Path 2

  1. Brain concussion
    trauma to the brain that causes any change in mental status
  2. Brain contusion
    Brusin (coup- counter coup)
  3. coup
    when the brain hits the skull from trauma
  4. counter coup
    when the brain recoils from a coup and hits the opposite side of the skull
  5. Brown-Sequard Syndrome
    • hemisection of the spinal cord
    • ipsilateral UMN signs and loss of tactile, vibration, and proprioception below lesion
    • contralateral pain and temp loss below lesion
    • ipsilateral loss of all sensation at lesion
    • LMN signs at level of lesion
  6. Horner's syndrome
    • hemisection of the spinal cord above T1
    • sympathectomy of the face
  7. PAMELa Horner
    • P- Ptosis
    • A- Anhidrosis anf fushing of affected side of face
    • M- Miosis
    • E- Enophthalmos
    • L-Loss of ciliospinal reflex
  8. Uncal herniation
    • ipsilateral dilated pupil/ptosis-> stretching CN 3
    • contralat homonymous hemianopia-> compression of ipsilat post cerebral A
    • ipsilateral paresis -> compression of contralat crus cerebri (false localizing sign)
    • duret hemorrhages/paramedian artery rupture-> caudal displacement of brain stem
  9. Anencephaly
    cephalad neurotube doesnt close (cranium)
  10. meningocele
    • a bubble of meningies extending out of the back
    • does not contain spinal cord
  11. myelomeningocele
    a bubble of meningies outside of the back that CONTAINS the spinal cord
  12. spina bifida
    • no meningies found
    • spinal cord out side of the spinal tract
  13. epidural hematoma
    • bleed between skull and dura
    • rupture of middle meningeal artery
    • slow onset of symptoms
    • caused by bone fragment from trauma
    • biconvex disk that does not cross suture lines
  14. Subdural Hematoma
    • between dura and arachnoid layer
    • caused by blunt trauma
    • from ruptured bridging veins (slow)
    • nonspecific symptoms
    • crescent-shaped hemorrhages that crosses sutures
  15. Subarachnoid Hemorrhages
    • between arachnoid layer and pia mater
    • caused by trauma or rupture of congenital berry aneurysms
    • high mortality
    • worst headache of my life
    • bloody or yellow spinal tap
  16. intracerebral hemorrhages
    • head trauma
    • rupture of intracerebral vessels
    • nontraumatic form= stroke
    • common in hematologic diseases
  17. cerebrovascular disease- facts
    • third most common cause of death
    • most common crippling disease
    • stokes
  18. cerebrovascular disease- types
    • global ischemia
    • cerebral infarct
    • intracerebral hemorrhage
  19. lacunar infarcts
    • widespread atherosclerotic narrowing of CVS causing multiple foci of ischemic necrosis
    • slowly progressive mental deterioration
  20. watershed infarcts
    systemic hypotension lowers perfusion from both sides and area in the border zone becomes hypoxic
  21. laminar necrosis
    hypoperfusion of deeper zones of grey matter supplied by short penetrating arteries
  22. cerebral infarct- causes
    • primary- thrombotic occlusion
    • secondary- thromboemboli
  23. cerebral infact
    • pale infarct (white mater) or red infarct (grey matter)
    • critical fase- edematous
    • long term- fluid-filled cavity
    • clinical presentation as a stroke
  24. clinical features of intracerebral hemorrhage
    • basal- rapid onset hemiplegia and hemiparesis
    • cerebellar- nausea and vomitting, loss of balance, severe headache, coma, die within 48 hours
    • pontine- die within hours of nonspecific symptoms
  25. most common site of intracerebral hemorrhage
    basal ganglia
  26. cause of intracerebral hemorrhages
    arterial hypertension
  27. lesion in the amygdala
    kluver-brucy syndrome
  28. syringomyelia
    • enlargement of the central canal of the spinal cord
    • crossing spinothalamic tract fibers are damaged
    • bilateral loss of pain and temp in the upper extremities
    • most common C8-T1
    • presents with Arnold-Chiari malformation
  29. Arnold-Chiari malformation
    • downward displacement of the cerebellar tonsils through the foramen magnum
    • may block CSF
  30. bacterial infections of the brain
    hematogenous route or from septic emboli
  31. neisseria meningitidis
    • bacterial infection
    • most important bacterial pathogen in adolescents
  32. streptococcus pneumoniae
    • bacterial infection
    • most cases of bacterial meningitis in adults
  33. E. coli and group B strep
    • bacterial infection
    • most important causes of bacterial meningitis in neonates
  34. viral infections of the CNS
    hematogenous routemeasles virus, rubella, adenovirus, herpesvirus, cytomegalovirus, rabies virus
  35. protozoal infections of the CNS
    • hematogenous route
    • toxoplasma gondii
  36. fungal infections of the CNS
    • hematogenous route
    • candita albicans, aspergillus flavus, cryptococcus neoformans
  37. prions infections of the CNS
    • kuru
    • creutzfeldt-jakob disease
    • mad cow disease
  38. encephalitis
    infection of the whole brain
  39. myelitis
    inflammation of the spinal cord
  40. cerebral abscess
    infection of the brain causing an abscess of pus and immune cells
  41. meningitis
    inflammation fo the meninges
  42. neurosyphilis
    infection of the brain and spinal cord resulting from untreated syphilis infection
  43. Kernigs sign
    • positive with the inability to straighten the leg when the hip is flexed to 90 degrees
    • test for meningitis
  44. Brudzinski sign
    • positive if patient's hips and knees flex when the neck is flexed
