Term
|
Definition
| relating to the brain and the blood vessels that supply it |
|
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Term
| Cerebro vascular Accident (CVA) |
|
Definition
technical term for stroke
a heterogenoues group of vascular disorders associated with damage to the brain's blood vessels and decreased blood flow within and to the brain |
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Term
|
Definition
Morbid enlargement in which the multiplication of cells is uncontrolled and progressive
make up 5% of brain cancers
appear in 2% of autopsies
most common in early or middle adulthood |
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Term
|
Definition
holes in the brain that result from damage
almost always cause some loss of function |
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Term
|
Definition
damaged neurons degenerate
tissue surrounds lesion shrinks, dies in hours
CSF fills cavity |
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Term
|
Definition
neuronal cell death; can be caused by lack of oxygen
4-6 minutes can cause necrosis |
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Term
|
Definition
complete absence of oxygen supply to the brain
heart attack, complications of anesthesia, near-drowning, severe trauma
causes permanent brain damage unless oxygen is quickly restored |
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Term
|
Definition
reduced, but not complete, oxygenation of the brain
high altitude, acute cardiac crisis, deep-sea divers |
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Term
|
Definition
essentialy chronic hypoxia during sleep
Blood oxygen levels can drop from 90%-50% or less
Morning headaches, poor attention and concentration, sleepiness
reversibility of damage is likely related to length of deprivation |
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Term
|
Definition
ventricles enlarge abnormally due to pressure build up in the CSF fluid
Due to
increased CSF production
decreased CSF absorption
blockage of the normal CSF flow distribution |
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Term
| Communication hydrocephalus |
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Definition
| when blood gets into the CSF and interferes with the reabsorption |
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Term
| Obstructive hydrocephalus |
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Definition
| there is an actual blockage in the CSF circulation |
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Term
| Brain uses __% of bodies oxygen |
|
Definition
|
|
Term
Hydrocephalus affects by...
and corrected by... |
|
Definition
squeezes parts of the brain against the skull
leads to neuronal death
surgically inserting a tube to shunt the CSF fluid into the peritoneal cavity of the abdomen |
|
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Term
| Cerebrovascular disorders facts |
|
Definition
Most common cause of disability in Western world
2nd leading cause of death in +85 year olds
3rd most common cause of death in the developed countries
avg. age ~70
500K/year
5% death rate |
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Term
|
Definition
CVA
a heterogeneous group of vascular disorders that result in brain injury
the brain's blood vessels are damaged, decreases blood flow within and to the brain
Always in the brain
rapid onset but can take hours for clinical symptoms to manifest
Early diagnosis and intervention is key
localized in 1 hemisphere |
|
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Term
| Stroke impairment of blood supply |
|
Definition
Decreased oxygen
Pocket of blood causes increases intracranial pressure (ICP)
toxin in the blood can damage brain tissue |
|
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Term
|
Definition
temporary strokes caused by insufficient blood supply to an area of the brain
Short-lasting attacks that cause only transient deficits |
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Term
|
Definition
blockage of an artery that causes severe loss of blood supply
more lasting neurological effects |
|
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Term
|
Definition
bleeding or displacement of the brain caused by a hemorrhage
severe form of stroke; permanent damage or death |
|
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Term
| Transient Ischemic Attacks |
|
Definition
Acute, focal (localized) neurological deficit, evidence by a transient loss of function
recovery within 24 hours; sometimes minutes
infrequent (< once a month) to frequent (daily)
no actual damage to neurons, temporary insufficient oxygen supply
20-30% greater risk of stroke
2/3 are male or hypertensive, or both |
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Term
|
Definition
results from inadequate blood supply to an area of the brain
tissue death or necrosis
result of an occlusion |
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Term
|
Definition
blockage of a blood vessel- stopping blood flow
usually caused by either a blood clot or a fatty deposit lodged in a blood vessel |
|
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Term
|
Definition
formulation of a blood clot or thrombus within a blood vessel
brain and heart location |
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Term
|
Definition
most common process in infarction
irregularly distributed yellow fatty plaques build up on the blood vessel walls |
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Term
|
Definition
a blood clot that has traveled from one part of the body to another
