Primary brain injury

Secondary brain injury

Critical factor regarding brain cell death

Which is more immediate as far as neurological dysfunction? Ischemia or Hypoxia?

Time before irreversible damage from lack of o2 to brain?

Mechanisms causing brain cell death

In anoxic depolarization, what leaves the cell?

In anoxic depolarization, what enters the cell?

When membrane integrity is lost in neuronal cells, what amino acid may released in excess?

Under normal circumstances, what is Glutamate involved in?

When membrane integrity is lost in neuronal cells, why isn't excess Glutamate removed?

What does excessive Glutamate trigger neurons to do?

What does excessive calcium uptake cause in neurons?

What do NMDA receptors do when activated?

What does excess nitric oxide do in the brain?

O2 free radicals?

Reperfusion injury

-O2 reenters cells--

Reperfusion injury

What exactly happens to the cell walls?

Reperfusion injury

What does lipid peroxidation result in?

Reperfusion injury

Arachidonic acid--

Autoregulation in the brain controls

Autoregulation in the brain is influenced by

Neurological hyperperfusion results in

Normal ICP

Any change to the volume of blood, CSF, or brain tissue results in compensatory changes

What causes visual disturbances in ICP?

Protrusion through an opening in the dura

Main focus during treatment of brain injuries

Most sensitive indicator of altered brain function

State of alertness and attentiveness is dependent on

(review)

GCS- Eyes

Review

GCS--Verbal

Review

GCS--Movement

The eyes do not move in sync

Cranial nerves involved with pupil reflex

Cranial nerves involved with eye movement

Focal TBI

Diffuse TBI

Polar TBI

Coup injuries

Contracoup injuries

Primary brain injuries

Pt suffers a brief period of disturbed consciousness, returns to normal (AKA lucid interval), then rapid deterioration.

- typically arterial- rapid onset

- CT imaging used

May be acute or subacute

typically involves bridging veins, slower onset

CT or MRI imaging

bleeding above pia mater, typically rupture of aneurism/ arteriovenous malformation

typically rupture of bridging veins

blood spreads through CSN causing meningeal irritation, hydrocephalus, headache, vasospasm, ischemia

TBI treatment includes maintaining--

Treatment of acute ICP

Bruising under the ear is called

Bilateral black eyes

A sudden onset of neurological dysfunction resulting in an infarct

Most common form of stroke

________ cause abnormalities in cerebral perfusion

5th leading cause of death in the united states

Who experiences CVD and stroke more? Men or women?

Area of hibernating cells around dead brain tissue

Stroke must be treated within _____ hours of onset of symptoms to be effective

Ischemic stroke

Hemorrhagic stroke occurs within the

Hemorrhagic strokes occur most commonly specifically in the

Imaging for stroke

Stroke

Initial motor deficits are ________ as function recovers, it becomes _________

homonymous hemianoptia

Stroke- expressive aphasia

Stroke- receptive aphasia

Most common causes of subarachnoid hemorrhage

Location of most cerebral aneurisms

Symptoms of cerebral aneurism

Cerebral aneurism imaging

arterial blood is shunted directly into venous system causing enlargement over time

Risk factors for CNS infection

CNS infection- Viral

CNS infection- Bacterial

Most common meningitis

What causes obstructive hydrocephalus in meningitis

Where does meningitis invade in the brain?

Steroid treatment is _________ in meningitis

Causes of encephalitis

Symptoms of meningitis

Symptoms of encephalitis- West Nile

Symptoms of encephalitis-herpes

Paroxysmal, excessive or abnormal electrical discharges in brain

Manifestations of seizure

Causes of seizure

Direct cause of electrical malfunction in seizure

aura is also called

neurons which may be recruited in seizure

Entire surface of brain is involved in a _______ seizure

Involvement in RAS or thalamus in seizure results in

When myoclonic jerks and automatisms occur w/ absence seizures..

