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patho
acute neurological and neurodegenerative disorders ch 30
| Question | Answer |
|---|---|
| Central nervous system | consists of brain and spinal cord |
| CNS association neurons | contained within CNS, usually relays from afferent and efferent |
| peripheral nervous system | cranial and spinal nerves, made up of afferent and efferent nerves |
| afferent nerves | SENSORY, dendrites distal to CNS and axons proximal |
| efferent nerves | MOTOR, dendrites proximal to CNS and axons distal |
| neurodevelopment disorders | impairment of brain function occurring as brain developes |
| what neurodevelopment disorders effect | language coordination attention behavior |
| brain tumors | space occupying lesions that cause increase in intracranial pressure ICP. can be malignant or benign |
| with type of brain tumor is life threatening | BOTH malignant AND benign tumors are life-threatening, unless accessible and removable |
| Gliomas | largest category of primary malignant tumor, classifies according to cell derivation and location of tumor |
| Primary tumor | tumor that originated in the BRAIN |
| secondary tumor | tumor that metastasized from somewhere else in the body, usually from breast or lung |
| primary malignant tumor | rarely metastasized outside the CNS (blood brain barrier) |
| pathophysiology of primary malignant brain tumors | usually not well- defined (irregular borders) invasive and have irregular projections into adjacent tissue usually inflammation around the tumor |
| etiology of brain tumors | brainstem and cerebellar tumors common in young children adults more frequently in the cerebral hemispheres |
| brain tumor signs and symptoms | seizures often a sign headaches, vomiting, lethargy, irritability, personality and behavior change, possible unilateral facial paralysis, visual probs. do not cause systemic signs of malignancy |
| brain tumor tx | tx may cause damage to normal CNS tissue surgery if accessible chemotherapy and radiation |
| Meningitis brain infection | inflammation of the meninges different age groups are susceptible to different causative organisms may be secondary to other infections |
| meningitis in young adults | most often dude to haemophiles influenza bacteria (more often in the fall or winter) |
| meningitis in children and young adults | neisseria meningitides or meningococci - classic meningitis pathogen. frequently carried in the nasopharynx of asymptomatic carriers. spread by respiratory droplets (later winter/early spring) |
| meningitis in older adults | streptococcus pneumonia major cause |
| signs and symptoms of meningitis | sudden onset, severe headache, back pain, photophobia (irritation of optical nerve), nuchal rigidity, kerning sign (legs), brudzinski sign (neck), vomiting, irritability, lethargy, fever/chills with leukocytosis, progressing to stupor or seizures |
| meningitis diagnostic test | examination of CSF (lumbar puncture) identify causative organism |
| meningitis treatment | aggressive antimicrobial therapy specific tx for ICP and seizures glucocorticoids (stop inflammation) vaccines are available for some types |
| brain abscess infection | usually occurs when bacteria or fungi enter the brain tissue after an infection or severe head injury. pus filled swelling in the brain |
| where brain abscesses usually are | frontal or temporal lobes localized infection |
| brain abscess etiology and patho | -may spread from an organism in the ear, throat, lung, sinuses -causes necrosis of the brain tissue and surrounding area of edema -may result from septic emoji, acute bacterial endocarditis site of injury or surgery |
| brain abscess Tx | surgical drainage and antimicrobial therapy |
| encephalitis infection | infection of the parenchymal (nerve or glial cells) or connective tissue of the brain and spinal cord. necrosis and inflammation developes in the brain tissue, results in permanent damage. |
| encephalitis types of infection | (infection may include meninges) -viral infect. (ex. herpes simplex virus) -bacterial infect. (ex. Lyme disease, tuberculosis) - autoimmune disorders (ex. MS, lupus) - allergic rxn (ex. to vaccines or medications) |
| encephalitis infection - early signs | severe headache, stiff neck, lethargy, vomiting, seizures, fever |
| encephalitis infection - Dx | imaging tests - CT scan or MRI CSF analyses |
| tetanus infection | caused by clostridium tetani, spores can survive in soil (years), wounds, exotoxin enter nervous system |
| tetanus infection - signs and symptoms | tonic muscle spasms, jaw stiffness, difficulty to swallow, stiff neck, headache, skeletal muscle spasm, respiratory failure (affects diaphragm) |
| Herpes Zosters (shingles) infection | caused by varicella-zoster virus in adults. years after primary infection of varicella, usually affect one cranial nerve or one dermatome |
| Herpes Zosters (shingles) infection signs and symptoms | pain, paresthesia, vesicular rash (if antiviral drugs started within 48 hours of onset, pain is significantly reduced) lesion and pain persist for few weeks post-therapeutic pain may persist for months to years in some cases |
| Herpes Zosters (shingles) infection Tx | vaccine available - chickenpox vax |
| head injuries | may involve skull fracture, hemorrhage and edema, direct injury to brain tissue. injury can be mild (bruising of tissue) or can be life-threatening (destruction of brain tissue/massive swelling of the brain) |
| concussion | minimal brain trauma -reversible interference with brain function -cause sudden excessive movement of the brain -result of mild blow to the head or whiplash-type injury -amnesia and headache to follow recovery: within 24 hours w/ NO permanent damage |
| contusion | -bruising of the brain tissue, rupture of small blood vessel (inflammation and edema) -blunt blow to the head, possible residual damage |
| closed head injury | skull is not fractured in injury brain tissue is injured and blood vessels may be ruptured extensive damage may occur when head is rotated |
| open head injury | involves fractures or penetration of the brain |
| depressed skull fractures | -involves displacement of a piece of the bone below the levels of the skull -compression of brain tissue -blood supply to are often impaired, pressure to brain |
| basilar fractures | occurs at the base of the skull leakage of CSF through ears or nose is possible may occur when forehead hits windsheild |
| contrecoup injury | area of brain contralateral to the site of direct damage is injured as brain bounces off the skull. may be secondary to acceleration or deceleration injuries |
| head injury | trauma to the brain tissue. causes loss of function in part of body controlled by that area of the brain. cell damage and bleeding leads to inflammation and vasospasm around injury site. hematoma: classified by their location in relation to the meninges |
| head injuries signs and symptoms | focal signs (neurological symptoms that affect a specific area of the brain or nervous system) general signs of increased ICP seizures cranial nerve impairment otorrhea or rhinorrhea fever (hypothalamus impairment or cranial systemic infection) |
| otorrhea | drainage from ear |
| rhinorrhea | drainage from nose |
| head injury Dx and Tx | MRI and CT to determine extent of brain injury glucocorticoid agents (decrease edema) antibiotics (reduce infections) surgery (to reduce ICP) oxygen (to protect remaining brain tissue) |
| spinal cord injury | damage may be temporary or permanent, axon regrowth may occur |
| spinal cord injury types | 1. laceration of nerve tissue by bone fragments or complete transection/crushing of cord (cord completely severed) 2. partial transection or crushing of the cord/bruising 3.prolonged ischemia and necrosis |
| 1. laceration of nerve tissue by bone fragments or complete transection/ crushing of cord (cord completely severed) | irreversible loss of all sensory and motor function at and below the level of the injury |
| 2. partial transection or crushing of the cord/bruising | may allow recovery of some functions |
| 3.prolonged ischemia and necrosis | permanent damage |
| spinal cord injury Tx | physical therapy or occupational therapy |
Created by:
ago24