Neurology Flashcards

Question

Acute Pain

Answer 1

``` Usually sudden and severe, short term Indicates tissue damage. May be localized or generalized. Initiates physiologic stress response. Increase blood pressure and heart rate; cool, pale, moist skin; increase respiratory rate; increase skeletal muscle tension Vomiting may occur. Strong emotional response may occur. ```

Answer 2

Occurs over extended time; may be recurrent. Usually more difficult to treat than acute pain Often perceived to be generalized. Individual may be fatigued, irritable, depressed. Sleep disturbances common Specific cause may be less apparent. Appetite may be affected. Can lead to weight gain or loss

Answer 3

Congested sinuses, nasal congestion, eye strain Muscle spasm and tension: From emotional stress In temporal area: Temporomandibular joint syndrome Migraine: Abnormal blood flow and metabolism in the brain Intracranial: Increased pressure inside the skull Central pain: Caused by dysfunction or damage to the brain or spinal cord Neuropathic pain: Caused by trauma or disease involving the peripheral nerves Ischemic pain: Results from a profound, sudden loss of blood flow to an organ or tissue Cancer-related pain: caused by advance of the disease; pain associated with treatment; result of coexisting disease

Answer 4

Middle of the brain orients body processes sensory input

Answer 5

back of brain | -vision

Answer 6

``` front of brain -personality decision-making movement behavior mood ability to plan ```

Answer 7

temple area hearing speech memory

Answer 8

heartrate respiration alertness

Answer 9

Controls voluntary movement | coordination

Answer 10

Anterior: carotids - at the circle of willis divides into middle cerebral artery (MCA) and anterior cerebral artery (ACA) Posterior: Vertebrals - converge to form the basilar artery - terminates into the L&R posterior cerebral arteries

Answer 11

- localized weakness in the wall of the artery - usually multiple - at points of bifurcation - initially small and asymptomatic

Answer 12

``` Enlarging aneurysm - pressure on surrounding structures or nerves - loss of visual field or visual disturbance - headache A small leak: - headache - photophobia - intermittent periods of dysfunction (confusion. slurred speech, weakness) - nuchal rigidity or neck stiffness Massive rupture: - immediate severe blinding headache - vomiting -photophobia -seizures and LOC -leading to death ```

Answer 13

surgical treatment - if diagnosed before rupture: clipping and tying off - clipping may be done after rupture: reduce rebleeding focused on reducing increased ICP and cerebral vasospasm

Answer 14

General term for all types of arterial changes - degenerative changes in small arteries and arterioles - loss of elasticity, walls thick and hard - lumen gradually narrows and may become obstructed - leading to ischemia and necrosis in tissues as kidney - cause of increased BP

Answer 15

Large and medium sized arteries - presence of atheroma: plaques consisting of lipis, calcium, and possible clots - related to diet, exercise and stress formation of fibro fatty lesions in initmal lining of arteries - vessel narrowing and ischemia - may occlude the vessel and predispose the formation of a thrombus - leading cause of CAD and CVD

Answer 16

``` essential element synthesized in liver transported in combination with proteins as Very low density lipoprotein (VLDL) low density lipoprotein (LDL) high density lipoprotein (HDL) ```

Answer 17

has higher cholesterol component than proteins transports cholesterol from liver to cells major factor contributing to atheroma formation "Bad" lipoprotein less than 3.5mmol/L is good unless high risk than 2.0mmol/L is target

Answer 18

has more protein than cholesterol transports chloesterol away from peripheral cells to liver catabolism in liver and excretion higher than 1.0 mmol/L for men and 1.3 for women

Answer 19

1. intake of cholesterol and triglycerides 2. Chylomicrons absorbed into blood and lymph 3. Lipid uptake by adipose and skeletal muscle cells 4. Remnants to liver 5. Liver synthesizes lipoproteins 6. LDL transports cholesterol to the cells 7. LDL attaches to LDL receptor in smooth muscle and endothelial tissue 8. HDL transports cholesterol from cells to liver

Answer 20

high triglycerides are linked to low levels of HDL, excess body weight and poorly controlled diabetes - less than 1.7mmol/L

Answer 21

rate shows how high HDL is relative to the overall levels a lower number is associated with decreased risk of heart disease less than 5.0mmol/L is target

Answer 22

``` affected by: excess caloric intake (Lower HDL, Raise LDL) saturated fats (raises VLDL and LDL) Cholesterol (increase LDL) Primary = familial Secondary = obesity, diabetes mellitus ```

Answer 23

``` nonmodifiable: - age -gender -genetic or familial Modifiable - obesity - sedentary -cigarette smoking - diabetes mellitus -poorly controlled hypertension - combination of oral contraceptives and smoking ```

Answer 24

- there is damage to the endothelium - cholesterol collects under damage and endothelium is oxidized - inflammatory response happens and brings monocytes - monocyte converts to macrophage and becomes engorged with cholesterol, becomes foamy and dies - foamy cells accumulate and pile, release cytokines which brings more monocytes etc - LDL is still being deposited forming a fatty streak - smooth muscle cells proliferate, multiply and move into the tunica intima - muscle cells cover the plaque by producing a fibrous cap of collagen and elastin. Calcium is deposited - platelets adhere to cap forming thrombus and release prostagladins which precipitate inflammation and vasospasm, drawing more platelets

