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Pathophysiology > Neurological Function and Dysfunction > Flashcards

Neurological Function and Dysfunction Flashcards

1
Q

What are the four divisions of the brain?

A

cerebrum
diencephalon
cerebellum
brainstem

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2
Q

Which of the following is incorrect?

A: Meningitis is more common than encephalitis

B: Ischemic events are a more common cause of stroke than hemorrhagic events

C: A lumbar puncture in an individual with raised ICP could be problematic

D: A lesion in the left motor cortex would result in left sided paralysis

A

D

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3
Q

A cerebellar stroke might result in which of the following?

A. Left sided lower leg paralysis

B. Difficulty speaking and slurred speech

C. Vertigo and postural imbalance

D. Facial drooping

A

C

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4
Q

Which of the following is correct?

A. Hemorrhagic strokes are more common than ischemic strokes

B. An embolic stroke is exactly the same thing as a thrombotic stroke

C. The most common cause of a hemorrhagic stroke is an arterio-venous malformation

D. The middle cerebral artery is one of the more commonly involved cerebral arteries in ischemic strokes

A

D

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5
Q

Which of the following is correct regarding intra-cranial bleeds?

A. Subdural bleeding is usually arterial

B. Epidural bleeding is usually venous

C. Epidural bleeds are usually post-traumatic, where as subdural bleeds may occur spontaneously in some situations

D. Epidural bleeding rarely affects intra-cranial pressure…Although it may result in brain herniation

A

C

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6
Q

Unilateral paralysis involving which cranial nerve might mimic a stroke?

A. CN X

B. CN XIII

C. CN VII

D. CN XII

A

C (facial nerve that results in facial droop)

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7
Q

what is in the cell and what is out of the cell?

A

potassium IN, sodium OUT

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8
Q

dura mater

A

outermost meningeal later that is a thick, tough, and collagenous membrane

venous sinuses collect blood from the cerebral veins between the two layers of the dura at the base of the septum

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9
Q

arachnoid mater

A

thin, delicate membrane that is weblike that has CSF flowing within it

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10
Q

pia mater

A

attached to the brain and is very thin

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11
Q

carotid arteries

A

supply the anterior portion of the brain

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12
Q

vertebral arteries

A

posterior portion of the brain

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13
Q

trabecular

A

strands of collagenous connective tissue that extend down to the pia mater that forms the subarachnoid space

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14
Q

circle of willis

A

where the four arteries intersect and distributes the blood to the rest of the brain

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15
Q

what are the beings that return the deoxygenated blood?

A

internal jugular and subclavian

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16
Q

dorsal column tract

A

fine touch and pressure sensory

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17
Q

anterolateral tract

A

pain response sensory

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18
Q

corticospinal tract

A

voluntary motor

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19
Q

what is the most common type of stroke?

A

ischemic

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20
Q

thrombus (ischemic stroke)

A

blood clot formed in place that blocks blood flow that is often a result of hypercoagulation or stiffened/narrow blood vessels

clot travels

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21
Q

atherosclerosis (ischemic stroke)

A

build-up of fats/cholesterol on the artery walls

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22
Q

ischemic (embolus stroke)

A

obstruction of an artery by blood or air

associated with cardiac dysrhythmias and carotid arteries

clot doesnt travel

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23
Q

what are the two hemorrhagic stroke types?

A

subarachnoid and parenchymal

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24
Q

AVM (hemorrhagic stroke)

