PATHO/PHARM EXAM 4 > Chapter 44 > Flashcards

Chapter 44 Flashcards

Acute Disorders of Brain Function (51 cards)

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1
Q

INCREASED ICP
-What is normal intracranal pressure in an adult?

A

0-15 mm Hg

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2
Q

INCREASED ICP: Etiology
-What causes this?

A
  1. Stroke
  2. Trauma
  3. Tumors
  4. Other primary & secondary disorders
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3
Q

INCREASED ICP: Manifestations
-What will the person experience?

A
  1. Headache
  2. N/V
  3. Altered LOC (drowsiness)
  4. Papilledema (edema of the optic disk)
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4
Q

INCREASED ICP: Complication
-What are the complications of elevated ICP?

A

Brain compression & herniation

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5
Q

INCREASED ICP: Complication
-What is a herniation?

A

Protrustion of brain tissue

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6
Q

INCREASED ICP: Complication
-What does herniation compress?

A

Midbrain & brainstem structures

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7
Q

INCREASED ICP: Management
-What can be done?

A
  1. CT scan
  2. Surgery
  3. removal of excess CSF
  4. Medication
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8
Q

INCREASED ICP: Management
-What is the goal of treatment?

A

To maintain an ICP of less than 20 mm Hg & cerebral perfusion pressure (CPP) of 50 mm Hg OR greater

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9
Q

GLASCOW COMA SCALE
-What is this?
-What does it use?

A

-Tool used to assess LOC
-Numeric scores

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10
Q

GLASCOW COMA SCALE
-What does it measure?

A

-Eye opening (4)
-Verbal response (5)
-Motor response (6)

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11
Q

GLASCOW COMA SCALE
-Which is the most powerful indicator?

A

Motor response

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12
Q

CRANIAL NERVE REFLEXES
-What does this test?
-What are the reflexes?

A

-Brainstem
1. Pupil reflex
2. Oculovestibular reflex
3. Corneal reflex

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13
Q

DECORTICATE POSTURE
-This is damage to where?
-What score is this?
-What type of posture is this?

A

-ABOVE brainstem
-3
1. Arms are FLEXED toward chest
2. Wrists are flexed/curled
3. Legs & feet are extended and internally rotated
4. Toes pointed

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14
Q

DECEREBRATE POSTURE
-This is damage to where?
-What score is this?
-What is this?

A

-BELOW brainstem
-2
1. Arms are EXTENDED
2. Wrists are flexed & EXTERNALLY rotated
3. Legs & feet are extended & internally rotated
4. Toes are pointed

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15
Q

TRAUMATIC BRAIN INJURY
-What is the leading cause of death & disability?

A

TBI

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16
Q

TRAUMATIC BRAIN INJURY
-What causes this?

A

Falls, sports injuries, firearms, violence, & transportation-related trauma

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17
Q

TRAUMATIC BRAIN INJURY
-How is TBI characterized?

A
  1. Severity
  2. Location of injury
  3. Mechanism of injury
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18
Q

TRAUMATIC BRAIN INJURY
-In terms of severity, what is a MILD GCS score?

A

> 12

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19
Q

TRAUMATIC BRAIN INJURY
-In terms of severity, what is a MODERATE GCS score?

A

9-12

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20
Q

TRAUMATIC BRAIN INJURY
-In terms of severity, what is a SEVERE GCS score?

A

8 OR below

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21
Q

TRAUMATIC BRAIN INJURY
-What are the three types of injuries that can occur?

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A
  1. Primary injury
  2. Intracranial hematoma
  3. Secondary Injury
22
Q

TRAUMATIC BRAIN INJURY: Primary Injury
-What are the 3 types?

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A
  1. Focal injuries (coup)
  2. Polar injuries (coup contracoup)
  3. Diffuse injuries
23
Q

TRAUMATIC BRAIN INJURY: Primary Injury
-Focal injuries

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A

Brain injury is localized to site of impact

24
Q

TRAUMATIC BRAIN INJURY: Primary Injury
-Polar injuries are to due what?

