Neuroscience Class: Glial Cells and Tumors

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Questions and Answers

What are tumors that develop out of astrocytes called?

Microgliomas

Ependymomas

Astrocytomas (correct)

Oligodendrogliomas

Which type of glial cell is responsible for forming myelin sheaths around axons?

Ependymal cells

Astrocytes

Oligodendrocytes (correct)

Microglial cells

Which glial cells are commonly associated with the immune response in the brain?

Oligodendrocytes

Ependymal cells

Astrocytes

Microglial cells (correct)

What is the main function of Schwann cells in the peripheral nervous system?

Supporting peripheral nerve fibers and forming myelin sheath Signup and view all the answers

What type of tumors are referred to as oligodendrogliomas?

Tumors from oligodendrocytes Signup and view all the answers

What is a common symptom caused by brain tumors due to increased intracranial pressure?

Seizure activity Signup and view all the answers

Which area of the brain, when affected by a tumor, is most likely to impact language processing?

Temporal lobe Signup and view all the answers

What diagnostic method is essential for evaluating a patient suspected of having a brain tumor?

Comprehensive neurologic examination Signup and view all the answers

A brain tumor located in the frontal lobe may impact which of the following executive functions?

Impulse control Signup and view all the answers

Which of the following symptoms may indicate a tumor located in the temporal lobe?

Sensations of strange smells Signup and view all the answers

What hormonal change might occur due to a brain tumor affecting the pituitary gland?

Increased cortisol production Signup and view all the answers

What is a likely effect of a tumor causing compression of adjacent structures in the brain?

Cerebral edema Signup and view all the answers

Which of the following is NOT commonly associated with brain tumors?

Enhanced social cognition Signup and view all the answers

What is a potential effect of a brain tumor located in the parietal lobe?

Numbness on the opposite side of the body Signup and view all the answers

Which symptom is associated with a brain tumor located in the occipital lobe?

Loss of vision on one side Signup and view all the answers

What describes gliomas?

Tumors that resemble normal glial cells Signup and view all the answers

What is the survival time for a patient diagnosed with Glioblastoma Multiforme (grade IV)?

8 to 10 months Signup and view all the answers

Which type of brain tumor is most aggressive and rapidly growing?

Glioblastoma Signup and view all the answers

Which symptom is NOT typically associated with a brain tumor located in the cerebellum?

Increased sensitivity to light Signup and view all the answers

What grade classification is indicative of lower aggressiveness in gliomas?

Grade I & II Signup and view all the answers

A tumor located in the brain stem is least likely to cause which of the following symptoms?

Numbness in limbs Signup and view all the answers

What should be monitored to prevent complications after a craniotomy?

Signs and symptoms of infection and bleeding Signup and view all the answers

Which of the following interventions is aimed at maintaining cerebral perfusion?

Maintaining a flat position or elevating the head of bed Signup and view all the answers

What potential electrolyte disturbance can occur post-craniotomy?

Hypernatremia Signup and view all the answers

How often should vital signs and neurologic status be assessed post-surgery?

Every 15 minutes to every hour Signup and view all the answers

Which action is advised to minimize the risk of CSF leakage after a craniotomy?

Using strict aseptic technique Signup and view all the answers

Which complication is specifically associated with increased intracranial pressure (ICP)?

Seizures Signup and view all the answers

What should be included in strategies to control factors that increase ICP?

Avoiding extreme head rotation Signup and view all the answers

Why should a patient be instructed to avoid sneezing after surgery?

It may lead to increased risk of CSF leakage Signup and view all the answers

Which type of brain tumors originates from external structures and is more prevalent in individuals above the age of 30?

Secondary brain tumors Signup and view all the answers

What is the most common malignant primary brain tumor found in adults?

Glioblastoma Signup and view all the answers

Which of the following symptoms is NOT commonly associated with brain tumors?

Weight gain Signup and view all the answers

What grading indicates a poorly differentiated brain tumor according to the WHO classification?

G3 Signup and view all the answers

What is a common characteristic of benign brain tumors?

Well-defined borders Signup and view all the answers

Which risk factor is most clearly associated with the development of primary brain tumors?

Ionizing radiation Signup and view all the answers

What symptom indicates increased intracranial pressure (ICP) related to brain tumors?

Headache Signup and view all the answers

What type of primary brain tumors predominates in adolescents and young adults?

