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Flashcards in Outcome 10 Neurology Deck (202):
1

Brain is damaged by a sudden disruption in the flow of blood to a part of the brain

Cerebrovascular Accident (CVA)

2

CVAs are also called _____ or _____

stroke or brain attack

3

3 types of vascular disorders causing CVA

1. Occlusion by an atheroma
2. Sudden obstruction by an embolus
3. Cerebral bleed/hemorrhage

4

Symptoms of CVA

Severe headache, aphasia, dysplasia, sudden weakness, numbness or paralysis, confusion or impaired consciousness, drooping of one side of eyelid and mouth, vision difficulties, sudden dizziness, loss of balance and coordination

5

T or F. CVA needs immediate intervention to limit brain damage.

T

6

2 families of drugs to treat CVA

1. Anticoagulants like Warfarin and Coumadin
2. Thrombolytic agents like aspirin or heparin (Iv)

7

Temporary episodes of impaired neurologic functioning caused by an inadequate flow of blood to a portion of the brain.

Transient Ischemic Attack (TIA)

8

TIAs are also called ____ or ____

"little strokes" or "mini strokes"

9

TIAs have a duration of less than ___ hours

24

10

TIAs are caused by a piece of plaque formed by ______

atherosclerosis

11

The plaque in TIA breaks away from a wall of an artery or heart valve and travels to the brain, which is known as an ____

emboli

12

Another cause for TIA are _______ from an arterial ulcer.

platelet fibrin emboli

13

Treatment for TIA depends on the _____ of the attack.

location

14

T or F. Anticoagulants are used during the episode to lessen the frequency or chance of TIA recurrences.

T

15

Chew _____ as symptoms appear in TIA

aspirin

16

Usually results in brain injury that can range from mild to life-threatening or fatal

head trauma

17

Collection or mass of blood forms between the skull and the dura mater

epidural hematoma

18

Epidural hematoma affects the area between the ____ and the ____, the outer most of the 3 meningeal layers

skull and the dura mater

19

In epidural hematoma, symptoms appear a few hours after ______

head trauma

20

Epidural hematoma symptoms include sudden headache, dilated pupils, nausea, vomiting, drowsiness and _____

hemiparesis

21

In epidural hematoma, blood from ______ seeps into and around the meningeal layers due to head trauma

ruptured vessels

22

In both subdural and epidural hematoma, sudden _____ and _____ causes brain to strike the skull

acceleration and deceleration

23

2 surgical interventions for subdural/epidural hematoma

1. craniotomy
2. cranial trephination or burr hole

24

Craniotomy and trephination are procedures done to remove ______ and to cauterize ______ if increasing intracranial pressure becomes life threatening

accumulated blood; the bleeding vessel

25

The cause of epidural hematoma is typically a _____

blow to the head

26

The blood collects or pools between the dura mater and the arachnoid membrane

subdural hematoma

27

What areas of the brain are affected in a subdural hematoma?

the dura mater and the arachnoid membrane

28

The general cause of a subdural hematoma is ______

the head striking an immovable object

29

Symptoms of an epidural hematoma typically appear within _____ of a head trauma,

a few hours

30

Subdural hematomas have a _____, causing symptoms to appear later

delayed symptom onset

31

Epidural hematomas are usually caused by ______, while subdural hematomas are caused by ______

a blow to the head; the head striking an immovable object

32

Possible bruising of the cerebral tissue

cerebral concussion

33

Cerebral concussion is also called a ______

mild traumatic brain injury

34

In a cerebral concussion there is a disruption of the normal ______ in the brain, but the brain itself usually is not permanently injured

electrical activity

35

Cerebral concussions are caused by ______ movement of the head, as in an acceleration-deceleration insult

back and forth

36

Cerebral concussions are also caused by ____ trauma or falling

blunt force

37

Cerebral concussions are treated with quiet bed rest with observation for signs of _____

behavioral changes

38

Most severe concussion where the injury includes bruising of brain tissue along or just beneath the surface of the brain

cerebral contusion

39

Another name for cerebral contusion

contrecoup insult

40

Cerebral contusion is caused by a _____ or impacting against a _____ as occurs in a car accident.

blow to the head; hard surface

41

In cerebral contusion, a _____ force against ______ of the brain occurring when colliding with the _____ may damage structures deep in the brain.

