Chaper 18-Disorders of the Central and Periperhal Nervous Systems and the Neuromuscular Junction

Question 1

An alteration in brain function or other evidence of brain pathology caused by an external force

Answer 1

Traumatic Brain Injury

Question 2

Classifications of Primary Brain Injury:

(1) affects one are of the brain
(2) affects more than one area of the brain

Answer 2

Focal

Diffuse

Question 3

Injury at site of impact

Answer 3

Coup Injury

Question 4

Injury from brain rebounding and hitting opposite side of skull

Answer 4

Contrecoup Injury

Question 5

LOC followed by a lucid period, Increasingly severe HAs, N/V, drowsiness, confusion, seizure, and hemiparesis. Medical Emergency

Answer 5

Epidural Hematoma

Question 6

Headache, drowsiness, restlessness or agitation, slowed cognition, and confusion

Answer 6

Subdural Hematoma

Question 7

Treatment for Subdural Hematoma

Answer 7

Burr Hole to remove clot

Question 8

Damage to delicate axonal fibers and white matter tracts that project to the cerebral cortex

Answer 8

Concussion

Question 9

Loss of the continuous tonic discharge from the brain or brainstem and an inhibition of suprasegmental impulses, complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control, transient drop in blood pressure and poor venous circulation, loss of thermal control, causing the body to assume air temperature, resolving when reflexes return or bladder relaxes

Answer 9

Spinal Shock

Question 10

4 clinical manifestations of Neurogenic Shock

Answer 10

Vasodilation
Hypotension
Bradycardia
Hypothermia

Question 11

Syndrome of sudden massive reflex sympathetic discharge associated with a spinal cord injury at the T6 or above

Answer 11

Autonomic Dysreflexia

Question 12

Autonomic Dysreflexia BP =

Answer 12

up to 300 mmHg systolic

Question 13

Treatment for Autonomic Dysreflexia

Answer 13

1) elevate HOB
2) Stimulus should be found and removed (empty bladder or bowel)
3) Administer topical nitro paste above the level of the lesion

Question 14

Three types of strokes

Answer 14

Hemorrhagic
Ischemic
Crytogenic

Question 15

Congenital abnormality and degenerative changes

Answer 15

Saccular (berry) aneurysms

Question 16

Diffuse arteriosclerotic changes:

Answer 16

Fusiform (giant) aneurysms

Question 17

Arteritis caused by bacterial emboli

Answer 17

Mycotic Aneurysms

Question 18

What type of hemorrhage would you find a Positive Kernig and Brudzinski sign?

Answer 18

Subarachnoid Hemmorhage

Question 19

When thigh is flexed a the hip and knee @ 90 degree then subsequent extension in the knee is painful

Answer 19

Kernig’s Sign

Question 20

What would a positive Kernig sign show

Answer 20

May indicate Subarachnoid Hemorrhage or Bacterial Meningitis

Question 21

What is a positive Brudzinski sign

Answer 21

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed

Question 22

What would positive Brudzinski sign show

Answer 22

Bacterial Meningitis

Question 23

Progressive, chronic, inflammatory, demyelinating autoimmune disorder of the CNS (affects more women)

Answer 23

Multiple Sclerosis

Question 24

Acquired, acute inflammatory autoimmune disease causing demyelination of the peripheral nerves or axonal disorder

Answer 24

Guillain-Barre Syndrome

Question 25

Treatment for Guillain-Barre Syndrome

Answer 25

Ventilator Support

IV immunoglobulin, plasmapharesis

Question 26

Has autoantibodies, defect in nerve impulse transmission at the neuromuscular junction

Answer 26

Myasthenia Gravis

Question 27

Tx for Myasthenia Gravis

Answer 27

Anticholinesterase drugs
Corticosteroids
Immunosuppressant drugs

Question 28

Treatment for Myasthenic crisis

Answer 28

Plasmapharesis