Chapter 5

Question 1

what type of specialized cells is the nervous system made up of

Answer 1

neurons

Question 2

about how many neurons are there in the human body

Answer 2

200 billion

Question 3

how many neurons are there in the brain

Answer 3

about 100 billion, or half of the total neurons in the body

Question 4

what are axons and dendrites responsible for

Answer 4

axons conduct impulses AWAY from the cell body and dendrites conduct them TOWARDS it

Question 5

what are the junctions between neurons called and what chemicals pass the impulses from one neuron to another

Answer 5

synapses are the junctions and neurotransmitters pass the impulses from one neuron to another

Question 6

brains require a huge supply of ____

Answer 6

oxygen

Question 7

oxygen is brought to the brain via the _____

Answer 7

carotid arteries

Question 8

what are the 3 regions of the brain

Answer 8

forebrain, midbrain, hindbrain

Question 9

what area of the brain is the cerebral cortex in and name 2 of its functions

Answer 9

forebrain, nerve pulses are received and analyzed here, and memories are stored. also conscious thought process, reasoning, deliberation, judgement

Question 10

what is the function of the midbrain

Answer 10

connects spinal cord with the forebrain and forms major part of the brainstem

Question 11

where is the medulla oblongata and what is it responsible for

Answer 11

it is part of the hindbrain and controls vital functions (breathing, blood circulation, swallowing).

Question 12

where is the cerebellum and what does it do

Answer 12

in hindbrain, coordinates movement, partially responsible for learning motor actions like riding a bike

Question 13

what is the cauda equina

Answer 13

extends from the spinal cord and supplies nerves to the legs

Question 14

what are the two separate parts of the peripheral nervous system

Answer 14

somatic and autonomic

Question 15

what is the somatic nervous system made up of and what does it do

Answer 15

nerves that connect the brain and spinal cord with skeletal muscles that are under voluntary control, such as arm and leg muscles. also connects sensory organs with the brain, convey info about touch and pain

Question 16

what is the autonomic nervous system made up of and what does it do

Answer 16

connects brain and spinal cord with internal organs and all processes within body that are not under voluntary control (HR, respiration, digestive process)

Question 17

what is the sympathetic nervous system

Answer 17

part of the autonomic nervous system, prepares for fight or flight/emergency situations

Question 18

what is the parasympathetic nervous system

Answer 18

part of the autonomic nervous system, maintains internal status quo in everyday scenarios, reduce HR and BP after response to an emergency

Question 19

what is the most important diagnostic technique in diagnosing neurological disorders

Answer 19

history and physical exam, observation

Question 20

what is the 3rd leading cause of death in most developed countries

Answer 20

stroke

Question 21

what are the main two pathological types of stroke

Answer 21

primary ischemic stroke and primary intracerebral hemorrhage

Question 22

what is the most common cause of stroke

Answer 22

ischemia

Question 23

what are the causes of ischemic stroke

Answer 23

atherosclerosis, blood clot that form on the brain (thrombus), blood clot or piece of atheromatous plaque or other material that travels to the brain from another location

Question 24

what is the most common cause of ischemic stroke (underlying disease)

Answer 24

atherosclerotic disease

Question 25

strokes caused by embolism are most commonly due to what

Answer 25

cariogenic emboli, clots that develop secondary to heart disorders such as valve defects or arrhythmia

Question 26

what are vertebrobasilar strokes and blockage or which arteries almost always result in severe disability or death

Answer 26

blockage of arterial vertebrobasilar systems that circulate blood within areas of brain such as medulla, cerebellum and midbrain. blockage of large arteries in this area almost always result in severe disability or death. those in smaller vessels are survivable.

Question 27

what is cause of lacunar stroke

Answer 27

lacunar infarcts commonly occur as result of an occlusion to a large cerebral artery. most in subcortical white matter, basal ganglia or pons

Question 28

what are the risk factors for intracerebral hemorrhage (comorbids)

Answer 28

similar to those for cardiovascular disease - HTN, heart disease, fib/flutter, smoking, hx of TIAs, generalized atherosclerotic disease, HLD, DM, use of OCPs

Question 29

what are possible causes for primary intracerebral hemorrhage

Answer 29

HTN (50% of cases), when blood vessel affected by diseases bursts, when blood vessel blocked by an embolism bursts, when AVM or aneurysm ruptures.

