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Patho > Week 6: Neuro > Flashcards

Week 6: Neuro Flashcards

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1
Q

What are the major functions of each of the four major regions of the brain?

A

Frontal lobe: primary motor cortex
Parietal lobe: primary somatosensory cortex
Temporal: primary auditory cortex
Occipital: primary visual cortex + visual association cortex to interpret the meaning of visual experiences

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2
Q

What is the primary role of the primary motor cortex?

A

important for precise movement of hands, feet and phonation (speech)

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3
Q

What is the primary role of the somatosensory cortex?

A

perceives meaningfulness of integrated sensory inputs

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4
Q

What is the role of the hypothalamus?

A

controls homeostatic processes in the body - water balance, hunger-satiety cycle, metabolism, temperature

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5
Q

Major functions of the brain stem?

A

respiratory control center, cardiovascular control center, vasomotor center

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6
Q

What is the role of the reticular activating system (RAS)?

A

maintains behavioral arousal, consciousness, and motivation

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7
Q

What is the role of the cerebellum?

A

skeletal muscle activity; balance & equilibrium

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8
Q

How does bone function to protect the CNS?

A

brain and spinal cord are enclosed in the skull and vertebral column that offer protection

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9
Q

How do the meninges protect the CNS?

A

three connective tissue membranes that protect CNS structures

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10
Q

What are the three meningeal layers?

A

Dura mater: double layer membrane surrounding the brain
Arachnoid mater: threadlike extensions span subarachnoid space and attach to the pia mater
Pia mater: clings tightly to the surface of brain and spinal cord

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11
Q

How does CSF protect the CNS?

A

watery broth in ventricles that provides a cushion

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12
Q

How does the blood brain barrier protect the CNS?

A

provides separation between blood and neurons - relatively impermeable capillaries
Allows for passage of key nutrients: water, glucose, essential amino acids; excludes unwanted molecules

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13
Q

General organization of nerves in the spinal cord

A

cervical (C1-C5), brachial (C5-T1), thoracic (T1-T12), lumbar (L1-L4), sacral (L4-S5)

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14
Q

Where do we sample CSF?

A

L3/L4

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15
Q

Posterior region of the spinal cord contains which tract(s)?

A

ascending/sensory tracts

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16
Q

Anterolateral sections of the spinal cord contains which tract(s)?

A

ascending/sensory & descending/motor information

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17
Q

Definition, causes and symptoms of TBI

A

Head injury and subsequent damage to brain, possibly cranial nerves
Causes: falls, vehicular accidents, violence
Symptoms: dependent on if it is diffuse or local, the severity and the part of the brain involved

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18
Q

Definition and causes of cerebrovascular disease

A

vascular injuries such as stroke that may present with similar clinical manifestations as TBI
Causes: hypertension and hyperlipidemia

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19
Q

What is the role of the Circle of Willis?

A

protective circulation system that facilitates blood flow to the brain, allows collateral flow if a portion of the brain is disrupted

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20
Q

Define spinal cord injury

A

injuries to cranial nerves that often accompany TBIs

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21
Q

What conditions do seizures accompany?

A

many neuro conditions including TBIs and CVD

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22
Q

Define consciousness

A

state of awareness and orientation to surroundings, ability to respond to stimuli
determined by the RAS

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23
Q

What tool is used to determine level of consciousness?

A

Glasgow Coma Scale

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24
Q

Define concussion - injury severity and reversibility, symptoms (5)

A

caused by sudden movement of brain, most common form of TBI
Severity: Diffuse
Reversibility: Typically reversible
Symptoms: Associated with temporary LOC, change in resp, hypotension, bradycardia and amnesia

