Chapters 13-18 Study Questions

Question 1

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

Answer 1

c

Question 2

a patient comes to you worried about a spinal tap will leave them paralyzed. What should you inform the patient

Answer 2

the cord terminates at L1 above where the spinal tap is done so there is no risk of paralyzation

Question 3

why does a paper cut often hurt but a huge abdominal aneurysm does not

Answer 3

nociception

Question 4

what describes neuropathic pain

Answer 4

burning, numbness, tingling, touch sensitivity, sharp and shooting pains, persists long after inciting pain

Question 5

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

Answer 5

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

Question 6

in what scenario would a lowered heart rate coinciding with a fever be expected

Answer 6

Leginnaires disease
drug induced fever

Question 7

which of the following may be a cause of pain
- leukotrienes
- prostaglandins
- hydrogen
- K ions

Answer 7

prostaglandin

Question 8

what would a patient with lower motor neuron damage present like

Answer 8

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

Question 9

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?

Answer 9

upper motor neuron

Question 10

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.

Answer 10

Myasthenia Gravis

Question 11

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.

Answer 11

Guillain-barre syndrome

Question 12

what do basal ganglia do

Answer 12

part of upper motor neuron cell bodies and they inhibit and modulate movement patterns

Question 13

Name disorders arising from basal ganglia involvement.

Answer 13

Tourette’s, Parkinson’s, dyskinesias

Question 14

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?

Answer 14

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

Question 15

secondary injury may be caused by

Answer 15

decreased blood supply, damage to blood vessels, release of digestive enzymes

Question 16

explain the difference
between primary injury and secondary injury to the spinal cord.

Answer 16

primary is the nerulogic damage that occurs at the moment of impact, secondary is what comes after the initial injuring event

Question 17

Describe some ways in which a spinal cord may be injured? explain the difference
between primary injury and secondary injury to the spinal cord.

Answer 17

blunt trauma, falls, hyperflexion, compression, penetration trauma, rotation,

Question 18

T/F: A C3 injury would cause quadriplegia, gross arm movements and sparing of the
diaphragm.

Answer 18

F (C1-C4 lead to total loss of respiratory function and quadriplegia)

Question 19

T/F: Neurogenic shock includes hypotension, bradycardia, loss of vasomotor tone

Answer 19

T

Question 20

T/F: Hypoxia causes ATP depletion or “power failure”

Answer 20

T

Question 21

T/F: Excitotoxicity leads to spreading injury across ischemic area

Answer 21

T

Question 22

T/F: Comas can be the result of structural, metabolic, or psychogenic injuries

Answer 22

T

Question 23

Comas can be a result of ________ lesions or _________ and ________ conditions.

Answer 23

structural, metabolic, toxic

Question 24

Some early signs of decreased LOC are

Answer 24

mild confusion, inattention, disorientation and blunted responsiveness

Question 25

Some later signs of decreased LOC are

Answer 25

extreme inattentiveness, very lethargic, agitated, only respond to very vigorous stimuli

Question 26

________-______ respirations are a type of breathing pattern often seen in heart
failure. May sound like increasing gasping with brief periods of apnea between.

Answer 26

Cheyenne-Stokes

Question 27

The _____ _____ _____ is used to assess LOC and motor, verbal, and eye cues are
assessed and rated accordingly. A score under ____ means you should ______.

Answer 27

Glascow Coma Scale (GCS); 8; intubate

Question 28

Increased MAP, a wide PP, and bradycardia would indicate ________ ________.

Answer 28

Cushings triad (due to increased ICP and is the brains last ditch effort to perfuse the brain)

Question 29

________ ________ ______ 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.

Answer 29

diffuse axonal injury; epidural hematoma