Pathophysiology 2 (HSC4558) - Exam 3 Study Guide Review

This (ese) structure(s) provide buoyancy and shock-absorbing capacity?

CSF and meninges

From external to internal, what is the name and order of meninges?

Dura, arachnoid, pia

Which glial cells make up the blood brain barrier?

Astrocytes

These cells are responsible for the production and maintenance of the cerebrospinal fluid

Ependymal cells

The cerebrum is made of all these structures

Cerebral cortex, basal ganglia, limbic cortex, and corpus callosum

Which structure contains midbrain, pons, and medulla?

Brainstem

Which lobe contains the visual cortex (vision)?

Occipital lobe

True or false: The frontal lobe contains the somatosensory cortex

False. It's the parietal lobe

This lobe contains the auditory and vestibular centers (balance and hearing)

Temporal lobe

Parts of the cerebrum most closely associated with memory and emotion

Limbic system

Principal structures of the diencephalon

Thalamus, Hypothalamus and Epithalamus

Processes and relays most of the signals traveling to and from the cortex and coordinates motor functions

Thalamus

Lesions of the this structure result in ataxia (impaired balance) and failure of rapid movements

Cerebellum

Which part (s) of the brain coordinates swallowing, vomiting and coughing?

Pons and Medulla

True or False: The spinal cord is part of the peripheral nervous system

False. It is part of the central nervous system

This division of the nervous system Consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves

Peripheral nervous system

Segment of the body innervated by a spinal nerve is called---------?

Dermatome

All spinal nerves merge into a large group called a plexus EXCEPT.

Thoracic nerves

True or False: Autonomic nervous system is composed of neurons in the PNS that mediate automatic or involuntary functions

False/ it contains neurons in the CNS and PNS

Most PSNS functions are controlled by?

Cranial nerves

Most SNS functions are controlled by?

Spinal nerves

Which divisions of the nervous system secrete Acetylcholine?

Somatic nervous system, PSNS, and preganglionic neurons of the SNS.

Post-ganglionic neurons of the SNS secrete which neurotransmitter?

Norepinephrine

Acetylcholine receptor on the effector cells of the PSNS is ......?

Muscarinic receptor

True or False: Inhibitory neurotransmitters create inhibitory postsynaptic potentials (IPSPs) caused by opening of channels that allow potassium influx or chloride efflux.

False. Potassium efflux and chloride influx

True or False: Peripheral neurons may regenerate if the injury is not severe

True

These structures send action potentials to the spinal cord through the dorsal root which are later intercepted by thalamus and relayed to the somatosensory cortex

Sensory receptors

Complete the following statement: Motor function is transmitted from the ------- down the --------crosses over down the ------to control motor function on the -------- side of the body

Motor function is transmitted from the primary motor cortex down the cortico-spinal tract, crosses over down the spinal cord to control motor function on the other side of the body

Motor activity preprogrammed into neuronal connections in the spinal cord that allow sensory information to cause a reaction in the spinal cord without going to brain

Spinal reflex

Protective mechanism that allows withdrawal of a body part from a physical threat while maintaining balance

Withdrawal reflex

True or False: Ischemia is aa main factor in primary insult but is not part of the secondary response

False. Ischemia (decreased blood flow) is a contributing factor either as the primary insult (e.g., stroke) or as part of the secondary response (e.g., vascular compression).

Reperfusion can be detrimental to cell survival because it increases-------?

Free radical production which induce cell toxicity

Increased ICP can occur as a result of accumulation of...?

Space-occupying lesions (e.g., tumors), vasogenic or cytotoxic edema, or with obstruction or excessive production of CSF, or blood volume expansion (e.g., hemorrhagic stroke).

What is the compensatory mechanism for ICP?

A slight increase in one component can be offset by a reduction in volume of the other two (ex: increase in blood is offset by decrease in CSF and brain tissue)

This phenomenon results in protrusion of brain tissue through an opening in the supporting dura of the brain

Herniation

This term is used to describe altered level of consciousness where the patient Falls asleep unless stimulated

Obtunded

True or False: Severity of TBI is classified by the Glasgow coma scale (GCS) with highest scores correspond to more severe TBI lesions.

False. Mild (GCS score 13 to 15), Moderate (GCS score 9 to 12) and Severe (GCS score 8 or below)

Type of primary TBI injury caused by acceleration-deceleration movement of the brain within the skull, resulting in double injury (usually opposite focal injury)

Polar injury

Collection of blood between dura and the inner surface of skull

Epidural hematoma

Which intracranial hematomas involve rupture of bridging veins?

Subdural and Subarachnoid Hemorrhages

Sudden onset of neurologic dysfunction caused by cardiovascular disease that results in an area of brain infarction.

Stroke

This type of stroke is associated with atherosclerosis and coagulopathies

Thrombotic stroke

This type of stroke associated with cardiac dysfunction or dysrhythmias (atrial fibrillation)

Embolic stroke

What is a transient ischemic attack (TIA)?

Temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes and is a warning sign for imminent stroke.

True or false: Morbidity and mortality is much higher in hemorrhagic stroke than ischemic stroke

True

Where do most hemorrhagic strokes happen?

Basal ganglia or thalamus

List the main stoke sequelae

Motor and Sensory Deficits, Language Deficits, and Cognitive Deficits

Lesion of an artery that results in dilation and ballooning of a segment of the vessel

Aneurysm

What are some risk factors for cerebral aneurysm?