twisting and shearing; two hemispheres; cranial bones

42

Contusion is associated with _____

skull fracture

43

A break or fracture in one of the bones of the cranium, when depressed or torn loose, they are pushed below the normal surface of the skull

depressed skull fracture

44

Depressed skull fractures are caused by ______ in the skull with a ______ object

direct impact; blunt object

45

In depressed skull fracture, a fractured bone may cut an ____ or ____ causing hemorrhage in the brain

artery or vein

46

Treatment for depressed skull fracture includes relieving the _____

intracranial pressure

47

Surgical intervention for depressed skull fracture that elevates the bone back into place

craniotomy

48

____ is used in depressed skull fractures until they are partially healed

head protection

49

Injury of the spinal cord affect the innervation of any spinal nerves distal to the point of insult.

paraplegia and quadriplegia

50

In para/quadriplegia, the ____ and ____ often result in the failure of spinal nerve functioning.


extent of the injury and consequential edema

51

Loss of nerve function below the waist, resulting in paralysis of the lower trunk and legs

paraplegia

52

Loss of nerve function at the cervical region resulting in paralysis of the arms, hands, trunk and legs

quadriplegia

53

Para/quadriplegia are due to _____ or _____

vertebral fractures or dislocation

54

In para/quadriplegia, the ____ causes injury/trauma to the cord and the severity of the trauma.

site

55

In paraplegia there is trauma to ___ and below

T1

56

2 other causes for paraplegia

1. vertical compression
2. hyperflexion

57

In quadriplegia, there is trauma to ___ and above

C5

58

Para/quadriplegia are treated with restoration of the normal ____ and ____ of the spine;

alignment and stability

59

4 other treatments for para/quadriplegia

1. decompression of the spinal cord, nerves and vertebrae 2. early rehab.
3. neck and spine stabilization.
4. hypothermic state to injured area

60

In para/quadriplegia, ____ is used to prevent or slow edema

methylprednisone

61

Degeneration or deterioration of an intervertebral disc that may result in pain in the areas served by the spinal nerves of the involved disc space.

degenerative disk disease (DDD)

62

DDD is caused by age due to decreased ____ in the disc, or ____ wear and tear.

water; mechanical

63

Misalignment in DDD can cause ____ and ____, eventually involving the nerve roots causing scarring.

inflammation and disc destruction

64

2 key diagnostic indicators that accompany a depressed skull fracture

1. battle's sign (bruising behind the ears)
2. racoon eyes (bruising around and under the eyes

65

DDD sequela is _____

spinal stenosis

66

4 treatments for DDD

1. be active
2. analgesics and NSAIDs
3. physical therapy
4. spinal fusion and freeing of the nerve roots from entrapment

67

Rupture of the nucleus pulposus through the annular wall of the disc and into the spinal canal

herniated and bulging disk

68

Herniated and bulging disk is also called ____ or ____

ruptured or slipped disk

69

4 causes for herniated and bulging disk

1. accumulated trauma
2. sudden impact
3. poor posture
4. aging

70

Conservative treatment of herniated and bulging disk consists of using ____ and ____

hot and cold packs

71

Family of drugs to treat herniated and bulging disk

relaxants and analgesics

72

3 surgical interventions used for herniated and bulging disks where the herniated disc may be excised

1. percutaneous discectomy
2. microdiscectomy
3. removal of the disk with laminectomy and fusion of the vertebrae

73

Pathologic condition brought about by trauma, degeneration or rupture of the nucleus pulposus

sciatic nerve injury or spinal stenosis

74

In sciatic nerve injury, rupture of the nucleus pulposus occur within intervertebral discs ___ through ___

L4, S3

75

In spinal stenosis, there is narrowing of the spinal canal or _____ because of compression on the spinal cord and spinal nerve roots

nerve root foramen (sciatica)

76

Trauma to sciatic nerve may result from a fall, gunshot or stab wounds, or poor ____

body mechanics

77

In spinal stenosis, ____ can lead to degeneration of the disc or the nucleus pulposus.

