Ch. 7 Neurological System Disorders

Question 1

Common symptoms of a middle cerebral artery (MCA) CVA

Answer 1

contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia (usually left MCA), apraxia (usually left MCA), spatial dysfunction (usually right CVA)

Question 2

common symptoms of internal carotid artery CVA

Answer 2

similar symptoms as MCA: contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia (usually left MCA), apraxia (usually left MCA), spatial dysfunction (usually right CVA)

Question 3

common symptoms of anterior cerebral artery (ACA) CVA

Answer 3

contralateral hemiplegia, grasp reflex, incontinence, confusion, or alexia

Question 4

common symptoms of posterior cerebral artery CVA

Answer 4

homonymous hemianopsia, thalamic pain, hemi-sensory loss, or alexia

Question 5

common symptoms of vertebrobasilar CVA

Answer 5

pseudobulbar signs (dysarthria, dysphagia, emotional instability), tetraplegia

Question 6

common symptoms of left CVA

Answer 6

the following are affected: movement on R side, processing sensory information on R side, visual reception from R field, visual verbal processing, bilateral motor praxis, verbal memory, bilateral auditory reception, speech, processing of verbal auditory information

Question 7

common symptoms of right CVA

Answer 7

the following are affected: L-sided movement, processing L-side sensory information, visual reception from L field, visual spatial processing, L motor praxis, nonverbal memory, attention to incoming stimuli, emotional lability, processing of nonverbal auditory information, interpretation of abstract information, interpretation of tonal inflections

Question 8

ASIA level A

Answer 8

complete, no sensory or motor function is preserved in the sacral segments S4-S5

Question 9

ASIA level B

Answer 9

incomplete, sensory but no motor function is preserved below the neurological level and extends through sacral segments

Question 10

ASIA level C

Answer 10

incomplete, motor function is preserved below the neurological level, and the majority of key muscle groups below the neurological level have a muscle grade less than 3/5

Question 11

ASIA level D

Answer 11

incomplete, motor function is preserved below the neurological level, and the majority of key muscle groups below the level have a muscle grade greater than or equal to 3/5

Question 12

ASIA level E

Answer 12

normal, sensory and motor function are normal

Question 13

Brown Sequard symptoms

Answer 13

ipsilateral: paralysis, loss of position sense (prop), loss of discriminative touch
contralateral: loss of pain, loss of thermal sense

Question 14

anterior cord SCI symptoms

Answer 14

bilateral loss of motor function, pain, pinprick, and temperature sensation below lesion
proprioception and light touch are preserved :)

Question 15

posterior cord SCI symptoms

Answer 15

loss of proprioception
motor function is preserved in varying degrees
pain, temperature, and touch are preserved :)

Question 16

Conus medullaris SCI symptoms

Answer 16

lower extremity motor and sensory loss and an areflxic bowel and bladder.
reflexes are occasionally preserved IF lesion is in sacral section

Question 17

cauda equina syndrome symptoms

Answer 17

LMN lesion; flaccid paralysis with no spinal reflex activity

areflexic bowel and bladder

Question 18

Describe decorticate positioning

Answer 18

Upper extremities are in spastic flexed position with internal rotation and adduction. Lower extremities are in spastic extended position, internally rotated, and adducted.

Question 19

Describe decerebrate positioning

Answer 19

Upper and lower extremities are in spastic extension, adduction, and internal rotation. Wrist and fingers flex, plantar portions of the feet flex and invert, the trunk extends, and the head retracts.

Question 20

What reflexes are impacted with TBI?

Answer 20

• Impaired righting reflexes observed with midbrain damage

- Absence of equilibrium reactions and protective extension with basal ganglia damage

Question 21

What does a Glasgow coma score of 8 indicate?

Answer 21

Scores below 8 indicate a severe brain injury.

Question 22

What does a Glasgow coma score of 10 indicate?

Answer 22

Scores between 9 and 12 indicate a moderate brain injury.

Question 23

What does a Glasgow coma score of 14 indicate?

Answer 23

Scores above 14 indicate a minor brain injury.

Question 24

What 3 areas does the Glasgow Coma Score assess?

Answer 24

eye opening, verbal responses, and motor responses

Question 25

Describe function at a Ranchos Los Amigos Level I

Answer 25

No response: is completely unresponsive to any stimuli presented

Question 26

Describe function at a Ranchos Los Amigos Level II

Answer 26

Generalized response: exhibits inconsistent and nonpurposeful reac- tions to stimuli

Question 27

Describe function at a Ranchos Los Amigos Level III

Answer 27

Localized response: reacts specifically to stimuli, though inconsis- tently

Question 28

Describe function at a Ranchos Los Amigos Level IV

Answer 28

Confused/agitated: has heightened state of activity with severely de- creased ability to process information

Question 29

Describe function at a Ranchos Los Amigos Level V

Answer 29

Confused, inappropriate nonagitated: appears alert with fairly consis- tent reactions, although increased complexity of commands causes more ran- dom responses

Question 30

Describe function at a Ranchos Los Amigos Level VI

Answer 30

Confused, appropriate: exhibits goal-directed behavior but is depen- dent on external input for direction

Question 31

Describe function at a Ranchos Los Amigos Level VII

Answer 31

Automatic/appropriate: behaves appropriately and is oriented to place and routine but frequently displays shallow recall

Question 32

Describe function at a Ranchos Los Amigos Level VIII

Answer 32

Purposeful and appropriate: is alert and oriented and able to re- call and integrate past and recent events. Each level (VIII, IX, and X) represents a decreasing need for assistance with routine daily living skills.