagic Stroke
Thrombotic Stroke
Embolic Stroke

22

Hemorrhagic Stroke

intracranial/cerebral hemorrhage
from an aneurysm
most common cause is hypertension

23

Thrombotic Stroke

arterial occlusions caused by thrombi formed in arteries supplying the brain or in the intracranial vessels

24

embolic stroke

an thrombus formed outside the brain

25

What are examples of Intracranial Aneurysms?

Saccular (berry) Aneurysms
Fusiform (giant) aneurysms

26

Saccular (berry) aneurysms

Exacerbated (caused) by hypertension
increases risk of hemorrhage
the walls move out on one side of the vein, kinda like it's gonna go through exocytosis

27

Fusiform (giant) Aneurysms

walls move out on both sides like when you blow up ling skinny balloons

28

Cavernous Angiomas

group of dilated blood vessels with no other brain tissue
these are not that dangerous because they rarely hemorrhage.

29

capillary telangiectasis

small abnormally dilated capillaries. These are not that dangerous because they rarely hemorrhage.

30

venous angioma

abnormal cluster of veins draining a region of brain tissue. These are not that dangerous because they rarely hemorrhage.

31

Arteriovenous malformation (AVM)

most lethal
arteries and veins in tangle of malformed vessels
"tangle of worms"

32

Cerebral edema

increase in the fluid (intracellular or extracellular) with the brain

33

What are different types of cerebral edema?

vasogenic
cytotoxic
ischemic
interstitial
Hyrdocephalus

34

Vasogenic edema

increased capillary permeability

35

cytotoxic edema

block active transport
problem transporting ions so you get water movement due to ion imbalances

36

ischemic Edema

follows cerebral infarction
increased capillary permeability
block active transport (ion imbalances)
water movement

37

interstitial edema

CSF moves across ependymal cells from ventricles to interstitial space

38

Hydrocephalus

type of interstitial cerebral edema
result of excess fluid within the cranial vault, subarachnoid space, or both.

39

What is hydrocephalus caused by?

an interference in CSF flow.
-decreased reabsorption
-increased fluid production
-obstruction within the ventricular system

40

snout reflex

lips purse whenever touched lightly

41

palmomental reflex

twitch of cheek when stroking the palm

42

cerebral death

irreversible coma
death of the cerebral hemispheres exclusive of the brainstem and cerebellum

43

do you have behavioral or environmental responses in cerebral death?

No.

44

which functions are normal during cerebral death?

respiratory, cardiovascular, temperature control, and GI function.

45

survivors of cerebral death

remain in coma
emerge in a vegetative state
-akinetic mutism (AM)
-Locked-in syndrome

46

Akinetic mutism

less aware

47

locked-in syndrome

more aware

48

seizures

disruption in balance of excitation and inhibition signals

49

the sudden transient alteration of brain function in seizures is caused by:

an abrupt explosive disorderly discharge of cerebral neurons

50

convulsion

tonic-clonic (jerky, contract-relax) movements associated with some seizures.

51

generalized seizures

bilateral

52

partial (focal) seizures

unilateral

53

status epilepticus

experience of a second seizure before the person has fully regained consciousness/capacity from the preceding seizure or a singe seizure lasting more than 5 minutes

54

what are some consequences of seizures

250% increase in adenosine triphosphate (ATP) demand
cerebral oxygen consumption increased by 60%
cerebral blood flow also increases aprox 250%
available glucose and oxygen are depleted

55

what are some consequences of the depletion of available glucose and oxygen during seizures?

may produce secondary hypoxia and acidosis
may result in progressive brain tissue injury and destruction

56

epilepsy

to be seized by a force from without

57

two signals of seizure

aura
prodroma

58

aura

partial seizure prior to "real" seizure

59

prodroma

some sign like headache prior to seizure

60

treatment for seizure syndromes

fat-rich diet reduces seizure frequency

61

Cerebral edema caused by increased capillary permeability would be called:

Vasogenic

62

multiple sclerosis

destruction of the CNS due to inflammation of the vessels in the CNS and demyelination of nerve cells. A development of scars throughout the CNS

63

What is the cause of MS

interaction between autoimmune conditions, genetic make-up and viral infections of the brain.
(herpes simples and epstein barr)

64

what are clinical manifestations of MS?

they are highly variable. It can attach any part of the CNS at any time. Which can cause problems with motor, sensory, cognitive, or autonomic system function.

