Flashcards in CNS Disorders fixed Deck (85):
Progressive failure of cerebral functions that is not caused by an impaired level of consciousness is:
T or F: Dementia frequently has an abrupt onset.
FALSE. Dementia never has an abrupt onset. If there is abrupt onset it is not dementia but another disease
What causes Alzheimer's disease?
An abruption in the cholenergic system, decrease in ACE, decrease in number of cells in the brain
Alzheimer's can cause an disturbances in:
Nerve cell communication, Decreased Metabolism, decreased Cell repair
What is the most common clinical manifestation of Alzheimer's disease?
Gradual onset with a chronic progressive decline in cognitive functioning
Other cognitive manifestations of Alzheimer's include:
Short term memory loss, Anxiety and agitation, Judgment, problem-solving and communication problems
On a day to day care basis, Alzheimer's can cause
Loss of ability to complete ADLs
An end stage clinical manifestation of Alzheimer's is:
Loss of bowel and bladder incontinence
The MMSE test is used to assess:
The stages of Alzheimer's
A high MMSE score correlates with (beginning or end) stage of the disease, a low MMSE score correlates with (beginning or end) stage of the disease
Compared to a healthy brain, a brain of a person with Alzheimer's disease will have these key differences:
Cortical shrinkage, enlarged ventricles, shrinking of the hippocampus- the more severe the disease, the more shrinkage will occur
How is the decrease in ACE (associated with Alzheimer's disease) managed?
*Increase ACETYLCHOLINE level by decrease its reuptake
*Pharmacologic agents that prevent Acetylcholine from breaking down.
[Acetylcholinesterase Inhibitors (AChEls)]
T or F: The purpose of Alzheimer's treatments is to slow the progression of the disease.
FALSE. The progression cannot be stopped
What are the two main goals of Alzheimer's drug treatments?
Improve cognitive function: memory, and Symptom control
T or F: Alzheimer's drugs should be given in very small doses.
Abnormal electrical activities within the NERVE CELLS in the brain
Seizures occur when:
A Synchronous, high frequency depolarization of a focus spreads to other parts of the brain
T or F: All seizures will manifest in generally the same way.
FALSE. Manifestations depend on location of focus and recruitment of other parts of the brain.
Congenital defects, Hypoxia at birth, Head Trauma, and cancer are all causes of:
Muscular weakness due to nerve damage
A neurological disorder characterized by jerky involuntary movements
flaccidity and floppiness is a result of:
Dysphagia, speech impairment, excitability, spasticity, and posturing are results of:
Difficulty swallowing as a symptom of disease
What are two types of posturing?
A position in which the patient holds their upper arms at their sides with elbows, wrists, and fingers flexed while legs are extended and internally rotated, and feet are plantar flexed is _______________ posture.
A position in which jaws are clenched, neck is extended, arms are addicted and stiffly extended at the elbows with forearms probated, wrists and fingers flexed is____________posturing
What are the two types of seizures?
Partial and generalized
What is the major difference between simple and complex partial seizures?
Level of consciousness: in complex you will see loss of consciousness
A seizure that only involves part of the brain is considered:
A partial seizure
A seizure that involves the whole brain in addition with loss of consciousness is:
A generalized seizure
A tonic seizure involves:
Contraction of the muscles
A clonic seizure involves
Relaxation of muscles
T or F: febrilE seizures are associated with epilepsy.
FALSE. They are a result of a fever.
What are the three seizure stages?
Aura, seizure, post-ictal
Visual or audio warning signs happen during the ____________ stage
T or F: The time block between the aura and seizure stage varies between person to person.
Confusion, Disorientation, Weakness, and Hypoglycemia are common during the _____________seizure stage.
What is a Status Epilepticus seizure?
A seizure that lasts >30 minutes
CNS depression during the post-ictal stage could lead to a patient:
Forgetting to breathe
A sign that a patient is hypoglycemic in the post-ictal stage is:
What is the goal of anticonvulsant drugs?
To control or prevent recurrence of seizures
What is the action of anticonvulsant drugs?
stabilize cell membrane by affecting cation transport
Can a child with epilepsy ever be off of medication?
Possibly, but must be weaned off slowly
Cerebrospinal fluid (CSF) leakage from nose or ear may indicate:
A skull fracture
Increased ICP, amnesia, hypotension are common signs of
A contusion will present as
Increased ICP; nuchal rigidity; fixed dilated pupil on the affected side; papilledema; hemiparesis; hemiplegia; and leakage of CSF from ears or nose are all s/s of:
A patient presenting with no loss of consciousness, confused would be described as a Grade ______ concussion.
A patient presenting with No loss of consciousness, brief retrograde amnesia would be described as a Grade ______ concussion.
A patient presenting with confusion & amnesia @ impact would be described as a Grade ______ concussion.
A patient presenting with immediate loss of consciousness would be described as a Grade ______ concussion.
What is Second Impact Syndrome?
After one concussion, 2nd blow causes catastrophic IICP, herniation, ischemia, and cell death
What is the difference between concussion and contusion?
Concussion is a bruised brain, contusion refers to a lesion in the brain
head strikes a surface
tearing of an artery & blood accumulates between inner skull & dura
impact of head against something
impact within the skull (rebound effect)
What is an example of an epidural?
unrestrained MVA (head hits windshield)
violent motion of brain tissue in the skull
What is an example of a subdural injury?
Shaken baby syndrome
What are the most common s/s of acute brain injury?
acute alteration in LOC, change in respiratory patterns
Abrupt onset of persistent neurological signs and symptoms because of a decreased blood supply to the brain is defined as:
Which neurological condition is the #3 cause of death in US, Hypertension is the major risk factor, responsible for 500,000/yr., 1/3 with neuro deficit
T or F: Age, race, gender, predisposing conditions, and substance abuse are all risk factors for stroke.
What are the two classifications for CVA?
Ischemic and Hemorrhagic
An ischemic CVA is due to
An interruption of blood flow
atherosclerosis, idiopathic are examples of:
thrombotic ischemic CVA
heart disease, carotid athero/art.pressure, and edema are examples of:
embolic ischemic CVA
Tissue damage as a result of IICP would be classified as:
An ischemic CVA
A Hemorrhagic stroke results in:
A hemorrhage in the brain
List 6 serious effects of a Hemorrhagic stroke
edema, hydrocephalus, re-bleeding, infarction, coma, death
Clinical manifestations of stroke are dependent on:
area affected and adequacy of collateral circulation
List 5 clinical manifestations of a hemorrhagic stroke:
1. LOC 2. aphasia: receptive, expressive, mixed 3. hemineglect syndrome 4. Cognitive and motor disorders 5. Long term; motor defects, language, speech, aphasia, Dysphagia
paralysis, gait, paresis, decision making, voluntary activity, thought process, affective responses, incontinence indicates a stroke in which region?
hemiplegia, sensory, aphasia, confusion/coma, neglect indicates a stroke in which region?
visual defects, hallucinations, memory loss, and repetitive activity are clinical manifestations of a stroke in which region?
An injury in the thalamus manifests with:
sensory, pain, tremors, aphasia
A celebellar injury may be observed by:
brain stem; visual deficits
What is the most important factor in treatment of a CVA?
Salvage brain tissue within 3 hrs!
An acute or chronic inflammation of the pia mater & arachnoid membranes is:
headache, nuchal rigidity, low grade fever are s/s of: