STUDY GUIDE NEURO Flashcards
(42 cards)
A communicating hydrocephalus is caused by an impairment of the:
a. Cerebrospinal fluid flow between the ventricles
b. Cerebrospinal fluid flow into the subarachnoid space
c. Blood flow to the arachnoid villi
d. Absorption of cerebrospinal fluid
ANS: D
Hydrocephalus from impaired absorption outside the ventricles is called communicating (extraventricular) hydrocephalus. The other options do not accurately describe the cause of a communicating hydrocephalus.
Which edema is most often observed with noncommunicating hydrocephalus?
a. Metabolic c. Vasogenic
b. Interstitial d. Ischemic
ANS: B
Interstitial edema is observed most often with noncommunicating hydrocephalus.
Which dyskinesia involves involuntary movements of the face, trunk, and extremities?
a. Paroxysmal c. Hyperkinesia
b. Tardive d. Cardive
ANS: B
Tardive dyskinesia is the involuntary movement of the face, trunk, and extremities. The other terms do not describe involuntary movements of the face, trunk, and extremities.
Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of increased:
a. Dopamine c. Norepinephrine
b. Gamma-aminobutyric acid d. Acetylcholine
ANS: A
The antipsychotic drugs cause denervation hypersensitivity, which mimics the effect of too much dopamine. None of the other options produce such an affect.
The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to the:
a. Lower midbrain c. Supratentorial
b. Pontine area d. Cerebral area
ANS: A
Central reflex hyperpnea, which is a sustained deep and rapid but regular respiratory pattern that is the result of central nervous system (CNS) damage or disease, involves the lower midbrain and upper pons. This neurologic injury is observed after increased intracranial pressure and blunt head trauma.
The body compensates for a rise in intracranial pressure by first displacing the:
a. Cerebrospinal fluid c. Venous blood
b. Arterial blood d. Cerebral cells
ANS: A
A rise in intracranial pressure necessitates an equal reduction in the volume of the other contents.
What group is most at risk of spinal cord injury from minor trauma?
a. Children c. Adults
b. Adolescents d. Older adults
ANS: D
Because of preexisting degenerative vertebral disorders, older adults are particularly at risk for minor trauma, resulting in serious spinal cord injury, especially from falls.
The edema of the upper cervical cord after spinal cord injury is considered life threatening because of which possible outcome?
a. Hypovolemic shock from blood lost during the injury
b. Breathing difficulties from an impairment to the diaphragm
c. Head injury that likely occurred during the injury
d. Spinal shock immediately after the injury
ANS: B
In the cervical region, spinal cord swelling may be life threatening because of the possibility of resulting impairment of the diaphragm function (phrenic nerves exit C3-C5).
What indicates that spinal shock is terminating?
a. Voluntary movement below the level of injury
b. Reflex emptying of the bladder
c. Paresthesia below the level of injury
d. Decreased deep tendon reflexes and flaccid paralysis
ANS: B
Indications that spinal shock is terminating include the reappearance of reflex activity, hyperreflexia, spasticity, and reflex emptying of the bladder
What term is used to describe the complication that can result from a spinal cord injury above T6 that is producing paroxysmal hypertension, as well as piloerection and sweating above the spinal cord lesion?
a. Craniosacral dysreflexia c. Autonomic hyperreflexia
b. Parasympathetic dysreflexia d. Retrograde hyperreflexia
ANS: C
Individuals most likely to be affected have lesions at the T6 level or above. Paroxysmal hypertension (up to 300 mm Hg systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and bradycardia (30 to 40 beats/minute) characterize autonomic hyperreflexia.
Autonomic hyperreflexia–induced bradycardia is a result of stimulation of the:
a. Sympathetic nervous system to ß-adrenergic receptors to the sinoatrial node
b. Carotid sinus to the vagus nerve to the sinoatrial node
c. Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
d. Bundle branches to the -adrenergic receptors to the sinoatrial node
ANS: B
The intact autonomic nervous system reflexively responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral vessels, the carotid sinus, and the aorta sense the hypertension and stimulate the parasympathetic system. The heart rate decreases, but the visceral and peripheral vessels do not dilate because efferent impulses cannot pass through the cord.
A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
a. L2-L3 c. L5-S1
b. L3-L5 d. S2-S3
ANS: C
Clinical manifestations of posterolateral protrusions include radicular pain exacerbated by movement and straining (medial calf suggests L5; lateral calf suggests S1 root compression).
