Nervous System

Question 1

Levels of consciousness

Answer 1

1. Vegetative state
2. Locked-in syndrome
3. Brain death

Question 2

Aphasia

Answer 2

inability to comprehend or express language(receptive and expressive)

Question 3

Dysarthria

Answer 3

Motor dysfunction affecting muscles used in speech-cannot articulate clearly

Question 4

Expressive aphasia(motor)

Answer 4

cannot speak or write fluently or approiatly

Question 5

Receptive aphasia(sensory)

Answer 5

unable to understand written or spoken language

Question 6

Global aphasia

Answer 6

combo of expressive and receptive aphasia, major brain damage.

Question 7

Agraphia

Answer 7

Impaired writing ability

Question 8

Alexia

Answer 8

Impaired reading ability

Question 9

Agnosia

Answer 9

loss of recognition or association

Question 10

Effects of Increased intracranial pressure

Answer 10

decreasing level of consciousness, headache, vomiting, increasing blood pressure w/increasing pulse pressure, slow heart rate, papilledema, pupil fixed and dilated

Question 11

Vital signs of increased intracranial pressure

Answer 11

Development of cerebral ischemia, systemic vasoconstriction, baroreceptor response, chemoreceptor response, improved cerebral circulation, high BP, low pulse, low respiration, can result in herniation

Question 12

Dx test for Intracranial pressure and herniation

Answer 12

CT, MRI, cerebral angiography, doppler ultrasound, electroencephalography, radionuclide to track perfusion in CNS, lumbar puncture used to check pressure and analyze CSF

Question 13

Brain tumors

Answer 13

cause ICP, primary malignant tumors rarely metastasize outside of CNS. Secondary brain tumors from breast or lung. Invasive and have irregular projections into adjacent tissue

Question 14

Transient Ischemic Attacks TIA

Answer 14

result from temporary localized reduction of blood flow in the brain

Question 15

TIA S/Sx

Answer 15

difficult to diagnose, directly related to location of ischemia, intermittent short episodes of impaired function, visual disturbances, numbness and paresthesia in face, transient aphasia or confusion may develop.

Question 16

Cerebrovascular Accidents- CVA’s

Answer 16

stroke-an infarction of brain tissue that results from lack of blood, occlusion of a cerebral blood vessel or rupture of cerebral vessel.

Question 17

Types of CVA’s

Answer 17

1. Occlusion of an artery by an atheroma-develops in lg arteries
2. Sudden obstruction caused by an embolus-lodging in a cerebral artery.
3. Intracerebral hemorrhage-caused by a rupture of a cerebral artery in patient w/severe hypertension

Question 18

CVA risk factors

Answer 18

diabetes, hypertension, systemic lupus, increasing age, congenital malformation of blood vessels, atherosclereosis, history of TIA’s, smoking, sedentary lifestyle

Question 19

CVA S/sx

Answer 19

Depends on the location of obstruction, size of artery involved, lack of voluntary movement or sensation on opposite side of body, initially flaccid paralysis, spastic paralysis develops weeks later.

Question 20

CVA Treatment

Answer 20

clot busting agents, surgical intervention, glucocorticoids, supportive treatment, OT/PT, treat underlying problems to reduce recurrences, rehab begins immediately.

Question 21

Cerebral aneurysms

Answer 21

localized weakness in the wall of an artery and frequently multiply. Usually at the points of bifurcation on the circle of willis, often aggravated by hypertension, slow bleed causes vascular type headache and rupture leads to sudden fatal increase in ICP and death.

Question 22

Cerebral aneurysm S/sx

Answer 22

loss of visual field or visual disturbance, headache and photophobia, intermittent periods of dysfunction, nuchal rigidity caused by meningeal irritation. Tx surgical before rupture and anti hypertensive drugs.

Question 23

Brain infections-Neisseria meningitidis or meningococci

Answer 23

Frequently carried in the nasopharynx of asymptomatic carriers, spread by respiratory droplets, occurs more frequently in late winter an dearly spring.

Question 24

Meningitidis S/sx

Answer 24

sudden onset is common, severe headache, back pain, photophobia, nuchal rigidity, vomiting, irritability, lethargy, fever, chills w/leukocytosis, progression to stupor or seizures. Dx examination of CSF-lumbar puncture

Question 25

Brain Abscess

Answer 25

localized infection, frontal or temporal lobes. Usually necrosis of brain tissue and surrounding area of edema. May spread from organisms in ear throat, lung, sinuses. May result from septic emboli, acute bacterial endocarditis, site of injury or surgery. Tx surgical drainage and antimicrobial therapy.

Question 26

Encephalitis

Answer 26

infection of the parenchymal or connective tissue in the brain and spinal cord. Infection may include meninges, usually viral. Headache, stiff neck, lethargy, vomiting, seizures, fever

Question 27

Types of head injuries

Answer 27

1. Concussion
2. Contusion
3. closed head injury
4. open head injury
5. depressed skull fractures
6. basilar fractures
7. contrecoup injury

Question 28

Hematomas

Answer 28

all types of hematomas lead to local pressure on adjacent tissue, general increase in ICP. Causes are sports injury, car or motor accident, falls are common.

Question 29

Hydrdocephalus-congenital neurological disorder

Answer 29

Excess CSF accumulates within the skull, compresses brain tissue and blood vessels, CSF accumulates because more is produced than reabsorbed.

Question 30

Spina bifida-congenital neurological disorder

Answer 30

group of neural tube defects of varying severity

Question 31

Cerebral palsy-congenital neurological disorder

Answer 31

group of disorders with some degree of motor impairment, abnormal formation of functional brain areas, infection, brain damage in perinatal period.

Question 32

MS

Answer 32

progressive demyelination of neurons in the brain, spinal cord and cranial nerves. Loss of myelin interferes w/conduction of impulses in affected fibers. May affect motor, sensory and autonomic fibers.

Question 33

MS S/sx

Answer 33

manifestations determined by areas of demyelination, blurred vision, weakness in legs, diplopia, scotoma, dysarthria, paresthesia, progressive weakness and paralysis extending to upper limbs. No definitive test or treatment.

Question 34

Alsheimers Disease

Answer 34

progressive cortical atrophy, neurofibrillary tangles and plaques. Gradual loss of memory and lack of concentration. No definite diagnostic tests, exclusion of other disorders. NO specific treatment.

Question 35

seizure disorders

Answer 35

uncontrolled, excessive discharge of neurons in the brain, maybe localized or generalized