Unit 5 Chapter 15-18 Flashcards
(215 cards)
1
Q
primary motor cortex responsible for
A
execution of a movement
2
Q
premotor cortex is responsible for
A
generating a plan of movment
3
Q
supplemental motor cortex is responsible for
A
rehearsing motor sequences of movement
4
Q
upper motor neurons are in the
A
brain and spinal cord
5
Q
upper motor neuron directly or indirectly innervate the
A
lower motor neurons or contracting muscles
6
Q
2 motor systems
A
extrapyramidal and pyramidal
7
Q
extrapyramidal
A
most go to the same side of the body
8
Q
pyramidal
A
most cross to other side of body
9
Q
upper motor neurons are located in
A
brain and spinal cord
10
Q
lower motor neurons send axons out of the
A
spinal cord
11
Q
hypotonia
A
reduced excitability of stretch reflex results in decreased muscle tone ranging from weakness to paralysis; decreased function of LMN, damage to stretch reflex or peripheral nerves
12
Q
hypertonia/spasticity
A
abnormal increase in muscle tone due to increased excitation, loss of inhibition of LMN or UMN lesions
13
Q
rigidity
A
greatly increased resistance
14
Q
a disease that has rigidity (inhibition of alpha LMN)
A
parkinsons
15
Q
clonus
A
rhythmic contraction and relaxation of limb
16
Q
upper motor neuron damage causes
A
weakness and loss of voluntary motion
17
Q
when there is upper motor neuron damage spinal reflexes remain intact but cannot be
A
modulated by the brain
18
Q
upper motor neuron results in what
A
increased muscle tone
hyperreflexia
spasticity
19
Q
lower motor neuron damage affects
A
directly innervating muslces
20
Q
when there is lower motor neuron irritation there is
A
spontaneous muscle contractions; fasciculations
21
Q
when there is lower motor neuron death there is
A
loss of spinal reflexes
flaccid paralysis
denervation atrophy of muscle
22
Q
paralysis
A
loss of movement
23
Q
paresis
A
weakness of incomplete loss of muscle function
24
Q
hemiparesis/hemiplegia
A
both limbs on one side
25
paraparesis/paraplegia
paralysis of both lower limbs
26
quadriparesis/quadriplegia
all four limbs
27
example of disease that affects the skeletal muscle
muscular dystrophy
28
muscular dystrophy is inherited or environmental
inherited
29
muscular dystrophy is what chromosome and recessive or dominant
X chromosome recessive
30
muscular dystrophy is duchenne inherited mutation results in defective form of _______ protein associated with muscle cell _____________ faults to provide normal attachment for contractile proteins
large, membrane
31
muscular dystrophy will progress to
respiratory failure
32
decreased acetylcholine release is called
botulism (neurotoxins)
33
you can acquire botulism from where
dented canned good
34
decreased acetylcholine effects on muscle cells
curare (drugs), myasthenia gravis
35
myasthenia gravis is a disease of where
neuromuscular junction
36
myasthenia gravis is what kind of disorder
autoimmune
37
myasthenia gravis affects the _____________ at neuromuscular junction
transmission
38
myasthenia gravis is antibody mediated loss of ________________ receptors at junction
acetylcholine
39
myasthenia gravis ocular to generalized weakness from __________ to _______ portions of the body
proximal to distal
40
will your respiratory system because compromised with myasthenia gravis
yes
41
what is a trigger for myasthenia gravis
thymus
42
peripheral nerve disorders
any primary disorder of the peripheral nerve
43
results of peripheral nerve disorders
muscle weakness, with to without atrophy and sensory changes
44
mononeruopathy does it affect multiple or one nerve
one
45
example of mononeuropathy
carpal tunnel
46
carpal tunnel is the compression of the
median nerve
47
carpal tunnel is caused by reduction in capacity which is _______ changes or increase on volume of contents which is ___________
bone, inflammation
48
polyneuropathy does it affect one or multiple nerves
multiple
49
example of polyneuropathy
Guillain barre
50
Guillain barre syndrome
infiltration of peripheral neurons, edema and demyelination
51
what is the cause of Guillain barre
unknown
52
Guillain barre is progressive ascending muscle weakness producing ________ _________
flaccid paralysis
53
is there recovery in Guillain barre
spontaneous recovery in 80-90%
54
back pain is what kind of nerve injury
peripheral