aging

78

An _____ may prompt more rapid degeneration of spinal stenosis

inflammatory autoimmune response

79

In spinal stenosis, aging and arthritic changes may also cause narrowing of the ____ and the ____

spinal canal and the foramen

80

3 treatment options for spinal stenosis

1. oral prednisone
2. physical therapy
3. ultrasound diathermy with massage

81

Pain in the head that is not confined to any one specific nerve distribution area

headache

82

Another word for headache

cephalalgia

83

Causes of headaches

--

84

Family of drugs to treat headaches

NSAIDs

85

Periodic severe headaches that may be completely incapacitating and almost always are accompanied by other symptoms, such as nausea and vomiting, anorexia, intense hemi cranial or bilateral throbbing pain and visual signs and symptoms

migraine

86

Causes of migraine is unknown but may be biological with changes in the _____

cerebral blood flow

87

2 types of spinal cord injuries

paraplegia and quadriplegia

88

In migraines there is ______ followed by _____ of the cerebral and cranial arteries

vasoconstriction; vasodilation

89

Family of drugs to treat migraines

analgesics

90

Chronic brain disorder, characterized by sudden episodes of abnormal intense electrical activity in the brain which results in seizure activity

epilepsy/seizure disorder

91

Type of epilepsy with known abnormalities in the brain resulting from a pathologic process, genetic or acquired

symptomatic epilepsy

92

Pathologic conditions associated with seizures

1. scar tissue on cerebral cortext from infection or trauma
2. cortical neoplasm
3. cerebral edema
4. TIAs
5. CVAs

93

Other possible causes of epilepsy

1. birth trauma (cerebral palsy)
2. drug toxicity
3. diabetes
4. hypoglycemia
5. other conditions depriving the brain of oxygen

94

Family of drugs to treat epilepsy

anticonvulsants ex.phenytoin, carbamazepine, valporic acid, etc

95

Common slowly progressive neurologic disorder characterized by the onset of recognizable disturbances

Parkinson's disease

96

4 recognizable disturbances in Parkinson's disease

1. “pill-rolling” tremor of the thumb and forefinger
2. muscular rigidity
3. slowness of movement
4. postural instability

97

T or F. In Parkinson's, the cause of the degeneration of nerves in the motor system is unknown.

T

98

In Parkinson's, a deficiency of _____ has been clinically demonstrated in patients with this disease

dopamine

99

Parkinson's can also occur after which three incidents?

1. after ingestion of poison, 2. after encephalitis
3. after taking certain major tranquilizers and certain antihypertensive drugs

100

In Parkinson's, degenerative disease of the brain involve ______ parts of the brain

preferentially various

101

T or F. There is no cure and no known way of preventing Parkinson's

T

102

A hereditary degenerative disease of the cerebral cortex and basal ganglia where progressive atrophy of the brain occurs

Huntington's chorea/disease

103

The exact cause of Huntington's disease is uncertain but it is an _____ trait that can be inherited by either sex

autosomal dominant

104

General cause of spinal cord injuries (para/quadriplegia)?

vertebral fractures and/or dislocations

105

3 ways to classify spinal cord injuries in terms of injury mechanism

1. compression
2. hyperflexion
3. hyperextension

106

In spinal cord injuries, damage occurring the ___ vertebral level is usually fatal

C3

107

Surgical treatment option for degenerative disk disease

spinal fusion and freeing of the nerve roots from entrapment

108

In ______ disk there is a rupture of the nucleus pulposus through the annular wall of the disk and into the spinal call

herniated disk

109

In _____ disk, the nucleus pulposus extends into the inner annulus only

bulging disk

110

Another name for spinal stenosis

sciatica

111

3 sciatic nerve injury/spinal stenosis surgical interventions

1. discectomy or microdiscectomy
2. spinal fusion
3. chemonucleolysis and/or decompression

112

For Huntington's disease, haloperidol lactate and fluphenazine are prescribed to reduce ____

agitation

113

Progressive destructive motor neuron disease that results in muscular atrophy

amyotrophic lateral sclerosis (ALS)

114

ALS is also called _____ disease

Lou Gehrig's

115

ALS may be caused by ______ trait

autosomal inherited

116

A new drug that has shown promise in slowing progression and extending life of ALS patients

Riluzole

117

In ALS, tizanidine and baclofen are muscle relaxants to help relieve _____

muscle spasticity

118

Neurologic condition typified by an overwhelming urge to move the legs or body part is to stop an uncomfortable or odd sensation

restless legs syndrome (RLS)

119

Restless legs syndrome incidence appears to increase after the ages ___ and ___

40 and 50

120

2 things that may play a role in causing RLS

1. anemia
2. stress

121

Family of drugs to alleviate or lessen symptoms in RLS

dopamine agonists

122

Frightening and anxiety provoking total loss of recent memory; learning process is completely blocked. Memory disturbances are involved

transient global amnesia

123

Transient global amnesia temporary duration is __ to __ hours

1 to 6 hours

124

5 precipitating events to transient global amnesia

1. stress or emotional events
2. swimming
3. immersion in cold water
4. driving a motor vehicle
5. sexual intercourse.