piece of plaque originally formed in the heart can break off into the blood and travel to the brain, and that area can die of infarction
33% associated with atrial fibrillation
Arrhythmia (irregular heartbeating) |
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Term
|
Definition
results from rupture of a blood vessel causing heavy spilling of blood into cerebral tissue
abrupt
poor prognosis
usually occurs when a weak spot in a blood vessel (aneurysm) ruptures |
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Term
|
Definition
| large accumulation of blood within tissue |
|
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Term
|
Definition
weak areas in the walls of an artery that cause the vessel to ballon out
can either be born with abnormality or develop it
causes hemorrhagic stroke if rupture
about 50% occur in middle cerebral artery
4% of adults have an aneurysm |
|
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Term
| intracerebral hemorrhages |
|
Definition
a hemorrhage within the brain in which a defective artery bursts
pre-existing hypertenstion
deficits usually localized
can be fatal
when bleeding ceases, usually no recurrence from same site |
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Term
|
Definition
occurs when a blood vessel on the surface of the brain bursts
blood gets into subarachnoid space
increase pressure of the brain
symptoms can range from a sudden headache to vomiting to an interruption in consciousness
typically do not see localized symptoms |
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Term
| Arteriovenous Malformation (AVM) |
|
Definition
| abrnomal redundant connections between blodd vessels that cause abnormal blood flow |
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Term
| Computed transaxial tomography (CT) scan |
|
Definition
initial evaluation for stroke
hemorrhages first appear as round lesions with uniform high density
edges become more irregular and lesion looks less dense
tumors show up with different density |
|
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Term
|
Definition
most accurate
invasive and entails some risk to patient
can show whther an obstructing plaque is significantly impairing blood flow and whether it can be easily removed
precise diagnosis of cerebral aneurysms, AVM, artery occlusion, stenosis |
|
|
Term
| Other diagnosing tests for cerebrovascular disease |
|
Definition
ultrasonic waves
Doppler imaging |
|
|
Term
| Factors involved in stroke recovery |
|
Definition
Size
smaller is better
Remaining intact vessels
"collateral blood vessels" supply blood to an area that blocked blood vessel used to
Premorbid Factors
previous strokes
Location |
|
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Term
|
Definition
communication between blood vessels by collateral channels
important defense |
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|
Term
Preventing stroke
Risk Factors |
|
Definition
History of stroke
heredity
sex (male)
ethnicity (African Americans, female)
Hypertenstion
Diabetes
High cholestrol
Smoking
Obesity |
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Term
|
Definition
new tissue
disorganized
no functional purpose
related to tumors |
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Term
|
Definition
| take over neighboring areas of the brain and destroy tissue |
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Term
|
Definition
| encaspulated and doesnt spread but causes problems due to compression surrounding brain tissue |
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Term
|
Definition
properties of tumor cells invade other tissue and are likely to re-grow or spread
more likely to reappear
difficult to completely remove
travel to other organs |
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Term
|
Definition
| tumor travels to other organs |
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Term
|
Definition
cell growth that is typically surrounded by fibrous capsule, typically noninfitrative
displaces healthy brain tissue |
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|
Term
Types of tumor:
Infitrating tumors |
|
Definition
Gliomas
glioblastoma multiforme (GBM)
Astrocytomas
Oligodendroglioma |
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Term
|
Definition
Meningiomas
metastic
acoustic neuroma
pituitary tumors |
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Term
|
Definition
Medulloblastoma
Pinealomas |
|
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Term
|
Definition
40-50% of all brain tumors
fast growing; made of glial cells |
|
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Term
|
Definition
Glioblastoma multiforme (GBM)
arises after middle age
usually confined to one hemisphere
large, grade 4
regrowth and eventual death common with 6-12 months after surgery
astrocytomas
infiltrative tumors of astrocytes
grow more slowly than BBMs
somewhat better prognosis
Oligodendroglioma
rare, slowly growing tumor that affects young adults |
|
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Term
|
Definition
noninfiltrating tumor
15% of all brain tumors
highley encaspulated
increases with age and twice as frequent in female
grows slowly |
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Term
|
Definition
Noninfiltrating tumor
all malignant tumors have the capacity to metastisize
primary site, lung, breast, skin
neurosurgeons do not try to remove them
40% of all brain tumors seen in elderly adults |
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Term
|
Definition
noninfiltrating tumor
progressively enlarging benign tumors within the auditory canal