65

how do you diagnose MS?

High IgGin CSF
multiple lesions throughout the CNS detected by MRI.

66

when does MS usually happen?

between 20-40 yrs old.

67

in which gender is MS more prevalent?

females (2:1)

68

where is MS more common?

the further away from the equator you are.

69

what type of disease is MS thought to be

autoimmune

70

What are the different types of MS

mixed (general)
spinal
cerebellar

71

Mixed MS (general)

commonly have central problems (vision disturbances, memory deficits, mood alterations) along with motor/sensory impairments

72

Spinal MS

mostly sensory and motor deficits

73

Cerebellar MS

mainly motor-loss of coordination

74

what are some treatments for MS?

prednisone (or other anti-inflammatory steroids) to decrease inflammation
interferon beta 1b and beta 1a
estrogen (clinical trials) for women

75

Acute confusion states

mental disorder with deficits in attention and coherence of thoughts and action
-secondary to drug intoxication, metabolic disorder, or nervous system disease

76

dementia

progressive failure of cerebral functions not caused by an impaired level of consciousness

77

classifications of dementia

cortical
subcortical

78

cortical dementia

alzheimers disease

79

subcortical dementia

parkinson and huntington disease

80

Alzheimers disease

most common neurodegenerative disease worldwide

81

what causes alzheimer's disease

degeneration of the brain manifested by:
-morphological changes
-biochemical changes
relates to genetic factors and poorly identified environmental factors.

82

Morphological changes in Alzheimer's disease

decreases surface area of the brain due to a decrease in size of the folds
neurofibrillary tangles
senile plaques
decreased blood flow to the brain

83

neurofibrillary tangles

intracellular tangles of microtubules and microfilaments (detected upon autopsy)

84

senile plaques

areas of degenerated cells that coalesce around a fibrous core (detected upon autopsy) formed from a protein named beta amyloid

85

Clinical Manifestations of alzheimer's disease

slow and progressive change in memory (recent memory loss first)
changes in mood
changes in motor function (late)

86

Our results suggest that _________levels may be a risk factor for dementia, even among
persons without diabetes

higher glucose

87

alzheimers disease is typifies by ______

amyloid plaques

88

_____ enhances breakdown of amyloid

ApoE
which then prevents plaques

89

how is insulin resistance related to alzheimer's disease?

insulin resistance reduces cognitive function

90

insulin resistance _____ risk of dementia

increases

91

ketones _____ cognitive function

improve

92

is there an approved test for early diagnosis of alzheimers disease?

No :(

93

how do we diagnose alzheimers disease?

by ruling out other diseases and following the course of the disease

94

what are some preventative measure for alzheimers'

diet rich in folate
reduce refined carbs
insulin-sensitizing meds
increase essential fatty acids
physical activity
mental exercise

95

what is treatment for alzheimers?

there is no cure

96

Parkinson's disease

destruction of brain dopamine neurons in the striatum and substantia nigra

97

functional dopamine

coordinate the brain centers that monitor body position
involved in neuronal circuits that permit pre-programmed movements (movements w/o thinking)
inhibits the acetylcholine that cause muscle movement (reduces spontaneous, involuntary movements)

98

Clinical manifestations of parkinson's disease

tremor at rest
rigidity
akinesia (pill rolling)
dementia, slow thought process, or depression
shuffling gait
frozen face
postural abnormalities
disorders of righting and equilibrium

99

Diagnosis for parkinsons

case history, course of disease, and brain scans

100

environmental factors relates to parkinsons:

head trauma
exposure to anesthetics
exposure to hydrocarbons
pesticide exposure
drinking well water
working with wood or wood products
with in janitorial services

101

Treatment of Parkinsons

Levodopa (Ldopa) precursor to DA.
dopamine agonists
inhibitor of monoamine oxidase (the enzyme taht degrades DA)
electrode placed in basal ganglia of the brain

102

Huntington Disease is autosomal ____

dominant

103

Huntington disease

a type of chorea (family of dyskinesias)
sever degeneration of the basal ganglia and frontal cerebral cortex
disrupted thought process

104

clinical manifestations of huntington's

abnormal movement (hyperkinesia)
dementia characterized by irritability (often becomes violent), apathy, inability to plan and organize, loss of short term memory, and slow thinking.
euphoria or depression (bipolar, swing back and forth)
changes in different parts of the bain (basal ganglia) detected by MRI

105

is there a treatment of huntington's

no