High blood pressure, acute alcohol intoxication, and recreational drug use (especially cocaine) implicated, or congenital defect of the middle layer of arteries.

True or false: Meningitis and cerebral abscess are commonly associated with bacterial infections while encephalitis is associated with viral infections

True

Which infection can precipitate obstructive hydrocephalus.

Meningitis where bacteria invades leptomeninges causing accumulation of inflammatory exudate leading to obstructive hydrocephalus.

Which viruses are associated with encephalitis?

West Nile virus, western equine encephalitis, and herpes simplex

Localized collection of pus within the brain parenchyma

Brain abscess

True or false: Seizure disorder results from alteration in membrane potential that makes certain neurons abnormally hyperactive and hypersensitive or hypoactive to changes in their environment

False. Only hyperactive. Neuronal hypoactivity does not result in seizure

Involvement of thalamus in a generalized seizure will cause what?

Loss of consciousness.

This type of seizure usually occurs in children and is associated with abrupt onset and termination

Petite mal seizures

This disorder is associated with continuing series of seizures without a period of recovery

between episodes.

Status epilepticus

True or False: Abnormal electrical activity restricted to one brain hemisphere is called

partial seizure

True

True or False: Dementia can be described as an abrupt onset of disturbed consciousness

and awareness, becoming worse at night, incoherence, and hallucinations.

False. That is the definition for delirium

Accumulation of amyloid plaques, and neurofibrillary tangles is associated with which

disorder?

Alzheimer Disease

Why are Acetylcholinesterase inhibitors preconized for Alzheimer's disease patients?

To decrease Ach degradation which is already depleted in Alzheimer's patients

What are the main risk factors for vascular dementia?

Stroke, hypertension, and diabetes

What are the gene factors associated with Parkinson's disease?

PINK1/parkin and Α-synuclein

Which disorder is associated with degeneration of dopaminergic neurons found in the substantia nigra and is treated with exogenous dopamine injection?

Parkinson's disease

What is the etiology of cerebral palsy?

Multiple etiologies:

• Prenatal infections or diseases of the mother;

• Mechanical trauma to the head before, during, or after birth;

• Exposure to nerve-damaging poisons or reduced oxygen supply to the brain

What is the etiology of cerebellar disorders?

Abscess, hemorrhage, tumors, trauma, viral infection, chronic alcoholism

This disease results in chronic demyelinating of the CNS that primarily affects young adults

Multiple sclerosis

Guillain Barre syndrome is Inflammatory demyelinating disease of the ------- nervous system

Peripheral nervous system

This disorder is also referred to as either acute idiopathic polyneuropathy or polyradiculoneuropathy

Guillain barre syndrome

Describes an idiopathic neuropathy of the facial nerve causing paralysis of the muscles on one side of the face

Bell Palsy

This function is Controlled by hair cells contained in the semicircular canals

Balance

Sensation of motion with no actual movement/exaggerated sense of motion is known a---?

Vertigo

Complete the following sentence: Sound waves cause movement of -------through the vestibular membrane which induces movement of neurosensory organs of hearing, the --------to bend producing an action potential in the --------.

Endolymph, hair cells, cochlear nerve

True or False: middle ear effusion is an example of mass loading mechanism responsible for conductive hearing impairment

True

Type of hearing impairment caused by disruption in the inner ear (cochlea or the vestibulo-cochlear nerve to the brain).

Sensorineural Hearing Impairment

True or False: Sensorineural hearing impairments are generally correctable with medical or surgical therapy, or both.

False. Sensorineural Hearing Impairment damage is irreversible.

Hearing loss caused by trauma is reversible unless------.

Cochlea is damaged.

Disease associated with excessive accumulation of endolymph in the membranous labyrinth

Meniere disease

Why are children more susceptible to Otitis media?

Because of shorter, more flexible, and horizontally positioned eustachian tubes

Fill in the blanks: In the visual pathway, light waves are converted to action potentials by-------s in the -----. Nerve waves are carried to the ------ and ------ to be processed in the -------.

In the visual pathway, light waves are converted to action potentials by photoreceptor cells in the retina. Nerve waves are carried to the optic disk and optic nerve to be processed in the occipital lobe.

True or False: a patient with Myopia/Nearsightedness is unable to see distant images clearly because the eye is shorter than normal.

False. Because the eye is longer than normal.

Which type of lenses are used to correct Hyperopia/Farsightedness?

Convex lenses

Clouding or opacity of lens leading to gradual, painless blurred vision, eventual loss of sight is associated with which eye disease?

Cataract

What may happen if retinal detachment is not repaired?

Space-occupying lesions (e.g., tumors), vasogenic or cytotoxic edema, or with obstruction or excessive production of CSF, or blood volume expansion (e.g., hemorrhagic stroke).

In this condition, increased intraocular pressure can cause decreased fluid flow through the retina leading to blindness

Glaucoma

True or false: Smell dysfunction frequently causes diminished ability to taste because olfactory and gustatory nerve impulses travel through the cranial nerves to the same area of the brain.

False. Smell dysfunction frequently causes diminished ability to taste because olfactory and gustatory nerve impulses travel together through the cranial nerves but to different areas of the brain.