arise from schwann cells of cranial nerve VIII
initial symptoms: tinnitus, partial deafness
patient may also lose taste on one side |
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Term
|
Definition
Pituitary Tumor; noninfiltrating
produce symptoms due to the pressure on the pituitary |
|
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Term
|
Definition
pituitary tumor; noninfiltrating
affect release of the pituitary hormones
acidophilic adenomas
chromophobic adenomas
basophilic adenomas
cushing's syndrome |
|
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Term
|
Definition
noninfiltrating pituitary tumor
includes neurologic symptoms, changes in bone structure, hypertension, diabetes
most serious of pit tumors and often requires complete removal of tumor |
|
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Term
|
Definition
childhood tumor; most common
rapidly growing and malignant tumor close to the fourth ventricle
2/3s of all tumors in children
increased cranial pressure due to obstructive hydrocephalus
early symptoms; headache, vomiting |
|
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Term
|
Definition
childhood tumor; common
tumors of thep ineal gland
often causes hydrocephalus |
|
|
Term
| Diagnosis of brain tumors |
|
Definition
equal for males and females
cerebellar medullablastomas and GBMs; males
Meningiomas; females
45% gliomas
15% pituitary adenomas
15% meningiomas
15% metastic brain tumors
10% other |
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Term
|
Definition
surgical removal
Malignant; radiation therapy follows surgical removal
Cannot remove tumor; radiation therapy primary treatment
chemotherapy also used |
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Term
|
Definition
similar to tumors
destroys and compresses brain tisue
different:
arises from an infection
localized pocket of pus
empty center
prior infection |
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Term
|
Definition
| bacterial or viral infection of meninges (protective covering around brain) |
|
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Term
|
Definition
aggressively attacks the medial temporal and orbital frontal areas
anterograde amnesia |
|
|
Term
|
Definition
has more generalized effects on brain
virus may damage brain
opportunistic infections |
|
|
Term
|
Definition
| an poisonous substance that affects brain |
|
|
Term
| Traumatic Brain Injury (TBI) |
|
Definition
| when an outside force traumatically injures the brain, |
|
|
Term
| top 3 sports where TBI is most prevalent |
|
Definition
equestrian
gymnastics
Cheerleading |
|
|
Term
| sports account for __% of all head injuries |
|
Definition
|
|
Term
|
Definition
Falls, violence, industrial accidents
Single Males under 30
15-24 highest risk
5-14 next highest
4:1 male/female ratio
Alcohol implicated in 1/3
about 500,000/year at $100,000 |
|
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Term
|
Definition
| physical forces placed on the neuron, specifically the axon and the cell body |
|
|
Term
| TBI retrograde degeneration |
|
Definition
forces tear the axon
once damaged, the axon may degenerate back into the cell body
can lead to cell death |
|
|
Term
| TBI Anterograde degeneration |
|
Definition
Tear or rupture of a cell body
neuron dies
damaged acon not activated by the postsynaptic axon
leads to domino effect |
|
|
Term
|
Definition
When one neuron fails to relay signal to next neuron, makes the rest of the neuron chain useless
stops communication between neurons |
|
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Term
|
Definition
when Axon is stretched but not destroyed it could grow and attach another part of the brain
good or bad |
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|
Term
|
Definition
something that physically lodges or pierces that damages the brain directly
2 factors
location of direct damage
secondary complications
most gunshots to the head are fatal |
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Term
|
Definition
| Blow to the head without penetration |
|
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Term
|
Definition
| brain is stationary and some external force causes it to suddenly accelerate |
|
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Term
|
Definition
| brain is already in motion, and an external force causes it to suddenly stop moving |
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Term
|
Definition
secondary injury on the opposite side of the brain due to it bouncing back in the other direction
happens during impact injuries
When hit by a bat on the right side, brain moves from right to left and back again |
|
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Term
|
Definition
| caused by the rough surface of the skull in those regions |
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Term
|
Definition
Consciousness
Language
motor function
Coma = score of 3-8 or less; severe
Not clear was causes coma |
|
|
Term
|
Definition
| research implicates damage to the Reticular activating system (RAS) (awareness) |
|
|
Term
|
Definition
imperfect instrument
confounding factors
Brainstem lesion |
|
|
Term
| Complications of moderate and severe brain injury |
|
Definition
Edema
Brain Herniation
hemorrhage
intracranial bleeding
skull fractures
pot-traumatic epilepsy |
|
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Term
|
Definition
intracranial pressure increases (swelling)
device instide the ventricles of aubarachnoid space to monitor the pressure
main cause of death |
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Term
|
Definition
intracranial pressure too high (>20mm Hg)
