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Pathophysiology > Week 2: Neuro > Flashcards

Week 2: Neuro Flashcards

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1
Q

most common cause of brain trauma

A

mvc & falls

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2
Q

brain trauma severity measured by the

A

glasgow coma scale

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3
Q

glasgow coma scale

A

mild (gcs 13-15)
moderate (gcs 9-12)
severe (gcs 3-8)

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4
Q

blunt tbi types

A 
concussion
epidural
subdural
subarachnoid
intracerebral hemorrhage
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5
Q

penetrating tbi types

A

missiles

fractures

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6
Q

mild concussion characteristics

A

Immediate clinical manifestations with no LOC or LOC that is less than 30 min
GCS is 13-15
Mild retrograde amnesia may exist for <24 hours
May be no diagnostic imaging evidence
Headache, attention deficit, dizziness

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7
Q

moderate concussion characteristics

A

LOC >30 min
Amnesia lasting 24 hours or more
GCS 8-13
Basal skull fracture may be present but no brain stem injury
Transitory decerebration or decortication with unconc.
Confusion, may have permanent deficits, vision

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8
Q

severe concussion characteristics

A

GCS <8
Associated with brainstem injury (pupillary reaction, cardiac and resp symptoms)
LOC may last >24 hours
Immediate autonomic dysfunction that may last weeks
Increased ICP
Severe compromised coordination

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9
Q

physical consequences of DAI

A

spastic paralysis, peripheral nerve injury, dysphagia, dysarthria, hearing and vision, taste and smell

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10
Q

cognitive consequences of DAI

A

disorientation, confusion, dyspasia, poor judgement

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11
Q

behavioural consequences of DAI

A

agitation, blunted affect, impulsiveness, social withdrawal, depression

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12
Q

clinical manifestations of epidural hematomas

A

Loss of consciousness -> period of lucidity -> inc. headache, vomiting, drowsiness, seizure, hemiparesis, if temporal lobe herniation begins - ipsilateral pupillary dilation

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13
Q

spinal cord injury patho

A
  • Vertebral injuries d/t acceleration, deceleration, or deformation injuries
  • Injure tissues through compression, exerting tension or traction, or shearing tissues through hyperextension, hyperflexion vertical rotation of the spine
  • Classified into:
    simple fracture, compressed fracture, comminuted fracture (burst or shattered) or dislocation
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14
Q

spinal cord injuries occur mostly at

A

C1-2, C4-7, T1-L2

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15
Q

SCI Clinical Manifestations

A
  • All motor, sensory, reflex and autonomic functions cease below level of transected area and also may cease with concussive, contused, compressed or ischemic areas
  • Paraplegia, quadraplegia
  • Return of spinal neuron excitability occurs slowly
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16
Q

hyperrflexia occurs

A

any time after spinal shock ceases

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17
Q

hyperrflexia sx

A

Hypertension, pounding headache, blurred vision, sweating above level of lesion, nasal congestion, nausea, bradycardia

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18
Q

spinal cord injury dx and tx

A

dx made by physical, radiologic, and myelographic exam

tx includes immobolizing the spine, surgical decompression and stabilization, and corticosteroids

