Term
| What is the consequence of a vascular disorder? |
|
Definition
| Interference with bloodflow |
|
|
Term
| What is the consequence of a hemorrhagic vascular disorder? |
|
Definition
|
|
Term
| (T/F) These disorders cause very specific symptoms |
|
Definition
| False, generalized symptoms |
|
|
Term
| (T/F) Vasospasm can be triggered by blood in the ISF |
|
Definition
|
|
Term
| What do ischemic vascular disorders cause in the brain? |
|
Definition
|
|
Term
|
Definition
| Lack of ATP (due to lack of bloodflow) therefore Na+ enters cells, and water follows |
|
|
Term
| What causes global ischemia? |
|
Definition
- Cardiac arrest
- Cardiac shock |
|
|
Term
| What is the cause of transient ischemic attacks? |
|
Definition
| Temporary, localized, small occlusions |
|
|
Term
| What usually causes these occlusions? |
|
Definition
- Atherosclerosis
- Embolism |
|
|
Term
| What are the signs of a TIA? |
|
Definition
- muscle weakness (paresis) in a limb
- paresthesia
- visual disturbance
- transient confusion |
|
|
Term
|
Definition
|
|
Term
| (T/F) TIA's serve as a potential warning sign for a stroke |
|
Definition
|
|
Term
| (T/F) TIA's cause the patient to lose consciousness |
|
Definition
|
|
Term
| What is another word for a cerebrovascular accident (CVA)? |
|
Definition
|
|
Term
|
Definition
| Infarction of brain tissue due to lack of blood |
|
|
Term
| (T/F) The damage done in 5 minutes is irreversible |
|
Definition
|
|
Term
| (T/F) Liquifactive necrosis develops in the area of infarction |
|
Definition
|
|
Term
| List the risk factors contributing to CVA |
|
Definition
- diabetes
- hypertension
- heart disease,
- atherosclerosis,
- contraceptives and smoking together |
|
|
Term
| What are 3 different categories/causes of CVAs? |
|
Definition
1. Occlusion by atheroma in a large artery
2. Embolus in cerebral artery
3. Intracerebral hemorrhage |
|
|
Term
| (T/F) The onset of the CVA by occlusion of a large artery has a rapid onset |
|
Definition
|
|
Term
| Why is a CVA caused be intracerebral hemmorrhage more damaging than the other two causes? |
|
Definition
| Becaue it increases ICP as well |
|
|
Term
|
Definition
- sudden weakness, paresthesia in limb on one side
- temporary loss of speech; confusion
- sudden vision loss
- sudden headache
- dizziness |
|
|
Term
| (T/F) CVA's always have noticeable effects |
|
Definition
| False, they sometimes occur in "silent" areas |
|
|
Term
| What acts to diminish the damage zone during a CVA? |
|
Definition
| Collateral circulation in the CoW |
|
|
Term
| Describe the onset of paralysis due to a CVA |
|
Definition
| Initially, the patient has flaccid paralysis. Eventually develops into spastic paralysis |
|
|
Term
| What occurs at the initial area of CVA? Does it persist? |
|
Definition
| Inflammation in the tissue surrounding the ischemic event (aka the penumbra); it subsides |
|
|
Term
| (T/F) Excototoxic injury occurs in these ischemic areas surrounding the site of the CVA |
|
Definition
|
|
Term
| Which two things remain after the inflammation subsides? |
|
Definition
|
|
Term
| List things used for the treatment of a stroke |
|
Definition
- “clot-busters” – tPA (plasmin is fibrinolytic)
- glucocorticoids
- long-term anti-coagulants (eg warfarin – interferes with Vit K)
- Treat hypertension
- Brain plasticity |
|
|
Term
| (T/F) tPA can be dangerous when used to treat a hemorrhagic stroke |
|
Definition
|
|
Term
| What is the role of the glucocorticoids? |
|
Definition
| - Reduce inflammation and edema |
|
|
Term
| How does brain plasticity help treat a stroke? |
|
Definition
| The brain can "rewire" itself after damage, so lost functions can be re-learned due to the ability of the brain to adapt |
|
|
Term
| What parts of cerebral circulation are vulnerable to aneurysms? |
|
Definition
| The bifurcations of the vessels in the circle of willis |
|
|
Term
| Where do most aneurysms occur? |
|
Definition
| At the junction of the anterior cerebellar and circulating arteries |
|
|
Term
| What are the consequences of an aneurysm, regardless of if it has ruptured or not? |
|
Definition
- Reduced perfusion
- Increased ICP (especially upon rupture) |
|
|
Term
| What does blood in the ISF in the brain trigger? |
|
Definition
|
|
Term
| What are the signs of an aneurysm occuring? |
|
Definition
- Intense headache
- Photophobia
- Slurred speech
- Confusion
- Nuchal rigidity (stiff extended neck) |
|
|
Term
| What is cause of all of these signs? |
|
Definition
| - Increased pressure on the optic chiasm or cranial nerves |
|
|
Term
| What causes nuchal rigidity? |
|
Definition
| Blood irritating the nerves on the neck |
|
|
Term
| How are brain aneurysms treated? Are the treatments successful? |
|
Definition
- Clipping of the affected area
- No, over 50% mortality rate |
|
|
Term
|