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25
What is a contusion and is it reversible?
bruising of brain tissue, small petechial hemorrhages that leak into brain tissue Reversibility: Partially reversible, depending on severity of injury
26
Define closed vs. open injury
Closed injury: skull intact | Open injury: skull fracture
27
Define primary vs. secondary brain injury
Primary brain injury: structural damage at the moment of trauma to neurons, glial cells, blood vessels Secondary brain injury: consequence of response to injury: changes to blood flow, edema and subsequent ICP which can lead to cell death or herniation - worsens the primary injury
28
Definition and major consequence: hypoxia and ischemic injury
result from decreased oxygen availability in the brain tissue Consequence: reduces availability of glucose and removal of waste products
29
Cerebral edema: definition and causes (2)
swelling of the brain due to accumulation of fluids | Causes: damage to BBB or inadequate waste removal
30
Definition and major consequence: increased ICP
results from fluid accumulation due to inflammatory or edematous processes resultant reduction in tissue perfusion can lead to hypoxia and neuronal death, can lead to herniation (often into brain stem area)
31
Define epidural hemorrhage
arterial bleed into extradural space between skull and outermost brain layer
32
Define subdural hemorrhage, common causes
most common meningeal hemorrhage, blood accumulates between dura mater and arachnoid mater causes: trauma, coagulopathy, alcoholism
33
Define intracerebral hemorrhage
disruption of cerebral vessels within the parenchyma resulting in neuro deficits, commonly found in frontal and temporal lobes
34
Define intracerebral hematoma
focal injury involving collection of blood in or around the brain, often caused by hemorrhage
35
Define transient ischemic attacks, what they are a risk factor for, the causes and s/s (4)
neuro events due to ischemia that are short-lived and resolve completely Risk factor for stroke Causes: embolus or thrombus involving any cerebral artery S/s: transient episodes of contralateral weakness, sensory deficits, visual impairments, aphasia
36
Define stroke, causes
sudden focal neuro deficit due to vascular disorder. Nontraumatic disruption of blood flow causes: occlusion of cerebral arteries by ischemia or hemorrhage
37
Define ischemic stroke
results from obstructed blood flow or systemic hypoperfusion, leading to ischemia, potentially irreversible necrotic process and cerebral infarction
38
Define hemorrhagic stroke
results from intracranial hemorrhage, deep in the parenchyma or near surface of the brain, often has HTN as underlying cause
39
Define aneurysm, a defect in ____ can lead to it, major consequence
localized dilation in a blood vessel wall that can rupture and lead to hemorrhage - tunica media - rupture can cause aneurysmal subarachnoid hemorrhage, s/s range from mild headache to coma and death
40
Causes and symptoms of spinal cord injury
Causes: any injury caused by trauma - vehicle accidents, falls, sports injuries, violence Symptoms: vary depending on site of injury and if nerve roots are damaged
41
What is the result of a spinal cord transection?
loss of motor, sensory, reflex and autonomic function below the level of injury; can be complete or partial
42
Differentiate between primary vs. secondary spinal cord injury
Primary SCI: occurs at time of accident and is irreversible | Secondary SCI: follows primary injury and spreads damage
43
Define meningitis, what are common causes (specific strains)?
infection of the meninges bacteria: strep pneumonia, Neisseria meningitidis, hameophilus influenzae Virus: enteroviruses, coxsackie virus, adenovirus, herpes, HIV, Epstein Barr virus, CMV
44
Define encephalitis, what are common causes (7)
infection and inflammation of brain tissue or spinal cord | Causes: equine encephalitis, west nile, herpes, HIV, cytomegalovirus, rabies, prion diseases (mad cow disease)
45
Define Parkinson Disease, what is the common cause and s/s
degenerative disease of CNS characterized by movement disorder Cause: death of dopamine-producing cells in substantia nigra of the basal ganglia S/s: movement related symptoms (tremor, bradykinesia, rigidity, postural instability), neuropsychiatric sx (dementia & depression)
46
What is the characteristic of cells death in Parkinson Disease?
Development of alpha-synuclein protein in the brain (Lewy bodies)
47
Define MS, s/s (5), Tx
autoimmune attack on myelin of CNS neurons that causes formation of plaques and destruction of myelin S/S: visual changes, muscle weakness, loss of coordination, numbness, mild cognitive impairments Tx: anti-inflammatory agents (corticosteroids)
48
Define ALS, S/S, Tx
condition characterized by loss of motor neurons S/S: Progressive weakness and muscle wasting, death usually within 5 years of dx Tx: supportive measures only - drugs (riluzole) can suppress glutamate and ameliorate sx
49
What is usually the cause of mortality in ALS?
