chapter 19

Question 1

What is Wernick’s area in the brain associated with?

Answer 1

speech, new neural connections with repetitve movement. (constant stimulas of this area to recover better from stroke)

Question 2

Resptive aphasia

Answer 2

cant understand what saying

Question 3

express anaphsia

Answer 3

can’t express what they want to say

Question 4

anphasa

Answer 4

brain effect

Question 5

dysarthia

Answer 5

muscle effect

Question 6

Damage to left hemisphere

Answer 6

Loss of logical thinking ability, analytical skills, other intellectual abilities, communication skills

Question 7

Damage to right hemisphere

Answer 7

Impairs appreciation of music and art
Causes behavioral problems
Spatial orientation and recognition of relationships may be deficient
Self-care deficits common

Question 8

Visual Loss: Hemianopia

Answer 8

Depends on site of damage in visual pathway
Optic chiasm damage
Vision lost in both eyes if chiasm is totally destroyed
Partial loss
Depends on particular fibers damaged
Optic tract or occipital lobe damage
Loss of the visual field on the side opposite to that of the damage

Question 9

Hemorrhage

(vascular disorder)

Answer 9

Increased ICP will cause local ischemia and generalized symptoms.

Question 10

Global cerebral ischemia

(vascular disorder)

Answer 10

Impaired perfusion of entire brain
Loss of function and generalized cerebral edema
Brain death if not reversed quickly

Question 11

Transient Ischemic Attacks (TIAs)

Answer 11

May occur alone or in a series
Result from temporary localized reduction of blood flow in the brain
Partial occlusion of an artery
Atherosclerosis
Small embolus
Vascular spasm

Question 12

Transient Ischemic Attacks (TIAs) (Cont’d)

Answer 12

Signs and symptoms
Difficult to diagnose after the attack
Directly related to location of ischemia
Intermittent short episodes of impaired function
e.g., muscle weakness in arm or leg
Visual disturbances
Numbness and paresthesia in face
Transient aphasia or confusion may develop
Repeated attacks may be a warning sign for obstruction related to atherosclerosis.

Question 13

CVA (stroke)

Answer 13

is an infarction of brain tissue that results from lack of blood.
Occlusion of a cerebral blood vessel
Rupture of cerebral vessel

Question 14

(Types of CVAs)

Answer 14

predisposing condition, onset, increased ICP effects

Question 15

Risk factors include:

of CVA

Answer 15

Diabetes, hypertension, systemic lupus erythematosus, atherosclerosis, history of TIAs, increasing age, obstructive sleep apnea, heart disease, smoking, sedentary lifestyle
Combination of oral contraceptives and cigarette smoking
Congenital malformation of blood vessels
Increasing age

Question 16

Meningitis

Answer 16

Bacterial infection in meninges of CNS
Microorganism reach the brain via blood by extension from nearby tissue or by direct access through wounds
Meningococcus binds to nasopharyngeal cells in an individual, cross mucosal barrier, attach to choroid plexus and enter CSF
Because membranes are continuous in subarachnoid space, infection spreads rapidly through the coverings of the brain
Inflammatory response to infection causes increased ICP

Question 17

Meningitis (cont.)

Etiology:

Answer 17

Children and young adults- pathogen carried in nasopharynx of asymptomatic carriers, spread by respiratory droplets
Epidemic common in schools or institutions, usually later winter, early spring

Neonates- usually in conjuction with neural tube defects, premature rupture of amniotic membrane, difficult delivery

Elderly- Steptococcus pneumoniae culprit

Question 18

Meningitis (cont.)

Sign/ symptoms

Answer 18

Sudden onset, severe HA, back pain, photophobia, nuchal rigidity
Kernig’s sign- resistance to leg extension when lying with hip flexed
Brudzinski’s sign- neck flexion causes flexion of hip and knee
Vomiting, irritibility, lethargy; progressing to stupor or seizures indicating inc. ICP
Fever, chills with leukocytosis indicating infection

Diagnosis: Examination CSF by lumbar puncture- elevated CSF pressure, cloudy, inc. leukocytes
Treatment: Antimicrobials, glucocorticoids
Prognosi: good with early diagnois

Question 19

spinal cord injuries

Answer 19

hyperflexion
hyperextension
compression

Question 20

Classification of vertebral fractures

(simple

Answer 20

Single line break

Question 21

classification of vertebral fractures (compression)

Answer 21

Crushed or shattered bone in multiple fragments

Question 22

classification of vertebral fractures (wedge)

Answer 22

Displaced angular section of bone

Question 23

classification of vertebral fractures (disslocation)

Answer 23

Vertebra forced out of its normal position

Question 24

Assessment using dermatome map

Answer 24

Assessment of movement and sensory responses

Can determine the degree of damage or recovery

Question 25

Hyperreflexia

Answer 25

(kicking knee out-reflex) may be exxacggurated during recovery - spinal cord

Question 26

Tetraplegia

Answer 26

Paralysis of all four extremities

Question 27

Paraplegia

Answer 27

Paralysis of the lower part of the trunk and legs

Question 28

Complications of Spinal Cord Injury

Answer 28

Urinary tract infections
Pneumonia
Skin breakdown
Spasm and pain
Depression

Question 29

Cerebral Palsy

Answer 29

Group of disorders marked by motor impairment
Caused by
Genetic mutations, abnormal fetal formation of functional brain areas, infection, hypoxia or brain damage in the perinatal period
Damage may occur before, during, or shortly after birth
Brain tissue is altered by malformation, mechanical trauma, hypoxia, hemorrhage, hypoglycemia, hyperbilirubinemia, infection → necrosis

Question 30

Multiple Sclerosis (MS)

Answer 30

Progressive demyelination of neurons in the brain, spinal cord, and cranial nerves
Different types of MS
Variation in effects, severity, and progression
Loss of myelin interferes with conduction of impulses in affected fibers.
May affect motor, sensory, and autonomic fibers
Occurs in diffuse patches in the nervous system

Question 31

Parkinson Disease

Answer 31

Progressive degenerative disorder
Dysfunction of the extrapyramidal motor system
Progressive degeneration in basal nuclei
Imbalance between excitation and inhibition in basal nuclei
Excess stimulation affects movement and posture.
Resting tremors
Muscular rigidity
Difficulty initiating movement
Postural instability

Question 32

Parkinson Disease (Cont’d) 
affected area

Answer 32

Other affected functions
Low voice, devoid of inflection
Dysarthria
Chewing and swallowing become difficult.
Prolonging eating time
Recurrent drooling
Face might resemble a mask.
Blinking of eyelids reduced
Blank staring face
Impairs communication

Other affected functions (Cont’d)
Autonomic dysfunction
Urinary retention
Constipation
Orthostatic hypotension
Threat of falls increases
Urinary tract and respiratory tract infections are common complications.
Dementia develops late in course of disease.

Question 33

Amyotrophic Lateral Sclerosis (ALS)

Answer 33

Also referred to as Lou Gehrig disease
No identified cause
Genes on various chromosomes have been linked to the disease
Progressive degenerative disease affecting upper motor neurons in the cerebral cortex and lower motor neurons in brainstem and spinal cord
No indication of inflammation around the nerves
Cognition unimpaired

Question 34

Dementia

Answer 34

Progressive chronic disease
Cortical function is decreased.
Impaired cognitive skills
Impaired thinking, judgment and learning
Memory loss
Confusion
Behavioral and personality changes
Many causes of dementia
Vascular disease
Infections
Genetic disorders