Exam 1- Alterations In Cognitive Systems, Cerebral Hemodynamics, And Motor Function

Question 1

Delerium

Answer 1

Hyperkinetic confusional state. Impaired or Lost detection. Acute metabolic state, reversible, impairs attention, focal deficits, fluctuating progression.

Question 2

Dementia

Answer 2

Chronic structural problem, irreversible, impairs memory, global deficits, slow progression

Question 3

Post ictal state

Answer 3

Caused by depletion of the glucose stores in the brain after a sz

Question 4

Alzheimer’s disease

Answer 4

Deterioration in the brain. Type of depression.

Get neurofibrillary tangles in the neurons and amyloid plaques.

Can be decades between onset of pathologic changes and clinical appearance.

Question 5

Cerebral perfusion pressure (CPP)

Answer 5

Pressure to perfuse brain cells.
CPP=MAP-ICP
60-110mmHg

Question 6

ICP

Answer 6

Pressure inside the skull. Measured directly.

5-20 mmHg

Question 7

Cerebral edema

Answer 7

Fluid moving into the brain tissue. Vasogenic, cytotoxic, ischemic, interstitial.

Question 8

Hydrocephalus

Answer 8

More CSF in the cranial vault, SA space, ventricles than we should.

Types; not reabsorbing, increased production, ventricular obstruction

Question 9

Huntington Dz

Answer 9

Rare autosomal non degenerative d/o

Altered thought process and intellect.

Severe degeneration of the basal ganglia and frontal cerebral artery. Decreased GABA, amino acids in CNS, hypotonia, abnormal movement, dementia.

Question 10

Parkinson’s Dz

Answer 10

Severe degeneration of the basal ganglia involving dopaminergic pathway (dopamine).

Imbalance in dopamine and cholinergic activity.

Onset in 40s, more men than women. Bradykinesia, intention tremor, cognitive-affective sx’s

Question 11

Focal brain injury

Answer 11

Specific and observable injury

Question 12

Multiple Sclerosis

Answer 12

Progressive, inflammatory, demyelinating, autoimmune d/o of the CNS.

Degeneration of the myelin sheath in CNS neurons.

Question 13

Amyotrophic lateral sclerosis (ALS)

Answer 13

Diffusely affects upper and lower motor neurons of the cerebral cortex, brainstem, and spinal cord. Progressive weakness leading to respiratory failure and death.

Question 14

Guillain-Barré Syndrome

Answer 14

Acute acquired immune-mediated dz causing demyelination of the peripheral nerves with relative soaring of axons.

Acute onset, ascending motor paralysis.

Humoral and cellular immunologic reaction.

Question 15

Myasthenia gravis

Answer 15

Chronic autoimmune dz mediated by acetylcholine receptor antibodies that act at the neuromuscular junction.

Weakness and fatigue of muscles of the eyes and the throat, causing diploplia, difficulty chewing, talking, and swallowing.

Question 16

Hypertonia

Answer 16

Increased muscle tone.
Spasticity
Muscle rigidity

Question 17

Hypokinesia

Answer 17

Loss of associated movement
Bradykinesia
Athetosis

Question 18

Hyperkenesia

Answer 18

Increased muscle movement. 
Chorea 
Akasthesia 
Tremor
Myoclonus

Question 19

Decorticate

Answer 19

Upper extremities flexed and lower extremities extended.

Hemispheric damage above midbrain

Question 20

Decerebrate

Answer 20

Upper and lower extremities extended. From severe damage to the cerebrum and the mid brain and upper pons.

Question 21

Paraplegia

Answer 21

Bilat extremities

Question 22

Hemiplegia

Answer 22

Unilateral paralysis

Question 23

Status epilepticus

Answer 23

Continuous seizures lasting more than 5 min

Question 24

Seizure

Answer 24

Initiation involves high-frequency firing bursts in a group of neurons that become hyper synchronized

Question 25

Herniation

Answer 25

When ICP is severely increased, the brain can herniated into another cranial compartment.

Question 26

Lower motor neuron damage

Answer 26

Leads to flaccidity

Question 27

Lower brainstem

Answer 27

Integrates motor responses like yawning and hiccups.

Question 28

Prefrontal area

Answer 28

Mediates executive attention cognitive functions

Question 29

Persistent vegetative state

Answer 29

Person is unaware of self or environment and has lost all cognitive function but maintains BP and breathing without support.

Question 30

Partial seizure

Answer 30

Unilateral neurons. Focal. Consciousness can be maintained.

Question 31

Generalized seizure

Answer 31

Bilateral neurons, nonfocal onset, and originate from a subcortical or deeper brain focus.

Question 32

Clonic phase

Answer 32

Phase of alternating contraction and relaxation of muscles.

Question 33

Tonic phase

Answer 33

Phase of muscle contraction associated with increased muscle tone. Associated with LOC.

Question 34

Sympathetic nervous system

Answer 34

Response to stress by preparing the body to defend itself. Releases the catecholamine epinephrine. Mobilizes energy stores and decreases the release of insulin. Redistributes blood flow.