Chapter 8 Diagnostics

Question 1

Babinski’s reflex*

Answer 1

• Reflex tested by stroking the sole of the foot, beginning at mid-heel and moving upward and lateral to the toes.
• Positive Babinski’s occurs when there is dorsiflexion of the great toe and fanning of the other toes
• normal in infants; abnormal in adults representing an upper motor neuron disease of the pyramidal tract

Question 2

brain scan

Answer 2

• Nuclear counter scanning of cranial contents two hours after an intravenous injection of radioisotopes
• Isotopes concentrate in abnormal tissue of brain, indicating a pathological process (usually in normal tissue, the isotopes do not cross the blood-brain barrier)

Question 3

What does a brain scan help diagnose?

Answer 3

acute cerebral infarction, cerebral neoplasm, cerebral hemorrhage, brain abscess, aneurysms, cerebral thrombosis, hematomas, hydrocephalus, cancer metastasis to the brain, and bleeds

Question 4

cerebral angiography

Answer 4

• a process
• Visualization of the cerebral vascular system via x-ray after injection of a radiopaque contrast medium into an arterial blood vessel
• May use carotid, femoral, or brachial artery

Question 5

What can be visualized with a cerebral angiography?

Answer 5

occlusions or aneurysms, vascular and nonvascular tumors, hematomas, and abscesses

Question 6

cerebrospinal fluid analysis

Answer 6

-Laboratory analysis of cerebrospinal fluid
-CSF obtained from a lumbar puncture analyzed for the presence of bacteria, blood, or malignant cells as well as for the amount of protein and glucose present
-normal CSF is clear and colorless without blood cells, bacteria or malignant cells
-normal protein level 15-45 mg/dl
normal glucose level 50-70 mg/dl

Question 7

CT scan of the brain

Answer 7

• Analysis of a three-dimensional view of brain tissue obtained as X-ray beams pass through successive horizontal layers of the brain
• CT = computerized tomography
• CAT=computerized axial tomography
• Images look down through the top of the head

Question 8

What do CT scans help detect?

Answer 8

intracranial tumors, cerebral infarctions, ventricular displacement or enlargement, cerebral aneurysm, intracranial bleeds, multiple sclerosis, hydrocephalus, and brain abscess

Question 9

chordotomy

Answer 9

• Neurosurgical procedure for pain control accomplished through a laminectomy
• Surgical interference of pathways within the spinal cord that control pain
• intent is to interrupt the tracts of the nervous system that relay pain sensations

Question 10

cisternal puncture

Answer 10

-Insertion of a short, beveled spinal needle into the cisterna magna in order to drain CSF or to obtain a CSF specimen

Question 11

Cisterna magna

Answer 11

shallow reservoir of CSF between the medulla and the cerebellum

Question 12

craniotomy

Answer 12

• Surgical procedure that makes an opening into the skull
• a bone flap must be created
• or a free-form flap where a portion is completely removed
• or a burr hole that allows the access to the brain

Question 13

echoencephalography

Answer 13

• Measurement of electrical activity produced by the brain and recorded through electrodes placed on the scalp
• can detect ventricular dilation or a vital shift of the midline
• there are limitation to this procedure

Question 14

electroencephalography (EEG)

Answer 14

• Measurement of electrical activity in the brain and recorded through electrodes
• Sleep-deprived EEG= Individual deprived of sleep for 24 hours before test
• Ambulatory EEG=Provides prolonged readings of electrical activity of brain over a 24-hour period of time, while person is awake or asleep; can confirm epilepsy
• helps provide info about cranial neurological problems, epileptic seizures, focal damage in the cortex, psychogenic unresponsiveness, and cerebral death

Question 15

electromyography

Answer 15

process of recording the electrical activity of muscle by inserting a small needle into the muscle and delivering a small current that stimulates the muscle

Question 16

laminectomy

Answer 16

-Surgical removal of the bony arches from one or more vertebrae in order to relieve pressure from the spinal cord

Question 17

lumbar puncture

Answer 17

• insertion of a hollow needle and stylet into the subarachnoid space, generally between the 3rd and 4th lumbar vertebrae
• Performed under strict aseptic technique

Question 18

A patient is comatose, and the doctor needs to evaluate brain death. Which test would be performed?
A. cisternal puncture
B. CT scan
C. echoencephalogram
D. electroencephalogram

Answer 18

d. This will record any electrical activity occurring in the brain and guide the next step in the decision-making process

Question 19

what can a lumbar puncture help diagnose?

Answer 19

meningitis, brain tumors, spinal cord tumors, encephalitis, and cerebral bleeding

Question 20

magnetic resonance imaging (MRI)

Answer 20

• Noninvasive scanning procedure that provides visualization of fluid, soft tissue, and bony structures without the use of radiation
• Provides far more preciseness and accuracy than most diagnostic tools
• absorbed radio frequency signals change the alignment of hydrogen atoms in the body and analyzed.
• persons with implanted metal devices cannot undergo an MRI due to the strong magnetic field
• can be used for all parts of the bod-the abdomen, chest, joints, nervous system, pelvis, and spinal column

Question 21

what is an open MRI scanner?

Answer 21

not placed in a tubelike machine, it is much more open for people with claustrophobia

Question 22

myelography

Answer 22

• Introduction of contrast medium into the lumbar subarachnoid space through a lumbar puncture in order to visualize the spinal cord and vertebral canal through x-ray examination
• aids in the diagnosis of adhesions and tumors producing pressure on the spinal canal or of intervertebral disc abnormalities

Question 23

neurectomy

Answer 23

Neurosurgical procedure to relieve pain in a localized or small area by incision of cranial or peripheral nerves; to interrupt the tracts that relay pain sensations

Question 24

pneumoencephalography

Answer 24

• Process used to radiographically visualize one of the ventricles or fluid occupying spaces in the central nervous system (CNS)
• accomplished by removing CSF and replacing it with oxygen, air, or helium

Question 25

polysomnogram

Answer 25

• Sleep study or sleep test that evaluates physical factors affecting sleep
• Physical activity and level of sleep are monitored by a technician while the patient sleeps
• Useful in evaluating sleep disorders such as sleep apnea, sleep walking, night terrors, restless leg syndrome, insomnia, and narcolepsy

Question 26

positron emission tomography (PET)

Answer 26

Computerized radiographic images of various body structures produced when radioactive substances are inhaled or injected

• color-coded images show the degree and intensity of the metabolic process
• used to access dementia, brain tumors, cerebral vascular disease, and brain tumors

Question 27

Romberg test

Answer 27

used to evaluate cerebellar function and balance

Question 28

stereotaxic neurosurgery

Answer 28

• Neurosurgery on a precise location of an area within the brain that controls specific function(s)
• May involve destruction of brain tissue with various agents such as heat, cold, and sclerosing or corrosive fluids
• it is possible for these tiny lesions to create lasting pain relief

Question 29

sympathectomy

Answer 29

Surgical procedure used to interrupt a portion of the sympathetic nerve pathway, for the purpose of relieving chronic pain

Question 30

tractotomy

Answer 30

• Through a craniotomy, the anterolateral pathway in the brain stem is surgically divided in an attempt to relieve pain
• morbidity and mortality rates are high

Question 31

transcutaneous electrical nerve stimulation (TENS)

Answer 31

Form of cutaneous stimulation for pain relief that supplies electrical impulses to the nerve endings of a nerve close to the pain site