Term
| Memory is a multi-stage process that incorporates the ability to bring in info and _____, _____, and _____. |
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Definition
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|
Term
Declaritive Memory is: _____.
Examples are _____.
Loccated in the _____. |
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Definition
explicit memory; able to recall
life history, events, experiences, info, facts
Basal Ganglia
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Term
Non-Declaritive Memory is _____.
Examples are: _____.
It is located in the _____. |
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Definition
Motor memory; unconcious/implicitmemory
procedures, motor actions (walking, writing, etc)
Cerebellum |
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Term
|
Definition
Memory that is not normal
Retrograde and Anterograde amnesia |
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Term
|
Definition
| Not able to recall wha has previously happened; can store new info |
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Term
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Definition
| Unable to store new memories; New data is not stored or processed |
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Term
| Retrograde + Anterograde amnesia is known as _____. |
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Definition
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Term
| Dysmensia can occur because of _____. |
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Definition
| Ischemia (low O2 leads to no metabolic processes), hypoxia, compression, toxins (ie. alcohol), Chemicals (ie. vallium) |
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Term
| Acute Confusional States (delerium) can be characterized by _____ and _____. |
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Definition
Attention deficits and Difficulty understanding thoughts and/or actions
(also: delerium tremors for alcohal withdrawal, difficulties sleeping, hallucinating, and hyperactivity)
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Term
| The _____, _____, and _____ are impacted during Acute Confusional State (delerium) |
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Definition
| Reticular activating system, Thalamus, and Basal Ganglia |
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Term
Acute Confusional State (delerium) can be brought on by _____, _____, and _____.
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Definition
| Drugs (esp Cochaine), metabolic disorders, and diseases affecting NS |
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Term
Acute Confusional State (delerium) are treated by:
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Definition
| Determining cause and getting rid of it. |
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Term
| The Monro-Kellie hypothesis states that: |
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Definition
| the cranial compartment is incompressible, and the volume inside the cranium is a fixed volume. Therefore, if there is an increase in brain tissue, blood, or CSF, something else must give. |
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Term
| Define Cerebral Hemodynamics |
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Definition
Blood flow (in conjunction with O2 supply) in the brain.
Changed by anything that alters the ability of blood to flow through the brain |
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Term
| Define the Cerebral Perfusion Pressure |
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Definition
Pressure needed to get blood to brain cells
CPP = Mean Arterial Pressure - Intra Cranial Pressure |
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Term
| Cerebral Blood flow is maintained by 7 things: |
|
Definition
Carotids
Vertebral Arteries
the Circle of Willis
CO2 (inc CO2, blood vessels dialate, inc blood flow)
H+ (inc H+, vessels dialate, inc blood flow)
O2 (dec O2, vessels dialate, inc blood flow)
Astrogia (contribute substances to inc blood flow if O2 goes down) |
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Term
| Stage 1 Compensation for changes in blood flow, CSF, and/or tissues in brain |
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Definition
| CSF flow increases and more CSF is absorbed by arachnoid |
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Term
Stage 2 Compensation for changes in blood flow, CSF, and/or tissues in brain
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Definition
| Pressure builds so arterioles constrict - yields Hypoxia (dec O2) and Hypercapnea (inc CO2) |
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Term
Stage 3 Compensation for changes in blood flow, CSF, and/or tissues in brain
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Definition
| Abilities of arteries to respond to O2, CO2, and H+ concentration is lost - yields hypoxia (dec O2) and Acidosis |
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Term
Stage 4 Compensation for changes in blood flow, CSF, and/or tissues in brain
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Definition
Cerebral blood flow ceases when intracranial pressure equals the Mean systolic arterial pressure
Brain herniates (pushes against something as something else increases - dangerous if damaged), hemorrhages, and is susceptable to hydrocephalus |
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Term
| Clinical Manifestations for Stage 1 cranial hypertension |
