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Z. PATH 2 > Outcome 10 Neurology > Flashcards

Outcome 10 Neurology Flashcards

1
Q

Brain is damaged by a sudden disruption in the flow of blood to a part of the brain

A

Cerebrovascular Accident (CVA)

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2
Q

CVAs are also called _____ or _____

A

stroke or brain attack

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3
Q

3 types of vascular disorders causing CVA

A
  1. Occlusion by an atheroma
  2. Sudden obstruction by an embolus
  3. Cerebral bleed/hemorrhage
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4
Q

Symptoms of CVA

A

Severe headache, aphasia, dysplasia, sudden weakness, numbness or paralysis, confusion or impaired consciousness, drooping of one side of eyelid and mouth, vision difficulties, sudden dizziness, loss of balance and coordination

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5
Q

T or F. CVA needs immediate intervention to limit brain damage.

A

T

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6
Q

2 families of drugs to treat CVA

A
  1. Anticoagulants like Warfarin and Coumadin

2. Thrombolytic agents like aspirin or heparin (Iv)

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7
Q

Temporary episodes of impaired neurologic functioning caused by an inadequate flow of blood to a portion of the brain.

A

Transient Ischemic Attack (TIA)

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8
Q

TIAs are also called ____ or ____

A

“little strokes” or “mini strokes”

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9
Q

TIAs have a duration of less than ___ hours

A

24

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10
Q

TIAs are caused by a piece of plaque formed by ______

A

atherosclerosis

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11
Q

The plaque in TIA breaks away from a wall of an artery or heart valve and travels to the brain, which is known as an ____

A

emboli

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12
Q

Another cause for TIA are _______ from an arterial ulcer.

A

platelet fibrin emboli

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13
Q

Treatment for TIA depends on the _____ of the attack.

A

location

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14
Q

T or F. Anticoagulants are used during the episode to lessen the frequency or chance of TIA recurrences.

A

T

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15
Q

Chew _____ as symptoms appear in TIA

A

aspirin

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16
Q

Usually results in brain injury that can range from mild to life-threatening or fatal

A

head trauma

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17
Q

Collection or mass of blood forms between the skull and the dura mater

A

epidural hematoma

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18
Q

Epidural hematoma affects the area between the ____ and the ____, the outer most of the 3 meningeal layers

A

skull and the dura mater

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19
Q

In epidural hematoma, symptoms appear a few hours after ______

A

head trauma

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20
Q

Epidural hematoma symptoms include sudden headache, dilated pupils, nausea, vomiting, drowsiness and _____

A

hemiparesis

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21
Q

In epidural hematoma, blood from ______ seeps into and around the meningeal layers due to head trauma

A

ruptured vessels

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22
Q

In both subdural and epidural hematoma, sudden _____ and _____ causes brain to strike the skull

A

acceleration and deceleration

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23
Q

2 surgical interventions for subdural/epidural hematoma

A
  1. craniotomy

2. cranial trephination or burr hole

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24
Q

Craniotomy and trephination are procedures done to remove ______ and to cauterize ______ if increasing intracranial pressure becomes life threatening

A

accumulated blood; the bleeding vessel

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25
Q

The cause of epidural hematoma is typically a _____

A

blow to the head

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26
Q

The blood collects or pools between the dura mater and the arachnoid membrane

A

subdural hematoma

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27
Q

What areas of the brain are affected in a subdural hematoma?

A

the dura mater and the arachnoid membrane

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28
Q

The general cause of a subdural hematoma is ______

A

the head striking an immovable object

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29
Q

Symptoms of an epidural hematoma typically appear within _____ of a head trauma,

A

a few hours

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30
Q

Subdural hematomas have a _____, causing symptoms to appear later

A

delayed symptom onset

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31
Q

Epidural hematomas are usually caused by ______, while subdural hematomas are caused by ______

A

a blow to the head; the head striking an immovable object

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32
Q

Possible bruising of the cerebral tissue

A

cerebral concussion

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33
Q

Cerebral concussion is also called a ______

A

mild traumatic brain injury

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34
Q

In a cerebral concussion there is a disruption of the normal ______ in the brain, but the brain itself usually is not permanently injured