Question 30

a stroke in the right hemisphere often causes paralysis in the _____ side of the body, and what are other possible symptoms

Answer 30

left (left hemiplegia). also can cause spatial and perceptual problems, diff with judgement, behavior, impose, memory

Question 31

left hemisphere stroke can cause paralysis in the ______ side of the body, and what are other possible symptoms

Answer 31

right. also can cause aphasia

Question 32

what are the underwriting considerations for TIA and stroke

Answer 32

age at time of episode, time elapsed since episode occurred, any persisting neuro deficit, underlying cause if known, if HTN adequacy of control, presence or absence of co-existing risk factors

Question 33

what is subarachnoid hemorrhage and usual cause

Answer 33

presence of blood within the subarachnoid space, usually caused by rupture of intracranial aneurysm

Question 34

what are other causes of subarachnoid hemorrhage

Answer 34

AVM, hematomas from trauma

Question 35

what are surgical treatments for aneurysm

Answer 35

clipping and coiling

Question 36

what are underwriting factors to consider when underwriting subarachnoid hemorrhage

Answer 36

severity of initial episode, results of all investigations and treatments, presence or absence of residual neurological symptoms including epilepsy, control of any co-existing risk factors particularly HTN.

Question 37

what is the most common disabling neurological disorder in young adults

Answer 37

MS

Question 38

what are subtypes of MS

Answer 38

relapsing-remitting, secondary progressive, and primary progressive

Question 39

what eye disorder has close relationship with MS

Answer 39

optic neuritis

Question 40

what are treatments for MS

Answer 40

symptomatic relief, disease modifying (injectables, infusions and oral therapies)

Question 41

what are underwriting considerations for MS

Answer 41

whether there is definite dx, age at onset, which subtype, date of last attack, frequency of attacks, current level of disability

Question 42

what are the major known causes of epilepsy

Answer 42

brain tumors, arteriovenous malformations, stroke

Question 43

what factors can increase risk of epilepsy up to 10 times

Answer 43

1) head injury w/concussion and one or more of following: LOC for over 30 mins, some loss of memory after injury, neurological abnormalities, skull fx. 2) CNS infections such as meningitis 3) cerebral palsy with mental handicap 4) febrile seizures that are unusually long or frequent or involve only one side of the body 5) alcohol abuse

Question 44

what are focal or partial seizures

Answer 44

confined to a localized area of the brain.

Question 45

what are types of focal seizures

Answer 45

simple with no LOC, and complex partial including those that become generalized

Question 46

what are generalized seizures

Answer 46

abnml electrical activity in brain. usually developmental in origin.

Question 47

what are the types of generalized seizures

Answer 47

grand mal, absence seizures/petit mal, other (myoclonic)

Question 48

are intracranial tumors generally considered benign or malignant? why? do they usually metastasize?

Answer 48

malignant, because of invasion of local tissue but rarely metastasize so don't fit the usual definition of cancer. benign tumors do occur. `

Question 49

what type of brain tumor is usually fatal within a year

Answer 49

glioblastoma

Question 50

what brain tumors can be compatible with several years of survival

Answer 50

low grade gliomas

Question 51

which brain tumors have more favorable prognosis

Answer 51

meningioma, acoustic neuroma, pinealoma

Question 52

which brain tumors have less favorable prognosis

Answer 52

astrocytoma, glioma, medulloblastoma, neuroblastoma, sarcoma

Question 53

what info should be obtained for underwriting brain tumors

Answer 53

precise histology, results of all investigations, treatment given, time since dx and completion of treatment, any residual neurological or psychological impairment

Question 54

what is temporal arteritis

Answer 54

inflammation of arteries supplying the scalp

Question 55

what are possible cause of encephalitis and what is it

Answer 55

viral, bacterial, parasitic, fungal. swelling of brain.

Question 56

what are symptoms of encephalitis

Answer 56

severe headache, sudden onset of fever, photophobia, stiff neck, N&V, drowsiness and confusion, seizures.

Question 57

what are common causes of encephalitis (specific infections)

Answer 57

herpes, common childhood illness (measles mumps rubella), insect borne viruses( west nile, EEE)

Question 58

what is meningitis and what can it be caused by

Answer 58

inflammation of meninges, membranes that surround brain and spinal cord. caused by virus or bacteria

Question 59

which has better prognosis, viral or bacterial meningitis

Answer 59

viral.

Question 60

what are symptoms of meningitis

Answer 60

severe headache, high fever, photophobia stiff neck, N&V, drowsiness and confusion, rash, seizures

Question 61

what are underwriting considerations for hydrocephaus

Answer 61

underlying cause if known, type of and respond to treatment, if shunt still in place then if there is hx of complications like blockages or infections, if any residuals

Question 62

the intracranial tumor that has a high cure rate with surgery alone is

Answer 62

meningioma

Question 63

the major known causes of epilepsy include all of the following except (thyroiditis, AVM, stroke, brain tumor? )

Answer 63

thyroiditis

Question 64

all of the following can cause epilepsy except (migraine, brain tumor, head injury, stroke)

Answer 64

migraine

Question 65

a stroke, as defined by The Who, includes which of the following: A) gradual onset of cerebral deficit, B) symptoms lasting more than 24 hrs, C) no apparent cause other than vascular

Answer 65

B and C are correct

Question 66

MS would have unfavorable prognosis with presence of which of the following? A) older age at onset B) bowel or bladder involvement C) relapsing remitting form

Answer 66

A and B are correct