A

congenital vascular lesions that cause swelling

initial manifestation is hemorrhage in half the cases

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25
aneurysm (hemorrhagic stroke)
not totally understood but is a weakness in the vessel that causes an out-pouching high mortality rate worst headache ever (meningeal irritation)
26
anterior cerebral (frontal) stroke signs
Motor and sensory loss on the opposite side with speech abnormality
27
middle cerebellar stroke signs
Motor and sensory loss on the opposite side with speech abnormality
28
posterior cerebral (occipital) stroke pattern
visual disturbance
29
vertebro-basillar (cerebellum/brainstem) stoke signs
disturbance of gait and visuals
30
umbra
core of the stroke
31
penumbra
the more reversible perimeter of the stroke
32
typical stroke manifestations
dysphagia aphasia middle cerebral artery or smaller branch involvement BE FAST
33
epidural hematoma
blood sits above the dura blunt force trauma to the temple lucent interval middl meningeal artery
34
Lucent interval
the section of time after the initial trauma of an epidural hematoma when the person is normal and conscious
35
subdural hematoma
sits IN the dura in the subarachnoid space shearing forces bridging veins slow onset of symptoms
36
brain herniation
the protrusion of brain tissue through an opening in the supporting dura in the brain Cushing triad: bradycardia irregular respirations widened pulse pressure
37
glasgow coma scale
3-15 score Eyes Open Open in response to speech To pain Never Verbal Oriented x 3 Confused speech Inappropriate Incomprehensible sounds None Motor Obeys commands Localized withdrawal from pain Withdrawal from pain Decorticate Decerebrate None (flaccidity)
38
meningitis
inflammation of the menninges that is most commonly caused by a bacteria headache, fever, stiff neck, altered mental status
39
encephalitis
inflammation of the brain parenchyma that is most commonly caused by a virus (strep pneumonia, n meningitides, h influenza b) typically evolve over several days and commonly include fever, headache, seizure, confusion, stupor, and coma altered mental status is possible
40
seizure disorder causes
Electrolyte disturbances (most common) Structural lesions (tumors) Infection Hypoxia Acidosis Acute Alcohol Withdrawal Idiopathic
41
generalized seizure
involves the whole brain motor/grandmal/ tonic-clonic nonmoter/petit/absence syndromes (mostly kids)
42
focal seizures
involves part of the brain simple is no impairment of consciousness but odd sensations, hearing troubles, etc complex is imparted awareness
43
epileptic seizure
problem is primarily in the brain causes: Head trauma Stroke Infection Tumor Congenital
44
non-epileptic seizure causes
Fainting (hypoxic seizure) Physiological Hypoglycemia Alcohol withdrawal Electrolyte imbalance (MOST common)
45
dementia
progressive deterioration and decline of memory and other cognitive changes like personality and behavior changes that has a slow onset
46
dementia clinical manifestations
The slow progression from memory loss and forgetfulness to the inability to self-care Cognitive deficits Anxiety Depression Psychosis Inability to complete activities of daily living
47
Alzheimer's disease etiology
Amyloid plaques Amyloid precursor protein= involved in normal cell membranes, but if beta-amyloid is produced wrong, the protein is cut in the wrong place which causes aggregates of B-amyloid form to create plaques in the brain causes neurofibrillary tangles atrophy of the brain acetylcholine imbalance
48
vascular dementia
results from multiple infarctions of the brain
49
Parkinson's disease
basal ganglia are affected but dopamine deficiency is big while acetylcholine is up (major imbalance)
50
acquired Parkinson's disease
rapid onset of symptoms that tense to be due to infection, drug toxicity, or trauma
51
idiopathic Parkinson's disease
insidious onset of symptoms that is likely from a genetic component A synuclein gene- a major component of Lewy bodies Parkin gene- protein degradation and clearance
52
what happens before the onset of symptoms of Parkinson's?
75-80% of dopamine neurons in substantia nigra are dead
53
Parkinson's clinical manifestations
Loss of flexibility Tremor Cogwheel rigidity Bradykinesia Micrographia Mask faces Low volume and monotone speech pattern Autonomic dysfunction
54
tardive kinesia
older term for tic-type things that were associated with anti-psychotics
55
Cerebral palsy
conditions to the upper motor neurons that control muscle movement and often appear during childhood and are permanent
