| The most sad type of Cancer | Bates is the Bible | Nociception | Applied Neurology.. uh oh | Jack of All Trades |
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What are common cancers to metastasize to the brain? (3)
Lung, Breast, Skin
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If someone is hyporeflexic, but still has a response what would their reflex grading scale be?
1+
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What is pain insensitive in the brain?
Parenchyma of the brain
Pia mater, arachnoid mater, parts of the duramater Ependymal and choroid plexus Skull except periosteum |
What is the diencephalon
thalamus, hypothalamus, pineal gland, pituitary gland
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What is Diagnostics used for Brain tumours?
CT or PET Scan - whole body to ID cancer, biopsy
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What sex is more likely to get a brain tumour?
more males than females → except meningiomas, which occur more frequently in women
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What is clonus?
a series of involuntary, rhythmic muscular contractions in response to a rapid muscle stretch reflex
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What is neuropathic pain
pain caused by abnormal neural activity that arises secondary to injury, disease, or dysfunction of the nervous system
Central pain - caused by CNS dysfunction, such as ischemic stroke, phantom limb pain Peripheral pain - caused by damage to peripheral nerves Presents as burning, deep pain |
What is the presentation of a brain tumour in the Occipital Lobe
Problems with vision
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What is the prognosis of Brain Tumours?
without treatment: 1 month
with treatment: < 1 year |
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What is the difference between primary and secondary brain tumours?
Primary arise from the CNS and brain itself, secondary metastasize to the brain
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What is nuchal rigidity
inability to passively flex neck due to increased tone in neck musculature
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What is nociceptive pain
Nociceptive pain = pain that is triggered by chemical, mechanical or thermal stimuli (noxious stimuli)
Nociception = sensory nervous system's process of encoding noxious stimuli Somatic pain (MSK) - localized and sharp pain Visceral pain - dull, diffuse and deep pain |
What is the presentation of a brain tumour in the Temporal Lobe
Problems with auditory, memory, or speech - aphasia
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What is 2 structures that can give rise to headaches
C1-C3 joints, ligaments, suboccipital muscles, Lev scap, trapezius, SCM
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What is the most common clinical features of a brain tumour? (4)
Seizures, Focal Neuro deficits, Headaches, Cognitive deficits
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What is Cranial nerve XI? What does it innervate? How would you test it?
Accessory nerve, innervates SCM and Trapezius - test these muscles, Cervical rotation/flexion, shoulder elevation
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True or false: A brain tumour will always cause pain
False - only will cause pain if pressing on a pain sensitive structure or increasing cranial pressure
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What is the presentation of a brain tumour in the Frontal Lobe
Problems with reasoning, movement, planning, emotions, speech, problem solving resulting in personality changes, weakness, aphasia, apraxia
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What is the ABCDE of breaking Bad News
A- advance preparation
B- build a therapeutic environment/relationship C- communicate well D - deal with patient and family reactions E - encourage and validate emotions |
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What percentage are primary vs secondary brain tumours in adults?
30% are primary (of which, 40% are benign), 70% secondary in adults
In kids, most are primary |
How would you test the spinothalamic tracts?
Test pain (pin prick vs dull), temperature (hot vs cold) along dermatomes
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What is the pain pathway
nociceptors detect stimulus → conversion of stimulus to an electric signal → C fibers and Aδ fibers carry afferent input to the dorsal horn of SC → secondary nociceptive neurons in the spinothalamic tract carry afferent input to the thalamus → pain perception and a response sent along efferent pathways to modulate pain
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What is the presentation of a brain tumour in the Parietal Lobe
Problems with orientation, perception and recognition of sensory stimuli or faces, understanding
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What is the pathophysiology of Nauseau
(just name some big pathways involved)
autonomic, endocrine changes
Medulla CTZ NTS gastric dysrhythmias |
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