    • test for meningitis
  45. syphilis
    bacterial inflammation (treponema pallidum)
  46. primary syphilis
    • painless ulceration (chancre) on the genitalia
    • usually heals spontaneously
  47. secondary syphilis
    • most contagious stage
    • symmetrical reddish rash on trunk, limbs, palms and soles
  48. tertiary syphilis
    • gummas (tumor balls) on the body
    • one to 10 years after initial infection
    • al capone
    • neurological and cardiovascular complications
    • argyll robertsons pupils (prostitiues pupils, like a prostitute, they accommodate but dont react)
  49. tests for syphilis
    • VDRL
    • RPR
  50. Tabes dorsalis
    • associated with tertiary syphilis
    • degeneration of dorsal roots and columns
    • impaired proprioception and locomotor ataxia
    • associated with Charcot's joints
  51. charcot's joints
    • progressive degenertaion of a weight bearing joint
    • bony destrution, bone resorption, and deformity
  52. AIDS related CNS lesions
    • toxoplasma
    • cryptococcus
  53. autoimmune diseases of the CNS
    multiple sclerosis
  54. multiple sclerosis
    • demyelinating disease
    • women more
    • genetic factors
    • muscle weakness, unsteady gait, incoordination of movements, sphincter abnormalities
  55. Multiple Sclerosis- vitamin D
    circumstantial, it is compelling. this theory can explain the striking geographic distrobution of MS, which is nearly zero in equatorial regions and increases dramatically with latitude in both hemispheres. ic can also explain two peculiar geographic anomalies, one in Switzerland with high MS rates at low altitudes and low MS rates at high altitudes, and one in Norway with a high MS prevalence inland and lower MS prevalences along the coast.
  56. inborn errors of metabolism (accumulations)
    • tay-sachs disease
    • neimann-pick disease
    • phenylketonuria
  57. nutritional disease
    • vit. B1 deficiency (wernicke-korsakoff syndrome)
    • vit B12 deficiency (uncoordination, spinal cord disease, abnormal gait, psychiatric symptoms)
    • nicotinic acid deficiency (dermatitis, diarrhea, delirium)
  58. Alcoholism
    • Wernicke-korsakoff syndrome
    • uncoordinated movements
    • subdural hematoma, pontine myelinolysis
    • delirium tremens
  59. neurodegenerative diseases
    • alzheimer's disease
    • parkinson's disease
    • huntington's disease
    • amyotrophic lateral sclerosis
  60. Alzheimer's disease
    • genetic factors- Down's
    • atrophy of the cortical parts of the frontal and temporal parts of the brain
    • 70+ years old
    • dementia
  61. dementia
    progressive loss of cognitive functions and functional decline
  62. Alzheimer's disease- autopsy findings
    • atrophic brain
    • neuritic (senile) plaques
    • deposition of amyloid
    • neurofibrillary tangles
    • Tau proteins
  63. Parkinson's disease
    • subcortical neurodegenerative disorder
    • elerly persons
    • dopaminergic neurons in substantia nigra
    • strange movments
    • lewy bodies
  64. signs and symptoms of parkinsons
    • tremor
    • instability while walking
    • depression
    • dementia
  65. Huntington's disease
    • autosomal dominant
    • involuntary, gyrating movements
    • dementia
    • atrophy of the cortex, subcortical nuclei and caudate and putamen
  66. characteristics of basal ganglia lesions
    • chorea
    • athetosis
  67. Amyotrophic lateral sclerosis
    • men more
    • motor weakness and progressive wasting of extremity muscles
    • fasciculations
    • slurred speech
    • loss of motor neurons in spinal cord, midbrain, and cerebral corted
    • loss of lateral cerebrospinal pathways
  68. neoplasms of the CNS
    • brain tumors have very high mortality rate
    • brain tumors occur at any age
    • 50% of tumors are primary neoplasms
    • malignant tumores of the CNS dont metastasize
  69. CNS tumors of only children
    malignant tumors of neural cells
  70. CNS tumors of adults only
    • gliomas or meningiomas
    • this is because adult neurons dont divide, can't give rise to tumors
  71. Astrocytomas
    • solid cerebral adult tumors
    • cystic tumors in children
    • well differentiated astrocytes
    • later indistinguishable from glioblastoma multiforme
  72. Glioblastoma multiforme
    • most common CNS tumor
    • 65 years of age
    • lateral hemispheres
    • highly variegated gross appearance
  73. histology of glioblastoma multiforme
    • anaplastic astrocytic cells
    • cells maintain fetal appearance
    • numerous mitotic figures
    • proliferative changes in blood vessels
  74. oligodendrogliomas
    • cerebral hemispheres
    • middle-aged adults
    • well circumscribed, partially cystic, calcified
    • well-differentiated
    • can progress to glioblastoma multiforme
  75. Ependymomas
    • children in ventricles
    • adults in spinal cord
    • filum terminale
    • line the papillary structures or form rosettes
  76. Medulloblastoma
    • cerebellum
    • childhood
    • usually located centrally
  77. Meningioma
    • usually benign, from meninges
    • midline, base of the brain, along spinal cord
    • epileptic seizures
    • good prognosis
  78. neuromas- 2 types
    • schwannomas
    • neurofibromas
  79. neuromas
    • solitary or multiple
    • mainly benign
    • rare
    • type 2 involves cranial nere, causing hearing loss and vertigo
  80. what percent of brain tumors are metastases
  81. most common tumore sites that metastasize to the brain
    • lung
    • breast
    • melanoma
Card Set
Path 2
Cards for test 1