56
spastic CP
Most common Rigidity/Hyperreflexia/Clonus Hemiplegia/Paraplegia/Quadriplegia
57
dyskinetic/athenoid CP
Second Most Common Slow, Jerky, uncoordinated purposeful movements
58
ataxic CP
Rare Gait disturbance Truncal stiffness
59
CP neurological complications
Seizures Intellectual Impairment Visual Problems Hearing Problems
60
hydrocephalus
abnormal accumulation of CSF that is often associated with neural tube defects
61
normal pressure hydrocephalus
On-set late in life Classic clinical triad: Gait instability Urinary incontinence Dementia
62
obstructive hydrocephalus
usually congenital
63
communicating hydrocephalus
Aquired
64
cerebellar disorders
clinical hallmark is ataxia and uncoordinated movement
65
multiple sclerosis
chronic autoimmune demyelinating disease of the CNS with a female predominance most are relapsing-remitting MS cases
66
MS clinical manifestations
Highly variable Optic and oculomotor nerves are commonly effective Lack of coordination Diplopia Paresthesias
67
spina bifida
failure of the neural tube to close folate is important prenatally for prevention
68
spina bifida cystic
protrusion of a sac-like structure
69
spina bifida occulta
the anomaly is not visible
70
amyotrophic sclerosis
degradation of motor neurons of the lateral columns (cortico-spinal tract)
71
ALS clinical manifestations
Weakness Atrophy Cramps Twitching Hyperreflexia in a weak, atrophic extremity Muscles of swallowing/breathing are affected
72
spinal shock
transient loss of function below the level of injury Flaccid Paralysis Loss of Reflexes Loss of Pain Sensation Loss of Bowel/Bladder Control
73
Guillain-barre syndrome
acute demyelination of the PNS that is often associated with infections triggers like C. jejuni
74
how does Guillain-barre syndrome progress?
Ascending pattern of paralysis that begins in the legs and progresses toward the head spontaneous recovery in the reverse direction of the onset
75
Bells palsy
paralysis of the facial nerve VII that tends to affect one side
76
focal injury
localized at the site of impact on the skull can be polar or diffuse
77
concussion
minor brain injury with no evidence on a scan but an alteration in LOC for less than 30 min
78
contusion
when brain tissue damage is seen
79
Polar injuries (coup contrecoup)
consequences of the brain shifting within the skull and meninges during acceleration-deceleration movement which results in injury at two opposite poles of the brain
80
Polar injuries (coup contrecoup)
consequences of the brain shifting within the skull and meninges during acceleration-deceleration movement which results in injury at two opposite poles of the brain
81
Monro-Kellie doctrine
the compensatory responses to a change in volume of any three components (CSF, brain tissue, and blood)
82
hemorrhagic strokes
hemorrhage within the brain parenchyma and usually occurs in the context of severe and often long-standing hypertension in approximately 60% of cases
83
ischemic stroke
sudden occlusion of a cerebral artery
84
thrombotic strokes
associated with atherosclerosis in extra or intracranial vasculature and hypercoagulable states
85
embolic strokes
from cardiac source
86
stages of a seizure
aura tonic- stiff body, incontinence clonic- jerky movements postictal- exhaustion and weak limbs
87
Which of the following is incorrect? A: Most seizures are probably idiopathic or hypoxic B: Most cases of dementia are a result of the abnormal production of a normal protein C: A patient presenting with a vertigo and ataxia is more likely to be having a cerebellar stroke than an inner ear problem D: In a woman of childbearing age, a little extra folate isn’t a bad idea
C
88
Which of the following statements regarding Multiple Sclerosis is correct? A. It is exactly the same disease as Guillan-Barre Syndrome, except MS is chronic and GB is not B. Males tend to get MS more than Females C. There is no cure for MS D. MS almost always initially presents with diplopia
C
89
Which of the following signs and symptoms would be atypical for Parkinson’s disease? A. A transient intention tremor in the right arm B. Muscular rigidity C. Depression D. Kyphosis
A
90
Which of the following statements regarding ALS is correct? A. It’s another non-specific demyelinating disease, like MS B. The disease primarily affects upper and lower motor neurons C. The disease primarily affects sensory neurons D. Most cases are related to one specific identified genetic mutation, with autosomal dominant inheritance
A

Pathophysiology (2 decks)

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