Low-grade gliomas Signup and view all the answers

Which of the following statements about malignant brain tumors is true?

They can cause life-threatening complications. Signup and view all the answers

Which lobe of the cerebrum is NOT one of the four primary lobes?

Cervical Signup and view all the answers

Which type of tumor is characterized as malignant and is most commonly found in children?

Medulloblastoma Signup and view all the answers

What is a common characteristic of meningiomas?

They are slow-growing and benign. Signup and view all the answers

Acoustic neuromas primarily affect which cranial nerve?

Eighth cranial nerve Signup and view all the answers

Which pituitary adenoma is characterized by elevated serum prolactin levels greater than 500 mU/L?

Prolactin-secreting adenoma Signup and view all the answers

What is the definitive method to diagnose brain tumors?

Brain biopsy obtained by open surgery Signup and view all the answers

What is the primary purpose of a craniotomy?

To relieve symptoms and gain access to intracranial structures Signup and view all the answers

Which type of surgery is a transsphenoidal approach associated with?

Accessing the brain through the mouth and nasal sinuses Signup and view all the answers

What type of tumor is primarily composed of abnormal blood vessels?

Angioma or Hemangioblastoma Signup and view all the answers

Which diagnostic method uses imaging to help locate and define brain tumors?

Computed tomography (CT) Signup and view all the answers

What type of therapy is often used in conjunction with surgery to treat brain tumors?

Brachytherapy Signup and view all the answers

Study Notes

Management of Patients with Brain Tumors

Brain tumors are diverse, with over 120 types and cysts.
Primary tumors originate from brain/spinal cord cells, while secondary/metastatic tumors derive from other parts of the body.
Secondary tumors are more frequent than primary tumors, originating from locations such as breast, lung, or GI tract.
Tumor cells can enter the brain via the bloodstream, cerebrospinal fluid (CSF), or lymphatic system.

Etiology

The precise cause of primary brain tumors is often unknown.
Ionizing radiation is a strong risk factor.
Other contributing factors include genetics and environmental elements.

Epidemiology

The incidence of brain tumors varies by age.
Adolescents and young adults frequently develop primary brain tumors, with a focus on low-grade gliomas.
Adults (30-40 years and older) demonstrate an increase in metastatic brain tumors.
Glioblastoma is the common malignant primary brain tumor in adults, with a median diagnosis age of 64.
Meningiomas and glial tumors account for most primary brain tumors in adults.

Incidence of Brain Tumors by Location

Location significantly impacts tumor incidence.
Specific areas like the frontal lobe (26%), temporal lobe (30%), and parietal lobe (12%) experience varying frequencies of tumor occurrences.

Benign vs. Malignant Tumors

Benign tumors rarely recur after removal, exhibit well-defined borders, and do not spread.
They typically exert pressure on brain tissues.
Malignant tumors have a high potential for return, have unclear borders, and can spread.
They rapidly grow and invade healthy brain tissue. They also spread to other parts of the body in certain cases.

Risk Factors

The origin of primary brain tumors is frequently unknown.
Ionizing radiation is a major risk factor.
Genetic and environmental factors may increase risks.

Clinical Manifestations

The symptoms of brain tumors depend on their position and size, as well as the impact on adjacent structures.
These may include headache, nausea/vomiting, seizures, motor weakness (ataxia, paralysis, hemiparesis, aphasia), mental status changes, memory loss, visual disturbances, hormonal effects (with pituitary adenomas), hearing loss, tinnitus, vertigo (in the case of acoustic neuromas), and increased intracranial pressure (ICP) symptoms.

Brain Lobes and Function

Different brain regions have varying roles.
The frontal lobe involves executive functions, like planning, decision-making.
The parietal lobe is involved in sensory information processing and spatial awareness.
The temporal lobe handles hearing, memory, and language processing.
The occipital lobe focuses on visual processing.
The cerebellum aids in motor coordination, balance, and movement.
The brain stem manages functions like breathing and heart rate.

Brain Tumor Classification

Classification considers the type of tissue involved, the location of the tumor, and the tumor grade (determined by biopsy).
Tumor grading signifies malignancy levels, from Grade 1 (well-differentiated) to Grade 4 (undifferentiated and highly malignant).
WHO criteria (for CNS) for tumor grading specify microscopic appearance and rate of growth in tumors.

Tumor Grading

Tumor grading is based on microscopic appearance and growth behavior.
Specific grades are identified according to WHO guidelines.

