Neurological, Psychophysiological, and Endocrine Disorders Flashcards
A _____________________ injury usually causes an alteration of consciousness and some degree of anterograde and retrograde amnesia.
Closed-head injury.
A ___________________ does not usually cause LOC and produces more localized damage and more highly specific symptoms.
Closed-head injury.
The severity of TBI is determined by considering several factors, including:
- A person’s initial score on the _________________________ (GCS)
- Duration of ______________________ (PTA)
- Duration of ______________________ (LOC)
- Glasgow Coma Scale
- Posttraumatic Amnesia
- Loss of Consciousness
Classification of TBI Severity - ___________________:
- Initial GCS: 13-15
- PTA: Less than 1 hour
- LOC: Less than 30 min.
Mild.
Classification of TBI Severity - ___________________:
- Initial GCS: 9-12
- PTA: 1-24 hours
- LOC: 30 min. to 24 hours
Moderate.
Classification of TBI Severity - ___________________:
- Initial GCS: 8 or less
- PTA: More than 24 hours
- LOC: More than 24 hours
Severe.
_______________________ following a TBI is often defined in terms of six levels: Conscious, confused, delirious, obtunded, stuporous, and comatose.
Alteration of consciousness.
With disorientation following TBI, in what order does recovery occur?
- Place
- Person
- Time
- Person
- Place
- Time
With retrograde amnesia, recent memories are affected more than remote, and recovery usually involves the return of _______________ memories first.
Remote.
Research on recovery from TBI has linked it to a number of factors (e.g., age, gender, SES), including the presence of ________________ on the ______________________ gene. The greatest recovery typically occurs during the first ___ months, with considerable additional recovery through the first year.
- Allele e4
- Apolipoprotein E (ApoE)
- 3
___________________________ refers to a pattern of somatic and psychological symptoms that occur in up to 50% or more of individuals who have experienced a mild brain injury. Common initial symptoms of PCS are headache, dizziness, nausea, blurred vision, and drowsiness. Subsequent symptoms include insomnia and fatigue, tinnitus, cognitive impairment, and irritability, depression, or anxiety. The majority recover within one to three months.
Postconcussional Syndrome.
There are three major causes of a CVA (stroke): __________________ (blockage of an artery by a blood clot), ______________ (sudden blockage of an artery by material from another part of the bloodstream), and hemorrhage.
- Thrombosis
- Embolism
The major risk factors for stroke are _______________________ and _________________________ (thickening of the lining of the arterial walls); other factors that increase that risk include atrial fibrillation, myocardial infarction, diabetes mellitus, cigarette smoking, and increasing age.
- Hypertension
- Atherosclerosis
Different symptoms are associated with stroke involving the middle, anterior, or posterior _________________, but common symptoms include contralateral hemiplegia, contralateral hemianesthesia involving face, arm, and leg, and contralateral visual field loss (homonymous hemianopia).
Cerebral artery.
_________________ hemisphere damage may produce aphasia and ideomotor apraxia; ___________________ hemisphere damage may cause contralateral neglect and dressing apraxia.
- Dominant (L) hemisphere
- Non-dominant (R) hemisphere
Stroke Symptoms - _________________ Cerebral Artery:
Contralateral hemiplegia and hemianesthesia, contralateral homonymous hemianopia, dysarthia, aphasia (dominant hemisphere affected), apraxia and sensory neglect (non-dominant hemisphere affected).
Middle.
Stroke Symptoms - _________________ Cerebral Artery:
Contralateral homonymous hemianopia, memory loss, unilateral cortical blindness, visual agnosia.
Posterior.
Stroke Symptoms - _________________ Cerebral Artery:
Contralateral hemiplegia, gait apraxia, apathy, depression, confusion, impaired judgment and insight, bowel and bladder incontinence, mutism.
Anterior.
______________________, an autosomal dominant gene-linked degenerative disease, has been linked to a loss of GABA-secreting neurons and glutamate excitotoxicity in the basal ganglia, especailly in thecaudate nucleus, putamen, and globus pallidus.
Huntington’s Disease.
____________________ is due to a progressive degeneration of dopamine-containing cells in the substantia nigra, which affects other areas of the brain that connect with these cells, including certain areas in the thalamus and frontal lobes.
Parkinson’s Disease.
_____________ symptoms of Parkinson’s Disease include tremor at rest (e.g., pill-rolling” between the thumb and forefinger), muscle rigidity, akathisia (“cruel restlessness”). _____________ symptoms include postural disturbances, speech difficulties, bradykinesia (slowed movement), and akinesia (a reduction or absence of spontaneous movement).
- Positive
- Negative
A __________________ is due to abnormal electrical activity in the brain that causes one or more of the following symptoms:
a) An aura that signals the onset of the seizure (e.g., a feeling, odor, or noise)
b) A LOC
c) Some type of abnormal movement
Seizure.
_________________ seizures are bilaterally symmetrical and do not have a focal onset.
Generalized.
Generalized Seizures: ___________________ include a tonic stage in which the muscles contract and the body stiffens, a clonic stage that involves rhythmic shaking of the limbs, and postictal (postseizure) depression or confusion with amnesia for the ictal event.
Tonic-clonic (grand mal).
Generalized Seizures: ___________________ are brief attacks involving a loss of consciousness without prominent motor symptoms. The person often exhibits a “blank stare” with frequent eye blinking. There is some evidence that the thalamus plays a role in the generation of these.
Absence (petit mal).
________________ seizures begin on one side of the brain and affect one side of the body initially, although they sometimes spread and become generalized seizures.
Partial.
_____________ partial seizures do not involve a LOC, while ____________ partial seizures entail some alteration in consciousness.
