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HCD III Module C: Intracranial Regulation Week 1
Terms in this set (61)
Encapsulated, well differentiated cells, easily accessible/operable
Not well encapsulated, undifferentiated cells, often not able to be completely resected
is a distinct protective mechanism that is a restrictive barrier between blood and CSF
dysfunction of blood brain barrier caused by increased capillary permeability; leakage causes swelling
Brain, blood, and CSF - have fixed volume
↑ one parameter must be accompanied by ↓ in one of the others to maintain normal pressure
50% of all primary intracranial tumors are __
slow growing; infiltrative; can usually resect some of it and then use radiation therapy for residual pieces
hypercellular; rapid onset; high recurrence
children, poor prognosis; often occurs is posterior fossa; can have metastasis is CSF in about 1/3 of the cases; lots of hydrocephalous
children, young adults, good prognosis; originates in ventricles; usually benign
slow grow; benign/malignant; onset is very subtle; often surgically resected
highly malignant; infiltative; very poor prognosis; hard to get all of it out
arises from meninges, either dura or arachnoid area
25% of intracranial tumors
Usually benign; well circumscribed (so can get it out pretty well); may be vascular (high risk for bleeding)
Compresses adjacent tissue (so brain trauma and death to cells)
Usually good prognosis, unless atypical
7% of tumors; Benign; microadenoma (smaller than 1 cm) vs. macroadenoma (larger than 1 cm)
__ Pituitary Adenoma: Grows in the pituitary, no hormone secretion, takes up space; puts pressure on surrounding tissue and causes damage that way
__ Pituitary Adenoma: Produces ↑ levels of pituitary hormones
Also known as "Vestibular Schwannoma"
Affects cranial nerve VIII (acoustic nerve)
Tinnitus, hearing loss, balance problems
Curable - surgery; though is Difficult to remove
but can cause damage to nerve which will affect quality of life
start somewhere else in body and then come to brain
20-40% of patient with cancer
Originate from outside brain
Discrete, round, ring enhancing
Symptoms are location dependent
Prognosis depends on # tumors, location, systemic disease, & patient age
headache; Mental; Seizure
Common S/S of Brain Tumor:
__ - (most frequent).
__ status changes --
Cognitive (can't think, can't add, etc.)
emotional (changes in behavior, confusion, etc.).
Visual; motor; gait
More S/S of brain tumor:
__ changes - occipital lobe
__ problems - frontal to parietal (contralateral for motor changes; i.e. right brain causes affects on left side of body)
Unsteady __, impaired balance, incoordination - cerebellar tumors
More S/S of brain tumor:
__ Problems -
Brocca's motor speech center (frontal lobe) →
Wernicke's sensory speech center (temporal lobe) - this affects understanding speech
___ Problems - parietal lobe
Hormone Imbalance - Pituitary/Hypothalamus
More S/S of brain tumor:
__ - projectile, N &/or V, 2nd to pressure on the medulla.
ANS changes - vasomotor, brainstem effects, ↑ temp & sweating.
__- swelling in brain pushes, if swelling pushes against optic disk then it is _
Brain Tumor Surgery - best option; total removal or "__" (_ is getting out majority and then following up with radiology)
Brain Tumor Pharmacology:
__ (dexamethasone)- will decrease swelling
H2 receptor blockers- block histamine reflex
Anticonvulants- because of potential for seizures
Brain Tumor Other treatments:
Gamma knife- one high dose of single high dose radiation
the changes in the retina that occur in the individual with diabetes. The retinal capillary structure undergoes alterations in blood flow, leading to retinal ischemia and breakdown in the blood-retinal barrier. It has 3 stages. Leading cause of blindness in individuals between 20 and 74 years of age
Retinopathy of prematurity (ROP)
is abnormal blood vessel development in the retina of the eye. It occurs in infants that are born too early (premature).
The vessels may stop growing or grow abnormally from the retina into the back of the eye. Because the vessels are fragile, they can leak and cause bleeding in the eye.
Almost all babies who are born before 30 weeks or weigh less than than 3 pounds at birth are screened for the condition.
Too much oxygen in neonates can cause it. So don't want O2 too high. Usually maintain it between 88 and 96.
it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain
The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain
__ hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open.
__ hydrocephalus — also called "obstructive" hydrocephalus — occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles.
occurs when stroke or traumatic injury cause damage to the brain. In these cases, brain tissue may actually shrink
NPH (Normal Pressure Hydrocephalus)
is an abnormal increase of cerebrospinal fluid in the brain's ventricles that may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery
In infancy, the most obvious indication of hydrocephalus is often a rapid increase in head __ or an unusually large head size. Other symptoms may include vomiting, sleepiness, irritability, downward deviation of the eyes (also called "sun setting"), and __.
headache; balance; personality
Older children and adults may experience different symptoms because their skulls cannot expand to accommodate the buildup of CSF. Symptoms may include __ followed by vomiting, nausea, blurred or double vision, sun setting of the eyes, problems with __, poor coordination, gait disturbance, urinary incontinence, slowing or loss of developmental progress, lethargy, drowsiness, irritability, or other changes in __ or cognition including memory loss.
