Exam 4 quiz 7 Flashcards
What sign is commonly observed in a person with a basilar skull fracture?
nystagmus (jerky eyeball movements)
periorbital bruising (raccoon eyes)
partial loss of visual fields
pinpoint pupils
periorbital bruising (raccoon eyes)
Signs of basilar skull fracture include “ecchymoses around both eyes (‘raccoon eyes’) and a bruise behind the ear (‘Battle’s sign’).
What sign is often the earliest indicator of increased intracranial pressure?
partial facial paralysis
fixed and dilated pupils
projectile vomiting
Decreased level of consciousness
Decreased level of consciousness
Signs of increasing ICP include decreased LOC (level of consciousness), pupillary dilatation, headache, vomiting, increased blood pressure, and papilledema.” (Capriotti, 2nd Ed., Pg. 853) “Early signs of increasing ICP include headache, caused by direct compression of brain tissue; vomiting, caused by compression of the vomiting center in the medulla; and decreasing LOC, caused by compression of the reticular activating system.” (Pg. 857) Other signs mentioned are later signs of elevated ICP.
What degree of neurological impairment is seen with a complete transection of the spinal cord?
partial return of sensory functions in areas below the level of injury
loss of sensation and motor activity below the level of injuty
reflex arc muscle activity below the level of injury
loss of balance and spatial orientation below the level of injury
loss of sensation and motor activity below the level of injury
A complete SCI (Spinal Cord Injury) indicates that there is no motor or sensory function below the site of injury.” (Capriotti, 2nd Ed., Pg. 869)
Decerebrate posturing in a head injury victim indicates which type of brain damage?
occipital lobe damage
descending motor tract injury
severe brain stem damage
injury to one hemisphere
severe brain stem damage
Decerebrate posture is an abnormal position where the arms are held straight out and toes pointed downward. The shoulders and neck are slightly arched as the patient lies supine. Decerebrate posturing results from upper brainstem damage and indicates more extensive brain damage than does decorticate posturing.” (Capriotti, 2nd Ed., Pg. 857
What pathophysiology results in Parkinson’s Disease?
motor fiber degeneration int he cerebral cortex
acetylcholine breakdown at the CNS synapses
loss of the myelin sheath in descending spinal motor tracts
basal ganglia degeneration with reduced dopamine levels
basal ganglia degeneration with reduced dopamine levels
Pathologically, Parkinson’s disease is mainly associated with progressive loss of dopamine-producing cells in the substantia nigra, which is within the basal ganglia of the midbrain. The basal ganglia modulates movements, such as posture, standing, walking, or writing. In the basal ganglia, Ach (acetylcholine) and dopamine are the neurotransmitters that modulate the body’s movements. Ach stimulates muscle movement, whereas dopamine has an inhibitory effect on movement. The depletion of dopamine in Parkinson’s disease creates an imbalance of these two neurotransmitters. The effects of unopposed Ach are apparent in the tremor and abnormal spasmodic, muscle movements.” “…There is also an accumulation of an abnormal protein called alpha-synuclein found in structures called Lewy bodies in the brainstem, spinal cord, and regions of the cortex….the accumulation of this protein is associated with neurodegeneration and cell death.” (Capriotti, 2nd Ed., Pg. 838)
An ER patient complaining of nausea and severe left jaw pain is diagnosed with a myocardial infarction. What type of pain is she experiencing?
visceral pain
phantom pain
referred pain
neurogenic pain
referred pain
Correct! “Referred pain occurs when the pain response occurs at a distance from the actual pathology….The best-known example of referred pain is pain experienced during myocardial infarction. Nerves from damaged heart tissue convey pain signals to spinal cord levels C4-T4 on the left side, which happen to be the same levels that receive sensation from the left side of the chest and part of the left arm. The brain doesn’t have a strong neurosignature of the heart, but it does have a strong impression from the adjoining thoracic skin and muscles, so it interprets the signals from the heart as pain in the chest and left arm.”
Which of the following conditions or actions can cause primary osteoarthritis?
Diabetes, congenital abnormalities, aging
Over-use of joints, aging, obesity
Congenital abnormalities, aging, over use of joints
Obesity, diabetes, aging
Over-use of joints, aging, obesity
Risk factors for OA (Osteoarthritis) include aging, obesity, history of participation in team sports, history of trauma or overuse of a joint, and heavy occupational work. Obesity has become a particularly common risk factor, as excess body weight places excess pressure on the knees and hips
A generalized seizure is characterized by
localized seizure activity
impaired awareness and bilateral cerebral involvement
seizure activity that can last for several hours
uncontrolled neuron damage in the brain
impaired awareness and bilateral cerebral involvement
Seizures are described as focal or generalized depending on the involvement of one or both hemispheres of the brain…Generalized seizures arise within one hemisphere and rapidly involve neurons distributed across both cerebral hemispheres.” In seizures classified as “Generalized onset”, the person will have “impaired awareness” and motor or non-motor activity (as in an absence seizure
Which of these terms best describes this fracture …. Straight across the bone horizontally, close together?
Open fracture
Transverse fracture
Greenstick fracture
Spiral fracture
Transverse fracture
A transverse fracture is one “where parts of the bone are separated but close to each other”. There is no break in the skin, which means it is “closed”, rather than an “open” fracture.
When a person does not realize they are having pain because other sensations, such as touch and temperature, close or inhibit the pain impulse’s ability to travel to the brain, this is referred to as
Neuromatrix theory
Phantom limb pain
Gate control theory
Referred pain
Gate control theory
The Gate Control Theory of pain refers to the theory that “when large nerve fibers from the periphery are stimulated” (such as by rubbing, applying cold, or other stimulus to the area), “small-diameter pain fibers cannot get through the interneuron gate”, since “the gate is closed”. (Capriotti, 2nd ed., Pg. 93-94)