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Definition
| confusion, drowsiness, loss of light responce and/or consensual responce in pupils, respiration altered |
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Term
Clinical Manifestations for Stage 2 cranial hypertension
|
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Definition
| Decreased LOC, Respirations change (Cheyne-Stokes Breathing), Central Neurogenic Hyperventilation, Bradycardia, Increased pulse pressure (larger gap between SBP and DBP ... SBP-DPB) |
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Term
Clinical Manifestations for Stage 3 cranial hypertension
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Definition
| Loss of autoregulation, ICP inc, hypoxia, acidosis |
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Term
| Clinical Manifestations for Stage 4 cranial hypertension |
|
Definition
Brain tissue shifts and herniats
Hemorrhage
Hydrocephalus
Blood flow to brain dec and then ceases |
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Term
| Normal Intracranial Pressure is: |
|
Definition
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Term
| Increased Intracranial Pressure (ICP) due to excess Brain tissue can lead to: |
|
Definition
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|
Term
Increased Intracranial Pressure (ICP) due to excess CSF can lead to:
|
|
Definition
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|
Term
Increased Intracranial Pressure (ICP) due to excess blood can lead to:
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Definition
Hematoma
*Note: HTN increases risk of inc ICP from blood |
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Term
| Uncal Supratentorial Herniation is defined when the __________ and pressure is placed on the _____, especially the _____. |
|
Definition
innermost part of temporal lobe moves past tentorium
brainstem
midbrain |
|
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Term
| Uncal Supratentorial Herniation compresses CN _____ and affects the _____ and _____ tracts. |
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Definition
Sluggish pupils
Ipsilateral
Contralateral |
|
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Term
| Central Supratentorial Herniation is characterized by a downward shif of the _____ and a quick loss of _____. It compresses the _____ and can compress _____. |
|
Definition
diencephalon
conciousness
frontal lobe
vessels |
|
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Term
| Infratentorial Herniations occurs when the Cerebellum moves through the __________. Symptoms include: |
|
Definition
foramen magnum
Arched, stiff neck; shoulders with paresthesias (tingly feeling); decreased conciousness; respiratory difficulty; and variable pulse rate. |
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Term
| Cerebral Edema can be caused by: |
|
Definition
| Trauma, infectino, neoplasia, ischemia, infarction, hypoxia |
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Term
| Vasogenic Cerebral Edema is caused by: _____, _____, and/or _____. |
|
Definition
capillary endothelium becoming more permeable
alteration in the BBB
proteins in intracellular spaces (inc osmotic pressure = more H2O in brain) |
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Term
| Cytoxic Cerebral Edema is caused by _____ and most often in the _____. |
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Definition
Direct toxins
Gray matter |
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Term
| Interstitial Cerebral Edema is caused by _____ and _____ and is associated with _____. |
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Definition
CSF going into brain tissue
increased pressure in white matter
hydrocephalus |
|
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Term
| Communicating Hydrocephalus is impaired absorption of _____ and affects the _____ (due to: ___________). |
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Definition
CSF
Arachnoid Villi
subarchnoid hemorrhage, congenital, injury, neoplasm, bleeding, etc) |
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Term
| Noncommunicating Hydrocephalus is an obstruction of __________ and can be _____ or from _____. |
|
Definition
CSF flow in ventricles
congenital (usually caused by problems with the aqueduct of sylvius)
Neoplasm |
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Term
PARESIS:
Hemiparesis
Paraperesis:
Quadriparesis: |
|
Definition
Weakness
One side
Top or Bottom
Top, bottom, and both sides |
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|
Term
PARALYSIS:
Hemiplegia:
Diplegia:
Paraplegia:
Quadriplegia: |
|
Definition
Loss of motor function
One side
Affecting symmetrical body parts
Top or Bottom
Top, bottom, and both sides |
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Term
| In blunt traumatic Brain injuries, the dura mater _____ and the brain tissue remains _____. |
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Definition
remains intact (non-missile)
in the skull (closed) |
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Term
| In penetrating Traumatic brain injuries, the dura mater _____, and the brain tissue is _____. |
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Definition
is no longer intact (Missile)
exposed to the environment (open) |
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Term
| Describe Primary, Secondary, and Tertiary responces concerning Traumatic Brain injuries... |
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Definition
Primary: injury that results from initial blow.
