Neurological Disorders: Cortical

Question 1

What is the Monro-Kellie Doctrine?

Answer 1

equilibrium in cranial vault

Question 2

What does an increase in CSF cause?

Answer 2

hydrocephalus
(in ventricles)

Question 3

What does an increase in blood volume cause?

Answer 3

brain aneurysm
AV malformation (unneeded connection)

Question 4

What does an increase in brain tissue volume cause?

Answer 4

inflammation
tumor

Question 5

What is a simple partial seizure?

Answer 5

don’t lose consciousness
focal motor, focal sensory

Question 6

What is a complex partial seizure?

Answer 6

some amnesia involved
psychomotor

Question 7

What 3 things does the Glasgow Coma Scale assess?

Answer 7

1. eye opening
2. best motor response
3. best verbal response

Question 8

What is a normal score on the Glasgow Coma Scale?

Answer 8

15

Question 9

What score is concerning on the Glasgow Coma Scale?

Answer 9

less than 7

Question 10

What is a CVA (stroke)?

Answer 10

disruption of cerebral blood flow not related to trauma

Question 11

What is the patho of a CVA?

Answer 11

1. deprivation of normal perfusion
2. cerebral infarction
3. inflammation

Question 12

What factors affect manifestations of a CVA?

Answer 12

area and extent

Question 13

What are the 4 manifestations of a CVA?

Answer 13

1. aphagia
2. dysphagia
3. paralysis on one side (facial droop)
4. decreased cognitive ability

Question 14

What is aphagia?

Answer 14

trouble understanding others
issues reading and writing
difficulty articulating speech

Question 15

What things are affected with decreased cognitive ability?

Answer 15

memory
reasoning
personality changes

Question 16

What is the patho of Transient Ischemic Attacks?

Answer 16

clot forms with spasms present around it

Question 17

What are the 3 manifestations of Transient Ischemic Attacks?

Answer 17

1. symptoms last less than 24 hours
2. neuro deficits
3. warning sign

Question 18

What is the patho of Alzheimer’s Disease?

Answer 18

1. cortical (brain tissue) atrophy
2. ventricular dilation
3. formation of plaques with cytoplasm which destroys nerve cells
4. amyloid deposits around BVs which decreases volume of brain tissue

Question 19

At what pressure is considered increased intracranial pressure?

Answer 19

greater than 15mmHg

Question 20

What is the patho of IICP?

Answer 20

1. increased blood volume, CSF, brain tissue
2. an increase in BV pressure increases cerebral perfusion pressure
3. herniation of brain

Question 21

How is CPP calculated?

Answer 21

MAP-ICP

Question 22

What is a normal cerebral perfusion pressure?

Answer 22

80-100mmHg at least 70

Question 23

What happens with herniation of the brain?

Answer 23

brain forced into obscure places in skull

Question 24

What are the 7 manifestations of IICP?

Answer 24

1. headache
2. changes in LOC
3. changes in reflexes
4. motor and visual changes
5. abnormal posturing
6. Cushing’s triad
7. fixed and dilated pupils

Question 25

What is decerebrate posturing?

Answer 25

severe head is back

Question 26

What is decorticate posturing?

Answer 26

less severe arms brought to core

Question 27

What is Cushing's triad?

Answer 27

a late sign of IICP 1. bradycardia 2. slow and deep respirations 3. widening pulse pressure

Question 28

What is the patho of Meningitis?

Answer 28

1. bacteria or virus replicates in CSF and releases toxins 2. inflammatory response that increases ICP

Question 29

What are the 8 manifestations of Meningitis?

Answer 29

1. headache 2. nuchal rigidity 3. ataxia 4. visual disturbances, photophobia 5. seizures 6. cloudy CSF 7. petechial rash 8. increases in WBCs

Question 30

What is nuchal rigidity?

Answer 30

neck becomes stiff

Question 31

What is ataxia?

Answer 31

gait or coordination dysfunction

Question 32

What is photophobia?

Answer 32

sensitivity to light

Question 33

What is the patho of seizures?

Answer 33

progressive depolarization of cells which creates excessive electrical discharges

Question 34

Where does a focal motor seizure occur?

Answer 34

locally and progresses distally

Question 35

What are the manifestations of a focal motor seizure?

Answer 35

contraversive movement (eyes and head turn to one side)

Question 36

Where does a focal sensory seizure occur?

Answer 36

lesion in sensory cortex of parietal lobe

Question 37

What are the manifestations of a focal sensory seizure?

Answer 37

simple, auditory, tactile, or visual disturbance (numbness, tingling)

Question 38

Where does a psychomotor seizure occur?

Answer 38

temporal lobe, medial surface of hemispheres, limbic system

Question 39

What are the 4 manifestations of a psychomotor seizure?

Answer 39

1. bizarre behavior 2. exaggerated emotions 3. automatisms 4. no verbal response

Question 40

What are automatisms?

Answer 40

actions without intention or conscious thoughts

Question 41

What are examples of automatisms present in a psychomotor seizure?

Answer 41

lip smacking grunting chewing

Question 42

What is the patho of a primary injury trauma?

Answer 42

1. minimal disruption (confusion, LOC, concussion) 2. extensive disruption (sever motor, sensory deficits)

Question 43

What is the patho of a secondary injury trauma?

Answer 43

inflammation increased ICP cerebral edema

Question 44

What is the patho of head trauma?

Answer 44

intracranial bleed/hematoma (clot forms after hemorrhage)

Question 45

What are the 5 manifestations of head trauma?

Answer 45

1. increased ICP 2. seizures because of altered membrane transport 3. abnormal bruising 4. blood or CSF drainage through ears and nose 5. altered motor and sensory function

Question 46

What is periorbital ecchymosis?

Answer 46

black eye associated with head trauma

Question 47

What is Battle's sign?

Answer 47

bruising behind ear associated with head trauma