A

electrical activity

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35
Q

Cerebral concussions are caused by ______ movement of the head, as in an acceleration-deceleration insult

A

back and forth

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36
Q

Cerebral concussions are also caused by ____ trauma or falling

A

blunt force

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37
Q

Cerebral concussions are treated with quiet bed rest with observation for signs of _____

A

behavioral changes

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38
Q

Most severe concussion where the injury includes bruising of brain tissue along or just beneath the surface of the brain

A

cerebral contusion

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39
Q

Another name for cerebral contusion

A

contrecoup insult

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40
Q

Cerebral contusion is caused by a _____ or impacting against a _____ as occurs in a car accident.

A

blow to the head; hard surface

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41
Q

In cerebral contusion, a _____ force against ______ of the brain occurring when colliding with the _____ may damage structures deep in the brain.

A

twisting and shearing; two hemispheres; cranial bones

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42
Q

Contusion is associated with _____

A

skull fracture

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43
Q

A break or fracture in one of the bones of the cranium, when depressed or torn loose, they are pushed below the normal surface of the skull

A

depressed skull fracture

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44
Q

Depressed skull fractures are caused by ______ in the skull with a ______ object

A

direct impact; blunt object

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45
Q

In depressed skull fracture, a fractured bone may cut an ____ or ____ causing hemorrhage in the brain

A

artery or vein

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46
Q

Treatment for depressed skull fracture includes relieving the _____

A

intracranial pressure

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47
Q

Surgical intervention for depressed skull fracture that elevates the bone back into place

A

craniotomy

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48
Q

____ is used in depressed skull fractures until they are partially healed

A

head protection

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49
Q

Injury of the spinal cord affect the innervation of any spinal nerves distal to the point of insult.

A

paraplegia and quadriplegia

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50
Q

In para/quadriplegia, the ____ and ____ often result in the failure of spinal nerve functioning.

A

extent of the injury and consequential edema

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51
Q

Loss of nerve function below the waist, resulting in paralysis of the lower trunk and legs

A

paraplegia

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52
Q

Loss of nerve function at the cervical region resulting in paralysis of the arms, hands, trunk and legs

A

quadriplegia

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53
Q

Para/quadriplegia are due to _____ or _____

A

vertebral fractures or dislocation

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54
Q

In para/quadriplegia, the ____ causes injury/trauma to the cord and the severity of the trauma.

A

site

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55
Q

In paraplegia there is trauma to ___ and below

A

T1

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56
Q

2 other causes for paraplegia

A
  1. vertical compression

2. hyperflexion

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57
Q

In quadriplegia, there is trauma to ___ and above

A

C5

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58
Q

Para/quadriplegia are treated with restoration of the normal ____ and ____ of the spine;

A

alignment and stability

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59
Q

4 other treatments for para/quadriplegia

A
  1. decompression of the spinal cord, nerves and vertebrae 2. early rehab.
  2. neck and spine stabilization.
  3. hypothermic state to injured area
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60
Q

In para/quadriplegia, ____ is used to prevent or slow edema

A

methylprednisone

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61
Q

Degeneration or deterioration of an intervertebral disc that may result in pain in the areas served by the spinal nerves of the involved disc space.

A

degenerative disk disease (DDD)

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62
Q

DDD is caused by age due to decreased ____ in the disc, or ____ wear and tear.

A

water; mechanical

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63
Q

Misalignment in DDD can cause ____ and ____, eventually involving the nerve roots causing scarring.

A

inflammation and disc destruction

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64
Q

2 key diagnostic indicators that accompany a depressed skull fracture

A
  1. battle’s sign (bruising behind the ears)

2. racoon eyes (bruising around and under the eyes

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65
Q

DDD sequela is _____

A

spinal stenosis

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66
Q

4 treatments for DDD

A
  1. be active
  2. analgesics and NSAIDs
  3. physical therapy
  4. spinal fusion and freeing of the nerve roots from entrapment
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67
Q

Rupture of the nucleus pulposus through the annular wall of the disc and into the spinal canal

