neurologic function 2

Question 1

vascular neurologic disorders

Answer 1

-transient ischemic attack
-cerebrovascular accident
-cerebral aneurysm

Question 2

transient ischemic attack (TIA)

Answer 2

“Mini Stroke”
A temporary episode of cerebral ischemia that results in symptoms of neurologic deficits, lasts 1-2 hours –> up to 24 hours
Begin suddenly and last for a short period
1 in 3 people experiencing a TIA eventually have a stroke
Manifestations are the same as for a stroke
Reflect the location of the ischemia

Question 3

Ischemia can occur because of:

Answer 3

cerebral artery occlusion
(e.g., thrombus, or plaque),
cerebral artery narrowing
(e.g.,atherosclerosis or spasms),
cerebral artery injury
(e.g., inflammation or hypertension)

Question 4

additional risk factors for transient ischemic attack

Answer 4

smoking, diabetes mellitus, advancing age, hypercholesterolemia, excessive alcohol consumption, and illicit drug use

Question 5

cerebral vascular accident (CVA)

Answer 5

“Stroke”
An interruption of cerebral blood supply
Ischemic damage is permanent

Question 6

ischemic strokes

Answer 6

-are the most common
-total vessel occlusion (e.g., thrombus, embolus, or plaque)

Question 7

Hemorrhagic strokes

Answer 7

-the most fatal
-cerebral vessel rupture (e.g., cerebral aneurysm, arteriovenous malformation, or hypertension)

Question 8

complications of cerebral vascular accident (CVA)

Answer 8

neurologic deficits and death

Question 9

cerebral vascular accident (CVA) risk factors

Answer 9

smoking, diabetes mellitus, advancing age, hypercholesterolemia, excessive alcohol consumption, and illicit drug use

Question 10

manifestations of TBI & CVA

Answer 10

-Muscle weakness or paralysis of the face, arm, or leg (usually unilateral)
-Aphasia or receptive aphasia
-Dysphagia
-Dysgraphia & Difficulty reading
-Vision issues (e.g., diplopia, nystagmus, and partial or complete loss of vision)
-Change in levels of consciousness
-Personality, mood, or emotional changes
-Confusion
-Agnosia (inability to recognize or identify sensory stimuli)
-Ataxia
-Vertigo or dizziness
-Incontinence of bowel or bladder

Question 11

cerebral aneurysm

Answer 11

-A localized outpouching of a cerebral artery due to weakening of the artery wall
-Most frequently occur in on the circle of Willis
-Can put pressure on surrounding tissue as well as leak or rupture, causing a CVA or death
-Many are asymptomatic until they grow large enough to compress surrounding structures or rupture

Question 12

cerebral aneurysm causes

Answer 12

congenital defects,
hypertension, diabetes mellitus, dyslipidemia,
connective tissue diseases (e.g., Marfan syndrome
traumatic brain injuries,
cigarette smoking, illicit drug use,

Question 13

cerebral aneurysm manifestations

Answer 13

-vision issues headache, eye pain
-A sudden, severe headache is an indication that the aneurysm has ruptured;
-may also resemble symptoms of increased ICP and CVA

Question 14

seizure disorders

Answer 14

epilepsy, focal seizures, generalized seizures

Question 15

seizure

Answer 15

transient physical or behavior alteration that results from an abnormal electrical activity in the brain

Question 16

epilepsy

Answer 16

seizure disorder resulting from spontaneous firing of abnormal neurons; characterized by recurrent seizures for which there is no underlying or correctable cause

Question 17

causes for seizure disorders

Answer 17

-altered membrane ion channels, altered extracellular electrolytes, and imbalanced excitatory and inhibitory neurotransmitters
-Can occur secondary to trauma, cerebral ischemia, electrolyte disorders, acidosis, infection, fever, chemical ingestion (e.g., medications, illicit drugs, and alcohol)

Question 18

two broad categories for seizure disorders

Answer 18

-focal and generalized
-not all can be easily defined as either focal or generalized

Question 19

focal seizures

Answer 19

-“partial seizure”
-Occurs in just one part of the brain
-Usually lasts just a few seconds
-Some people may experience auras (unusual sensations just prior to an impending seizure)
-these are actually simple focal seizures in which the person maintains consciousness
-Seizure characteristics tend to be similar with every seizure

Question 20

focal aware seizure

Answer 20

-individual remains conscious but expereiences unusual feelings or sensations that can take many forms (e.g., sudden and unexplainable feelings of joy, anger, sadness, or nausea; hear, smell, taste, see, or feel things that are not real)