S/S: Normal pressure hydrocephalus: problems __, impaired __ control, progressive mental impairment and dementia, general slowing of movements or feet may feel stuck
Hydrocephalus is most often treated by surgically inserting a __ system. This system diverts the flow of CSF from the CNS to another area of the body where it can be absorbed as part of the normal circulatory process.
Monitor for ABGs for acidosis as CO2 is a potent __ that can increase ICP
refers to a group of neurological disorders that appear in infancy or early childhood and permanently affect body movement, muscle coordination, and balance.
CP affects the part of the brain that controls __ movements
ataxia; spasticity; tone
The early signs of cerebral palsy usually appear before a child reaches 3 years of age. The most common are a lack of muscle coordination when performing voluntary movements ( __); stiff or tight muscles and exaggerated reflexes (__); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a "scissored" gait; and muscle __ that is either too stiff or too floppy
S/S: Normal pressure hydrocephalus: problems __, impaired bladder control, progressive mental impairment and dementia, general slowing of movements or feet may feel stuck
A motor system disorder caused by loss of dopamine neurons
a central nervous system disorder caused by degeneration of neurons that produce the neurotransmitter dopamine
When dopamine neurons are degenerated, acetylcholine signaling is increased, causing an imbalance that contributes to the clinical manifestations of _ disease.
it is a progressive disease; early symptoms may not be noticed for several months, and full expression of symptoms may not be seen for many years after diagnosis
Tremor; Rigidity; fatigue
S/S of Parkinsons: __ in the hands, arms, legs, jaw, and face
__ and stiffness of the limbs and trunk
Motor symptoms: tremor, rigidity, bradykinesia, postural instability
Nonmotor symptoms: __, irritability, and loss of sense of smell, cognitive deficits, emotional changes, sleep problems
effective in reducing tremor, bradykinesia, and rigidity, but problems with balance and non-motor symptoms may not be relieved
levodopa almost always given in combination with __ to prevent side effects
Huntington's disease (HD)
is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person's physical and mental abilities during their prime working years and has no cure.
decreased GABA and acetylcholine and increased dopamine
HD is known as the quintessential family disease because every child of a parent with HD has a __ chance of carrying the faulty gene.
Symptoms usually appear between the ages of 30 to 50, and worsen over a 10 to 25 year period. Ultimately, the weakened individual succumbs to pneumonia, heart failure or other complications.
judgment; gait; chorea
S/S of Huntington's: Personality changes, mood swings & depression
Forgetfulness & impaired __
Unsteady __ & involuntary movements (__)
Slurred speech, difficulty in swallowing & significant weight loss
are periods of abnormal electrical discharges in the brain that may cause involuntary movement and/or behavior and sensory alterations. It appears that spontaneous, disordered discharge of activity that occurs during a _ exhausts energy metabolites or produces locally toxic molecules, altering LOC for a time after
The brain's metabolic demand for __ increases dramatically during a seizure. If this demand isn't met, hypoxia and brain damage result.
__ __ seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Hereditary factors are important in many of these seizures.
__ __ (focal seizures) begin with an electrical discharge in one limited area of the brain
__ phase: sharp tonic muscle contraction forcing air out of lungs which may cause client to cry out; loss of postural control; muscle rigid with jaw clenched; urinary incontinence common; breathing ceases and cyanosis; pupils fixed and dilated; 15-60 seconds
__ phase: contraction/relaxation of muscles in all extremities; hyperventilation; eyes roll back; froths at mouth; 60-90 seconds
__ __: continuous seizure with only short periods of calm; great danger of hypoxia, acidosis, hypoglycemia, hyperthermia; exhaustion if seizure activity not halted
disruption of the superficial epithelium of the cornea.
Superficial abrasions of the cornea are extremely painful but generally heal rapidly without complication or scarring. Photophobia and tearing are commonly present.
The outer surface of the eye may be subjected to burns caused by heat, radiation, or explosion, but chemical burns are most common.
The client who experiences a burn to the eye will give a history of face and eye contact with a caustic substance or another burning agent and will complain of eye pain and decreased vision.
The client's eyelids may be swollen; his or her face and lips may be affected. The appearance of the client's eye may vary depending on the type of burn.
For alklaline, want to use normal saline for rinsing but make sure it is NOT a buffered normal saline
Want to rinse for 30 minutes
__ injury: the layers of the eye spontaneously reap proximate after entry of a sharp-pointed object or small missile (e.g., a BB) into the glove. __ eye injuries are those that have a single entrance wound from the injury.
__ injury: the layers of the eye do not spontaneously reapproximate, resulting in rupture of the globe and potential loss of ocular contents. A _ eye injury involves an entry and exit wound, both of which are caused by the same source
Sports injuries are a common cause of __ __ to the eye. Motor vehicle crashes, falls, and physical assault are examples of other causes of blunt eye trauma.
Blunt trauma may lead to a minor eye injury such as lid ecchymosis (black eye) or subconjunctival hemorrhage
Hyphen, bleeding into the anterior chamber of the eye, is a potential result of blunt eye trauma
Separation of the retina, or sensory portion of the eye, from the chorioid, the pigmented vascular layer, is known as a retinal detachment
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