Secondary: rapid responce where O2 decreases = loss of metabolic process = damage to brain tissue
Tertiary: days to months later; swelling and bleeding in brain |
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Term
|
Definition
| a contusion at the site of a blunt injury. |
|
|
Term
|
Definition
| a contusion on the opposite side if of blunt injury. Typically happens when hit in the back (coup on the front) or on the temperal side (coup on the other side) |
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Term
| Contusion symptoms include: |
|
Definition
4 min loss of consciousness (with a temporary loss of reflexes)
Bradycardia
Quick apnea then breath
Decreased blood pressure
Vital signs normal
Reflexes normal upon awakening
Wake up alert |
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Term
| Most Extradural Hematomas are _____ (arterial/venous) and symptomes include __________. (Also note that the increased pressure leads to an emergency.) |
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Definition
Arterial
Headache, vomitting, seizures, hemaphoresis |
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Term
| Acute subdural hematomes are characterized by: __________. |
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Definition
| Headaches (w/i 48 hrs), drowsiness, restlessness, decreased LOC, and increased agitation. |
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Term
| Chronic subdural hematomes are characterized by: __________. They may be due to __________. |
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Definition
Headaches and dementia if bleeding continues
old age, alcohol, previous brain injuries |
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|
Term
Intracerbral Hematomas:
Occurs:
Symptoms: |
|
Definition
contusion inside brain and damages blood vessels so that they bleed into the cerebral cortex.
3-10 days post injury
Decreased LOC; other injuries can mask symptoms |
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Term
| Diffuse Axonal Injuries occur when _____ which leads to _____ which yields an influx of _____ and abnormally _____ and eventually leads to _____. |
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Definition
Neurons tear or stretch
free radicals causing problems with cell membranes
Calcium
excites neurons
Excitotoxicity (over excitement of neurons till damaged) |
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Term
| Differentiate between a Mild and a Classic concussion |
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Definition
Mild: no loss of consciousness and temporary
Classic: immediate loss of consciousness |
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Term
| Vertebral injuries can be from 4 different types of damage (_____) and typically occur in these 3 areas of the back: |
|
Definition
Simple fracture
Compressed fracture (squished)
Comminuted fracture (shattered)
Dislocation
C1-C2, C4-C7, and T1-L2 |
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Term
| Spinal injuries to C3-C5 are especially dangerous because |
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Definition
| any damage may affect the Phrenic nerve and result in decreased respiration |
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Term
Spinal Shock is immediate response to __________ and results in a temporary __________.
Symptoms: |
|
Definition
transection (cut) of the spinal cord
cessation (stop) of reflexes below level of injury.
Extreme drop in BP, Flaccid Paralysis, Absent reflexes (weeks to months), and altered bowel and bladder movements |
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|
Term
Once spinal shock has been resolved, Autonomic Dysreflexia is:
Symptoms: |
|
Definition
a life threatening, sudden increase in blood pressure.
Headache, blurry vision, sweating above lesion, nausea, bradycardia |
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Term
| Global Hypoperfusion means _____ and results in a _____. |
|
Definition
the the brain isn't gettin enough blood
Cerebrovascular Accident (CVA) = Stroke = Brain Attack |
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Term
| Risk factors for CVAs/strokes/brain attacks include: |
|
Definition
HTN
Cigarettes
Diabetes (I and II)
Blood disorders (esp with platelets - easier to clot)
Elevated lipoprotein A (inc risk of atherosclerosis - fatty build up in arteries)
Cardiac Problems
Atrail fibrillation (atria quiver rather than compress = blood doesn't get pushed through body well = blood clots)
Hyperhomocysteinema (inc in hormon homocystein) |
|
|
Term
| Arterial Occlusion Strokes are caused by |
|
Definition
| Atherosclerosis (fatty plaque that occurs in vessels) and thrombus (blood clot) in the brain. |
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Term
| Describe a Transient Ischemic Attack (TIA) |
|
Definition
| Type of stroke that is brief, neurologic dysfunction, focal disturbance with no infarction and symptoms lasting less than one hour |
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Term
| An Embolic stroke is caused by _____. |
|
Definition
a thromus that forms elsewhere.
increased chance with bronken limbs (make sure to help ambulate them) |
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Term
| A hemorrhagic stroke is caused by _____. |
|
Definition
a ruptured aneurysm (popped blood vessel).
note... HTN increases risk. |
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Term
| A lacunar stroke occurs in _____. Symptoms are pure _____ or _____. |
|
Definition
the basal ganglia (and sometimes pons).
