Pathophys ch22 ch23 Neuro Study Guide

Question 1

Beta 2-adrenergic receptors are primarily located in the?

Answer 1

lungs

Question 3

Define vegetative state

Answer 3

a loss of awareness and mental capabilities resulting from diffuse brain damage. Brain stem functions continue supporting respiratory and cardiovascular and autonomic functions

Question 5

List criteria for brain death

Answer 5

*cessation of brain function including function of the cortex and the brain stem (eg. a flat or inactive EEG) *Absence of brain stem reflexes or responses *Absence of spontaneous respirations when ventilation assistance is withdrawn. *Establishment of the certainty of irreversible brain damage by confirmation of the cause of the dysfunction by 2 MDs at 2 different times.

Question 7

Define aphasia

Answer 7

An inability to comprehend or to express language. (expressive/ receptive/ global)- Related to damage in Broca’s Area or Wernickes Area in left hemisphere. Regeneration or replacement of neurons does not occur in CNS

Question 9

An early indicator of increasing intracranial pressure is?

Answer 9

• Decreasing level of consciousness or responsiveness (lethargy).
• Severe headache/ vomiting/ papilledema.
• Increased CSF pressure and pulse pressure.

Question 11

Why does a brain tumor cause a headache?

Answer 11

result from increased ICP and compression of the adjacent optic chiasm/ nerves or tracts - resulting visual disturbances is common.

Question 13

Do primary brain tumors metastasize outside the CNS?

Answer 13

Not usually

Question 15

What are some of the benefits of transient ischemic attacks?

Answer 15

They are advantageous IF they serve as a warning and lead to early diagnosis and treatment of a problem before the occurance of a cerebrovascular accident (CVA or stroke)

Question 17

What is the probable source (structure) of an embolus casing CVA?

Answer 17

Thrombi may break off of an atheroma or mural thrombi may form inside the heart after a myocardial infarction then break away. An emboli can also result from tumors/ air/ infection

Question 19

List the characteristics of a stroke:

Answer 19

• sudden transient weakness/ numbness/ tingling in the face, arm or leg on one side of the body
• Temporary loss of speech/ failure to comprehend/ confusion
• sudden loss of vision *sudden severe headache
• unusual dizziness or unsteadiness
• immediate medical treatment may prevent permanent brain damage

Question 21

What would be the result if you had an occlusion of a left cerebral artery?

Answer 21

Contrilateral weakness in the leg or arms and impaired spacial relationship.

Question 23

Bacterial meningitis causes swelling and purulent exudates to form where in the brain?

Answer 23

covers the surface of the brain and fills the sulci causing the surface to appear flat.

Question 25

Significant signs of acute bacterial meningitis include:

Answer 25

• Severe headache/ back pain/ photophobia/ nuchal rigidity.
• Vomiting/ irritability/ lethargy/ stupor/ fever and chills.
• Meningococcal infections result in petechial rash or extensive ecchymoses over the body.
• Newborns have a high-pitched cry/ feeding problems/ irritability/ lethargy.
• Some cases caused by highly virulent organisms - DIC develops and vascular collapse/shock and death occurs.

Question 27

Describe the pathophysiology of Guillian-Barre

Answer 27

Known as postinfectious polyneuritis or acute idiopathic polyneuropathy or acute infectious polyradiculoneuritis.
It is an inflammatory condition of the peripheral nervous system. Local inflammation accompanied by accumulated lymphocytes and demyelination and axon destruction occur.
These changes cause impaired nerve conduction especially in the motor fibers.
The critical period is when the motor function of diaphragm and respiratory muscles become paralyzed.

Question 29

Secondary brain injury following a head injury is likely to occur because of?

Answer 29

• Additional effects of cerebral edema - hemorrhage - hematoma - cerebral vasospasm - infection - ischemia
• Systemic factors may be infection and hypoxia

Question 31

An epidural hematoma is located where?

Answer 31

between the dura and the skull.

Question 33

During the period of a spinal shock following a spinal injury at C5 possible effects would include what?

Answer 33

interfering with phrenic nerve innervation to the diaphragm and therefore affecting respiration.

Question 35

Where do cerebral aneurysms usually occur?

Answer 35

At the points of bifurcation on the circle of Willis.

Question 37

In a brain abscess what microorganisms are responsible for the abscess?

Answer 37

staphylococci/ streptococci/ pneumococci.

Question 39

Define encephalitis

Answer 39

Considered an infection of the parenchymal or connective tissue in the brain and cord particularly the basal ganglia.
Various viruses demonstrate an affinity for particular types of cells.