Question 21

complex focal seizure

Answer 21

-individual has changes in or loss of consciousness, producing a dreamlike experience; may display strange, repetitious behaviors (e.g., moving their mouth, walking in a circle) called automatisms

Question 22

frontal lobe focal seizure manifestations

Answer 22

jacksonian seizure
-tingling feeling in hand or arm
-adversive seizures
-eyes or head both turn to one side

Question 23

pariental lobe focal seizure manifestations

Answer 23

tingling in or jerking of leg, arm, face

Question 24

temporal lobe focal seizure manifestations

Answer 24

-strange smell or taste
-altered behavior
-feeling as if “i’ve been there before” or “ive seen that before” (deja vu)
-lip smacking or chewing movements

Question 25

occipital lobe focal seizure manifestations

Answer 25

flashing lights or spots
vomiting

Question 26

generalized seizures

Answer 26

-abnorm neuronal act on both sides of the brain
-may cause loss of consciousness, falls, or massive muscle spasms
-postictal period: just after the seizure, the individual may be confused, fatigued, and fall into a deep sleep

Question 27

(generalized) absence seizure

Answer 27

-individual may appear to be staring into space and/or have jerking or twitching muscles

Question 28

(generalized) tonic seizure

Answer 28

-causes stiffening of muscles of the body, generally those in the back and extremities

Question 29

(generalized) clonic seizure

Answer 29

-causes repeated jerking movements of muscles on both sides of the body

Question 30

(generalized) tonic-clonic seizure (previously called grand mal seizure)

Answer 30

-causes stiffening of the body and repeated jerks of the arms and/or legs as well as loss of consciousness

Question 31

chronic degenerative disorders

Answer 31

multiple sclerosis, parkinson’s disease, amyotrophic lateral sclerosis (ALS), Myasthenia gravis, Huntington’s Disease

Question 32

multiple sclerosis (MS)

Answer 32

-Debilitating autoimmune condition that involves a progressive and irreversible demyelination of brain, spinal cord, and cranial nerves
-Damage occurs in diffuse patches throughout the nervous system and slows or stops nerve impulses
-Symptom onset usually occurs between 20 and 40 years of age
-More common in females

Question 33

multiple sclerosis manifestations

Answer 33

-Vary depending on the degree of damage and the specific nerves affected
-Characterized by remissions and exacerbations: fatigue, ataxia, muscle spasms, paresthesia or abnormal sensation in any area, problems moving arms or legs, vision issues (e.g., diplopia and vision loss), diffuse neurological, dysfunctions

Question 34

parkinson’s disease

Answer 34

-progressive condition involving the destruction of the substantianigra in the brain
-Results in a lack of dopamine
-Causes movement issues that typically include tremors (involuntary shaking) of the hands and head
-Slowing or stopping of automatic movements (e.g., blinking)

Question 35

Parkinson’s disease manifestations

Answer 35

-Difficulty initiating or continuing movement (e.g., walking or getting out of a chair)
-Loss of fine hand movements (writing & eating can become difficult)
-Shuffling gait/Unsteady gait
-Slowed movements
-Dysphagia
-Masklike appearance to face
-Myalgia, Muscle cramps

Question 36

parkinson’s tremors

Answer 36

-Usually occur in the limbs at rest or when the limb is held out
-Go away during purposeful movement
-Eventually can be seen in the head, lips, tongue, and feet
-May be worse when tired, excited, or stressed
-Finger–thumb rubbing (“pill-rolling” tremor)

Question 37

amyotrophic lateral sclerosis

Answer 37

-“Lou Gehrig’s disease”
-Damage of the upper motor neurons of the cerebral cortex and lower motor neurons of the brain stem and spinal cord
-nerves lose their ability to trigger muscle movement, resulting in muscle weakness, disability, paralysis, and eventually death (usually w in 3 yrs of onset of symptoms)
-may also increase the risk for dementia

Question 38

amyotrophic lateral sclerosis

Answer 38

-manifestations become progressively worse as more motor neurons are damaged
-the loss of upper motor neurons results in spastic paralysis
-the loss of lower motor neurons results in flaccid paralysis

Question 39

early manifestations of amyotrophic lateral sclerosis

Answer 39

-footdrop
-lower extremity weakness or clumsiness,
-slurred speech, dysphagia
-muscle cramps and twitching in upper extremities and the tongue

Question 40

ALS manifestations

Answer 40

-freq begins in the upper or lower extremities and then spreads to other parts of the body
-as the disease advances, muscles become progressively weaker until they are paralyzed
-eventually affects chewing, swallowing, speaking, and breathing
-paralysis of the diaphragm
-aspiration - pneumonia

