Key Concepts for Exam 3 Patho 1
Understand risks for hemorrhagic stroke
Uncontrolled hypertension
Complication: another bleeding episode, more strokes
Contrast thrombotic and hemorrhagic stroke
Thrombotic- strokes are associated with atherosclerosis and coagulopathies. (Results from occlusion) Hemorrhagic stroke- Hemorrhage (bleeding within the brain) secondary to injury severe chronic Mortality is much higher.
ends stage of ICP=Cushing's reflex/ triad- (sympathetic nerves system functions) Respirations become erratic; Systolic b/p goes up , pulse goes down
TBI
Types and pathophysiology
Focal-(coup) one focus point. AT SITE OF IMPACT.
Polar- coup countercoup. TWO POLE LOBES, ex. Frontal lobe and occipital lobe
Diffuse-axonal damage. Widespread tearing sheering of neuronal damage.
Glasgow coma scale
Standardized tool for assessing LOc
What indicates poor findings?
A score less than 8 is severe
Posturing:
Decorticate-abnormal flexor
Decerebrate: abnormal extensions
Manifestations of Brain Injury
Decerebrate posturing
Cranial nerves 3.4 and 6 - review functions of each
Cranial nerve #3: oculomotor responsible for movement
Cranial nerve #4:controls the direction of the superior oblique muscle. This muscle moves the eye down and rotates the top toward the nose. It also helps pull the eye outward when the eye is looking downward. When this nerve is damaged, it may not do its job.
Cranial #6: also called the abducens nerve, controls the movement of the lateral rectus muscle. This muscle moves the eye outward, away from the nose. When this nerve is damaged, it may not be able to do its job. Cranial nerve #6 if injury nystagmus may happen
Affected in trigeminal neuralgia affected cranial nerve #ff
Bell palsy affected cranial nerve #7
Basilar skull fracture signs
Clear fluid from nose or ear unilaterally, raccoon black eyes
Late and early signs of ICP
Early sign- LOC change
Late-stage - alterations in respiration pattern becomes erratic
Contra lateral- right sided stroke left sided weakness
Epsilateral-
Especially in hemorrhagic stoke- a change in LOC they are bleeding or having another strokes
AVM and aneurysm pathophysiology
Arteriovenous malformation-structural abnormalities of the cerebral arteries(conjoined arteries and veins) predispose individuals to intracerebral bleeding and hemorrhagic stroke. Arterial blood is blending with the venous making the pressure high in the venous system distending the vain that can consequently can rupture. This don't occur with age it can happen at any time because of proximity in vascular. This are congenital.
An aneurysm- is a lesion of an artery that results in dilation and ballooning of a segment of the vessel with histologically less organized structure compared with normal arterial tissue. they occur mainly in the substructurally subarachnoid area of the brain intracerebral bleeding and hemorrhage occurs.
Epidural bleed- upper surface of the brain
Subdural- mostly brain mass harder to get too than an epidural
Subarachnoid-inner circle that encompasses the CSF very difficult to get to
Tonic-clonic seizures signs
-Seizure Complex, partial and tonic clonic= loss of consciousness and loss of bladder control
Seizures=The hyperactive firing of the electrical impulses
Tonic clonic-loss of conciouss ness
Post ictal stage- waking up from seizure let it happen on its own do no