125

Transient global amnesia patient may have experienced _____ on previous occasions, usually without nausea, vomiting or photosensitivity

migraine headaches

126

T or F. Transient globa amnesia is treatable

F

127

Degeneration of peripheral nerves

peripheral neuritis

128

Another name for peripheral neuritis

neuropathy

129

Peripheral neuritis is caused by toxicity of what 6 vthings

1. chronic alcohol intoxication
2. arsenic
3. lead
4. carbon disulfide
5. benzene
6. phosphorus

130

2 other causes for peripheral neuritis

1. infections
- mumps
- pneumonia
- diphtheria
2. metabolic or inflammatory disorders
- diabetes
- rheumatoid arthritis
- gout
- systemic lupus erythematosus

131

2 physiologic causes of headache

1. tension headache
2. vascular headache

132

Headache strain on facial, neck and scalp muscles

tension

133

Headache caused by edema within the blood vessels of the head resulting in change in arterial size

vascular

134

Type of preparation taken at the first sign of a migraine to help

Ergot preparation

135

Symptoms of migraine other than a headache

nausea
anorexia
visual symptoms

136

Seizure that arises from a localized area in the brain

partial seizure

137

Seizure where there is diffuse electrical abnormality within the brain

generalized seizure

138

Prolonged seizure activity – one seizure follows another with no recovery of consciousness between attacks

status epilepticus

139

Families of drugs to treat peripheral neuritis

anticonvulsants and tricylic antidepressants

140

Pain of the area innervated by the fifth cranial (trigeminal) nerve, the trigeminal nerve

trigeminal neuralgia

141

Another name for trigeminal neuralgia

tic doloureux

142

Trigeminal neuralgia may be related to compression of a _____ by a tumor or vascular lesion

nerve root

143

Trigeminal neuralgia is a sequela to _____ or _____

multiple sclerosis or herpes zoster

144

Families of drugs to treat trigeminal neuralgia

analgesics, anticonvulsants or muscle relaxants

145

Disorder of facial nerve that causes a sudden onset of weakness or paralysis

Bell's palsy

146

Symptoms of Bell's palsy result from blockage of impulses from the cranial nerve # __ caused by compression of the nerve in the bony canal

7th cranial (facial) nerve

147

_____ has been noted in a small percentage of people with Lyme disease

bilateral facial paralysis

148

T or F. Early treatment is critical in Bell's palsy

T

149

Procedure to stimulate the nerve and prevent muscle atrophy in Bell's palsy

electrotherapy

150

4 other treatments for Bell's palsy

1. warm moist heat
2. gentle massage
3. facial exercise to stimulate muscle tone
4. prednisone

151

Inflammation of the meninges, the membranous coverings of the brain and spinal cord

meningitis

152

Meningitis can originate directly from which 3 areas?

1. brain
2. spinal cord
3. sinuses

153

3 bacteria most responsible for meningitis

1. Haemophilus influenza
2. Neisseria Meningitidis
3. Streptococcus pneumoniae

154

4 treatment options for meningitis

1. aggressive IV antibiotic therapy
2. anticonvulsants to control seizure
3. glucocorticoids to reduce cerebral inflammation and edema
4. aspirin and acetaminophen are used for headaches

155

Inflammation of brain tissue

encephalitis

156

3 types of encephalomyelitis

1. Eastern equine
2. Western equine
3. Venezuelan equine

157

Non-endemic encephalitis

West Nile viral encephalitis

158

Encephalitis is caused by viruses or the toxins from ____ or ____ from mosquito bites

chickenpox measles or mumps

159

Antiviral agents are effective against only ____ encephalitis

herpes simplex

160

4 encephalitis treatments

1. mild analgesics for pain,
2. antipyretic for elevated temperatures,
3. anticonvulsants for seizure activity
4. antibiotic for any intercurrent infection