<1 cm
associated with smoking
motor or sensory |
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Term
| What causes a Cerebral Infarction? |
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Definition
| Abrupt or gradual, complete occlusion of blood vessels and blood supply ceases to the brain. (can be globalized or localized) |
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Term
| Cerebral Hemorrhage (bleeding in the brain) is typically associated with: _____ and results in _____. |
|
Definition
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|
Term
| What type of stroke is it not wise to give the victim blood thinners (aspirin, heparin, or Tissue Plasminogin Activators (TPA))? |
|
Definition
|
|
Term
| What are ways to decrease risks of strokes? |
|
Definition
Anti-platelets (clotting)
Dec BP
Dec cholesterol (to dec atheroscleratic plaque)
Anti-coagulants (heporrin, aspirin, TPA, warpfrin) |
|
|
Term
| What is the best sign that a patiend is having an Aneurysm? |
|
Definition
| "Worst headache of my life" |
|
|
Term
|
Definition
Familial, episodic
4-72 hours
multifactorial disorder
pain on one side of head and worsens with: movement, light (photophobia)
can be associated with throbbing, nausea and vomitting |
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Term
| Migraines can be triggered by: |
|
Definition
Fatigue
Hypoglycemia
Overexertion
Weather changes
Stress
No stress
Hormonal changes
Afferent stimuli (video games, loud noises)
Alcohol
Nitrates (perservatives in food) |
|
|
Term
| Describe the 3 phases of Migraines: |
|
Definition
Premonitory: "just don't feel right;" dopaminergic/hypothalamic; weak, strange feeling
Aura: smell, feel or thought; dec electrical activity in brain = dec blood flow
Headache: blood vessels dialate; lasts 4-72 hours |
|
|
Term
| The autonomic reflex of the trigeminal nerve is stimulated with this type of headache: |
|
Definition
|
|
Term
| Cluster headache symptoms include: |
|
Definition
| One-sided, tearing and redding of eye, burning, located behind eye, nausea, stiff neck |
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|
Term
| Cluster headaches are found in this age bracket and can be _____ (episodic/chronic)? |
|
Definition
20-50 year old men
both episodic and chronic |
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|
Term
| A theory for the cause of tension headaches is: |
|
Definition
| Hypersensitive trigeminal nerve (which explains the Jaw and neck tension.) |
|
|
Term
| Describe the characteristics of tension headaches: |
|
Definition
| men and women, gradual onset, hours to days, chronic - 15 per month for at least 3 months |
|
|
Term
| How many times and for how long do Chronic Paroxysmal Hemicranias occur? |
|
Definition
| 4-12 times per day (cluster headaches) and they last from 20 min to 2 hours |
|
|
Term
| The most common brain tumors are _____ and are usually in: _____, _____, and _____. |
|
Definition
Astrocytomas
Cerebrum, hypothalamus, pons |
|
|
Term
| Treatment for Astrocytomas include: _____, _____, and _____. |
|
Definition
| Surgery, Radiation, and Chemotherapy |
|
|
Term
| Oligodendroglioma's are found in (middle/old) aged people, are (slow/fast) growing, and are (well/poorly) differentiated. |
|
Definition
middle
slow
well (more like it's supposed to look like - opposed to an anaplastic cell) |
|
|
Term
| Oligodendroglioma's typically have a _____ year survival. |
|
Definition
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|
Term
| Ependymoma's block _____, which cause _____, _____, and _____. |
|
Definition
CSF Flow
Headaches, nausea, and vomiting |
|
|
Term
| Ependymoma' arise from _____ cells and found mostly (70%) in the _____. |
|
Definition
Ependymal
Fourth Ventricle |