Clinical Presentation

Brain tumors produce symptoms due to local invasion, adjacent structure compression, and increased intracranial pressure (ICP).
The clinical manifestations correlate with the involved brain areas' functions.
Patients require a detailed medical history, neurological examination, and diagnostic neuroimaging studies for proper evaluation.

Pathophysiological Results of Brain Tumors

Increased intracranial pressure (ICP), cerebral edema/inflammation, seizure activity, obstruction of cerebral spinal fluid (CSF) flow (hydrocephalus), and altered pituitary function/hormonal changes are possible consequences.

Symptoms of Tumors in Different Brain Regions

Frontal lobe tumors can cause problems with concentration, decision-making, speech/language production, emotions, and behavior.
Temporal lobe tumors can affect hearing, memory, language understanding, and emotional processing.
Parietal lobe tumors can impair sensory perception, spatial awareness, and body recognition.
Occipital lobe tumors can create vision problems, including difficulty recognizing colors or objects.
Cerebellum tumors cause balance issues, coordination problems, and difficulties with walking and/or speech.
Brainstem tumors can lead to headaches, balance disturbances, walking difficulty, and facial weakness.

Management

Management involves surgery, radiation therapy, and chemotherapy, tailored to the tumor type, location, and accessibility.
Surgery aims to alleviate symptoms and decompress affected areas.
Radiation therapy is a fundamental treatment component.
Chemotherapy plays a role, often used concurrently with other treatments.

Intracranial Surgery

Craniotomy involves opening a portion of the skull to access the brain.
Burr holes are smaller openings used for diagnosis or surgical exploration.
Trans-sphenoidal approach is a less invasive technique using the nasal cavity to reach the pituitary gland.

Preoperative Care

Before surgery, patients need a baseline neurological examination.
Understanding of the surgery and preparation are crucial.
Preoperative procedures include medical evaluations and scans.
Medications like antibiotics and corticosteroids support pre-surgical care.

Drug Therapy

Medications are used to manage symptoms and prevent complications.
Analgesics (pain relief), steroids (inflammatory control), anti-seizure drugs, anti-emetics, and muscle relaxants are often used.
Mannitol can help reduce increased intracranial pressure (ICP).

Postoperative Care

Postoperative care involves close monitoring for complications like increased intracranial pressure (ICP), cerebral edema, seizures, and infection.
Supporting respiratory function, controlling pain, and preventing complications are critical.

Nursing Diagnoses

Common nursing diagnoses focus on issues like ineffective cerebral tissue perfusion, risk for imbalanced body temperature, impaired sensory perception, and changes in body image.

Nursing Interventions

Nurses implement various interventions, including monitoring vital signs, supporting respiratory function, managing pain, and preventing complications.

Potential Complications

Potential post-craniotomy complications include increased intracranial pressure (ICP), bleeding, infection, seizures, and fluid/electrolyte imbalances.

Interventions to Maintain Cerebral Perfusion

Nurses meticulously monitor respiratory status to maintain appropriate oxygen levels.
Reducing cerebral edema plays a critical role.
Controlling factors that could raise intracranial pressure (ICP) is a notable intervention.

Interventions (continued)

Nurses manage various patients' issues by encouraging deep breathing, turning and positioning, using suction if necessary, and offering humidified oxygen.

Preventing Infections

Assessing the surgical incision and monitoring for signs of infection are crucial.
Instructions regarding coughing/sneezing are vital.
Maintaining strict aseptic technique helps minimize infection risk.

Nursing Interventions for Metastatic Brain Tumors

Implementing a palliative approach is essential and includes measures to provide comfort, maintain functionality, and acknowledge patients' preferences and anxieties.
Patient and family support is essential.
Referrals to healthcare providers and other resources that may aid the patient.
Managing symptom relief is also important.

Improving Nutrition

Patient-centered dietary plans, incorporating preferred foods and supplements, meet nutritional requirements and promote comfort.
Thoroughly recording dietary intake is important for monitoring nutritional needs.

Conclusion

This comprehensive summary provides a detailed overview of brain tumor management, encompassing assessment, diagnosis, treatment (including surgical approaches), nursing care, and potential complications.

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Test your knowledge on glial cells and the tumors that arise from them in this quiz. You'll explore different types of glial cells, their functions, and associated brain tumors. Ideal for students studying neuroscience or biology.