Term
1.
What is the leading cause of dementia? |
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Definition
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Term
1.
What is the primary neurotransmitter that is decreased in DAT? |
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Definition
acetylcholine
*other neurotransmitters also contribute to decline of memory and attention |
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Term
1.
what are protective factors against DAT? |
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Definition
activity
presence of apoE and antioxidant substances
low calorie diet
menopausal estrogen REPLACEMENT
NSAIDS |
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Term
1.
what chromosome(s) is/are implicated in DAT? |
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Definition
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Term
1.
what large structural changes happen in DAT? |
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Definition
shrinking of cerebral cortex, hippocampus
enlarging of ventricles |
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Term
1.
what microscopic structural changes happen in DAT? |
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Definition
neuritic plaque formation with amyloid beta protein
neurofibrillary tangles
degeneration of forebrain cholinergic neurons with loss of acetylcholine |
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Term
1.
where is amyloid deposited furthering complications with DAT? |
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Definition
| amyloid is deposited in cerebral arteries causing angiopathy/decreased blood flow |
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Term
2.
what is another way to describe spastic paralysis? |
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Definition
| upper motor neuron paralysis or paresis |
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Term
2.
what is diplegia?
what is the common cause for diplegia? |
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Definition
paralysis on symmetrical parts of the body
usually due to cerebral palsy |
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Term
2.
what is hemiplegia?
what is the common cause of hemiplegia? |
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Definition
paralysis to the entire left or right side of the body
usually due to stroke |
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Term
2.
according to Dr Grossman, is pyramidal motor syndrome is a motor neuron syndrome for the upper or lower motor neurons?
how is it manifested? |
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Definition
Lower motor
-affects involuntary and voluntary movement
-spastic or elastic hypertonia, and exaggerated tendon reflex |
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Term
3.
when checking the dolls eye response, what are we looking for?
why |
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Definition
oculocephalic response
measures destructive or obstructive injury to brainstem |
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Term
4.
is there verbal response in a coma?
is there motor movement in a coma? |
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Definition
no verbal response
possible to have involuntary motor movement |
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Term
4.
what is an irreversible coma? |
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Definition
| death of the cerebral hemispheres (excluding the brainstem and cerebullum |
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Term
5.
decreased levels of the neurotransmitter GABA is at the root of which disorder?
Is there another disorder that this is implicated in? |
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Definition
epilepsy (seizures)
-epilepsy is the diagnosis after all other causes ruled out
also Huntingtons Chorea |
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Term
5.
what happens with blood flow, ATP, and O2 consumption during a seizure? |
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Definition
increased blood flow of 250%
increased ATP of 250%
O2 consumption increased by 60% |
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Term
6.
What is an acute confusional state affecting the reticular activating system of the upper brainstem and its projections? |
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Definition
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Term
6.
The upper brainstem and its projections are affected in delirium. What part in particular is affected? |
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Definition
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Term
6.
what neurotransmitters are involved with delirium?
state for each if it is increased or decreased |
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Definition
acetylcholine increased
dopamine increased
serotonin increased
GABA increased OR decreased (most likely decreased) |
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Term
7./14.
what is spinal shock?
what are the main effects? |
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Definition
a combination of areflexia/hyporeflexia and autonomic dysfunction that accompanies spinal cord injury.
loss of cutaneous and deep tendon reflexes below the level of injury with loss of sympathetic outflow, resulting in hypotension and bradycardia. |
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Term
7./14.
what is neurogenic shock?
what are the main effects? |
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Definition
Hemodynamic phenomenon-loss of vasomotor tone & loss of sympathetic nervous system tone
-hypotension
-bradycardia
-poikilothermia-temperature dysregulation |
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Term
7.
what are effects from lower motor neuron disease?
what is the prime neurotransmitter involved? |
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Definition
impaired voluntary and involuntary movements
flaccid paralysis
glutamate makes muscles relax in lower motor neuron syndromes |
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Term
7.
what are the effects of upper motor neuron disease?
whaat is the prime neurotransmitter involved? |
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Definition
spastic paresis or paralysis,
hypertonia and hyperreflexia
glutamate makes muscles contract in upper motor neuron syndromes |
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Term
7.
what is the concern with hyperextensibility in lower motor neuron syndromes? |
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Definition
| muscles become susceptible to damage because the normal protective mechanisms that prevent muscle fiber imjury are impaired |
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Term
8.
what is a chronic inflammatory disease involving degeneration of CNSmyelin, scarring or formation of plaque, and loss of axons? |
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Definition
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Term
8.
what is the cause of the chronic inflammation in MS? |
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Definition
autoimmune response to self-antigens in genetically susceptible individuals
also, Ca++ is neurotoxic and proinflammatory.
microglia and macrophages release NOS and ROS
immune cells produce glutamate, a neurotoxin |
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Term
8.
who is more likely to get MS? |
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Definition
| MS twice as common in women than men |
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Term
8.
what is the cause of MS? |
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Definition
etiology unknown,
links to HLA, as well as:
Vitamin D deficiency
cigarette smoking
EBV |
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Term
8.
what electrolytes are affected with MS? |
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Definition
| demyelination disrupts Na+, Ca++, and K+ |
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Term
8.
which is the most common form of MS? |
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Definition
a relapsing, remitting course.
once walking problems develop, disease progression is quick |
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Term
8.
what method is used to diagnose MS?