A

herniated and bulging disk

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68
Q

Herniated and bulging disk is also called ____ or ____

A

ruptured or slipped disk

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69
Q

4 causes for herniated and bulging disk

A
  1. accumulated trauma
  2. sudden impact
  3. poor posture
  4. aging
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70
Q

Conservative treatment of herniated and bulging disk consists of using ____ and ____

A

hot and cold packs

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71
Q

Family of drugs to treat herniated and bulging disk

A

relaxants and analgesics

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72
Q

3 surgical interventions used for herniated and bulging disks where the herniated disc may be excised

A
  1. percutaneous discectomy
  2. microdiscectomy
  3. removal of the disk with laminectomy and fusion of the vertebrae
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73
Q

Pathologic condition brought about by trauma, degeneration or rupture of the nucleus pulposus

A

sciatic nerve injury or spinal stenosis

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74
Q

In sciatic nerve injury, rupture of the nucleus pulposus occur within intervertebral discs ___ through ___

A

L4, S3

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75
Q

In spinal stenosis, there is narrowing of the spinal canal or _____ because of compression on the spinal cord and spinal nerve roots

A

nerve root foramen (sciatica)

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76
Q

Trauma to sciatic nerve may result from a fall, gunshot or stab wounds, or poor ____

A

body mechanics

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77
Q

In spinal stenosis, ____ can lead to degeneration of the disc or the nucleus pulposus.

A

aging

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78
Q

An _____ may prompt more rapid degeneration of spinal stenosis

A

inflammatory autoimmune response

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79
Q

In spinal stenosis, aging and arthritic changes may also cause narrowing of the ____ and the ____

A

spinal canal and the foramen

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80
Q

3 treatment options for spinal stenosis

A
  1. oral prednisone
  2. physical therapy
  3. ultrasound diathermy with massage
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81
Q

Pain in the head that is not confined to any one specific nerve distribution area

A

headache

82
Q

Another word for headache

A

cephalalgia

83
Q

Causes of headaches

A

–

84
Q

Family of drugs to treat headaches

A

NSAIDs

85
Q

Periodic severe headaches that may be completely incapacitating and almost always are accompanied by other symptoms, such as nausea and vomiting, anorexia, intense hemi cranial or bilateral throbbing pain and visual signs and symptoms

A

migraine

86
Q

Causes of migraine is unknown but may be biological with changes in the _____

A

cerebral blood flow

87
Q

2 types of spinal cord injuries

A

paraplegia and quadriplegia

88
Q

In migraines there is ______ followed by _____ of the cerebral and cranial arteries

A

vasoconstriction; vasodilation

89
Q

Family of drugs to treat migraines

A

analgesics

90
Q

Chronic brain disorder, characterized by sudden episodes of abnormal intense electrical activity in the brain which results in seizure activity

A

epilepsy/seizure disorder

91
Q

Type of epilepsy with known abnormalities in the brain resulting from a pathologic process, genetic or acquired

A

symptomatic epilepsy

92
Q

Pathologic conditions associated with seizures

A
  1. scar tissue on cerebral cortext from infection or trauma
  2. cortical neoplasm
  3. cerebral edema
  4. TIAs
  5. CVAs
93
Q

Other possible causes of epilepsy

A
  1. birth trauma (cerebral palsy)
  2. drug toxicity
  3. diabetes
  4. hypoglycemia
  5. other conditions depriving the brain of oxygen
94
Q

Family of drugs to treat epilepsy

A

anticonvulsants ex.phenytoin, carbamazepine, valporic acid, etc

95
Q

Common slowly progressive neurologic disorder characterized by the onset of recognizable disturbances

A

Parkinson’s disease

96
Q

4 recognizable disturbances in Parkinson’s disease

A
  1. “pill-rolling” tremor of the thumb and forefinger
  2. muscular rigidity
  3. slowness of movement
  4. postural instability
97
Q

T or F. In Parkinson’s, the cause of the degeneration of nerves in the motor system is unknown.

A

T

98
Q

In Parkinson’s, a deficiency of _____ has been clinically demonstrated in patients with this disease

A

dopamine

99
Q

Parkinson’s can also occur after which three incidents?