A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli?
a. Middle cerebral c. Posterior cerebral
b. Vertebral d. Anterior cerebral
ANS: D
Symptoms of an embolic stroke in only the right anterior cerebral artery would include left-sided contralateral paralysis or paresis (greater in the foot and thigh) and mild upper extremity weakness with mild contralateral lower extremity sensory deficiency with loss of vibratory and/or position sense and loss of two-point discrimination.
Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
a. Embolic c. Lacunar
b. Hemorrhagic d. Thrombotic
ANS: C
A lacunar stroke (lacunar infarct) is a microinfarct smaller than 1 cm in diameter. Because of the subcortical location and small area of infarction, these strokes may have pure motor and sensory deficits.
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
a. Hemorrhagic c. Embolic
b. Thrombotic d. Lacunar
ANS: C
High-risk sources for the onset of embolic stroke are atrial fibrillation (15% to 25% of strokes), left ventricular aneurysm or thrombus, left atrial thrombus, recent myocardial infarction, rheumatic valvular disease, mechanical prosthetic valve, nonbacterial thrombotic endocarditis, bacterial endocarditis, patent foramen ovale, and primary intracardiac tumors.
Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
a. Intracranial c. Epidural
b. Subarachnoid d. Subdural
ANS: B
Assessment findings related to only a subarachnoid hemorrhage include meningeal irritation and inflammation, causing neck stiffness (nuchal rigidity), photophobia, blurred vision, irritability, restlessness, and low-grade fever. A positive Kernig sign, in which straightening the knee with the hip and knee in a flexed position produces pain in the back and neck regions, and a positive Brudzinski sign, in which passive flexion of the neck produces neck pain and increased rigidity, may appear.
In adults, most intracranial tumors are located:
a. Infratentorially c. Laterally
b. Supratentiorially d. Posterolaterally
ANS: A
Approximately 70% to 75% of all intracranial tumors diagnosed in adults are located supratentorially (above the tentorium cerebella).
Spinal cord injuries most likely occur in which region?
a. Cervical and thoracic c. Lumbar and sacral
b. Thoracic and lumbar d. Cervical and thoracic-lumbar
ANS: D
Vertebral injuries most often occur at vertebrae C1-C2 (cervical), C4-C7, and T1-L2 (thoracic lumbar).
The most likely rationale for body temperature fluctuations after cervical spinal cord injury is that the person has:
a. Developed bilateral pneumonia or a urinary tract infection.
b. Sustain sympathetic nervous system damage resulting in disturbed thermal control.
c. Sustained a head injury that damaged the hypothalamus’s ability to regulate temperature.
d. Developed septicemia from posttrauma infection.
ANS: B
Spinal cord injuries result in disturbed thermal control because the sympathetic nervous system is damaged.
A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia. He reports severe head pain and blurred vision. The most likely explanation for these clinical manifestations is that he is:
a. Experiencing acute anxiety
b. Developing spinal shock
c. Developing autonomic hyperreflexia
d. Experiencing parasympathetic areflexia
ANS: C
Autonomic hyperreflexia is the only option that is characterized by paroxysmal hypertension (up to 300 mm Hg systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and bradycardia (30 to 40 beats per minute).
Which neurotransmitter is reduced in people with schizophrenia?
a. Dopamine c. Acetylcholine
b. Gamma-aminobutyric acid d. Serotonin
ANS: B
In the dorsal prefrontal cortex of schizophrenic brains, glutamic acid decarboxylase, the major enzyme in gamma-aminobutyric acid GABA biosynthesis, is diminished, which likely impairs synaptic performance and cognitive and behavioral functions associated with this brain region.
Which would be considered a positive symptom of schizophrenia?
a. Blunted affect c. Poverty of speech
b. Auditory hallucinations d. Lack of social interaction
ANS: B
Positive symptoms frequently occur during a psychotic episode, when an individual loses touch with reality and experiences something that should be absent (e.g., hallucinations).
Alterations in which part of the brain are linked to hallucinations, delusions, and thought disorders associated with schizophrenia?
a. Parietal lobe c. Temporal lobe
b. Limbic system d. Hypothalamus
ANS: C
.
Only temporal lobe alterations may be responsible for the production of positive schizophrenic symptoms, such as hallucinations, delusions, thought disorders, and bizarre behavior.
The link between major depression and cortisol secretion is that individuals with depression:
a. Show suppression of plasma cortisol when given dexamethasone.
b. Have a decreased plasma cortisol level, despite the administration of exogenous corticosteroids.
c. Show that persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression.
d. Have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed.
ANS: C
.
Persistent elevations in cortisol may also induce immunosuppression that compromises the body’s immune systems to contain inflammation and infectious diseases. Increasing evidence suggests that inflammation is another risk factor that triggers the onset of depression.
