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Neurological Disorders & Head Injuries: Components of the Nervous System

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What neurotransmitter is associated with learning and memory, as well as its involvement in Alzheimer’s disease?

Acetylcholine

Which neurotransmitter is linked to Parkinson’s disease and schizophrenia?

Dopamine

What neurotransmitter is connected to depression, aggression, and schizophrenia?

Serotonin

Which neurotransmitter is known for its role in anxiety and epilepsy?

Gamma-aminobutyric

What is the 'Gate Keeper' that regulates incoming and outgoing signaling within the brain?

Reticular Formation

What plasmalike liquid fills the space between the arachnoid and pia mater layers to provide cushion and support?

Cerebrospinal fluid

What is the main function of the sympathetic nervous system?

Controls the changes in the body needed to respond to threats

Which type of cells in the nervous system are responsible for protecting neurons from pathogens?

Neuroglia cells

Why can neurons not be replaced if they are damaged?

They cannot 'cell divide'

Which part of the nervous system controls the changes required for the 'feed or breed' response?

Parasympathetic nervous system

In which type of nervous system do severed nerves have a better chance of reestablishing connections after injury?

Peripheral Nervous System

What is the primary function of neural tissue in the body?

Generate bioelectrical impulses

What is the function of the Dura Mater in the skull?

Lines the skull and separates different parts of the brain

Which part of the skull may hemorrhage during severe head trauma?

Temporal bone

What are the lobes contained in the Middle Fossa of the skull?

Temporal, occipital, and parietal lobes

Which layer of the meninges is described as a fragile web-like structure?

Arachnoid Mater

What is the calculation for cerebral perfusion pressures (CPP)?

$ ext{Mean Arterial Pressure} - ext{Intracranial Pressures}$

What is considered the normal range for Cerebral Perfusion Pressures (CPP)?

$60-80$ mmHg

What is the function of the Trigeminal Cranial Nerve?

Chewing, pain, and touch of the face and mouth

Which Cranial Nerve is primarily associated with hearing and balance?

Auditory

What is the main function of the Oculomotor Cranial Nerve?

Movement of the eyeball, pupil, and eyelid

Which space is located between the dura mater and the outside of the brain?

Subdural space

Which cranial nerve is involved in the movement of the eyeball?

Abducens

What is a common function of the Glossopharyngeal Cranial Nerve?

Swallowing and saliva secretion

What is the medical emergency status of Transient Ischemic Attacks (TIA)?

Emergencies that require immediate attention

What is the cause of Hemorrhagic Stroke?

Ruptured cerebral aneurysm

Which symptom is typically associated with Hemorrhagic Stroke?

Difficulty swallowing (Dysphagia)

What does AVM stand for in the context of strokes?

Arteriovenous malformation

What does the Cincinnati Stroke Scale help identify?

Large Vessel Occlusions

How does the Los Angeles Motor Scale aid in stroke assessment?

Assessing Large Vessel Occlusions

What is being assessed when a patient is asked to show their teeth (smile) in the RACE score?

Facial palsy

In the RACE score, how is the Arm Motor Function assessed by extending the patient's arm?

1: Moderate (limb upheld less than 10 seconds)

What does the RACE score evaluate by extending the leg of the patient?

Leg motor function

How is moderate Facial Palsy described in the RACE score?

(slightly asymmetrical)

Which part of the RACE score evaluates eye movements and cephalic deviation?

Leg Motor Function

What is the most common type of ischemic stroke described in the text?

Thrombotic Cerebral Thrombosis

What is the main cause of an Embolic Cerebral Embolism as mentioned in the text?

A small piece of plaque or clot lodged in a narrow artery

In the context of Cerebrovascular Accidents (CVA), what is the pathophysiological result of hemorrhagic strokes?

Infarction caused by impaired cerebral perfusion

What is the primary consequence of continued blockage in cases of ischemic strokes due to thrombosis or emboli?

Brain death due to infarction

Which condition serves as a warning sign for a possible Stroke, according to the text?

Transient Ischemic Attack (TIA)

What are the risk factors associated with Thrombotic Cerebral Thrombosis, as stated in the text?

"Risk Factors: Resulting from atherosclerosis"

What is the sensitivity rate of the BE FAST assessment in identifying Large Vessel Occlusions?

0.60

How long after the Last Known Well Time is the treatment window for Transient Ischemic Attack (TIA) according to the text?

6-16 hours

Which medication is recommended for treating Ischemic Stroke according to the text?

TPA tissue plasminogen activator

What is the primary risk factor for Bell’s Palsy mentioned in the text?

Infection of herpes simplex virus

For Hemorrhagic Stroke, which procedure involves filling an aneurysm with coils to prevent bleeding?

Coiling (aneurysm embolization)

What is the main treatment approach for Bell’s Palsy as mentioned in the text?

Steroids and ABX

What type of injury occurs when the brain strikes the inner surface of the skull opposite the primary impact?

Contra coup injury

What is the primary cause of increased Intracranial Pressures (ICP) as per the Monro-Kellie Hypothesis?