A
  1. after ingestion of poison, 2. after encephalitis

3. after taking certain major tranquilizers and certain antihypertensive drugs

100
Q

In Parkinson’s, degenerative disease of the brain involve ______ parts of the brain

A

preferentially various

101
Q

T or F. There is no cure and no known way of preventing Parkinson’s

A

T

102
Q

A hereditary degenerative disease of the cerebral cortex and basal ganglia where progressive atrophy of the brain occurs

A

Huntington’s chorea/disease

103
Q

The exact cause of Huntington’s disease is uncertain but it is an _____ trait that can be inherited by either sex

A

autosomal dominant

104
Q

General cause of spinal cord injuries (para/quadriplegia)?

A

vertebral fractures and/or dislocations

105
Q

3 ways to classify spinal cord injuries in terms of injury mechanism

A
  1. compression
  2. hyperflexion
  3. hyperextension
106
Q

In spinal cord injuries, damage occurring the ___ vertebral level is usually fatal

A

C3

107
Q

Surgical treatment option for degenerative disk disease

A

spinal fusion and freeing of the nerve roots from entrapment

108
Q

In ______ disk there is a rupture of the nucleus pulposus through the annular wall of the disk and into the spinal call

A

herniated disk

109
Q

In _____ disk, the nucleus pulposus extends into the inner annulus only

A

bulging disk

110
Q

Another name for spinal stenosis

A

sciatica

111
Q

3 sciatic nerve injury/spinal stenosis surgical interventions

A
  1. discectomy or microdiscectomy
  2. spinal fusion
  3. chemonucleolysis and/or decompression
112
Q

For Huntington’s disease, haloperidol lactate and fluphenazine are prescribed to reduce ____

A

agitation

113
Q

Progressive destructive motor neuron disease that results in muscular atrophy

A

amyotrophic lateral sclerosis (ALS)

114
Q

ALS is also called _____ disease

A

Lou Gehrig’s

115
Q

ALS may be caused by ______ trait

A

autosomal inherited

116
Q

A new drug that has shown promise in slowing progression and extending life of ALS patients

A

Riluzole

117
Q

In ALS, tizanidine and baclofen are muscle relaxants to help relieve _____

A

muscle spasticity

118
Q

Neurologic condition typified by an overwhelming urge to move the legs or body part is to stop an uncomfortable or odd sensation

A

restless legs syndrome (RLS)

119
Q

Restless legs syndrome incidence appears to increase after the ages ___ and ___

A

40 and 50

120
Q

2 things that may play a role in causing RLS

A
  1. anemia

2. stress

121
Q

Family of drugs to alleviate or lessen symptoms in RLS

A

dopamine agonists

122
Q

Frightening and anxiety provoking total loss of recent memory; learning process is completely blocked. Memory disturbances are involved

A

transient global amnesia

123
Q

Transient global amnesia temporary duration is __ to __ hours

A

1 to 6 hours

124
Q

5 precipitating events to transient global amnesia

A
  1. stress or emotional events
  2. swimming
  3. immersion in cold water
  4. driving a motor vehicle
  5. sexual intercourse.
125
Q

Transient global amnesia patient may have experienced _____ on previous occasions, usually without nausea, vomiting or photosensitivity

A

migraine headaches

126
Q

T or F. Transient globa amnesia is treatable

A

F

127
Q

Degeneration of peripheral nerves

A

peripheral neuritis

128
Q

Another name for peripheral neuritis

A

neuropathy

129
Q

Peripheral neuritis is caused by toxicity of what 6 vthings

A
  1. chronic alcohol intoxication
  2. arsenic
  3. lead
  4. carbon disulfide
  5. benzene
  6. phosphorus
130
Q

2 other causes for peripheral neuritis

A
  1. infections
    - mumps
    - pneumonia
    - diphtheria
  2. metabolic or inflammatory disorders
    - diabetes
    - rheumatoid arthritis
    - gout
    - systemic lupus erythematosus
131
Q

2 physiologic causes of headache

A
  1. tension headache

2. vascular headache

132
Q

Headache strain on facial, neck and scalp muscles

A

tension

133
Q

Headache caused by edema within the blood vessels of the head resulting in change in arterial size