it can push the brain downward through the foramen magnum
extreme pressure on the lower brainstem
deep coma within minutes to hours
in untreated, patient dies of respiratory failure
treatment:
Lower ICP
pharm-induced coma
surgically remove a lode of brain |
|
|
Term
|
Definition
bleed between brain and the dura mater
severe brain injuries
involves a ruptured cortical vain
brain compressed by pocket of blood
Symptoms
contralateral hemingresis
ipsilateral pupil dilation
changes in level of conscioussness
diagnosed with CT scan |
|
|
Term
| Extradural (epidural) hematoma |
|
Definition
same thing as Subdural hemorrhage but occurs between the skull and the dura
large middle meningeal artery
treatment
drilling one or more holes in the skull
shunt for draining
must be done quickly |
|
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Term
|
Definition
"Frank"
Mistaken for a robber and was beaten severely
ICP so severe that they had to remove part of his brain so he could survive
can't live on his own, intense anger outbursts |
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Term
|
Definition
microscopic hemorrhages that clot
15% of fatal head injuries
difficult to treat |
|
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Term
|
Definition
simple linear fracture
depressed skull fracture
infections, CSF leaks, bleeding
higher likelihood of brain damage |
|
|
Term
|
Definition
10% of severe CHI
40% of penetrating head injuries
scar tissue in the brain
onset may be delayed as much as 2 years
anticonvulsant medication |
|
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Term
|
Definition
Consciousness
no loss of consciousness greater than 30 minutes
no memory loss for more than 24 hours after trauma
GCS score does not go below 13
Headache, dizziness, fatigue, vague "memory" problems
accel/decel forces can cause shearing/stretching of neurons
head injuries are cumulative in effect |
|
|
Term
| Postconcussional syndrome |
|
Definition
cognitive and behavioral consequences of mild head injury
Headache, fatigue, irritability, dizziness, lack of concentration, memory problems
after a few months, permanent symptoms |
|
|
Term
| Treatment of head injuries |
|
Definition
ABC:
Airway
Breathing
Circulatory status
diagnostic imaging
neurologist evaluation |
|
|
Term
| Neuropsych menifestations |
|
Definition
Post traumatic amnesia (PTA)
Retrograde Amnesia
Anterograde amnesia |
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Term
|
Definition
| using other behavioral strategies to work around the problem |
|
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Term
|
Definition
unmasking of function after temporary nuronal disruption
natural recovery of parts of the brain that have been damaged
not permanently damaged |
|
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Term
|
Definition
the ability of the brain to reorganize after an injury
axonal and collateral sprouting
denervation supersensitivity |
|
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Term
|
Definition
practicing impaired skill
rebuilding related axonal connections |
|
|
Term
|
Definition
training patient in home
practice daily living skills
Little empirical research on effectiveness |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 90-minute cycles of arousal |
|
|
Term
| Suprachiasmic Nucleus (SCN) |
|
Definition
| Contains Circadian Rhythm |
|
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Term
|
Definition
| fast, random, low voltage |
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Term
|
Definition
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|
Term
|
Definition
|
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Term
|
Definition
| Sleep spindles, K complexes |
|
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Term
|
Definition
slow-wave sleep
deep restorative sleep |
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Term
|
Definition
fast, random
similar to awake
REM stages increase in time as sleep continues. other sleep shortens |
|
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Term
| How much time to infants spend in REM sleep? |
|
Definition
Around 50%
when not in REM spend most time in 4th stage |
|
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Term
|
Definition
daily patterns of sleep and wakefulness
located in the suprachiasmic nucleus |
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|
Term
| Venrolateral preoptic area of Hypothalamus |
|
Definition
| Master switch for arousal |
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Term
|
Definition
Neurotransmitter that is the primary transmitter that puts you to sleep
Reduces thalamus and RAS activity |
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|
Term
|
Definition
Stage 1 and 2 sleep: inhibits RAS
becomes stronger in stages 3 and 4
REM: releases inhibition
Causes RAS to fire in bursts
Burst reach occipital cortex (dream imagery)
Eyes move (REM) to watch the imagery |
|
|
Term
| How does the body paralyze itself during sleep? |
|
Definition
Brain inhibits spinal motor pathway
stop producing norepinephrine and serotonin |
|
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Term
|
Definition
function of REM sleep
Acetylcholine increases
linked to REM and memory consolidation
GABA may decrease consolidation |
|
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Term
|
Definition
Function on REM sleep
Frued
mostly abandoned in 1900s for behaviorism |
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Term
|
Definition
serious disorder resulting from frequent episodes of apnea (cessation of airflow) during sleep.