An increase in the volume of one component within a fixed cavity

Which type of hematoma occurs between the dura layers and is characterized by the symptom 'worst headache of my life'?

Subdural hematoma

What kind of injury involves shearing, stretching, or tearing of nerve fibers?

Diffuse Axonal Injury (DAI)

What is the crucial factor for good outcomes in patients with Diffuse Axonal Injury?

Initial care by EMS personnel

What is the outcome of patients with Diffuse Axonal Injury considered to be?

Unpredictable

What are the three components of Cushing's Triad that indicate brain herniation?

High blood pressure, low heart rate, irregular respirations

Which solution is used in severe cases of brain injury to help reduce intracranial pressure?

Mannitol

What is the goal for systolic blood pressures in traumatic brain injuries?

130-145

Why should Dextrose IV solutions be avoided in traumatic brain injuries?

To avoid increasing intracranial pressure

What is the target Mean Arterial Pressure (MAP) for traumatic brain injuries?

>90 MAP

Why is hyperventilation indicated in traumatic brain injuries only for herniation?

To decrease intracranial pressure

What is the effect of increased carbon dioxide levels on cerebral blood vessels?

Increase intracranial pressure

What is the outcome of an incomplete spinal cord injury known as Anterior cord syndrome?

Paraplegia

Which level of spinal cord injury is usually fatal?

C1-C3

What is a consequence of low carbon dioxide levels on blood flow?

Constrict blood flow resulting in decreased CPP

Why is it important to manage the airway in cases of spinal cord injury?

Assist in treating shock

What type of hemorrhage is characterized by a lucid period and is arterial in nature?

Epidural hematoma

Which type of brain injury has the highest percentage of patients presenting to the ER, with most making uneventful recoveries?

Mild brain injury

What is the primary neurological assessment tool mentioned in the text that helps evaluate neurological function following brain injury?

Glasgow Coma Scale (GCS)

Which type of hemorrhage occurs between the tough mother and cobweb mother and is more common, accounting for 30% of severe brain injuries?

Subdural hematoma

For a patient with a GCS score of 10, what level of brain injury category does this score typically fall under according to the text?

Moderate brain injury

Which part of the skull may hemorrhage during severe head trauma, located above the 'tough mother' mentioned in the text?

Dura mater

What is the primary medication used to treat Parkinson's Disease?

Levodopa

Which of the following types of medications can induce Parkinsonism?

Antipsychotics

What is the characteristic symptom of meningitis?

Severe headache

Which class of medications is implicated in inducing Serotonin Syndrome?

SSRIs

What is the main cause of bacterial or viral meningitis?

Bacteria or viruses

What is the primary pathophysiological mechanism of Amyotrophic Lateral Sclerosis (ALS)?

Rapid demyelination of motor neurons

In the context of seizure management, which medication is commonly used for its antiseizure properties and not typically for its sedative effects?

Phenobarbital

What distinguishes Myasthenia Gravis from other autoimmune disorders?

Sporadic muscle weakness affecting different muscle groups

Which factor contributes to the deadliness of Amyotrophic Lateral Sclerosis (ALS)?

Progressive muscular neuron death

What is a common sign that would necessitate ventilator support in individuals with Myasthenia Gravis?

Difficulty swallowing

What is the primary cause of neurogenic shock as mentioned in the text?

Central nervous system injury

Which symptom is not typically associated with neuro storms?

Bradycardia

What is the function of betablockers in the management of spine injuries?

To control neuro storms

What is the primary treatment for neurogenic shock according to the text?

0.9% NS infusion

Which condition is characterized by a 'loss of sensation and reflexes below the injury site'?

Spinal shock

What is the common cause of epilepsy as mentioned in the text?

Anoxia, trauma, toxins, and metabolic abnormalities

What is the pathophysiological process that leads to the development of hydrocephalus in meningitis?

Blockage of the draining system by thickened CSF

Which sign is used to assess resistance to painful knee extension in Kernig's sign?

Hip reflex

What is the most serious form of Spina Bifida where both meninges and spinal cord protrude through an opening in the vertebral column?

Myelomeningocele

In cerebral palsy, what is the primary cause of bilateral paralysis resulting from inadequate blood or oxygen supply to the brain?

Inadequate supply during fetal development

Which symptom is a characteristic sign of meningitis indicating neck stiffness?

Neck rigidity

What is the reflex response when pressure is applied to the cheeks in Brudzinski's sign?

Forearm flexion

Which autoimmune condition is characterized by symptoms progressing from distal to proximal and typically does not affect cardiac muscles?

Guillain-Barre Syndrome

What is the main feature of Multiple Sclerosis caused by the release of lymphokines and cytokines?

Sensory impairment

Which neurological disorder involves a degenerative process affecting dopaminergic neurons in the basal ganglia?

Parkinson's Disease

What distinguishes Guillain-Barre Syndrome from Multiple Sclerosis in terms of muscle paralysis?

Progresses from proximal to distal

Which condition causes damage to nerve cells and targets muscles in the body, leading to poor speech and dysphagia?