Definition
1. Concussion
2. Contusion |
|
|
Term
| What is causes a concussion? |
|
Definition
|
|
Term
| (T/F) Physical damage to the brain is evident in a concussion |
|
Definition
|
|
Term
| What are the two consequences? |
|
Definition
- Loss of consciousness
- Amnesia |
|
|
Term
| (T/F) Recurrent concussions can lead to permanent brain injury |
|
Definition
|
|
Term
|
Definition
| Bruising of the brain tissue |
|
|
Term
| What causes this bruising? |
|
Definition
| Rupture of small vessels supplying the brain |
|
|
Term
| Describe what kind of fractures can happen to the skull |
|
Definition
- Both open and closed
- Depressive fracture
- Linear fracture
- Compound fracture |
|
|
Term
| What is a basilar fracture? |
|
Definition
| Fracture at the base of the skull |
|
|
Term
| (T/F) CSF often leaks through the ears or nose with a basilar fracture |
|
Definition
|
|
Term
| What are two consequences of CSF leakage? |
|
Definition
- Cranial nerve damage
- Discoloration around the eyes |
|
|
Term
|
Definition
| When the brain impacts the skull for the first time upon skull impact |
|
|
Term
|
Definition
| When the brain rebounds off the opposite site from impact |
|
|
Term
|
Definition
| Blood pooling (anywhere in the body_ |
|
|
Term
| List the 4 types related to brain injury |
|
Definition
1. Epidural
2. Subdural
3. Subarachnoid
4. Intracerebral |
|
|
Term
| What does an epidural hematoma lead to? Why? What causes an EH? |
|
Definition
- Brief LOC -> headache -> brainstem herniation
- Blood fills space between dura and bone, increased pressure causes herniation
- Severe trauma |
|
|
Term
| List characteristics of a subdural hematoma |
|
Definition
- Acute or subacute symptoms
- Elderly not as affected
- Blood fills space between dura and arachnoid
- Caused by tears in veins |
|
|
Term
| List characteristics of a subarachnoid hematoma |
|
Definition
- Rupture of the blood vessels at the base of the brain
- No hematoma actually occurs because blood mixes with CSF |
|
|
Term
| List the characteristics of an intracerebral hematoma |
|
Definition
- Caused by a shearing injury or hypertension
- Weeks to months |
|
|
Term
| List the signs of brain injury |
|
Definition
- Increased ICP
- Blood in CSF
- Fever
- Seizure
- CN disturbances
- CSF leaks from nose/ears
- Blood from ears |
|
|
Term
| Why would alcohol impair diagnosis of ICP? |
|
Definition
| Because alcohol dehyrdrates the body therefore pulling water out f the brain |
|
|
Term
| (T/F) Blood in CSF appears in all types of brain injury |
|
Definition
| False, only in those that causes blood to enter the CSF (subarachnoid) |
|
|
Term
| What is seen as a result of cranial nerve impairment? |
|
Definition
| – smell, vision, hearing, dysphagia, accessory breathing muscles all affected |
|
|
Term
| What is otorrhea/rhinorrhea? |
|
Definition
|
|
Term
|
Definition
| Pressure on the hypothalamus prevents homeostatic processes |
|
|
Term
| How are brain injuries treated? |
|
Definition
|
|
Term
| What are the most vulnerable areas for spinal cord injury? |
|
Definition
|
|
Term
|
Definition
- Hyperflexion/hyperextension of neck
- Compression injuries |
|
|
Term
| (T/F) Both nerves and axons can regenrate |
|
Definition
|
|
Term
| What does this depend on? |
|
Definition
| If the myalin is intact or not - axons can regenerate along a pathway |
|
|
Term
| What occurs immediately after a spinal cord injury? |
|
Definition
|
|
Term
| What is seen with spinal shock? |
|
Definition
| - No impulses, therefore flaccid paralysis and loss of sensation |
|
|
Term
| What is seen with cervical injury, on top of spinal shock symptoms? |
|
Definition
| Loss of ANS functions (low BP, loss of temp/bladder/bowel control) |
|
|
Term
| (T/F) As the inflammation from injury subsides, reflex activity returns to the subject |
|
Definition
|
|
Term
|
Definition
| Paralysis has switched from flaccid to spastic |
|
|
Term
| What is seen if there is an incomplete spinal chord injury? |
|
Definition
| - Ipsilateral paralysis for UMN function (since tracts cross at medulla) - Ipsilateral fine touch/pressure sensation loss - Contralateral pain/temp loss/crude touch |
|
|
Term
| What is autonomic dysreflexia? |
|
Definition
| Triggering of autonomic response by noxious signal (autonomic response shouldn't actually happen) |
|
|
Term
| Describe what occurs with this? |
|
Definition
| Widespread SNS stimulation causes increased BP and vasoconstriction. Baroreceptors sense this and slow HR (via unaffected vagus) |
|
|
Term
| (T/F) Autonomic dysreflexia occurs n all spinal cord injurues |
|
Definition
| False, only in cervical spinal injury |
|
|
Term
| List some complications of ANS dysreflexia |
|
Definition
| Decubitus ulcers and respiratory infeciton |
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