Exam 3

Question 1

classic concussion - Grade IV

Answer 1

• disconnection of cerebral systems from brainstem
• physiological and neurological dysfunction without substantial anatomic disruption
• loss of consciousness <6 hours
• amnesia (anterograde and retrograde

Question 2

mild concussion grade I-III

Answer 2

Grade I - confusion, disorientation, momentary amnesia
Grade II- momentary confusion and retrograde amnesia
Grade III - confusion with retrograde and anterograde amnesia

Question 3

autonomic dysreflexia - triggered by sustained stimuli at T6 or below

Answer 3

caused by - restrictive clothing, pressure areas, full bladder or UTI, fecal impaction

Question 4

autonomic dysreflexia - triggered by sustained stimuli at T6 or below

responses above level of injury

Answer 4

vasodilation

• increased BP (severe and rapid)
• flushed face
• headache
• distended neck veins
• lowered heart rate
• increased sweating`

Question 5

autonomic dysreflexia - triggered by sustained stimuli at T6 or below

responses below level of injury

Answer 5

• vasoconstriction
• pale
• cool
• no sweating

Question 6

arteriovenous malformation (AVM)

Answer 6

defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth. They are comprised of snarled tangles of arteries and veins.

Question 7

Positive Kernig and Brudzinski sign

Answer 7

subarachchnis hemorrhage - blood escapes from defective or injured vasculature into subarachnoid space.

Question 8

most common primary central nervous system tumor

Answer 8

astrocytoma

Question 9

multiple sclerosis

Answer 9

autoimmune - usually familial - usually in 40’s and 50’s and comes and goes

tinnitus - decreased hearing - diplopia - blurred vision - urinary retention - spastic bladder - constipation - weakness leading to paralysis - muscle spasticity - vertigo

Question 10

coup injury

Answer 10

primary impact of head injury - intial bang on the head

Question 11

contrecoup/countercoup injury

Answer 11

when the brain moves inside the head in the opposite direction of the original bang

Question 12

myasthenia gravis

Answer 12

caused by chronic autoimmune - IgG antobodies against acetylcholine receptors.

fatigue of muscle in eyes and throat - difficulty chewing, talking, swallowing - diplopia -

Question 13

myasthenic crisis

Answer 13

undermedicated - muscle weakness - can impact respiratory muscle - can’t give meds to remedy

Question 14

cholingergic crisis

Answer 14

overmedicated - causes muscle twitching

Question 15

guillain-Barre syndrome

Answer 15

begins in lower extremities and goes up bilaterally-causes symmetrical weakness leading to paralysis - increased pain at night - increased BP - lowered pulse- possible autoimmune cause - affects respiratory, talking, swallowing, bowel and bladder control

Question 16

ischemic stroke - 80% of strokes

Answer 16

decreased blood to an area of the brain - usually caused by a blood clot

Question 17

hemorrhagic stroke - 20% of strokes

Answer 17

blood vessel rupture - can be intracerabral or subarachnoid

Question 18

clinical manifestations immediately following spinal cord injury

Answer 18

necrosis consumes 40% within 4 hours and 70% within 24 hours. cord swelling increases degree of dysfunction - release of toxic excitatory amino acids, accumulation of of endogenous opiates, lipid hydrolysis with production of active metabolites, and local free radical release.
produce further ischemia, vascular damage, and necrosis of tissue.

Question 19

cavernous angioma

Answer 19

a blood vessel abnormality characterized by large, adjacent capillaries with little or no intervening brain. The blood flow through these vessels is slow.

symptoms - seizures, headache, hemorrhage or compression of surrounding brain tissue, weakness, numbness, double vision, visual disturbance or language difficulties.

Question 20

capillary telangiectasia

Answer 20

small areas of abnormally dilated capillaries within otherwise normal brain tissue.

Question 21

arteriovenous malformation

Answer 21

defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth. They are comprised of snarled tangles of arteries and veins.

Question 22

arteriovenous angioma

Answer 22

a congenital tumor consisting of a tangle of coiled, usually dilated arteries and veins, islets of sclerosed brain tissue, and, occasionally, cartilaginous cells. The lesion, which may be distinguished by an intracranial bruit, generally arises in the vascular system of the pia mater and may grow to project deeply into the brain, causing seizures and progressive hemiparesis.

Question 23

right cerebral vascular accident/stroke

Answer 23

left body paralysis - short attention span - spacial/perceptual difficulties - visual field difficulties - minimize problems - impaired judgement - impulsivea

Question 24

left cerebral vascular accident/stroke

Answer 24

paralyzed right side - impaired speech and language - visual field deficits - aware of dificits - depressin and anxiety - impaired laguage and math skills

Question 25

FASTG

Answer 25

Pneumonic stroke assessment -
F - facial droop
A - arm drift
S - speech "you can't teach an old dog new tricks"
T - Time last normal
G - glucose - test to rule hypoglycemia