55
back pain is often due to
compression of nerve root by vertebrae or vertebral disc
56
basal gangila
inhibit and modulate movement patterns
57
2 main pathways of the basal ganglia
dopamine, y-aminobutyric acid (GABA) pathway
58
the dopamine pathway if from the substantia nigra to the
striatum
59
the GABA pathway is from the striatum to the globus pallidus and
substantia nigra
60
characteristics of disorders of the basal ganglia
involuntary movements, alterations in muscle tone, disturbances in body posture
61
chorea
irregular wriggling/writhing movement
62
athetosis
continuous twisting movement
63
ballismus
violent flinging movements
64
dystonia
rigidity
65
dyskinesias
wriggling, writhing movements
66
example of basal ganglia disorders
tics, tremors
67
which disease is a result of basal ganglia dysfunction
tourette syndrome
68
parkinsons is a degenerative disorder of BG caused by progressive deterioration of ___________ pathway
negrostriatal
69
parkinsons will have ______ depletion, tremors, rigidity, and what kind of movement
dopamine, bradykinesia (slow movement)
70
amyotrophic lateral sclerosis/Lou Gehrig affects what cells of the spinal cord
anterior horn
71
amyotrophic lateral sclerosis/Lou Gehrig affects what of the brain
motor nuclei (brain stem) and UMN (cerebral cortex
72
amyotrophic lateral sclerosis/Lou Gehrig will have fiber atrophy in the
CS tract and lateral and anterior columns
73
amyotrophic lateral sclerosis/Lou Gehrig the death of the LMN leads to ____________ with subsequent shrinkage of musculature and muscle fiber atrophy
denervation
74
does amyotrophic lateral sclerosis/Lou Gehrig lead to respiratory failure
yes
75
what is the most common non traumatic cause of neurologic disability among young and middle age adults
multiple sclerosis
76
multiple sclerosis is the destruction of _______ on axons
myelin
77
multiple sclerosis: when there is no myelin there is decreased
conduction velocity
78
multiple sclerosis there is demyelination of nerve fibers where
white matter of brain, spinal cord and optic nerve
79
multiple sclerosis demyelination is a result of
immune mediated inflammatory response in genetically susceptible individuals
80
multiple sclerosis is characterized by
exacerbations and remissions over many years in several different sites in the CNS (AKA: getting better and then getting worse but every time the get even worse)
81
spinal cord injury is most common in
males
82
majority of causes of spinal cord injuries is because of
vehicular and falls
83
immediate damage of spinal cord injury is
spinal cord shock and primary neurologic damage
84
spinal cord shock
temporary complete loss of function below injury
85
primary neurologic injury
irreversible damage to neurons
86
neurogenic shock will have Brady or tachycardia
bradycardia
87
why would someone with neurogenic shock have bradycardia
because vagus nerve is stimulated
88
primary injury
neurologic damage that occurs at the MOMENT of impact
89
secondary injury
refers to the complex biochemical processes affecting cellular function. can be minutes or weeks after primary
90
upper motor neurons are
t12 and above
91
do spinal reflexes still work in upper motor neurons
yes
92
in upper motor neuron damage they are no longer modulated by the
brain
93
someone with upper motor neuron damage they will have what
hypertonia and spastic paralysis
94
lower motor neurons are
t12 and below
95
in lower motor neuron damage the cells in the spinal reflex arcs are
damaged
96
lower motor neuron damage will present with what paralysis
flaccid
97
you need what to grip hand
C7-C8
98
c1-c4 injury
quadriplegic
no respiratory function
99
c4-c5 injury
quadriplegic
possible loss of respiratory function due to edema
100
c5-c6 injury
quadriplegic
gross arm movements
sparing of diaphragm
101
neurogenic/spinal shock you will have
loss of vasomotor tone and sympathetic innervation to the heart
102
lost sympathetic activity can lead to
hypotension due to vasodilation
bradycardia
103
differentiate between hypovolemic and neurogenic
hypovolemia will have tachycardia and neurogenic will have Bradycardia
104
autonomic dysreflexia
acute episode of exaggerated sympathetic reflex responses occurring with injuries T6 and above
105
vasovagal response can lead to
dilatation
106