|
|
Term
| Treatment for Ependymoma's include: _____ and _____. |
|
Definition
|
|
Term
| Papilledema is characterized by swelling of the _____. |
|
Definition
|
|
Term
| Meningiomas are usually (benign/malignant), (slow/fast) growing, and involves the _____. |
|
Definition
benign
slow (but faster during pregnancy)
meningies of the dura mater |
|
|
Term
| 1/2 of intracranial tumors are: |
|
Definition
| Metastic Lesions (tumors that start somewhere else and spread to the brain - primary sites include: lungs, breast, skin, kidneys, GI Tract) |
|
|
Term
| Describe the 4 routes of entry for CNS Infections: |
|
Definition
Hematogenous: blood flow
Direct Implantation: screw in brain
Local Extension: infection can spread to brain from somewhere else
Peripheral Nervous System: infection the moves up through peripheral nerves |
|
|
Term
| CNS infections damage the _____ or _____. |
|
Definition
|
|
Term
| Meningitis is and inflamation of the _____, _____, and _____. |
|
Definition
Pia Mater
Arachnoid Membrane
Subarachnoid space |
|
|
Term
| During Bacterial Meningitis, _____ and _____ are found in CSF, giving it a _____ color. |
|
Definition
Neutriphils, Albumin
Cloudy |
|
|
Term
| Inflammatory mediators are stimmulated in bacterial meningitis because: |
|
Definition
| bacteria enter the meninges, replicate, lysis, and release endotoxins. |
|
|
Term
| Clinical manifestations of bacterial meningitis include: |
|
Definition
| headache, stiff neck (nuchal rigidity), photophobia (light sensitivity), irritability, cloudy consciousness, nausea and vomiting (due to pressure on postrema), seizures, petechia and purpura, and cranial nerve damage (VIII) |
|
|
Term
| In bacterial meningitis, protein levels are _____ (high/low/normal) and glucose levels are _____ (high/low/normal) in comparison to viral meningitis, in which protein levels are _____ (high/low/normal) and glucose levels are _____ (high/low/normal). |
|
Definition
high
low
(slightly) high
normal |
|
|
Term
| Treatments for bacterial meningitis are: |
|
Definition
| antibiotics, vaccines, steroids |
|
|
Term
| Treatments for viral meningitis are: |
|
Definition
| N/A - viral meningitis is self limiting and it is only possible to treat the symptoms. |
|
|
Term
| Causes of Viral Encephalitis include: |
|
Definition
| Arthropod borne, HSV1 and 2, Varicella - Zoster, CMV, Poliomyelitis, Rabies, HIV - 1 |
|
|
Term
| A generalized infection of the brain or spinal cord that can be transmitted by arborvirus (carried by insects), herpes simplex, or rabies (which can travel up peripheral nerves) is _____. |
|
Definition
|
|
Term
| A localized collection of pus or neutriphils, dead cells, and plasma is known as a _____. |
|
Definition
|
|
Term
| Brain Abscess' symptoms include: _________, and can be treated by _____ and _____. |
|
Definition
Infection, Fever, Headache, Nausea, Vomiting, Alterations in cognition, Neck Pain, Drowsiness
Antibiotics and surgery |
|
|
Term
| A Bacterial infection of CSF from a tick bite is known as _____ and is characterized by: _________. |
|
Definition
Lyme Disease
Fever, Headache, Fatigue, and Erythem Migrans ("bullseye pattern") |
|
|
Term
| Guillain Barre and Myasthenia Gravis are examples of _____ disorders |
|
Definition
|
|
Term
| Guillain Barre's symptom is: |
|
Definition
a gradual paralysis (polyneuorpathy) that travels proximal to distal, bottom to top.
Note: if the phrenic nerve is also dymyelinated, pt will have problems breathing. |
|
|
Term
| Myasthenia Gravis is an autoimmune disorder in which antibodies are formed for _____, thus _____ (decreasing/increasing) the number of _____. |
|
Definition
acetyl choline receptors
decreasing
receptors |
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