Hypoxia
Most common sleep disorder |
|
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Term
|
Definition
disorder that consists of irresistible daytime "sleep attacks"
Disorder of the brainstem that controls and reulates sleep and wakefulness |
|
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Term
|
Definition
excessive muscle relaxation
gasping for air
5 times an hour (for diagnosis)
markedly disrupted sleep
absence of the normal progression of stges
low oxygen
possible cause of SIDS |
|
|
Term
|
Definition
Upper airway collapses
Body weight compromises respiratory effort |
|
|
Term
|
Definition
| brain fails to send necessary signals to breath |
|
|
Term
|
Definition
not a strict dichotomy
generally have both obstructive and central
common |
|
|
Term
| Risk factors of sleep apnea |
|
Definition
|
|
Term
| Clinical features of sleep apnea |
|
Definition
being tired
irritability
hypertension
heart failure
head aches
snoring |
|
|
Term
|
Definition
CPAP- continuous positive airway pressure
or
Surgery |
|
|
Term
| Narcolepsy condition and symptoms |
|
Definition
Lifelong, occur from puberty-25, 1/1000
excessive daytime sleepiness- FIRST!
hypnagogic hallucinations
hazy dreams as person is passing out
cataplexy
loss of muscle tone
sleep paralysis
imbalance of wakefulness, REM and NREM sleep
not a psychological disorder
cause unknown
no cure |
|
|
Term
|
Definition
Reversible loss of consciousness
sudden
abnormal
Rapid synchronous firing
500 times a second (80 firings per second is normal)
External stimuli
internal triggers
are a symptom, not a disorder |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
varied
genetic
infection
fever
TBI
tumors
alcohol and drug use or withdrawal |
|
|
Term
|
Definition
syndrome in which brain seizure activity is a primary and chronic symptom
diagnosable
at least 2 seperate seizures (recurrent)
one seizure with probability with another
1% of pop have epilepsy
3% increase of chance by 75
10% of people will have 1 seizure |
|
|
Term
| precursory phase of seizure |
|
Definition
patient witnesses some sort of aura
happens in 70% of patients |
|
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Term
|
Definition
| origin location in the brain |
|
|
Term
|
Definition
gradually emerging into full consciousness after a seizure
person bites tongue
loses bladder control
lasts from minutes to hours |
|
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Term
|
Definition
| Both cortical hemispheres |
|
|
Term
|
Definition
confined to specific area
simple partial
consciousness preserved
complex partial
consciousness impaired |
|
|
Term
|
Definition
Seizure
stiffening of the whole body |
|
|
Term
|
Definition
seizure
rhythmic jerking of limbs |
|
|
Term
|
Definition
Seizure
arrhythmic bursts of jerky movements
typically less than a second |
|
|
Term
|
Definition
seizure
Sudden loss of muscle tone
no longer than 15 seconds
person remains conscious |
|
|
Term
|
Definition
brief loss of awareness
ages 4-14
generally outgrow the absence seizures |
|
|
Term
|
Definition
Partial Seizures
behavior reflect brain region
no significant alternation of consciousness |
|
|
Term
|
Definition
partial seizure
involves alteration of consciousness
similar to simple but loss of consciousness |
|
|
Term
| Secondary generalized seizure |
|
Definition
| Starts in part of the brain but spread to the whole brain |
|
|
Term
|
Definition
seizure "marches" to more areas of the brain
starts in arm and moves around body |
|
|
Term
| Assessing and treating seizures |
|
Definition
EEG and other imaging techniques
difficult because patient might not seizure
Functional deficits lead to seizure foci
Cognitive strengths and weaknesses
presurgical evaluation (if nothing else works)
Wada test |
|
|
Term
|
Definition
puts half of your brain to sleep
focuses on Memory and language
then test cognitive functions on awake hemisphere |
|
|
Term
|
Definition
no specific pattern
varies by patient
some show no deficits
complex attention and memory |
|
|
Term
| Generalized tonic-clonic seizure |
|
Definition
| widespread neuropsych dysfunction |
|
|
Term
|
Definition
| lateralized cognitive dysfunction |
|
|
Term
| temporal lobe complex partial seizures |
|
Definition
language and memory deficits
fewer attention problems |
|
|
Term
|
Definition
Medication is most widely used
generally effective
generalized tonic-clonic: bensodiazapines
absent seizures: GABA Antagonists
moto disturbances: Klonopin |
|
|
Term
|
Definition
Seizure treatment
low card diet
mimic effect of biochemical changes that occur during fasting
mechanism of action is not fully understood
used when medication does not
poor side effects of meds
37% have a 90% reduction |
|
|
Term
| Normal adults spend __% in REM sleep |
|
Definition
|
|
