Intracranial Regulation, Inflammation, Gallbladder Disease Flashcards

Flashcards covering key concepts from lecture notes on intracranial regulation, inflammation (specifically nephritis), and gallbladder disease.

What protects the brain?

Meninges, cerebrospinal fluid (CSF), skull, blood-brain barrier

What are early signs of cerebral dysfunction?

Behavior changes, alterations in level of consciousness (LOC)

What primitive reflexes are present in neonates?

Stepping reflex, startle reflex, sucking reflex, Babinski reflex

Up to what age is the Babinski reflex considered normal?

Age 2

What are signs of possible depression in the elderly?

Mood changes, weight loss, anorexia, constipation, early morning awakening

What is the normal intracranial pressure (ICP) in adults (supine)?

5-15 mm Hg

What three components does the Monroe-Kellie Doctrine describe?

Brain matter, blood, and CSF

Why are changes in personality, memory, and judgement often the first signs of IICP?

The cerebral cortex is very sensitive to hypoxia.

How is Cerebral perfusion pressure (CPP) calculated?

CPP = MAP – ICP

What are early clinical manifestations of increased ICP?

Confusion, restlessness, lethargy, disorientation to time first, then place/person, decreased GCS

What are the late clinical manifestations of increased ICP?

Comatose, no response to painful stimuli

What are early signs of motor impairment related to increased ICP?

Hemiparesis/hemiplegia of contralateral side

What are late signs of motor impairment related to increased ICP?

Decorticate, Decerebrate, Flaccidity

What does Cushing’s triad indicate?

Increased intracranial pressure

What are the components of Cushing's Triad?

Irregular respirations/bradypnea, bradycardia, widening pulse pressure

What is the surgical treatment for increased ICP?

Decompressive craniectomy, Hematoma evacuation, Shunt placement –VP most common

What medication is used to reduce high intracranial pressure?

Mannitol

Why is mechanical ventilation a consideration in IICP?

To control hypoxia and prevent hypercapnia. Hypercapnia can cause significant increase in IICP

What is the most common cause of IICP in school-age children?

Falls, sports injury, bicycling without helmet, abuse

What are the symptoms of IICP in infants?

Bulging fontanelles, drowsiness, vomiting, lethargy

What are the main characteristics of Cerebral Palsy?

Disorders affecting movement, muscle tone, and posture

What is the percentage of congenital CP cases?

85-90%

What is Spastic CP?

Increased muscle tone with stiff, awkward movements

What is Dyskinetic CP?

Inability to control movement of hands, arms, feet, and legs

What is Ataxic CP?

Balance and coordination are primarily affected

What are key signs/symptoms of CP in infants younger than 6 months?

Head lag, abnormal stiffness or floppiness, overextension of neck and back, legs crossing or scissoring

Why is early intervention vital for CP?

To improve quality of life

What is the definition of Seizures?

Periods of abnormal electrical discharges in brain causing involuntary movement and/or behavior and sensory alterations

What is Epilepsy?

Chronic seizure activity characterized by recurrent seizures secondary to a central nervous system (CNS) disorder

What are common seizure triggers?

Environmental (loud noises, strobe light), Physiological stimuli, stress, high or low blood glucose, anxiety, fatigue, infection, metabolic disturbance

What is a Focal Seizure?

Abnormal electrical activity contained to a limited portion of the brain

What is a Generalized Seizure?

Abnormal electrical discharge in both hemispheres of brain

What are characteristics of Tonic-clonic seizures?

Loss of consciousness, muscles suddenly contract, person falls, rhythmic contractions

What are characteristics of Absence seizures?

Vacant state often confused with attention lapse, sudden activity stop – does not fall, lip smacking, eye rolling

What is an Aura in relation to seizures?

Seizure “warning sign”. Some sort of sensory disturbance occurs, changes to thoughts, memory, awareness

What is the Postictal phase following a seizure?

LOC decreased, sleepy but arousable, confusion, headache, nausea. Short term paralysis – Todd’s paralysis

What is DT's?

Delirium tremens, aka alcohol withdrawal delirium - Severe, life-threatening form of alcohol withdrawal

What is Status Epilepticus?

Any seizure lasting longer than 5 minutes or seizures that occur back-to-back without recovery time

What are important aspects of Seizure Care?

Maintain patient airway, protect patient from self-harm, position patient on side, suction to clear airway as needed, monitor oxygenation

What is a stroke?

Neurologic deficits result from a sudden decrease in blood flow to a localized area of the brain

What are stroke risk factors?

Hypertension, heart disease, diabetes mellitus, sleep apnea, high cholesterol, smoking

What strokes symptoms more likely in women?

General Weakness, Disorientation & Memory Issues, Fatigue, Nausea or Vomiting

What are BE FAST stroke symptoms?

Balance Loss, Eyes blurred vision, Face drooping, Arm weakness, Speech difficulty, Time to call for ambulance

What is neglect syndrome in relation to strokes?

Damage to the right hemisphere, patients often fail to be aware of objects on their left side

What is Aphasia in relation to stroke?

Difficulty with speaking or receiving language

What is Dysarthria in relation to stroke?

Unclear, difficult speech

What are Time goals for treatment of ischemic stroke?

Door to CT within 10 minutes, CT read within 25 minutes, Door to TPA – within 60 minutes

What needs to be identified to decide on TPA usage in stroke treatment?

Identify last known well time, if less than 4 hours TPA is an option

What are main sings of stroke in neonates?

Repetitive facial movements, staring, apnea, jerking of muscles of face, arms, or legs

What is nephritis?

Kidney inflammation

What causes acute post infectious glomerulonephritis?

Develops as a response to group A strep infection of the skin or throat

What is Lupus nephritis?

Autoimmune attacks on kidney caused by Immune complexes in the glomerular wall

What is Goodpasture syndrome?

Autoimmune disorder of unknown etiology characterized by formation of antibodies that cling to the glomerular basement membrane AND to the alveolar basement membrane. Causes both renal failure and pulmonary hemorrhage/respiratory failure

What are important diagnostics for nephritis?

Cultures for group A strep, KUB, ESR to detect inflammatory response, renal biopsy or scan, BUN/Cr, GFR, Lytes, Urinalysis

What are the main treatments to manage nephritis?

Supportive treatment of associated conditions, Immunosuppression, Dietary protein and sodium restricted, Plasmapheresis

What is the gallbladder responsible for?

Storing bile created by the liver

What are Gallstones also known as?

Cholellithiasis

What is the main risk factor for gallstone in women?

Pregnancy

What is the main surgical treatment for gallbladder disease?

Laparoscopic cholecystectomy