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Physio > physio final lecture 6/microbiome/TBI/stroke syndrome > Flashcards

physio final lecture 6/microbiome/TBI/stroke syndrome Flashcards

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1
Q

Broca’s Area

A

“non-fluent” “Broca’s broken words”
motor frontal lobe
speech is slow and broken
known

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2
Q

Wernicke’s area

A

“fluent”
sensory, temporal lobe
speech is normal and excessive

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3
Q

Learning

A

acquisition of new information
process by which experiences change our nervous system and our behaviors

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4
Q

stage 1 of learning

A

sensory information;
first processed through out senses
“echoic memory”
< 1 second

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5
Q

Stage 2 of learning

A

short term memory
meaningful/salient information
< 1 minute
can support via repetition or chunking (7 +/- 2 rule)

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6
Q

stage 3 of learning

A

long term memory
short term memories are converted into long term memories (consolidation “made solid”)
can be retrieved across lifetime
increased retrieval “rehearsal” = strengthening of memory
hippocampus

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7
Q

Observational learning

A

“social learning theory”
process of learning by watching the behaviors of models
occurs via operant conditioning and vicarious conditioning (can be positive or negative)
pro social and antisocial modeling

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8
Q

pro social modeling

A

prompts engagement in helpful and healthy bxs

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9
Q

antisocial modeling

A

prompts others to engage in aggressive/unhealthy bx

Bandura and BoBo doll - physical aggression

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10
Q

we are more likely to mimic models who:

A

positive perception (like or high status)
shared traits
stand out
familiarity
self-efficacy in mimicry
social media - influencers
violence in games and entertainment

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11
Q

social learning theory order:

A

attention > retention > production > motivation (positive or negative)

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12
Q

Middle cerebral artery (MCA) stroke

A

90% of strokes
largest of the brain arteries
supplies most of the outer surface of the frontal, parietal, temporal, and basal g

includes: pre-central (sensory) and post-central (motor) gyrus

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13
Q

MCA stroke symptoms

A

contralateral weakness and sensory loss in upper extremities
loss of visual field
left MCA stroke = speech deficits (Broca’s and Wernicke’s aphasia)
Right MCA stroke = neglect and poor motivation (flat prosody)

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14
Q

Anterior cerebral artery (ACA) stroke

A

less common
Left ACA > R ACA
feeds deep structures in the brain: frontal, parietal, corpus callosum and bottom of cerebrum

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15
Q

ACA stroke symptoms

A

contralateral motor and sensory loss in lower extremities
poor gait and coordination (clumsy)
slowed initiation (abulia)
flat affect
urinary incontinence

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16
Q

Post-stroke depression tx =

A

early psychopharmacological tx is KEY

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17
Q

Depression and post-stroke considerations

A

1/3 survivors
6x increased risk of depression 2-3 years post stroke
more common in Left frontal and BG stroke
adversely effects fxal recovery
increased risk factors = premorbid depression and social isolation post stroke

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18
Q

Anxiety and post-stroke considerations

A

1/4 meet GAD criteria post stroke
less common

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19
Q

Psychosis and post-stroke considerations

A

more common in right-temporo-parietal-occipito area lesions, seizures and subcortical atrophy
pseudobulbar affect = 10-15% post-stroke patients
hypomanic symptoms = 1%

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20
Q

BE FAST (strokes)

A

Balance - have they lost balance
Eyes - have they lost vision in one/both eyes
Face - does the persons face look droopy
Arms - can they raise both arms for 10 secs
Speech - do they have slurred speech
Time - “time is brain” call 911

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21
Q

tissue plasminogen (tPA)

A

can be administered within 4.5 hours
helps restore blood flow to brain regions affected by stroke
after time limit = hemorrhagic effect

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22
Q

deficiency of vitamin D

A

depression/negative emotions
nearly 40-50% of men and women in Denver metro are deficient in vitamin D
more melanin in skin = harder to synthesize vitamin D
concurrent use with anti-depressants = supported

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23
Q

magnesium deficiency

Study These Flashcards
A

w/stress = increased agitation, anxiety, sleeplessness, headaches, and apathy
can tx restless leg syndrome
slow response time to reach steady state via oral supplements (~30 weeks)

