Chapters 13-18 Study Questions Flashcards
Which of the following is not true about the blood brain barrier?
- alcohol, nicotine, and heroine enter the BBB readily
- it is a chemically stable environment
- trauma and infection decrease peremability
- more permeable at birth
c
a patient comes to you worried about a spinal tap will leave them paralyzed. What should you inform the patient
the cord terminates at L1 above where the spinal tap is done so there is no risk of paralyzation
why does a paper cut often hurt but a huge abdominal aneurysm does not
nociception
what describes neuropathic pain
burning, numbness, tingling, touch sensitivity, sharp and shooting pains, persists long after inciting pain
a 6 year old male patient arrives in the E.R stating he is having abdominal pain. what should your next move be as a healthcare provider
children can self report pain, continue an assessment, and discuss any pain management options with the parents and patient. Begin an assessment to see if the child is in pain
in what scenario would a lowered heart rate coinciding with a fever be expected
Leginnaires disease
drug induced fever
which of the following may be a cause of pain
- leukotrienes
- prostaglandins
- hydrogen
- K ions
prostaglandin
what would a patient with lower motor neuron damage present like
patients neurons will be irritated or there will even be death of neurons so spinal reflexes are lost, flaccid paralysis occurs and denervation atrophy of muscles takes place
A patient of yours has suffered damage to the motor unit. They are experiencing
increased muscle tone, hyperreflexia, and spasticity. Their spinal reflexes are intact but they
cannot be controlled by the brain. Has your patient suffered damage to the upper or lower
motor neuron?
upper motor neuron
Which autoimmune disorder matches this description?: disorder of transmission at the
NMJ; antibody mediated loss of acetylcholine receptors at the junction. Respiration is
compromised, thymus is implicated as trigger or inciting factor. Skeletal muscle weakness.
Eyes, face and swallowing muscles are most impacted.
Myasthenia Gravis
Which disorder would best fit the description?: infiltration of peripheral neurons,
edema, demyelination, unknown cause, progressing muscle weakness producing flaccid
paralysis. Spontaneous recovery in 80-90% of cases.
Guillain-barre syndrome
what do basal ganglia do
part of upper motor neuron cell bodies and they inhibit and modulate movement patterns
Name disorders arising from basal ganglia involvement.
Tourette’s, Parkinson’s, dyskinesias
Demyelination of nerve fibers in white matter of the brain, spinal cord, and optic nerve
resulting from immune-mediated inflammatory response in genetically susceptible
individuals is best described as what disease?
Multiple Sclerosis (MS): patients will often experience periods where they feel slightly better and then will relapse and feel much worse than before. This cycles and the patient gradually gets worse with each relapse
secondary injury may be caused by
decreased blood supply, damage to blood vessels, release of digestive enzymes
explain the difference
between primary injury and secondary injury to the spinal cord.
primary is the nerulogic damage that occurs at the moment of impact, secondary is what comes after the initial injuring event
Describe some ways in which a spinal cord may be injured? explain the difference
between primary injury and secondary injury to the spinal cord.
blunt trauma, falls, hyperflexion, compression, penetration trauma, rotation,
T/F: A C3 injury would cause quadriplegia, gross arm movements and sparing of the
diaphragm.
F (C1-C4 lead to total loss of respiratory function and quadriplegia)
T/F: Neurogenic shock includes hypotension, bradycardia, loss of vasomotor tone
T
T/F: Hypoxia causes ATP depletion or “power failure”
T
T/F: Excitotoxicity leads to spreading injury across ischemic area
T
T/F: Comas can be the result of structural, metabolic, or psychogenic injuries
T
Comas can be a result of ________ lesions or _________ and ________ conditions.
structural, metabolic, toxic
Some early signs of decreased LOC are
mild confusion, inattention, disorientation and blunted responsiveness
Some later signs of decreased LOC are
extreme inattentiveness, very lethargic, agitated, only respond to very vigorous stimuli
________-______ respirations are a type of breathing pattern often seen in heart
failure. May sound like increasing gasping with brief periods of apnea between.
Cheyenne-Stokes
The _____ _____ _____ is used to assess LOC and motor, verbal, and eye cues are
assessed and rated accordingly. A score under ____ means you should ______.
Glascow Coma Scale (GCS); 8; intubate
Increased MAP, a wide PP, and bradycardia would indicate ________ ________.
Cushings triad (due to increased ICP and is the brains last ditch effort to perfuse the brain)
________ ________ ______ is a result of sudden rotational movement in the skull
causing shearing. ____ _______ is a contusion between the skull and dura marked by a LOC,
regular level of consciousness then another rapid LOC.
diffuse axonal injury; epidural hematoma