161

4 recognizable disturbances associated with Parkinson's disease

1. pill rolling tremor
2. muscular rigidity
3. slowness of movement (shuffling gait)
4. postural instability

162

Acute rapidly progressive disease of the spinal nerves

Guillain-Barré syndrome

163

Guillain-Barré syndrome is on ____ but has more of a ____ process

autoimmune; infectious

164

Surgical treatment option for Parkinson's disease

deep brain stimulation

165

Guillain-Barre syndrome has been known to follow a _____ or gastroenteritis after 10-21 days

respiratory infection; gastroenteritis

166

Guillain-Barré syndrome is associated with _____ of the nerves

demyelination

167

To treat Guillain-Barré syndrome, _____ washes the plasma to remove antibodies, thereby shortening the time required for recovery

plasmapheresis

168

IV ____ may be beneficial in treating Guillain-Barré syndrome

immunoglobulin

169

Collection of pus can occur anywhere in the brain tissue

brain abscess

170

CNS abscesses may be the result of _____ or _____ infections elsewhere in the body

local or secondary

171

3 common causative organisms for brain abscess

1. Staphylococci
2. Streptococci
3. Pneumococci

172

Brain abscess can be caused by ______ including head trauma and a craniotomy wound, or a port of entry for microorganism

breaches in the integrity of CNS

173

2 drugs to treat brain abscess

1. IV antibiotics to resolve infection
2. Mannitol or steroids are to reduce cerebral edema

174

Drainage of the brain abscess may be necessary to relieve _____ and to _____ the offending organism

intracranial pressure; culture

175

Viral infection of the anterior horn cells of the gray matter of the spinal cord and causes a selective destruction of the motor neurons

poliomyelitis

176

Another name for poliomyelitis

Postpolio syndrome

177

In poliomyelitis, ____ enters the body through the nose and throat and crosses into the gastrointestinal tract

poliovirus

178

In poliomyelitis, poliovirus reproduces in the ____ and travels in the ____

lymphoid tissue; bloodstream

179

In poliomyelitis, poliovirus travels to CNS where the virus assaults the ____ of the ____

motor neurons of the spinal cord

180

Poliomyelitis is transmitted from person to person by ____ or ____

infected oropharyngeal secretion or feces that contain the virus

181

2 types of polio vaccines

1. inactivated polio vaccine (IPV)
2. oral poliovirus vaccine (OPV)

182

3 different serotypes of polio virus

Type1
Type2
Type 3

183

_____ vaccine and ____ vaccine afford immunity from all 3 forms of poliomyelitis

sabin trivalent oral vaccine; salk vaccine

184

Ceaseless, uncontrolled, involuntary movements (Huntington's)

chorea

185

T or F. Huntington's chorea causes personality changes

T

186

T or F. Mind functioning is affected in ALS

F; the main result of ALS is muscular atrophy

187

Peripheral neuritis typically affects the ____ of the ____

distal muscles of the extremities

188

Peripheral neuritis leads to muscle ____ and sensory ____

weakness; loss

189

Surgical treatment for trigeminal neuralgia to alleviate pain

dissection of nerve root

190

T or F. Bell's palsy is usually bilateral

F; usually unilateral

191

What must be ruled out before treating Bell's palsy

CVA

192

Key symptom of meningitis

stiff neck

193

Stiffness of the neck that resists any sideways or flexion-extension movement

nuchal rigidity

194

2 diagnostic signs of meningitis

1. Kernig's sign
2. Brudzinski's sign

195

2 types of meningitis

1. bacterial
2. viral (less serious)

196

Type of causative pathogen for encephalitis

virus, but can be caused by toxins from chickenpox, measles, or mumps

197

In Guillain-Barre Syndrome, symptoms start at ___ and ___

feet and hands

198

In Guillain-Barre Syndrome, progressive muscle weakness and paralysis follows in ___ to ___ hours

24 to 72 hours

199

Guillain-Barre is on an autoimmune basis but can also follow a ____ or ____

respiratory infection; gastroenteritis

200

A lumbar puncture contraindicates when diagnosing a brain access because the increased ICP can cause the ____ to ____, causing death

brainstem to herniate

201

Type of neurons selectively destroyed in poliomyelitis

motor neurons

202

Postpolio syndrome typically appears ___ years or more after the original infection in a person who has had polio

30