- Simple
- Complex
_______________________ is the most common cause of partial seizures.
Temporal lobe epilepsy.
Seizure Symptoms - __________________ Lobe:
- Automatisms (e.g., lip smacking, chewing, stereotyped swimming movements)
- Hallucinations
- Sudden feeling of fear, happiness, sadness or other alteration in emotion
- Sense of deja vu or jamais vu (feeling of unfamiliarity with an object or place)
- Changes in personality
- Alteration in sexual behavior
- Autonomic signs (flushed face, pupillary dilation, changes in heart and breathing rates)
Temporal.
Seizure Symptoms - __________________ Lobe:
- Motor symptoms (e.g., jerky movements in the arm or leg on the opposite side of the body)
- “Speech arrest” (inability to talk) or other speech disturbance
- Olfactory hallucinations or illusions
- Autonomic symptoms
Frontal.
Seizure Symptoms - __________________ Lobe:
- Unusual physical sensations on the opposite side of the body (e.g., numbing, tingling, or burning)
Parietal.
Seizure Symptoms - __________________ Lobe:
- Rapid eyeblinking
- Unusual visual phenomena (e.g., flashing lights, balls of light, strange colors in the visual field opposite the affected lobe)
Occipital.
Multiple Sclerosis is more common in _____________ than in _____________, and onset is most often between the ages of ___ and ___.
- Women
- Men
- 20 and 40
At initial diagnosis, 80-85% of individuals with MS have the ___________________ type, which is characterized by alternating periods of relapse and remission. The majority of these individuals will eventualy convert to the ___________________ type, which involves a gradual worsening of symptoms without distinct periods of relapse and remission.
- Relapsing-remitting type
- Secondary progressive type
The __________________ are characterized by physical symptoms that are caused, maintained, or exacerbated by emotional factors. Most involve a single organ system, and many are related to the activity of the autonomic nervous system.
Psychophysiological.
Excessive activity of the sympathetic division of the ANS is believed to underlie ___________________ and _________________, while overactivity of the parasympathetic division has been linked to ___________________.
- Essential hypertension
- Migraine headache
- Ulcerative colitis
___________________ syndrome is a rapid deep-breathing attack that produces a drop in carbon dioxide, leading to respiratory alkalosis and cerebral hypoxia. Symptoms include chest pain, tingling and numbness in the hands and feet (parasthesia), dizziness, impaired concentration and memory, and tinnitus.
Hyperventilation.
____________________ hypertension is diagnosed when high blood pressure is not due to a known physiological cause, while __________________ hypertension is diagnosed when elevated blood pressure is related to a known disease. The former accounts for 85-90% of all cases of high blood pressure.
- Primary (essential)
- Secondary
____________________ involves general muscle aches, tenderness, and stiffness, fatigue, and sleep disturbances. It is more common in females than males and occurs most often in middle-age.
Fibromyalgia.
About 12% of migraine sufferers experience __________________ migraine, which starts with an aura (focal neurologicial symptoms), while the remaining sufferers have ____________ migraine, which does not have an aura but may be signaled by gastrointestinal or other symptoms.
- Classic
- Common
A ________________ headache involves excruciating, usually burning, pain that occurs in clusters (one or more a day) over a two to three month period. The nonthrobbing pain is usually located behind one eye and may also involve the face and temple.
Cluster.
A ________________ headache is characterized by nonthrobbing pain, usually on both sides of the head, at the back of the neck, and/or in the facial area. It is often experienced as a band of tightness around the head.
Tension.
______________ headaches are experienced as fullness, tension, or a throbbing ache. The pain is usually most severe first thing in the moring and is worsened by bending forward.
Sinus.
The _________________ system consists off several glands that release hormones directly into the circulatory system, which carries them to target organs where they exert their effects in various ways.
Endocrine.
The _______________ gland is also referred to as the “master gland” because of the effects it exerts on other endocrine glands. It secretes several hormones, including antidiuretic hormone (ADH) and somatotropic (growth) hormone.
Pituitary.
__________ acts in the kidneys to mediate fluid retention, and hyposecretion produces diabetes insipidus (excessive water loss).
ADH.
________________ stimulates muscle and skeletal growth and promotes protein synthesis. Hyposecretion of this hormone in childhood produces dwarfism, while hypersecretion results in giantism. Hypersecretion in adulthood causes acromegaly, which is characterized by grossly enlarged hands, feet, and facial features.
Somatotropic hormone.
The primary secretion of the thyroid gland is ______________, which regulates general metabolism. Hypersecretion produces ________________________, a disorder characterized by speeded-up metabolism, elevated body temperature, heat intolerancce, increased appetite with weight loss, accelerated heart rate, agitation, emotional lability, fatigue, insomnia, and reduced attention span.
- Thyroxine
- Hyperthyroidism (Graves Disease)
Hyposecretion of thyroxine produces __________________, which involves slowed metabolism, reduced appetite with weight gain, slowed heart rate, lowered body temperature, lethargy, depression, decreased libido, apathy, confusion, and impaired concentration and memory.
Hypothyroidism.
The pancreas releases ______________, which is involved in the uptake and use of glucose and amino acids.
Insulin.
Hyperinsulinism causes ____________________ (low blood glucose), a disorder involving hunger, dizziness, headaches, blurred vision, palpitations, anxiety, depression, and confusion.
Hypoglycemia.
Hypoinsulinism produces ___________________ (excessive blood glucose), which, when untreated, causes increased appetite with weight loss, polyuria, polydipsia, increased susceptibility to infection, and apathy, confusion, and mental dullness.
Diabetes mellitus.
