Neuro Exam Ii - Ward

Front 1

Consequences of basal fracture

Back 1

rhinorrhea
otorrhea
meningitis

Front 2

Skull Fractures

Back 2

Closed
Open
Linear
Comminuted
Depressed
Occult

Front 3

common fracture

Back 3

usually associated with fracture of the wing of the sphenoid

Front 4

Skull fracture Features

Back 4

-KE is dissipated at the suture lines
-diastatic

Front 5

Concussion

Back 5

-sudden arrest of head
-loss of consciousness, cessation of breathing and loss of reflexes
-biochemistry (ions fluxes)
-increased vascular permeability
-amnesia and neuropsychiatric symptoms continue

Front 6

Contusion

Back 6

-bruise
-wedge shaped
-transmission of kinetic injury
-blood in gyri (GM), in WM and subarachnoid space
-a cause of SAH
-axons are red from ischemia

Front 7

Why would you get contusions on the frontal and temporal lobe?

Back 7

-these areas are inclined to rough material and shearing

Front 8

What is the response to a contusion of the gyri?

Back 8

-PMNs then macrophages
-yellow (hemosiderin) plaque in days after bruise
-gliosis and cavitation (inward bubbles)
-avulsion resulting in parenchymal injury
-coup and contracoup

Front 9

Whiplash

Back 9

sprain of anterior neck vertebral ligaments

Front 10

Dashboard injuries

Back 10

-frontal and basal brain

Front 11

What are the lesions from diffuse axonal injury (DAI)?

Back 11

-Petechiae is in the center of the corpus callosum and near the brain stem (central axial petechiae)
-from breaking capillaries
-there can be some lateral damage
-50% die in 2 weeks if they go into a coma

Front 12

blow to jaw

Back 12

-causes head to rotate to away from the medial aspect
-boxing and car accidents
-brain will hit the falx
-Axons going from frontal to temporal to frontal to occipital can be torn
-DAI

Front 13

What is DAI not associated with?

Back 13

skull fractures
contusions
hematomas
subarachnoid hemorrhages
low falls (duration of acceleration short)

Front 14

Histology of DAI?

Back 14

-Hemorrhages
-Axonal, swelling at nodes of Ranvier
-retraction balls (elastic roll up)
-gliosis, glial nodules, tract degeneration

Front 15

Linear acceleration

Back 15

-hit in the nose, can affect the cerebellum and medulla

Front 16

traumatic vascular injury

Back 16

Carotid
Epidural
Subdural
Subarachnoid
Intraparenchymal
Cavernous sinus (leading to AV fistula)

Front 17

Epidural Hematoma

Back 17

-tear of artery
-usually middle meningeal
-causes dura to detach and smooth compression of brain surface (diagnostic)
-this leads to a lucid moment before going into coma
-

Front 18

Subdural Hematoma

Back 18

-between arachnoid and dura
-tear of veins
-clear subarachnoid space
-fibroblasts grow in from the dura
-pita pocket from dura inwardsd
-rebleeding because neovascularization (always leaky)

Front 19

Hydrocephalus

Back 19

from SAH

Front 20

Intraparenchymal Hemorrhage

Back 20

-from lacerations, contusions, auto accidents
-Spat apoplexie, rare, deep hemorrhage later after tauma (sudden death)

Front 21

above C4

Back 21

-quadraplegia
-respiratory paralysis
-diaphragmatic paralysis

Front 22

Subarachnoid Hemorrhage

Back 22

-berry aneurysms (cerebral arteries)
-vascular malformations

Front 23

Below C4

Back 23

-paraplegia
-isolated tract damage

Front 24

Subluxation

Back 24

-slipping of vertebrae that cuts the spinal cord

Front 25

Hour-glass lesion

Back 25

ascending/descending tract legion to spinal cord

Front 26

Shaken baby syndrome

Back 26

-SAH
-gliding lesion (cortex glides on the white matter and shear penetrating meningeal vessels)
-intramedullary and intracordal hemorrhage (medulla and SC)

Front 27

Acute bacterial meningitis shows what types of cells?

Back 27

3 mononuclear cells:
lymphocytes, plasma cells and macrophages

Front 28

basal acute bacterial meningitis

Back 28

H influenzae
-pus through foramina and BV

Front 29

corticol acute bacterial meningitis

Back 29

S pneumoniae
-pus through foramina and BV

Front 30

What are two complications ABM?

Back 30

fibrosis
communicating hydrocephalus

Front 31

AVM

Back 31

swollen brain
pathogen in CSF
mild lymphocytic infiltration

Front 32

Three ways to get bacteria form right to left in the heart to avoid the lungs.

Back 32

hole in the heart (endocarditis)
AV fistula
patent ductus

Front 33

What does an old abcess go through?

Back 33

-gliosis
-fibroblasts are delivered from leaky by neovascularization
-rim of collagen, granulatin tissue
-liquefaction necrosis

Front 34

What is seen in the CSF during a brain abcess?

Back 34

high protein, high WBC's, normal glucose

Front 35

How does an infection damage the CNS?

Back 35

-direct injury
-microbial toxins
-inflammation
-immune-mediated

Front 36

TB meningitis

Back 36

-granuloma of the meningies
-communicating hydrocephalus
-or peripheral neuropathy
-obliterating endarteritis --. arterial occlusion and white infarcts

Front 37

heubner

Back 37

-obliterative endarteritis in meningovascular syphilis
-perivacular cuff of plasma cells

Front 38

paretic syphilis

Back 38

-invasion by spirochetes
-windswpet cortex with gliosis and iron deposits.

Front 39

tabetic syphilis

Back 39

-dorsal roots, impaired senses
-loss of axons and myelin
-lightning pains
-absent of deep tendon reflexes
-skin and joint damage from injuring self (Charcot joints)

Front 40

Viral enchephalitis

Back 40

-associated with meningitis (meningoencaphalitis)
-mononuclear inflitrates
-herpes VE wants to go to the temporal lobe...tropism
-JC virus goes to oligodendrocytes....tropism