Seizure

Single or several jerks

Drop attack seizures

Partial seizure w/o change in consciousness

Partial seizure w/ change in consciousness

Partial seizure w/o change in consciousness that progresses to generalized

Antiseizure meds may be discontinued after

Grand mal seizures are

Dementia- non-alzheimers

Deficient synthesis of acetylcholine in brain

Ruling out dementia

Treating dementia

N-methyl-D-aspartate inhibitors can be used to treat

(NMDAAAAAA)

Dopanime deficiency in the basal ganglia (substantia nigra)

Lewy Bodies

Difficulty initiating and controlling movements (akinesia), tremors, rigidity

Tremors of parkinsons

Lack of expression

shuffling

no arm swing

drooling

Nonprogressive damage to motor control areas of brain in childhood

Major types of cerebral palsy

Causes of cerebral palsy

Cerebral palsy treatment

Abnormal accumulation of CSF in cerebroventricular system

Neural tube deficit or obstruction of aqueduct of sylvius (premature closure before bitrh)

Hydrocephalus symptoms

Abnormal absorption of CSF blocking flow in subarachnoid space or subarachnoid villi

Ventriculoperitoneal shunt

ventriculostomy

Normal pressure hydrocephalus

Obstruction in aqueduct or lesion in the 4th ventricle blocking flow of CSF

Part of brain responsible for smooth coordinated movement of muscle, postural reflexes and balance

Demyelination of MS often effects

MS affected by

Double vision

vision blur

memory loss

poor coordination

bowel/bladder

sensory deficits

Meds for MS

defective closure of bony encasement of spinal cord

Spina bifida occulta

Spina bifida cystica

Classification of spina bifida cystica

Spina bifida diagnostics

Muscular weakness progressing from arms

Both upper and lower motor neurons

Highly suggestive of ALS

ALS diagnosis

Glutamate inhibitors treat

Types of spinal cord injuries

Secondary spinal cold injuries..

Spinal shock

Spinal shock is CHARACTERIZED by

Guillan-Barre is a _____________ disease of the ___________

acute idiopathic polyneuropathy AKA polyradiculoneuropathy

Guillan Barre is ____________

ALS is ____________

Guillan-Barre diagnostics

Guillan Barre treatment

Bell palsy imaging

Bell Palsy onset

Bell palsy is suspected to be caused by

Hyperacusis

Bell palsy typically resolve in __ weeks

Bell palsy treatment

POSITIVE symptoms of schizophrenia

POSITIVE symptoms of schizo caused by

Catatonic motor behaviors are a _________ symptom of schizophrenia

NEGATIVE symptoms of schizophrenia

NEGATIVE symptoms of schizophrenia are caused by

Cognitive clinical manifestations of schizo

Anhedonia is a symptom of

Diagnosis of schizophrenia requires at least two of these symptoms and much have at least one of ******

___________ causes decreased neurotransmission and connectivity

Schizophrenia involves an excess of _________ and a deficit of ___________

____________ increases synaptic behavior and neurotransmitter output (schizophrenia)

causes a decrease in neurotransmission and connectivity like dopamine

Risk of schizophrenia as a child of a schizophrenic

prenatal infections, malnutrition, birth complications and brain injury are all risk factors for

pyramidal cells not lines up

exposure to flu 2nd trimester

impairment of hippocampal development

Neuro structure-- schizophrenia

neuro structure-- schizophrenia-- hippocampus

neuro structure-- schizophrenia--prefrontal cortex

MDD lasts at least ___ years

MDD diagnosis

MDD hallmark- Adults

MDD hallmark-- children

Neurobio of MDD

Symptoms of serotonin syndrome

In MDD, there is a reduction in ______ which causes hippocampus cell atrophy

Bipolar children

Bipolar one involves

Bipolar two involves

hypomanic- __ days

manic-__ days

Probably bio mechanisms of bipolar

lithium inhibits

Lithium toxicity first signs