explain how it is used. |
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Definition
McDonald criteria
1.clinical eval- disease for at least 24 hours for at least 2 episodes
2.MRI-MS lesions in time and space
3. CSF- IgG index present for 2/3 of people.
4. Blood-Oligoclonal bands of IgG on electrophoresis |
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Term
9.
what is an arterio-venous malformation? |
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Definition
| arteries flow directly into veins through a vascular tangle of malformed vessels without a true capillary bed |
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Term
9.
in who does AVMs occur most? |
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Definition
younger than 30
in families |
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Term
extra?
what is the Monro-Kellie Hypothesis? |
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Definition
there is a fixed volume within the cranium. an altered level any of the 3 main constituents affects volume of the others.
the three components are BLOOD, CSF, and BRAIN TISSUE |
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Term
10.
what are risk factors for TIA? |
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Definition
| HTN, smoking, cardiac disease (a-fib), metabolic syndrome, ETOH, high cholesterol |
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Term
10.
what is an acronym used to diagnose TIA? |
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Definition
ABCD2
Age
BP
Clinical symptoms
Duration of symptoms
Diabetes |
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Term
10.
how long does a TIA last? |
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Definition
| never longer than 24 hours |
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Term
10.
what is the most common cause of artery blockage in ischemic stroke? |
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Definition
| ATHEROSCLEROSIS and inflammatory processes |
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Term
10.
what are the two types of ischemic stroke? |
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Definition
thrombotic ischemic stroke
embolic ischemic stroke
-disease or damaged cerebral arteries become blocked by the formation of a clot within the brain
-50% of all strokes |
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Term
10.
are women or men more at risk for ischemic stroke?
who also is at greatest risk? |
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Definition
women
older age 60+
african americans |
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Term
10.
what is the gold standard of treatment for ischemic stroke? |
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Definition
| tPA (tissue plasminogen activator) |
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Term
10.
what is he most common cause for a stroke in the subarachnoid space? |
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Definition
| burst aneurism is most common |
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Term
10.
what are the most common causes of hemorrhagic stroke? |
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Definition
elevated BP
aging of blood vessels |
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Term
10.
what is the greatest risk factor for subarachnoid hemorrhage?
What is implicated in weaknening of the vascular walls? |
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Definition
family history is a risk factor
genetics: IL6 release causes MMPs to mediate response to vacular walls |
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Term
11.
in what diseases is acetylcholine associated?
how? |
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Definition
DAT- decreased ACh-secreting neurons
myasthenia gravis (muscle weakness)- reduced ACh receptors |
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Term
11.
what are the monoamines? |
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Definition
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Term
11.
in what diseases is Serotonin associated?
how? |
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Definition
schizophrenia
involved with mood, anxiety, sleep |
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Term
11.
in what diseases is dopamine associated?
how? |
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Definition
parkinson disease (depression of voluntary motor control)
-destruction of dopamine-secreting neurons
-also implicated is an altered level of acetylcholine |
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Term
11/12
in what diseases is GABA associated?
how? |
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Definition
epilepsy
-GABA is the main inhibitory neurotransmitter
-inhibits excessive discharge of neurons |
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Term
12.
what is the underlying cause of epilepsy? |
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Definition
unknown cause
2/3 of seizures have an unknown cause |
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Term
12.
why eat a ketogenic diet? |
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Definition
prevent epilepsy
-high fat, high protein diet |
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Term
13.
what region is affected in Parkinson Disease? |
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Definition
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Term
13.
what are the 4 cardinal S/S of Parkinson Disease? |
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Definition
Cogwheel rigidity-jerks with tremors
resting tumor
akinesia-no voluntary movements
stooped posture |
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Term
14.
what vertebrae are usually not affected with a spinal cord injury? |
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Definition
| L3-L5, C3 all usually not affected |
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Term
14.
what are S/S of neurogenic shock? |
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Definition
bradycardia
hypotension
vasodilation
hypothermia |
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Term
14.
what are the S/S of spinal shock? |
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Definition
complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control in all segments below the level of the lesion.
faulty control of diaphoresis, |
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Term
14.
does circulation quickly return to white matter or gray matter during an injury? |
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Definition
| white matter- usually within 24 hours |
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Term
15.
what type of TBI accounts for more than 2/3 of head injury deaths? |
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Definition
focal brain injury
-point of impact and rebound effects |
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Term
15.
what are examples of primary TBI? |
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Definition
Intracerebral hemorrhage
Subdural hemorrhage
Subarachnoid hemorrhage
Epidural hemorrhage
Cerebral contusion
Cerebral laceration
Axonal stretch injury |
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Term
15.
what are examples of secondary TBI? |
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Definition
Edema
Impaired metabolism
Altered cerebral blood flow
Free radical formation
Excitotoxicity |
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Term
15.
what is the cause of tertiary TBI? |
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Definition
| hypoxia due to primary injury |
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Term
16.
what is the cause of positive blood in CSF? |
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Definition
subarachnoid hemorrhage
(also can be caused by a botched spinal tap) |
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Term
17.
what are causes of autonomic hyperreflexia? |
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Definition
| full bladder, impacted colon |
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Term
17.
what happens with autonomic hyperreflexia?
how is it treated? |
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Definition
massive reflex sympathetic discharge
-increased ICP, high BP- up to 300mmHg, bradycardia, blurredvision, sweating above lesion, flushing of the skin- medical emergency
-remove the stimulus: straight cath, remove impacted stool |
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Term
15.
loss of consciousness for 6+ hours is the hallmark of what? |
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Definition
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