Question 41

myasthenia gravis

Answer 41

-autoimmune condition in which acetylcholine receptors are impaired or destroyed
-leading to a disruption of normal communication btwn the nerve and muscle at the neuromuscular junction
-This disruption causes weakness of the voluntary skeletal muscles because of inadequate nerve stimulation
-muscle weakness typically increases during periods of activity and improves after periods of rest

Question 42

myasthenia gravis manifestations

Answer 42

-muscles that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved
-the muscles that control breathing and neck and limb movements may also be affected
-facial paralysis or weakness
-fatigue
-hoarseness or changing voice
-eye and vision issue (e.g., diplopia, ptosis, blurred vision, and difficulty maintaining gaze)
-breathing difficulty
-dysphagia

Question 43

factors that can worsen and cause a myasthenic crisis

Answer 43

-fatigue, illness, stress, extreme heat, alcohol consumption, and certain meds

Question 44

myasthenic crisis

Answer 44

potentially life-threatening complication that occurs when the muscles become too weak to maintain adequate ventilation
-diaphragm weakness/paralysis

Question 45

huntington’s disease

Answer 45

-condition caused by a genetically programmed degeneration of neurons in the brain
-autosomal dominant disorder involving a defect on chromosome 4
-offspring have 50% chance of inheriting
-leads to progressive atrophy of the brain, particularly in the basal ganglia and the frontal cortex
-no cure and no treatment
-universally fatal
-Most cases appear between 30 and 40 years of age, but may appear in childhood or adolescence
-Illness duration ranges from 10 to 30 years

Question 46

common causes of death by Huntington’s disease

Answer 46

-Most common causes of death are infection (most often pneumonia), injuries related to a fall, or other complications (e.g., suicide)

Question 47

huntington disease manifestations

Answer 47

behavioral changes:
-irritable, apatehtic
-antisocial
-paranoia & psychosis
-aggression and severe depression
cognitive changes:
-dementia
-loss of memory, muscle memory
-trouble focusing & decision making
motor deficiencies:
-rapid, jerky movements ‘chorea’
-tremors
-grimaces & twitching
-unsteady gait (increased fall risk)
-dysarthria & dysphagia

Question 48

dementia

Answer 48

-cortical function is decreased, impairing cognitive skills and motor coordination
-Issues with memory are common, short-term memory losses, confusion about historical events
-Behavioral and personality changes interfere with relationships, work, and activities of daily living

Question 49

dementia causecauses of dementia

Answer 49

vascular disease (e.g., atherosclerosis), infections, toxins, and genetic conditions

Question 50

types of dementia

Answer 50

-Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, frontotemporal dementia, Creutzfeldt-Jakob disease, and AIDS dementia complex

Question 51

alzheimer’s disease

Answer 51

-most common form of dementia
-brain tissue degenerates and atrophies, causing a steady decline in memory and mental abilities
-not a part of norm aging, but risk increases w age

Question 52

three pathologic characteristics of alzheimer’s disease

Answer 52

-amyloid plaques mix w a collection of additional proteins, neuron remnants, and other nerve cell pieces
-neurofibrillary tangles: abnorm collections of a protein called tau that clumps together
-connections btwn neurons responsible for mem and learning are lost; neurons cannot survive when their connections to other neurons are lost

Question 53

alzheimer’s disease risk factors

Answer 53

Additional risk factors: family history, hypertension, hypercholesterolemia, diabetes mellitus, and history of traumatic brain injury

Question 54

alzheimer’s disease manifestations

Answer 54

-Include memory loss, problems with abstract thinking,
-difficulty finding the right word to express thoughts or even follow conversations,
-difficulty reading and writing
-disorientation (even in familiar surroundings)
-loss of judgment or social norms
-difficulty performing familiar tasks
-personality changes, hallucinations

Question 55

complications of alzheimer’s disease

Answer 55

infections (primarily pneumonia and urinary tract infections), injuries related to falls, malnutrition, dehydration, and decubitus ulcers

Question 56

brain tumors

Answer 56

-umbrella term for multiple forms of cancer
-may be malignant or benign
-may be primary, but most are secondary tumors (most commonly breast cancer, colon cancer, lung cancer, melanoma, and sarcoma)
-can be life-threatening due to increased ICP and difficulty accessing to surgically remove
-complications: neurologic deficits, seizures, personality changes, and death

Question 57

brain tumor manifestations

Answer 57

-vary depending on size and location
-Include:
Headaches of increasing frequency and severity
Unexplained nausea or vomiting
Vision problems
Gradual loss of sensation or movement in an extremity
Balance difficulties
Speech difficulties
Confusion
Hearing problems
Hormonal (endocrine) disorders