A

vascular

134
Q

Type of preparation taken at the first sign of a migraine to help

A

Ergot preparation

135
Q

Symptoms of migraine other than a headache

A

nausea
anorexia
visual symptoms

136
Q

Seizure that arises from a localized area in the brain

A

partial seizure

137
Q

Seizure where there is diffuse electrical abnormality within the brain

A

generalized seizure

138
Q

Prolonged seizure activity – one seizure follows another with no recovery of consciousness between attacks

A

status epilepticus

139
Q

Families of drugs to treat peripheral neuritis

A

anticonvulsants and tricylic antidepressants

140
Q

Pain of the area innervated by the fifth cranial (trigeminal) nerve, the trigeminal nerve

A

trigeminal neuralgia

141
Q

Another name for trigeminal neuralgia

A

tic doloureux

142
Q

Trigeminal neuralgia may be related to compression of a _____ by a tumor or vascular lesion

A

nerve root

143
Q

Trigeminal neuralgia is a sequela to _____ or _____

A

multiple sclerosis or herpes zoster

144
Q

Families of drugs to treat trigeminal neuralgia

A

analgesics, anticonvulsants or muscle relaxants

145
Q

Disorder of facial nerve that causes a sudden onset of weakness or paralysis

A

Bell’s palsy

146
Q

Symptoms of Bell’s palsy result from blockage of impulses from the cranial nerve # __ caused by compression of the nerve in the bony canal

A

7th cranial (facial) nerve

147
Q

_____ has been noted in a small percentage of people with Lyme disease

A

bilateral facial paralysis

148
Q

T or F. Early treatment is critical in Bell’s palsy

A

T

149
Q

Procedure to stimulate the nerve and prevent muscle atrophy in Bell’s palsy

A

electrotherapy

150
Q

4 other treatments for Bell’s palsy

A
  1. warm moist heat
  2. gentle massage
  3. facial exercise to stimulate muscle tone
  4. prednisone
151
Q

Inflammation of the meninges, the membranous coverings of the brain and spinal cord

A

meningitis

152
Q

Meningitis can originate directly from which 3 areas?

A
  1. brain
  2. spinal cord
  3. sinuses
153
Q

3 bacteria most responsible for meningitis

A
  1. Haemophilus influenza
  2. Neisseria Meningitidis
  3. Streptococcus pneumoniae
154
Q

4 treatment options for meningitis

A
  1. aggressive IV antibiotic therapy
  2. anticonvulsants to control seizure
  3. glucocorticoids to reduce cerebral inflammation and edema
  4. aspirin and acetaminophen are used for headaches
155
Q

Inflammation of brain tissue

A

encephalitis

156
Q

3 types of encephalomyelitis

A
  1. Eastern equine
  2. Western equine
  3. Venezuelan equine
157
Q

Non-endemic encephalitis

A

West Nile viral encephalitis

158
Q

Encephalitis is caused by viruses or the toxins from ____ or ____ from mosquito bites

A

chickenpox measles or mumps

159
Q

Antiviral agents are effective against only ____ encephalitis

A

herpes simplex

160
Q

4 encephalitis treatments

A
  1. mild analgesics for pain,
  2. antipyretic for elevated temperatures,
  3. anticonvulsants for seizure activity
  4. antibiotic for any intercurrent infection
161
Q

4 recognizable disturbances associated with Parkinson’s disease

A
  1. pill rolling tremor
  2. muscular rigidity
  3. slowness of movement (shuffling gait)
  4. postural instability
162
Q

Acute rapidly progressive disease of the spinal nerves

A

Guillain-Barré syndrome

163
Q

Guillain-Barré syndrome is on ____ but has more of a ____ process

A

autoimmune; infectious

164
Q

Surgical treatment option for Parkinson’s disease

A

deep brain stimulation

165
Q

Guillain-Barre syndrome has been known to follow a _____ or gastroenteritis after 10-21 days

A

respiratory infection; gastroenteritis

166
Q

Guillain-Barré syndrome is associated with _____ of the nerves

A

demyelination

167
Q

To treat Guillain-Barré syndrome, _____ washes the plasma to remove antibodies, thereby shortening the time required for recovery