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19
Q

primary brain tumor types

A

intracerebral and extracerebral

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20
Q

intracerebral tumor types

A

astrocytoma
glioblastoma multiforme
pituitary adenoma

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21
Q

extracerebral tumor types

A

meningioma

neurofibroma

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22
Q

astrocytoma

A

arises from astrocytes

relatively slow growing

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23
Q

glioblastoma multiforme

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A

from more mature glial cells

rapidly growing

24
Q

pituitary adenoma

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A

from pituitary cells

resulting in secreting tumour

25
meningioma
from arachnoid cells | problems due to location
26
neurofibroma
arises from schwann cells | nerve sheath
27
cva risk factors
``` Arterial hypertension ( systolic & diastolic) Smoking Diabetes Insulin resistance Polycythemia and thrombocythemia Impaired cardiac function Atrial fibrillation ```
28
ischemic stroke cause
arterial occlusions due to thrombi in the brain
29
transient ischemic attacks
intermittent blockage - all neurologic deficits completely clear within 24 hours
30
completed stroke
CVA that has reached its maximum destructiveness in producing neurologic deficits
31
embolic stroke
involves fragments of thrombi from outside the brain
32
hemorrahagic stroke
from hypertension, ruptured aneurysms, bleeding into a. tumor, bleeding disorders, head trauma, illicit drug use
33
subarachnoic hemorrahagic stroke
uncontrolled bleeding on surface of the brain
34
intracerebral hemorrahagic stroke
an artery deep in the brain ruptures, usually due to increased BP
35
cerebral infarction patho processes
global and focal
36
global process
affects neurons most susceptible to ischemia
37
focal process
central zone of cell loss surrounded by a zone of injured cells that could survive if reperfused in one hour
38
hemorrhagic infarcts result from
reperfusion d/t resumption of blood flow
39
cerebral hemorrhage primary cause
hypertension, bleeding precipitated by aneurysms in smaller vessles or arteriolar necrosis, mass of blood forms
40
CVA dx and tx
dx through CT and CM tx through drug therapy to prevent further thrombotic events, augments blood flow, reperfuses tissues and protects neurons
41
thrombotic strokes tx
controlling cerebral edema and increasing ICP
42
embolic strokes tx
preventing further emboli
43
seizures description and characteristics
sudden explosive disorderly discharge of cerebral neurons characterized by sudden transient alteration in brain function
44
conditions associated with seizures
cerebral lesions, biochemical disorders, cerebral trauma, epilepsy
45
seizure triggers
``` hypoglycemia fatigue emotional or physical stress febrile illness excess H2O ingestion constipation use of stimulant drugs withdrawal from depressant drugs hyperventilation environmental stimuli ```
46
generalized seizures
bilateral neuron involvement, general onset, originate from subcortical or deeper brain focus, impaired or lost consciousness
47
partial seizures
unilateral neuron involvement, originate from cortical brain tissue, maintain consciousness if only unilateral, but may become generalized
48
status epilepticus
multiple seizures without regaining consciousness or seizure lasting >30 minutes
49
epileptogenic focus
group of neurons with more permeable plasma membranes that are hypersensitive to stimuli like hyperthermia, hypoxia, hypoglycemia
50
seizures dx
- health history - PE & lab tests to look for systemic diseases that can cause seizures - rule out neuro diseases - EEG to assess type of seizure and identify cause
51
seizures tx
correct or control cause of seizure Drugs to suppress seizure without intolerable side effects Social stigma/family and client counselling
52
meningitis
Infection of meninges caused by bacteria, virus, fungi, or parasites In CSF through the subarachnoid space Starts elsewhere in body and crosses blood brain barrier Meningococcus and steptococcus most common Fever chills, petechial rash, neck stiffness
53
multiple sclerosis
Demyelinating disease with white matter plaques Relapsing, remitting most common Primary and secondary progressive types also Steroids acutely, interferon chronically
54
myasthenia gravis
Insidious onset with progressive muscle weakening Diagnosed with Tensilon test and antibody assay EMG is diagnostic Steroids, anticholinesterase drugs, immunosuppressants such as azothiprine or cyclosporine used
55
guillain barre syndrome
Acquired inflammatory disease that results in demyelination of peripheral nerves Almost always preceded by viral illness, often mild Starts with leg paralysis and goes to entire body Treatment is supportive with ventilation common
56
alzheimer's disease
Dementia disease characterized by global progressive loss of cognitive mental function Pathophysiology not understood but neurofibrillary tangles seen microscopically and neuritic plaques Diagnosis is clinical
57
parkinson's disease
Degenerative disease of dopamine pathway in the substantia nigra Primary and secondary Secondary due to trauma, infection, or neoplasm Usually after age 40, peaking in onset around 60

Pathophysiology (12 decks)

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