in autonomic dysreflexia how will the patient appear above T6
flushed skin, headache, bradycardia
107
in autonomic dysreflexia how will the patent appear below t6
cold and goosebumps
108
three metabolic factors affect cerebral blood flow
CO2, O2, and H ion concentration
109
CO2
dilates
110
hypoxia causes ATP depletion or
power failure
111
what is produced with anaerobic metabolism
lactic acid/pyruvate acid
112
acid damages cells
membranes, structures and DNA
113
ischemia is
reversible damage
114
ischemia interfers with
delivery of energy sources, damage to blood vessels and changes in blood
115
how does ischemia cause changes in blood
desaturation, clotting, sludging
116
in excitotoxicity the neuron firing releases
glutamate
117
glutamate causes
neighboring neurons to fire
118
excitotoxicity causes ________ of injury across the ischemic area
spreading
119
glutamate eventually causes calcium cascade which leads to
release of intracellular enzymes, protein breakdown, free radical formation, lipid per oxidation, fragmentation of DNA, nuclear breakdown
120
ischemia can be focal which is, or global which is
focal= stroke
global= cardiac arrest
121
ischemia can lead to excessive influx of ________ resulting in edema and ________ influx initiates a cascade of events including release of intracellular and nuclear enzymes causing cell destruction
sodium, calcium
122
glutamate is a principal ____________ neurotransmitter
excitatory
123
when you have intracranial pressure greater than arterial blood pressure
arteries collapse, blood flow to brain is cut off
124
RAS controls your
cosniousness
125
coma is diffuse or focal dysfunction in the
reticular activating system
126
3 types of coma
metabolic, structural or psychogenic
127
coma can be caused by 2 things
changes in structure
metabolic/toxic conditions
128
coma induced by structure changes
structural lesions
vasular lesions
trauma
brain tumors
brain abscesses
increased ICP
non traumatic
hydrocephalus
129
coma included by meatbolic/toxic conditions
ELECTROLYTES: HYPER/HYPONATREMIA (SODIUM) AND HYPERCALCEMIA
hypoxia/CO2 retention
decreased O2
shock
sepsis
hypoglycemia
DKA
HHS
poisoning
drugs
alcohol
hypertensive encephalopathy
acute hypertensive crisis
meningitis/encephalitis
renal failure
130
pressure volume curve shows
units of volume and the associated pressure in the cranium
131
earlier signs of diminution in LOC
inattention, mild confusion, disorientation and blunted responsivness
132
signs of further deterioration in decrease of LOC
marked inattentive
lethargic and agitated
may only respond to vigorous or noxious stimuli
133
normal person has a GSC of
15
134
if GCS is under 8
intubate
135
respiration problems
cheyne stokes
central neurogenic hyperventilation
136
cheyne stokes occurs in
heart failure
137
central neurogenic hyperventilation occurs with issues in the
BRAIN
138
central neurogenic hyperventilation occurs when bleeding in head and puts pressure on
pons and medulla
139
cushings triad is the last ditch effort to
perfuse the brain
140
Cushing triads appears with
increased MAP, wide PP, bradycardia
141
increased MAP of cushings is at least
60
142
normal PP is
40
143
coup injury
under direct impact area
144
contrecoup
sustained injury on opposite side due to bounceback
145
you want to avoid __________ and ____________ during resuscitation phase
hypotension, hypocarbia
146
concussion
momentary interruption of brain function with or without LOC
147
+ LOC
there was LOC
148
diffuse axonal injury
diffuse microscopic changes, most common cause of PVS
149
diffuse axonal injury is consequence of sudden ___________ movement
rotational
150
diffuse axonal injury can only be detected
histologically
151
contusion
bruise to cortical surface
152
ipsilateral
same side (pupil dilatation)
153
contralateral
opposite (hemiparesis
154
epidural hemotoma
between skull and dura, arterial, LOC-lucid, LOC-decline
155
is epidural hematoma fast or slow bleed
fast
156
subdural hematoma
between dura/subarachnoid, venous, acute, subacute or chronic
157
is subdural hematoma fast or slow bleed
slow
158
intracerebral hematoma
in cerebrum, single or multiple, more common in older and alcoholic
159
primary injuries are
immediate
160
subdural space has bridging veins which leads to
slower bleeding
