Module 18

Question 1

What pathologic changes occur in Parkinson disease?

Answer 1

Degeneration of basal ganglia dopamine-producing neurons, formation of Lewy bodies.

Question 2

What are the 3 classic clinical manifestations of Parkinson disease?

Answer 2

Resting tremor, rigidity, and bradykinesia.

Question 3

What are the two different types of cerebral edema?

Answer 3

Vasogenic (fluid from vessels into interstitial space) and Cytotoxic (cellular swelling due to ischemia or intoxication).

Question 4

How do the clinical manifestations of acute hydrocephalus differ from normal-pressure hydrocephalus?

Answer 4

Acute: Rapid onset, signs of IICP; Normal-pressure: Slow onset, memory changes, gait disturbance, urinary incontinence.

Question 5

What is the normal range for intracranial pressure (ICP)?

Answer 5

0–15 mm Hg.

Question 6

What are compensatory mechanisms for increased ICP?

Answer 6

CSF reabsorption, venous compression, arterial vasoconstriction.

Question 7

What causes fixed dilated pupils?

Answer 7

Brain herniation compressing cranial nerve III.

Question 8

What is the earliest indicator of increased ICP?

Answer 8

Decreasing level of consciousness (LOC).

Question 9

How does a focal brain injury differ from a diffuse brain injury?

Answer 9

Focal involves a specific area (e.g., contusion); diffuse affects widespread brain areas (e.g., concussion, DAI).

Question 10

What is the source of bleeding for an epidural hematoma?

Answer 10

Meningeal artery or vein, usually from temporal fossa injury.

Question 11

What clinical manifestations are expected with an epidural hematoma?

Answer 11

Brief LOC, lucid interval, rapid deterioration, ipsilateral pupil dilation, contralateral hemiparesis.

Question 12

What causes a diffuse axonal injury?

Answer 12

Shearing forces from acceleration–deceleration injury.

Question 13

What would be a normal response to the oculocephalic reflex (Doll’s eyes)?

Answer 13

Eyes move in the opposite direction of head turn.

Question 14

What is a TIA and why are the clinical manifestations transient?

Answer 14

Transient ischemic attack—brief neurological deficit without infarction due to temporary ischemia.

Question 15

Small vessel strokes caused by arteriosclerosis from chronic hypertension or diabetes

Answer 15

lacunar strokes

Question 16

What are the clinical manifestations of a hemorrhagic stroke?

Answer 16

Sudden onset, vomiting, headache, contralateral hemiplegia, coma.

Question 17

What organisms may cause meningitis?

Answer 17

Bacteria (e.g., Neisseria, Streptococcus pneumoniae), viruses.

Question 18

What are positive Brudzinski and Kernig signs?

Answer 18

Brudzinski: Neck flexion causes hip/knee flexion; Kernig: Inability to straighten leg when hip is flexed.

Question 19

Sensory disturbance before a seizure, often visual or olfactory.

Answer 19

Aura

Question 20

Amyloid plaques and neurofibrillary tangles in cerebral cortex and hippocampus; loss of acetylcholine.

Answer 20

pathologic findings in Alzheimer’s disease

Question 21

What are the two types of cerebral edema?

Answer 21

Vasogenic edema and Cytotoxic edema.

Question 22

What causes vasogenic edema?

Answer 22

Hemorrhage, brain injury, and infections.

Question 23

What causes cytotoxic edema?

Answer 23

Water intoxication and severe ischemia.

Question 24

What are the clinical manifestations of vasogenic edema?

Answer 24

Focal neurologic deficits, disturbances in consciousness, severe intracranial hypertension.

Question 25

What are the clinical manifestations of cytotoxic edema?

Answer 25

Stupor and coma.

Question 26

What are the causes of hydrocephalus?

Answer 26

Overproduction of CSF, impaired reabsorption of CSF, obstruction of CSF flow.

Question 27

What are the clinical manifestations of acute hydrocephalus?

Answer 27

Develops rapidly with signs and symptoms of increased intracranial pressure (IICP).

Question 28

What are the clinical manifestations of normal-pressure hydrocephalus?

Answer 28

Develops slowly with memory changes, gait disturbance, and urinary incontinence.

Question 29

What are the causes of increased intracranial pressure (IICP)?

Answer 29

Increased brain tissue, CSF, or blood in the skull.

Question 30

What are the compensatory mechanisms for IICP?

Answer 30

Reabsorption of CSF, venous compression, and arterial vasoconstriction.

Question 31

What are the types of brain herniation?

Answer 31

Cingulate gyrus herniation, central or transtentorial herniation, uncal herniation, infratentorial herniation.

Question 32

What are clinical manifestations of IICP?

Answer 32

Decreasing LOC, pupillary changes, altered breathing patterns, widened pulse pressure, bradycardia.

Question 33

What are the two main types of traumatic brain injuries?

Answer 33

Primary (focal or diffuse injuries) and secondary (brain swelling, infection, ischemia).

Question 34

What are examples of focal brain injuries?

Answer 34

Contusions, epidural hematomas, subdural hematomas, intracerebral hematomas.

Question 35

What are examples of diffuse brain injuries?

Answer 35

Concussions and diffuse axonal injuries (DAI).

Question 36

What causes a concussion?

Answer 36

Acceleration–deceleration injury.

Question 37

What are the symptoms of post-concussion syndrome?

Answer 37

Headache, irritability, insomnia, poor concentration and memory.

Question 38

What is the diagnosis method for diffuse axonal injury?

Answer 38

CT scan usually shows no intracranial lesions; based on immediate onset of unconsciousness.

Question 39

What is the normal highest level of consciousness (LOC)?

Answer 39

Alert and oriented to self, others, place, and time.

Question 40

What do abnormal oculomotor responses indicate?

Answer 40

Brainstem injury.

Question 41

What causes Cheyne-Stokes respiration?

Answer 41

Brainstem damage or dysfunction due to increased intracranial pressure or cerebral hypoxia.