Chapter 18 Flashcards
meningitis
clinical manifestations
_________, ________
kernig sign
brudzinski sign
multiple sclerosis
______ and _______ of the central nervous system.
Various mechanisms cause irreversible tissue damage of the CNS (inflammation, _______ injury, demyelination, scarring or _____ formation, and ____ degeneration) that characterizes multiple sclerosis
MS is described as occurring when a ____ infectious insult to the CNS has occurred in a ______ susceptible individual with a subsequent abnormal immune response in the CNS
demyelination, inflammation oligodendrocyte plaque axonal previous genetically
classic cerebral concussion Grade IV Physiologic and neurologic dysfunction without substantial anatomic disruption Loss of \_\_\_\_\_\_\_\_ (<6 hours) \_\_\_\_\_\_ and \_\_\_\_\_\_ amnesia Uncomplicated (no focal injury) Complicated (focal injury)
consciousness
anterograde
retrograde
Clinical manifestationsimmediately noted after a spinal cord injury
A complete loss of ____ function in all segments ____ the level of the lesion characterizes a spinal cord injury. Severe impairment below the level of the lesion is obvious; it includes ____ and _____ in muscles, absence of _____, loss of ____ and rectal control, transient ___in blood pressure, and poor _____circulation.
reflex below paralysis flaccidity sensation bladder drop venous
abscess
Abscesses may occur in association with a contiguous spread of infection, such as the ______, _____cells, ____ cavity, and nasal _____
middle ear
mastoid
nasal
sinuses
demyelinating disorders
types
CNS: _______ is an autoimmune disorder diffusely involving the degeneration of CNS myelin and loss of axons
multiple sclerosis
tick borne spirochete bacterial infection
lyme disease
neuromuscular junction disorders
myasthenia gravis
Chronic ____ disease
__ antibody produced against _______ receptors on the postsynaptic membrane
autoimmune
IgG
acetylcholine
mild concussion
mild but traumatic brain injury
immediate but transitory effects
Temporary _____ disturbances, causing _____ and ______ deficits but no loss of consciousness in grades I and II
Grade I—_______, ________, and momentary _____, resolving within __ minutes
Grade II—Momentary _____ and retrograde _____
Grade III—Confusion with retrograde and ______amnesia upon and after impact; loss of consciousness for seconds or minutes
axonal attention memory confusion, disorientation, amnesia 15 confusion amnesia anterograde
faulty control of sweating
A spinal cord injury results in disturbed thermal control because the ______ is unable to regulate a damaged _______ nervous system.
This damage causes faulty control of _____ and ______ through capillary dilation.
hypothalamus
sympathetic
sweating
radiation
Diffuse Axonal Injuries DAIs
Focal brain injuries account for more than ____s of head injury deaths; DAIs accounts for less than _____
However, more severely disabled survivors, including those in an _______ state or reduced level of consciousness, have DAIs.
2/3
1/3
unresponsive
encephalitis
most common form: caused by ___________ (mosquito borne) and ________ virus
arthropodborne
herpes simplex
___-___motor and sensory changes of the lateral ____ legs and __ of the feet
Clinical manifestations of posterolateral protrusions include radicular pain exacerbated by movement and straining (medial calf suggests __; lateral calf suggests ___ root compression).
L5-S1
legs, soles
L5
S1
neurologic complications of AIDs
Opportunistic infections- Opportunistic infections may be bacterial, fungal, protozoal, or viral in origin and produce nervous system disease. ____________s an example of such an infection.
Parasitic infection
__________: Most common
cryptococcus neoformans
toxoplasmosis
cerebrovacular accident
greatest risk factor
hypertension
Upper cervical cord after spinal cord injury
In the cervical region, spinal cord _____ may be life threatening because of the possibility of resulting impairment of the _____ function (phrenic nerves exit . _____).
swelling
diaphragm
c3-c5
The most likely rationale for body temperature fluctuations after cervical spinal cord injury is
Spinal cord injuries result in disturbed thermal control because the _______ nervous system is damaged.
sympathetic nervous system
spinal cord injury
Primary spinal cord injury (cont’d)
Most common locations are cervical (_____) and thoracic-lumbar (____) vertebrae.
1,2, 4-7
T1-L2
lacunar stroke
_______ is smaller than 1 cm in diameter and involves the occlusion of the small ______ arteries.
Microinfarcts resulting in pure ___ or pure _____ deficits
Because of the _____ location and small area of infarction, these strokes may have pure motor and sensory deficits.
microinfarction
perforating
motor, sensory
subcortical
cerebrovascular accident
depend on the ____ affected
contralateral weakness in ___, ____ and or _____
artery
arms, legs, face
__________ is the most common and serious form of
CNS tuberculosis.
tubercular meningitis
Symptoms of an embolic stroke in only the ___ anterior cerebral artery
Would include ___-sided contralateral _____ or ____ (greater in the foot and thigh) and mild upper extremity _____with mild contralateral lower extremity _____ deficiency with loss of vibratory and/or position sense and loss of two-point discrimination.
right left paralysis paresis weakness sensory
parasitic infection
Toxoplasmosis is the most common opportunistic infection and occurs in approximately one third of individuals with ___
AIDs
Diffuse Brain Injury
concussion
Classic concussion:
Transient cessation of respiration can occur with brief periods of _______, and a ______ in blood pressure occurs, lasting __ seconds or less. Vital signs stabilize within a few ______ to within normal limits.
bradycardia
decrease
30
seconds
spinal cord injury
clinical manifestations
Loss of ____ control, causing the body to assume ___temperature
thermal
air
embolic ischemic stroke
High-risk sources for the onset of embolic stroke are ______ (_% to _% of strokes), left ventricular _______ or thrombus, left ____ thrombus, recent ___, ______ valvular disease, mechanical prosthetic ____, nonbacterial thrombotic _____, ______ endocarditis, ___ foramen ovale, and primary _____ tumors.
atrial fibrillation 15, 25 aneurysm atrial MI rheumatic valve endocarditis bacterial patent intracardiac
older adults
Because of preexisting degenerative _____ disorders, older adults are particularly at risk for _____ trauma, resulting in serious spinal cord injury, especially from ____
vertebral
minor
falls
migraine headache
Migraine is diagnosed when it is not attributable to any other disorder and when any two of the following features occur: _____ head pain, _____ pain, pain worsening with ____ moderate or severe pain intensity; and at least one of the following: nausea or _____, or both, or _____ and phonophobia
unilateral pulsating activity vomiting photophobia
guillan-barre syndrome
____, _____ inflammatory autoimmune disease causing demyelination of the _____ nerves or axonal disorder. GBS is considered to be an ______ disease triggered by a preceding bacterial or viral infection.
acute, acquired
peripheral
autoimmune
headache sydromes
The cluster headache attack usually begins without warning and is characterized by severe, unilatera _____, _____ , periorbital, and retrobulbar or temporal pain lasting __ minutes to _hours
tearing, burning, periorbital
30, 2