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A

acceleration-deceleration movement of the brain within the skull (hits one side and then the other, so TWO INJURY SITES)

25
**TRAUMATIC BRAIN INJURY**: *Primary Injury* -What are diffuse injuries?
Movement of the brain within the skull causes WIDESPREAD neuronal/axonal injury (shaking)
26
**TRAUMATIC BRAIN INJURY**: *Intracranial Hematomas* -What are the types?
1. Epidural hematoma 2. Subdural hematoma 3. Subarachnoid hemorrhage
27
**TRAUMATIC BRAIN INJURY**: *Intracranial Hematomas* -What is epidural hematoma associated with? -How does it progress? -What is it in origin?
-Skull fracture -RAPIDLY -Arterial
28
**TRAUMATIC BRAIN INJURY**: *Intracranial Hematomas* -What is subdural hematoma associated with? -How does it develop?
-shearing of bridging veins -SLOWLY
29
**TRAUMATIC BRAIN INJURY**: *Intracranial Hematomas* -What does a subarachnoid hemorrhage result from?
Trauma to bridging veins
30
**TRAUMATIC BRAIN INJURY**: *Secondary Injury* -What are these?
1. Ischemia 2. Increased ICP 3. Altered vascular regulation
31
**TRAUMATIC BRAIN INJURY**: *Treatment* -How can these be treated? (4)
1. Cardiopulmonary stabilization 2. Surgery, ICP management, medication, antibiotics 3. CSF drainage 4. Seizure prophylaxis
32
What is the most common form of a stroke?
Ischemic stroke
33
**ISCHEMIC STROKE** -This results from what?
Sudden occlusion of a cerebral artery secondary to thrombus formation OR embolization
34
**ISCHEMIC STROKE** -Who is affected more?
Females
35
**ISCHEMIC STROKE**: *Clinical Manifestations* -What are they?
1. Contralateral hemiplegia 2. Hemisensory loss 3. Contralateraly hemianopsia (visual field blindness)
36
**ISCHEMIC STROKE**: *Treament* -What is the aim of early thrombotic therapy? -This MUST be institued within what time?
-Salvaging the penumbra -3 hours of symptom onset
37
**STROKE SEQUELAE** -What deficits occur?
1. Motor & sensory 2. Language 3. Cognitive
38
**STROKE SEQUELAE** -Where are the motor & sensory deficits? -What is lost?
-Contralateral to the side of the brain -visual field on the paralyzed side
39
**STROKE SEQUELAE** -What are the language deficits?
1. Broca aphasia 2. Wernicke aphasia
40
**STROKE SEQUELAE** -What is broca aphasia also called? -What is broca aphasia? -What is damaged?
-Expressive aphagia -Difficulty producing speech -LEFT frontal lobe
41
**STROKE SEQUELAE** -What is another name for Wernicke aphasia? -What is this? -What is damaged?
-Receptive aphasia -Difficulty understanding language -LEFT tempral lobe
42
**STROKE SEQUELAE** -What are the cognitive deficits?
1. Lanuage impairment 2. Poor judgement 3. Concentration, memory, & reasoning may be impaired
43
What are the two CNS infections?
Meningitis & Encephalitis
44
**MENINGITIS** -What is this?
Inflammation of the meninges
45
**MENINGITIS**: *Etiology* -This is the most common sequela to what? -This is ___ in origin
-microbial invasion of CNS -bacterial
46
**MENINGITIS**: *Manifestations* -What will the patient feel?
-Headache -Fever -Stiff neck (meningismus)
47
**MENINGITIS**: *Treatment* -What should be given? -What should be managed? -What medications are given?
-Supportive care -Management of complications -Empiric IV antibacterial drug therapy to target the specific pathogen AND corticosteroids
48
**ENCEPHALITIS**: *Etiology* -What is this?
Inflammation of the brain parenchyma
49
**ENCEPHALITIS**: *Etiology* -What is brain parenchyma?
Functional tissue of brain
50
**ENCEPHALITIS**: *Etiology* -What can this be caused by?
Viruses, bacteria, fungi, & parasites
51
**ENCEPHALITIS**: *Treatment* -How is this treated?
-Fluid resuscitation -Treatment of pain -Management of seizures
PATHO/PHARM EXAM 4
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