A

plasmapheresis

168
Q

IV ____ may be beneficial in treating Guillain-Barré syndrome

A

immunoglobulin

169
Q

Collection of pus can occur anywhere in the brain tissue

A

brain abscess

170
Q

CNS abscesses may be the result of _____ or _____ infections elsewhere in the body

A

local or secondary

171
Q

3 common causative organisms for brain abscess

A
  1. Staphylococci
  2. Streptococci
  3. Pneumococci
172
Q

Brain abscess can be caused by ______ including head trauma and a craniotomy wound, or a port of entry for microorganism

A

breaches in the integrity of CNS

173
Q

2 drugs to treat brain abscess

A
  1. IV antibiotics to resolve infection

2. Mannitol or steroids are to reduce cerebral edema

174
Q

Drainage of the brain abscess may be necessary to relieve _____ and to _____ the offending organism

A

intracranial pressure; culture

175
Q

Viral infection of the anterior horn cells of the gray matter of the spinal cord and causes a selective destruction of the motor neurons

A

poliomyelitis

176
Q

Another name for poliomyelitis

A

Postpolio syndrome

177
Q

In poliomyelitis, ____ enters the body through the nose and throat and crosses into the gastrointestinal tract

A

poliovirus

178
Q

In poliomyelitis, poliovirus reproduces in the ____ and travels in the ____

A

lymphoid tissue; bloodstream

179
Q

In poliomyelitis, poliovirus travels to CNS where the virus assaults the ____ of the ____

A

motor neurons of the spinal cord

180
Q

Poliomyelitis is transmitted from person to person by ____ or ____

A

infected oropharyngeal secretion or feces that contain the virus

181
Q

2 types of polio vaccines

A
  1. inactivated polio vaccine (IPV)

2. oral poliovirus vaccine (OPV)

182
Q

3 different serotypes of polio virus

A

Type1
Type2
Type 3

183
Q

_____ vaccine and ____ vaccine afford immunity from all 3 forms of poliomyelitis

A

sabin trivalent oral vaccine; salk vaccine

184
Q

Ceaseless, uncontrolled, involuntary movements (Huntington’s)

A

chorea

185
Q

T or F. Huntington’s chorea causes personality changes

A

T

186
Q

T or F. Mind functioning is affected in ALS

A

F; the main result of ALS is muscular atrophy

187
Q

Peripheral neuritis typically affects the ____ of the ____

A

distal muscles of the extremities

188
Q

Peripheral neuritis leads to muscle ____ and sensory ____

A

weakness; loss

189
Q

Surgical treatment for trigeminal neuralgia to alleviate pain

A

dissection of nerve root

190
Q

T or F. Bell’s palsy is usually bilateral

A

F; usually unilateral

191
Q

What must be ruled out before treating Bell’s palsy

A

CVA

192
Q

Key symptom of meningitis

A

stiff neck

193
Q

Stiffness of the neck that resists any sideways or flexion-extension movement

A

nuchal rigidity

194
Q

2 diagnostic signs of meningitis

A
  1. Kernig’s sign

2. Brudzinski’s sign

195
Q

2 types of meningitis

A
  1. bacterial

2. viral (less serious)

196
Q

Type of causative pathogen for encephalitis

A

virus, but can be caused by toxins from chickenpox, measles, or mumps

197
Q

In Guillain-Barre Syndrome, symptoms start at ___ and ___

A

feet and hands

198
Q

In Guillain-Barre Syndrome, progressive muscle weakness and paralysis follows in ___ to ___ hours

A

24 to 72 hours

199
Q

Guillain-Barre is on an autoimmune basis but can also follow a ____ or ____

A

respiratory infection; gastroenteritis

200
Q

A lumbar puncture contraindicates when diagnosing a brain access because the increased ICP can cause the ____ to ____, causing death

A

brainstem to herniate

201
Q

Type of neurons selectively destroyed in poliomyelitis

A

motor neurons

202
Q

Postpolio syndrome typically appears ___ years or more after the original infection in a person who has had polio

A

30

Z. PATH 2 (17 decks)

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