Clin Med: Nervous System

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Bethalex88
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154822
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Clin Med: Nervous System
Updated:
2012-05-19 20:12:29
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Diseases nervous system
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Diseases of Nervous system
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  1. Huntington's Disease
    • Autosomal dominant
    • Onset: 4th decade
    • Involuntary movement & facial grimaces
    • Atrophy of caudate & putamen nuclei & ventricular enlargement
    • 15 yrs from onset of symptoms to death
  2. Astrocytoma
    • Origin: neuroglial
    • CNS neoplasm
    • Derived from: astrocytes (role in nurishment, physical support, clean up debris)
    • Range from: well differentiated to highly malignant
    • Symptoms: seizures, motor deficits, mental changes
  3. Oligodendroglioma
    • Origin: Neuroglial
    • CNS neoplasm
    • Derived from: oligodendrocytes (provide myelin sheath)
    • Onset: adult
    • Symptom: seizures
  4. Ependymoma
    • Origina: neuroglial
    • CNS neoplasm
    • Derived from: ependymal cells (line ventricals in brain)
    • Onset: 1st & 3rd decade
    • Presents: in 4th ventricle, hydrocephalus
  5. Meningioma
    • Origin: Meningeal
    • CNS neoplasm
    • Benign
    • Slow growing
    • Involves: Brain parenchyma
    • Onset: middle aged adults
    • Possible symptoms: headache, focal seizures, visual disturbances
  6. CNS Neoplasms: Metastatic origin
    • Primary sites in order: lung, breast, melanoma, kidney, GI
    • Symptoms: headache, seizures
  7. Wallerian degeneration
    • Degeneration of distal segment of a transected nerve
    • Accumulation of organelles
    • Atrophy of Schwann cells replaced by fibrose tissue
  8. Distal axonopathy
    • "dying back"
    • Proximal axon is in tact as toxic & metabolic neuropathies cause damage on distal end
    • Regeneration is possible if cause is removed
  9. Segmental demyelination
    Damage to myelin sheaths
  10. Diabetic Neuropathy
    • Most common form of symmetrical polyneuropathy
    • Can involve: sensory & autonomic nerves
    • Extensive segmental demyelination secondary to axonal degeneration
  11. Guillain-Barre disease
    • Autoimmune disorder
    • Progressive ascending motor paralysis
    • May affect spinal & cranial nerves
    • Preceded by viral infection
    • Segmental demyelination
  12. Amyotrophic lateral sclerosis
    • Degenerative disease
    • Onset: 6th decade
    • Progressive wasting of extremities
    • Motor weakness
    • Respiratory failure
    • Degeneration of upper motor neurons
    • Damage to corticospinal tracts
    • Degeneration of anterior horn cells --> atrophy
  13. Parkinson's disease
    • Onset: 5th & 6th decades
    • Loss of neurons in substantia nigra
    • Clincal signs: tremors, bradykinesia, rigidity, postural changes, poor balance, slow voluntary movement, shuffling gait, dementia
  14. Alzheimer's
    • Loss of recent memory, dementia, insomnia, anxiety
    • Meninges are thickened
    • Cortical atrophy
    • Death secondary to respiratory infections
  15. Multiple Sclerosis
    • Most common demyelinating disease
    • Unknown etiology
    • Possibly autoimmune
    • "plaque" hallmark -> demyelination in white matter
    • Onset: young adults
    • relapsing & remitting course
    • Possible lesions in optic nerve --> blindness,
    • Lesion of brain or spinal cord--> ataxia, paraplegia
  16. Leptomeningitis
    • Bacterial infection
    • Newborns: E. coli
    • Infants & children: H. influenza
    • Adolescents, young adults: N. Meningitidis
    • Adults & young children: Step. pneumoniae
    • Purulent exudate in meninges
    • Increased CSF pressure, neutrophils & protein
    • Decreased glucose
    • Clinical signs: Agitation, headache, photophobia, stiff neck, positive meningeal signs
  17. Cerebral abcess
    • Bacterial infection
    • Via bloodstream from sinus infections, ear infections, mastoid infections
    • Starts as acute inflammatory reaction
    • Symptoms: inc. intracranial pressure
    • Cavity develops whe dead tissue from necrotic walled off area is removed
  18. Hydrocephalus
    • Increased CSF
    • Causes ventricular distention
    • Inability of aracnoid villi to transfer fluid to venous drainage or blockage of CSF pathways:
    • Noncommunicating: Blockage within the brain
    • Communicating: Blockage within subarachnoid space
  19. Infarction
    • Loss of blood supply leading to necrosis
    • 1. Vascular thrombosis: thrombus forms attached to vessel walls (stationary)
    • 2. Embolism: thrombus in motion
  20. Hypertensive hemorrhage
    • Most common, non-traumatic cause
    • Most frequently in basal ganglia
    • Vessels previously damaged by chronic hypertension or hypertensive microaneurysms
    • Compress brain parenchyma
  21. Cerebral hemorrage
    • Collection of bloody fluid within brain stem or cerebral hemispheres
    • Non-traumatic cause
  22. Saccular aneurysm
    • Most common (5-6% of population)
    • At bifurcation of vesselsUsually in: Middle cerebral artery & its branches
    • Anterior cerebral & anterior communicating artery: more prone to rupture
  23. Arteriovenous malformations
    • Mixture of veins, arteries, & arterialized veins in brain hemispheres
    • A mess of them; disorganized bunch
    • Cause: seizures, intracerebral hemorrhage from rupture
  24. Subarachnoid hemmorage
    • Bleeding into subarachnoid space (b/n arachnoid mater & pia mater)
    • Common cause: trauma & rupture of preexisting arterial aneurysm
  25. Subdural hematoma
    • Accumulation of blood in subdural space
    • Brain injury to fontal or occipital region (w/o fracture)
    • Causing VEIN injury
    • Chronic, slower to manifest
    • May display confusion & later coma
  26. Epidural
    • Accumulation of blood in epidural space (b/n skull & dura mater)
    • Injury to temporal bone (fracture)
    • Damage to mid meningeal ARTERY
    • Rapid progression
    • First loss of consciousness, then recovery, then coma, death

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