Failure of respiratory muscles
50
What are two pathologic associations with ALS?
May involve excess glutamate in synapses | Mutations in superoxide dismutase gene associated, suggesting oxidative stress may contribute to cell death
51
What are the basic divisions of the PNS?
Afferent (sensory): detects, transmits and processes environmental information from internal/external sources through a variety of receptors Efferent (motor): initiates voluntary and involuntary movement
52
What are the levels of afferent neurons?
Sensory unit: afferent neuron and all receptors that send information along it Dermatome: area of skin supplied by a single spinal nerve transmitting to a dorsal root ganglion and spinal cord segment Receptive field: area that sends information along a single afferent neuron
53
Which column do myelinated fibers travel along? Is it ipsilateral or contralateral? Where does it cross?
1. Dorsal columns 2. ipsilateral 3. medulla
54
Which column do unmyelinated fibers travel along? Is it ipsilateral or contralateral? Where does it cross?
1. anterolateral system 2. contralateral 3. spinal cord at point of entry
55
What sensory information is carried by fast vs. slow myelinated fibers?
Fast: touch, proprioception, pressure Slow: touch, temperature, fast pain
56
What sensory information is carried by unmyelinated fibers?
Slow pain, hot and cold, itch
57
What are the basic steps in control of voluntary movement? (4)
1. Commands initiated in association cortex 2. Commands relayed to sensorimotor cortex, cerebellum, and subcortical nuclei 3. Initial command broken down into series of smaller motor programs 4. Motor programs transmitted through descending motor pathways to carry out commands
58
Define pyramidal tracts, what are characteristics of diseases of these tracts?
originate in the sensorimotor cortex of the cerebral cortex, descend through the basal ganglia and brain stem, cross or remain uncrossed at the medulla from where they descend the spinal cord Diseases (eg. Stroke) characterized by spasticity and paralysis
59
Define extrapyramidal tracts, what are characteristics of diseases of these tracts?
remaining tracts that do not transverse the brainstem Diseases (eg. Parkinson) result in involuntary movements, muscle rigidity, immobility without paralysis
60
What is the major role of the ANS?
governs body processes without conscious effort
61
What are the roles of the two divisions of the ANS?
Sympathetic: mobilizes the body Parasympathetic: conserves body
62
Which neurotransmitters are adrenergic?
epinephrine, norepinephrine
63
Which neurons release norepinephrine?
most sympathetic postganglionic neurons
64
Which neurotransmitter is cholinergic?
acetylcholine
65
Which neurons release acetylcholine?
preganglionic neurons | parasympathetic postganglionic neurons
66
What is the general response of adrenergic receptors?
Alpha-adrenergic: vasoconstriction of blood vessels in skin and viscera, not in airway smooth muscle Beta-adrenergic: vasodilation of blood vessels in skeletal muscle, increase heart rate and contractility, relaxation of airway smooth muscle, blocked by propranolol
67
Define pain
unpleasant sensory and emotional experience associated with actual or potential tissue damage
68
Define nociceptive pain, causes
cutaneous, deep somatic or visceral origins of pain | Causes: mechanical, thermal or chemical damage - trauma, burns, infection, exposure to toxins
69
Which substance is released from nerve terminals? What is it's major role?
Substance P sensitizes nociceptors by causing release of histamine and serotonin from platelets and mast cells that contribute to inflammation
70
Describe fast pain, which fibers carry it, localization, cutaneous or visceral?
prickling, stabbing Carried on A-delta fibers (myelinated) Good localization Cutaneous: fast pain on the surface
71
Describe slow pain, which fibers carry it, localization, cutaneous or visceral?
dull ache, burning Carried by C fibers (unmyelinated) Poor localization Visceral: slow pain (chest pain due to myocardial infarction
72
Define deep somatic pain
fast and slow pain (arthritis or sprained ankle)
73
Define referred pain
localized to place other than the origin of the pain
74
Describe Brown-Sequard Syndrome, S/S
SCI that alters functions of the PNS S/S: loss of voluntary motor function from the corticospinal tract, proprioception loss from ipsilateral side of the body, contralateral loss of pain and temperature sensations from the lateral spinothalamic tracts for all levels below the lesion
75
Describe Guillan-Barre Syndrome, S/S, causes, consequences
infection that initiates autoimmune destruction of peripheral nerves s/s: ascending paralysis, weakness in extremities migrating toward the trunk, altered sensations, pain, dysfunction of ANS Causes: infection with bacteria such as campylobacter jejuni or CMV Consequences: damage to myelin and can result in paralysis as well as sensory and autonomic disturbances

Patho (14 decks)

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