24
Q

omega-3 fatty oils

Study These Flashcards
A

add on tx for depression = strong evidence
add on tx for ADHD = some evidence

25
Anorexia
twin studies = 58-76% hereditary risk increases with premature birth or birth trauma associated with: - loss of gray and white matter in the brain - enlarged ventricles and widened sulci (shrinkage of brain tissue) inhibited emotional facial expression despite reporting similar or more intense emotions tissue loss can be reversed with successful eating disorder tx
26
starvation study
6 months ate at 50% of baseline loss 25% of body weight demonstrated preoccupation w/food, ritualistic eating, erratic mood, impaired cognition, slowed eating/lingering post-study: complained of fat on their abdomens and legs
27
excessive exercise
starved mice will still run on their wheel all day = looking for food?
28
gender differences in anorexia
women at less post-fast than men
29
anorexia tx
CBT, increasing eating speed, stimulation of ACC
30
restricted food access =
starvation = anorexia
31
alpha diversity
a measure of microbial ecology of "species" diversity within a sample; species in my mouth
32
beta diversity
a measure of microbial ecology of species diversity between samples: difference in species in my mouth compared to someone else's mouth
33
dysbiosis
disruption of the gut microbial diversity and community structure; due to reduction in beneficial bacteria and overgrowth of harmful bacteria, yeast, and/or parasites
34
alpha diversity, beta diversity, dysbiosis
"health promoting" "disease predisposing"
35
one factor contributing to increase in chronic inflammatory d/o in high income countries =
failing immunoregulation attributable to reduced exposure to the microbial environment within which the mammalian immune system co-evolved "old friends" and a Failure of immunoregulation
36
"old friends" and psychiatric d/o
some psychiatric d/o in developed countries might be attributable to failure of immunoregulatory circuits to terminate ongoing inflammatory response
37
sex/age breakdown of TBI
highest: - males 15-24 yrs (400,000) - females 75+ yrs (100,000) - total: people 15-24 years (250,000) lowest: - males: 45-54 and 65-74 years - females: 35-44 and 55-64 years - total: people:
38
Diffuse axonal injury (DAI)
shearing/tearing of the brain's long connecting nerve fibers (axons) that happen when the brain is injured as it shifts and rotates inside the skull damage to white matter changes are microscopic can lead to disorders of consciousness (persistent vegetative state, coma) difficult to see on CT or MRI can occur without other visible damages
39
grade 1 DAI
mildest form of DAI microscopic changes in the white matter of the cerebral cortex, corpus callosum, brain stem and cerebellum
40
grade 2 DAI
moderate form of DAI grossly evident focal lesions isolated to the corpus callosum
41
grade 3 DAI
severe form of DAI additional and severe focal lesions on the brainstem itself
42
classification system for TBI
duration of unconsciousness Glasgow coma scale post-traumatic amnesia
43
classification system for TBI: mild
duration of unconsciousness: <30 mins Glasgow Coma scale: 13-15 PTA: <24 hours
44
classification system for TBI: moderate
duration of unconsciousness: 30 min-24 hours Glasgow Coma scale: 9-12 PTA: 1-7 days
45
Classification system for TBI: severe
duration of unconsciousness: >24 hours glasgow coma scale: 3-8 PTA: >7 days
46
Glasgow coma scale
eye opening best motor response verbal response
47
Glasgow coma scale limitations
substance use administered drugs intubation - no verbal response injury to eye - no eye opening hemiplegia - no motor response language - verbal response
48
non-injury risk factors that can influence TBI outcomes
pre-injury psychiatric status and conduct issues/incarceration = negatively effect outcome, can prolong symptoms age at injury - older = longer recovery level of education stable employment 6 months pre-injury = best predictor of return to employment post-injury marital status = proxy for perceived social support other non-neurological injuries sustained = physical injuries can prevent return to meaningful activities
49
why loss of consciousness in subarachnoid hemorrhage
"transient intracranial circulatory arrest" "percussive" blood pressure impact of the hemorrhage increases ICP (intracranial pressure) = reduced CPP (cerebral perfusion pressure)
50
Hunt-Hess and Fisher Scale grade I
HH: asymptomatic or minimal headache and slight nuchal rigidity Fisher: no blood visualized
51
Hunt-Hess and Fisher scale grade V
HH: deep coma, decerebrate rigidity, moribund appearance
52
hemiplegia
paralysis affecting one side of the body (face arm trunk leg)
53
hemiparesis
implies a lesser degree of weakness than hemiplegia
54
neglect
failure to attend to, respond to, and/or report stimulation that is introduced contralateral to the lesion - most often seen with non-dominant parietal association area lesions - affects contralesional side persistent neglect is a negative fxal outcome predictor
55
Agnosia
acquired inability to associate a perceived unimodal stimulus (visual, auditory, tactile) with meaning disorder of recognition NOT NAMING
56
anosagnosia
denial of deficit
57
prosopagnosia
impaired ability to recognize faces

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