Question 41

Describe Reye’s sndrome

Answer 41

Linked to a viral infection such as influenza in young children that have been treated with asprin (ASA).
A noninflammatory cerebral edema develops leading to increased ICP.
Hepatomegaly occurs with fatty liver changes.

Question 43

Otorrhagia is

Answer 43

blood leaking from the ear through a fracture site with torn blood vessels and meninges.

Question 45

Which part of the brain controls the brain?

Answer 45

hypothalamas

Question 47

Treatment to reduce swelling and pressure in spinal injury?

Answer 47

Treatment and rehabilitation begin at the time of injury, immobilization of the spine/ maintain breathing/ prevent shock.
Traction or surgery may be required to relieve pressure and repair tissues.
Glucocorticoids help reduce inflammation.

Question 49

In noncommunicating hydrocephalus excess CSF accumulates because?

Answer 49

more is produced than absorbed often because of obstruction to the flow at some point.

Question 51

A myelomeningocele is?

Answer 51

Herniation of the spinal cord and nerves along with the meninges and CSF.
Result is considerable neurologic impairment. Most serious form of spina bifida.

Question 53

When and how can you assess for spina bifida?

Answer 53

The presence of spina bifida can be diagnosed prenatally by ultrasound.
Amniocentesis detects the presence of AFP that has leaked into the amniotic fluid surrounding the fetus.

Question 55

All individuals with cerebral palsy have what in common?

Answer 55

Some degree of motor impairment caused by brain damage in the prenatal period.
All children have altered mobility which provides the basis of classifying CP.

Question 57

Generalized seizures are characterized by?

Answer 57

Seizures lasts for 5-10 seconds. There is a brief loss of awareness and sometimes transient facial movements such as twitches of the eyelids or lip smacking.

Question 60

The course of multiple sclerosis is marked by?

Answer 60

progressive degeneration

Question 62

Common early signs of multiple sclerosis is marked by?

Answer 62

Blurred vision is a common early sign. Initially weakness in the legs often occurs resulting from plaques on the corticospinal tract.

Question 64

Discuss the patho of Parkinson’s

Answer 64

Dysfunctions of the extrapyramidal system occurs because of progressive degeneration in the basal nuclei especially the substantia nigra. A deficit of dopamine.

Question 66

What age group does Parkinson’s usually apply to?

Answer 66

Usually develops after 60 in both men and women.

Question 68

ALS is a progressive degeneration of?

Answer 68

Both upper motor neurons in the cerebral cortex and lower motor neurons in the brain stem and spinal cord.

Question 70

Discuss myasthenia gravis.

Answer 70

an autoimmune disorder that impairs the receptors for acetylcholine (ACh) at the neuromuscular junction

Question 72

Huntington’s disease presents with what physical mental abnormalities.

Answer 72

Mood swings and personality changes develop.

Restlessness and choriform (rapid, jerky) movements in the arms and face..

Question 74

With Alzheimer’s disease what are the characteristics changes in the brain?

Answer 74

Progressive corticol atrophy which leads to dilated ventricles and widening of the sulci.
Neurofibilary tangles that impair conduction.

Question 76

Typical characteristics of schizophrenia include:

Answer 76

Symptoms may be grouped as positive (delusions/ bizarre behavior) or negative (flat emotions/ decreased speech). Disorganized thought processes are the basic problem.
Short attention span.

Question 78

What physical problem would a herniated disc cause at the lumbar level?

Answer 78

Pain in the lower back radiating down the posterior aspect of one or both legs (sciatic nerve pain).
If nerve compression is extensive muscle weakness develops.
Interference with micturation (bladder emptying) may develop.

Question 80

Define herniated disc

Answer 80

protrusion of the nucleus pulposus (inner gelatinous component) of the intervertebrae disc through a tear in the annulus fibrous (tough outer covering of the disc).

Question 82

Define atheoid and choreiform cerebral palsy

Answer 82

involuntary movements and loss of coordination with fine movements.

Question 84

Drugs to treat seizures include

Answer 84

Anticonvulsant drugs such as phenytoin (Dilantin)

Question 86

Define status epilepticus

Answer 86

recurrent or continuous seizures without recovery of consciousness.

Question 88

Alzheimer’s disease has what characteristics

Answer 88

Personality changes/ lack of initiative/ repetitive behavior/ impairments in judgement/ abstract thinking and problem solving abilities.