Answer 25

serum lipid levels: LDL and HDL exercise stress testing: Screening for arterial obstruction nuclear med studies: determine the degree of tissue perfusion

Answer 26

- weight loss - increase exercise - dietary modification - reduction of sodium intake - control hypertension - control of primary disorder - cessation of smoking - antilipidemic drugs - surgical intervention: CABG

Answer 27

- an infarction of brain tissue that results from lack of blood - 5 minutes of ischemia causes irreversible nerve cell damage - central area of necrosis develops - all function lost - surrounded by an area of inflammation. this zone will regain function following healing Types: Ischemic, hemorrhagic

Answer 28

Thrombotic: occlusion - atheroma, often in large arteries Embolus: sudden obstruction - lodging in a cerebral artery May be transient (TIA)

Answer 29

Atherosclerosis happens Cerebral edema and area of infarction keep increasing in the first 48-72 hrs. with gradual obstruction, collaterals tend to enlarge or extend into adjacent tissue Neurons do not regenerate: area of scar tissue with perm loss of neurons Recovery of some loss of function is possible -

Answer 30

come on suddenly and include one or more of the following - face may droop - may not be able to raise arm on one side - may feel confused and have trouble understanding what people are saying - speech may sound slurred and jumbled when you talk (aphasia) - may have difficulty seeing with one or both eyes - S&S develop depending on where the damage is done

Answer 31

uncommon but often fatal - problems with breathing, heart function, balance and coordination, chewing, swallowing, speaking, and seeing as well as weakness and paralysis on both sides of body

Answer 32

less common than in the cerebrum but can cause severe effects including problems with balance and coordination, dizziness, headaches, nasuea and vomiting

Answer 33

cause weakness or paralysis on the right side of your body, and cognitive problems including difficulties with reading talking and thinking and learning and remembering new information

Answer 34

cause problems with vision, depth perception, short-term memory loss, and judgement, as well as weakness or paralysis on the left side, and a tendency to ignore things on your left side including your own left arm and leg

Answer 35

Anosognosia: incorrect perception of self and illness, secondary to loss of parietal lobes Erroneous perception of self in space, may neglect all input from the affected side Homonymous hemianopia: blindness occurs in same half of visual fields of both eyes agnosia: inability to recognize an object by sight, touch or hearing apraxia: inability to carry out learned sequential movements on command

Answer 36

may occur singly or in a series | result from temporary localized reduction of blood flow in the brain

Answer 37

``` partial occlusion of an artery atherosclerosis small embolus: blood clot after rupture vascular spasm local loss of autoregulation ```

Answer 38

directly related to location of ischemia intermittent short episodes of impaired function: muscle weakness in arm and leg Visual disturbances numbness and paresthesia in face transient aphasia or confusion may develop repeated attacks may be a warning sign for obstruction

Answer 39

- caused by rupture of a cerebral artery in patient with severe hypertension and aneurysm - effects are evident in both hemispheres - complicated by secondary effects of bleeding Usually abrupt onset -10-20% of all strokes -HTN, ruptured aneurysm, trauma - 50% mortality rate - +++++ disability (mortality)

Answer 40

blood from vessel leaks into surrounding cerebral tissue blood accumulation exerts pressure on surrounding areas macrophages move in: phagocytosis of blood and necrotic tissue

Answer 41

bleeding within the brain 10% of all strokes

Answer 42

bleeding into the CSF between the arachnoid and the pia mater membranes on the surface of the brain

Answer 43

``` severe and sudden headache "thunderclap" vomitting nuchal (neck muscles) rigidity stupor, coma seizures ```

Answer 44

``` clot busting agents thrombectomy/embolectomy surgical intervention glucocorticoids supportive treatment occupational and physical therapists treat underlying problem rehab ```

Answer 45

stop smoking lose weight and be active control diabetes, HTN, dyslipidemia, Afib modify alcohol use

Answer 46

- massive fasting hyperchylomicronemia even following normal dietary intake resulting in high TG - deficiency of lipoprotein lipase or normal apoliprotein CII (rare) - not associated with increase CAD - treat: low fat diet, no drug therapy

Answer 47

- elevated LDL with normal VLDL due to a block in LDL degradation. result = increased serum cholesterol but normal TG levels - caused by defects in the synthesis or processing of LDL receptors - ischemic heart disease is greatly accelerated - treat: diet, heterozygotes: Cholestyramine and niacin or a statin

Answer 48

similar to type IIA except VLDL is also increased - elevated serum TG and cholesterol levels caused by overproduction of VLDL by the liver relatively common treatment: diet, drug therapy similar to type iia

Answer 49

serum LDL increased -> increased TG and cholesterol cause is either overproduction or underutilization of LDL due to mutant apolipoprotein E Xanthomas and accelerated vascular disease develops in patients by middle age treat: diet, niacin and fenofibrate or statin

Neurology Flashcards

(73 cards)