alterations in cognitive systems, cerebral hemodynamics, and motor function (2)

Question 1

_____: state of awareness of self, environment, and arousal

Answer 1

full (alert)

Question 2

awareness involves ____

Answer 2

cognitive functions (attentional, memory, language)

Question 3

______: awake but lack awareness

Answer 3

arousal

Question 4

priority neurological assessment

Answer 4

level of consciousness (LOC)

Question 5

changes in LOC are a critical index of what

Answer 5

nervous system function

Question 6

_____ centers regulate breathing pattern and are controlled by CO2; breathing changes arean alteration in arousal

Answer 6

lower brainstem

Question 7

________: abnormal rhythm of breathing with alternating periods of hyperventilation and apnea

Answer 7

posthyperventilation apnea (cheyne-stokes respirations)

(increased rate - decreased rate - apnea - increased rate)

Question 8

name some motor responses that are considered alterations is arousal

Answer 8

• vomiting, yawning, hiccupping (involve the medulla)

Question 9

what does vomiting without nausea indicate

Answer 9

direct involvement of the CNS

Question 10

______: cannot communicate through speech or body movement but is conscious and cognition is intact

Answer 10

irreversible coma (locked-in syndrome)

Question 11

what is brain death criteria

Answer 11

• unresponsive coma, no spontaneous respirations (apnea), no brainstem function
• flat brain activity for 6-12 hours from an EEG

Question 12

____: cannot recognise objects (tactile, visual, auditory)

Answer 12

agnosia

Question 13

______: cannot comprehend or produce speech

Answer 13

aphasia/dysphasia

(treatment - speech therapy)

Question 14

_______: ACUTE deficits in attention, thoughts, actions

Answer 14

delirium

(treatment - identify cause)

Question 15

name some common causes of delirium

Answer 15

post-operation infection, UTI in the elderly

(drugs, metabolic disorders, nervous system disease)

Question 16

_____: CHRONIC, PROGRESSIVE failure of cerebral functions limiting memory, speech, and behavior

Answer 16

dementia

(no cure)

Question 17

most common form of dementia

Answer 17

alzheimer’s

Question 18

name common risk factors for alzheimer’s

Answer 18

• age/family history
• presents with neurofibrillary tangles and neuritic plaques on CT scan
• loss of acetylcholine

Question 19

______: increase in the fluid within the brain tissue (intracellular or extracellular)

Answer 19

cerebral edema

Question 20

_____ cerebral edema: related to blood vessels and blood flow

Answer 20

vasogenic

Question 21

____ cerebral edema: toxins

Answer 21

cytotoxic

Question 22

_____ cerebral edema: increased fluid around brain tissue

Answer 22

interstitial

Question 23

normal cranial pressure

Answer 23

5-15 mmHg

Question 24

name the four stages of increased intracranial pressure

Answer 24

pre-stage 1: cerebrospinal fluid is displaced to maintain ICP
stage 1: compensation phase (vasoconstriction and external compression compensations may maintain elevation in ICP)

stage 2: more pressure

stage 3: brain hypoxia and loss of brain autoregulation

stage 4: brain herniation (shifting of brain tissue that disrupts blood flow and damages brain tissue)

Question 25

______: excess fluid accumulates within the cerebral ventricles, subarachnoid space, or both

Answer 25

hydrocephalus

Question 26

______ hydrocephalus: due to obstruction of CSF inside ventricles

Answer 26

noncommunicating (obstructive)

Question 27

______ hydrocephalus: due to impaired reabsorption of CSF

Answer 27

communicating (nonobstructive)

Question 28

_______ hydrocephalus: due to injury (head injury)

Answer 28

acute

Question 29

________: weakness; partial paralysis

Answer 29

paresis

Question 30

______: loss of motor function

Answer 30

paralysis

Question 31

_____: lower motor neuron syndrome where extremities have no muscle tone

Answer 31

flaccid paresis/paralysis

Question 32

_____: lower motor neuron syndrome that presents with decreased reflexes

Answer 32

hyporeflexia/ areflexia

Question 33

what can disorders of posture be caused by (2)

Answer 33

disease or severe head injury

Question 34

____ posture: flexion of extremities

Answer 34

decorticate

Question 35

_____ posture: rigid extension of extremities

Answer 35

decerebrate

Question 36

_____: loss of voice control (disorder of expression)

Answer 36

hypomimesis

Question 37

_____ hypomimesis: produce speech but not comprehend

Answer 37

expressive

Question 38

______ hypomimesis: cannot comprehend tone of speech

Answer 38

receptive

Question 39

______: abnormal, involuntary movements that occur as spasms

Answer 39

dyskinesias

Question 40

_____ dyskinesias: rapid, repetitive movements of face, arms, and trunk

Answer 40

tardive (adverse effect from taking antipsychotic drugs)

Question 41

Parkinson disease is a LOSS of _______ cells in basal ganglia

Answer 41

dopamine-producing cells

Question 42

name some manifestations of Parkinson disease

Answer 42

- wide-eyed, unblinking, staring expression with immobile facial muscles -flexed and abducted arms held stiffly at the side (muscle stiffness) - bradykinesia (decreased movement) and akinesia (no movement) - resting tremor - dementia, depression

Question 43

________: progressive, inflammatory degeneration of the upper/lower motor neurons in the CNS

Answer 43

amyotrophic lateral sclerosis (Lou Gehrig disease) (treatment = no cure, may prolong life for months only)

Question 44

name some manifestations of amyotrophic lateral sclerosis

Answer 44

- voluntary and involuntary muscle function is affected BUT cognition remains intact until death - progressive muscle weakness leads to respiratory failure

Question 45

name two demyelinating disorders (damage to the myelin sheath)

Answer 45

- multiple sclerosis (CNS demyelination) - Guillain-Barre syndrome (PNS demyelination)

Question 46

name some common causes for demyelinating disorders

Answer 46

- genetics - viral infections - autoimmune reactions - environmental toxins

Question 47

_____: acute inflammatory, autoimmune disease (demyelinating disorder)

Answer 47

Guillain-Barre Syndrome

Question 48

S/S of Guillain-Barre syndroms

Answer 48

rapid onset of ascending motor paralysis

Question 49

_________: chronic autoimmune disease that limits nerve impulse and NM junction (IgG antibody produced against acetylcholine receptors)

Answer 49

myasthenia gravis

Question 50

manifestations of myasthenia gravis disease

Answer 50

- Descending paralysis (starts in face and moves to respiratory system) - Weakness / fatigue of face and throat = diplopia, difficulty talking and swallowing - Weakness / fatigue worsens with activity and improves with rest -Myasthenic crisis -Cholinergic crisis

Question 51

_____: manifestation of myasthenia gravis that presents as severe muscle weakening, leading to respiratory distress

Answer 51

myasthenic crisis

Question 52

______: manifestation of myasthenia gravis that looks like myasthenic crisis but occurs minutes after taking anticholinergics

Answer 52

cholinergic crisis