161
increased IP pushes the
brain out of position
162
herniation from side is an
unacal herination
163
uncal herentaion presents with pupil dilatation why
compression of the ocularmotor nerve
164
brain dead clinical exam
absence of brain stem reflexes and motor responses to pain
absence of respiration with PCO2 of 60 mm Hg or more
165
chronic tramuatic encephalopathy
progressive deleting disease due to brain injury associated with sporting events, blast injuries
166
what racial group is most likely to die from a stroke
black
167
carotid bruit
turbulent sound in carotid artery
168
what is the most common type of stroke
ischemic
169
penumbra (halo)
space between healthy and dead tissue
170
in stroke the survival of tissue depends on
timely return of circulation, toxins, and edema
171
what is the most fatal type of stroke
hemorrhagic
172
hemorrhagic is the
rupturing of blood vessel
173
TIA
temporary episode of neurologic dysfunction, caused by focal ischemia
174
TIA is it ischemic
yes
175
TIA long or short lasting
short
176
TIA and ischemic stroke have the same
symptoms
177
TIA
transitent ischemic attack
178
what is the most common cause of hemorrhagic stroke
hypertension
179
__% of strokes are ischemic
87
180
Aneurysmal subarachnoid hemorrhage if it ruptures could lead to
hemorrhagic stroke
181
Aneurysmal subarachnoid hemorrhage
bulge at site of localized weakness in muscular wall of arterial vessel
182
Aneurysmal subarachnoid hemorrhage mortality rate
high
183
Aneurysmal subarachnoid hemorrhage 50% might have __________ before
headache
184
Aneurysmal subarachnoid hemorrhage symptoms
excruciating headache, nuchal rigidity, photophobia, diplopia, blurred vision, stroke syndrome, pituitary deficits
185
what is FAST
Facial weakness
Arm weakness
Speech problems
Time to call 911
186
meningitis is inflammation of
pia, arachnoid, and CSF filled arachnoid space
187
meningitis can be caused by what types of bacteria
strep, H. influenza, meningoccus
188
in meningitis bacteria replicate and undergo _______ in CSF which leads to the release the ___________ and leads to inflammatory mediator, ___________ bind and damage ____________ cells of BB barrier pathogens enter ______________ space causing cloudy purulent exudate
lysis, endotoxins, neutrophils, endothelial, subarachnoid
189
meningitis have very similar symptoms of flu, what is some symptoms that differentiate between flu
meningeal signs (neck and light)
190
can a benign tumor cause death
yes because of its locatio
191
focal disturbances
seizures, hallucinations, weakness or palsies in specific areas, sensory deficits
192
generalized disturbances
increased cranial pressure: headache, vomiting, visual problems
193
unprovoked/primary/idiopathic=
seizure disorder
194
epilepsy
recurrent seizures not provoked by other illnesses or circumstances
195
provoked/secondary, CNS insults, metabolic conditions such as
hypoglycemia, hypoxia, hypocalcemia, rapid withdrawal of alcohol or barbs
196
observe an _____ with seizures
aura
197
when to call 911 with seizures
when they do not stop
last longer than normal with a patient with chronic seizures
seizure starts right after one ends
198
status epilepticus
medical emergency seizure
199
always _____ seizures
time
200
delirium
acute, reversible, change in behavior
201
delirium can be caused by
hospitalization/isolation
202
alzheimers disease cause
multifactoral
203
alzheimers disease diagnosis is by
exclusion
204
alzheimers is most common form of
dementia
205
what races are more likely to get alzheimers
blacks, hispanics
206
alzheimers is atrophy or hypertrophy
atrophy
207
alzheimers: decrease in level of ______ _________________ activity in cortex and hippocampus; enzyme required for synthesis of ___________
choline acetyltransferase, acetylcholine
208
acetylcholine is associated with
memory
209
microscopically amyloid
containing neurotic plaques and neurofibularry tangles
210
alzheimers disease is insidious meaning
slow
211
amyloid b form
amyloid plaques
212
other causes pf dementia
microinfacts
crutzfeldt-Jakob disease
frontotemporal dementia
vit b 12 deficiency
inherited
213
which cause of dementia is vasular in nature
microinfarcts
214
alzheimer is believed to be caused by
amyloid plaque
215
microinfarts
small infarction of brain