Multiple Sclerosis

What distinguishes Guillain-Barre Syndrome from Parkinson's Disease in terms of progression and duration of symptoms?

Rapidly progressive over days to weeks

Study Notes

Here are the study notes for the text:

Neurotransmitters and Diseases

  • Acetylcholine: effects on learning and memory, Alzheimer's disease, and PNS muscle movement
  • Dopamine: Parkinson's disease and schizophrenia
  • Norepinephrine: Depression
  • Serotonin: Depression, aggression, and schizophrenia
  • Glutamate: Learning and major excitatory neuron
  • Gamma-aminobutyric acid (GABA): Anxiety and epilepsy
  • Endogenous opioids: Pain and analgesia

Reticular Formation and Reticular Activation System

  • Reticular Formation: "Gate Keeper", regulates incoming and outgoing signaling
  • Reticular Activation System: responsible for alertness and formulation of responses

Central Nervous System (CNS)

  • Skull: houses and protects the brain
  • Vertebral column: houses and protects the spinal cord
  • Meninges: membranes that encase the CNS
    • Dura mater: outer and toughest layer
    • Arachnoid layer: middle layer with a spider web-like vascular system
    • Pia mater: innermost layer
  • Cerebrospinal fluid: plasma-like liquid that fills the space between the arachnoid and pia mater layers

Skull and Spinal Cord

  • Skull: a rigid case that protects the brain
  • Spinal cord: housed inside and protected by the vertebrae of the spinal column
  • Bones of the skull:
    • Frontal bone
    • Parietal bone
    • Temporal bone
    • Occipital bone
    • Sphenoid, Lacrimal, and Ethmoid bones

Cranial Fossa

  • Anterior Fossa: contains the frontal lobes
  • Middle Fossa: contains the temporal, occipital, and parietal lobes
  • Posterior Fossa: contains the brainstem and cerebellum

Cerebral Perfusion Pressures (CPP)

  • Calculation: Mean Arterial Pressure (MAP) - Intracranial Pressure (ICP)
  • Normal CPP: 60-80 mmHg
  • Normal ICP: 5-10 mmHg

Neurological Disorders and Head Injuries

  • Types of strokes:
    • Hemorrhagic stroke: bleeding in the brain
    • Ischemic stroke: blockage of blood flow to the brain
  • Signs and symptoms of stroke:
    • Sudden weakness or numbness of the face, arm, or leg
    • Sudden confusion or trouble speaking
    • Sudden trouble seeing or blurred vision
    • Sudden severe headache with no known cause
    • Sudden loss of balance or coordination
  • Traumatic brain injury:
    • Focal brain injury: damage to a specific area of the brain
    • Diffuse axonal injury: damage to the brain cells and their connections

Neurological Assessment

  • Glasgow Coma Scale (GCS): assesses the level of consciousness
  • Pupils:
    • Reactivity to light
    • Size and shape
  • Muscle responses:
    • Gross motor assessments
    • Muscle strength and tone

Trauma to the Head and Spine

  • Skull fractures:
    • Linear fracture
    • Depressed fracture
    • Basilar fracture
  • Spinal cord injuries:
    • Complete injury: total loss of motor and sensory function below the level of injury
    • Incomplete injury: partial loss of motor and sensory function below the level of injury

Hospital Treatment

  • Mild to moderate head injuries: watch and wait, antiemetic and anti-seizure medication

  • Severe head injuries:

    • Hypertonic solutions
    • Mannitol
    • Craniotomy
    • Ventricular drainage
  • Spinal cord injuries:

    • Immobilization and stabilization
    • Steroids to reduce inflammation
    • Surgical intervention to stabilize the spine### Guillain-Barré Syndrome
  • Rapidly progressive and potentially fatal motor neuropathy that develops in 7-12 days

  • Caused by an autoimmune response that destroys the myelin sheath surrounding axons

  • Symptoms progress from distal to proximal and usually do not affect cardiac muscles

  • Symptoms last up to 6 months to years

  • Treatment is clinically based on the signs and symptoms

  • If treated, patients can recover

Multiple Sclerosis

  • Demyelination of the white matter of the brain and spinal cord caused by the release of lymphokines and cytokines
  • Injury to the underlying axons damages nerve cells and targets muscles
  • Symptoms include:
    • Sensory impairment
    • Weakness
    • Paralysis
    • Hyperreflexia
    • Tremors
    • Poor speech
    • Dysphagia
  • Treatment involves:
    • Muscle relaxants
    • Steroids

Parkinson's Disease

  • Disorder of the extrapyramidal system characterized by:
    • Progressive muscle rigidity
    • Akinesia (loss of voluntary muscle movement)
    • Tremors
  • Caused by a degenerative process involving the dopaminergic neurons in the basal ganglia
  • The affected area is responsible for:
    • Posture
    • Coordination
    • Voluntary motor movements

Learn about the components of the nervous system, including the Central Nervous System (CNS) and Peripheral Nervous System (PNS). Explore how the CNS and PNS work together to receive and react to environmental stimuli at a physiologic and cognitive level.

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