Test 3 practice Qs Flashcards
Identify the three (3) cardinal signs of Parkinson’s disease.
Resting tremor
Bradykinesia/akinesia
Rigidity/muscle stiffness
Neurons in the substantia nigra of the basal ganglia (which degenerate in Parkinson’s disease) secrete which neurotransmitter?
Dopamine
Which structures of the nervous system are affected by demyelination in MS vs Guillain-Barré syndrome:
Spinal nerves, brain, spinal cord, cranial nerves, optic nerves
MS: Spinal cord, optic nerves, brain (CNS)
G-B: Spinal nerves, cranial nerves
Describe each of the following types of MS:
relapse-remitting
primary progressive
secondary progressive
- Relapse-remitting: periods of acute exacerbation with no progression of disease in between
- Primary progressive: continuous progression of disease from onset
- Secondary progressive: begins as relapse-remitting but eventually becomes continuously progressive
Which of the following conditions is most strongly associated with certain bacterial or viral infections?
Epilepsy, Myasthenia Gravis, Guillain-Barré syndrome, Parkinson’s disease
Guillain-Barré syndrome,
Muscle weakness that worsens with exertion and improves with rest is likely to indicate:
MS, Parkinson’s, myasthenia gravis, or epilepsy?
myasthenia gravis
Describe the following types of seizures:
Tonic, simple partial, tonic-clonic, myoclonic, atonic, absence
Tonic - Increase in muscle tone and body rigidity w loss of consciousness
Simple partial - Limited motor or sensory experience without the LOC or awareness
Tonic-clonic - LOC w increased muscle tone and body rigidity followed by convulsions
Myoclonic - brief muscle jerks or twitches, usually involving a single muscle group
Atonic - widespread loss of muscle tone
Absence - brief episodes of altered consciousness characterised by staring and unresponsiveness
What are the proportions of the following components for intracranial volume?
Brain tissue, blood, CSF
Brain tissue 80%
Blood 10%
CSF 10%
Outline some of the impacts that can result from a rise in intracranial pressure (ICP).
- Decreased cerebral blood flow leading to hypoxia and hypercapnia
- Compression of brain tissue and brain herniation leading to decr. respiration
- Alterations in consciousness leading to coma
- Alterations in ventilation leading to decr. respiration
- Pupils become fixed and dilated
Describe arousal and identify the part of the brain which mediates it.
- State of wakefullness or an awareness of one’s surroundings
- Mediated by the reticular formation of the brainstem
What are the categories on the GCS?
Motor response, eye opening, verbal response
On the GCS, a severe TBI would score bw what range?
3-8
Distinguish between an open (penetrating) and closed (blunt) TBI.
In an open TBI the skull and meninges are damaged/broken, exposing the brain to the external environment whereas a closed TBI there is not damage/breakage of the skull and meninges and the brain is not exposed
What is an example of a diffuse brain injury?
Concussion
The coup injury in a TBI refers to what?
the damage occurring at the point of impact
The countercoup injury in a TBI refers to what?
the damage occurring in areas of the brain opposite to the point of impact
Hemorrhagic stroke is most commonly caused by what?
Ruptured aneurysm
What are the 2 main causes of an ischemic stroke?
Embolus and thrombus
Identify what each of the letters in the acronym FAST stand for and outline what each one means.
F: face, refers to whether one side of mouth droops
A: arm, refers to whether one arm drifts downwards
S: speech, refers to whether there’s slurred or difficult speech
T: time, refers to the need to act fast
What is a cord laceration?
Tearing of neural tissue resulting in loss of function
What is the difference between a complete and incomplete spinal cord injury?
Complete - involves total loss of sensory and motor functions at and below lesion level
Incomplete - there is some level of sensory and/or motor function retained below the lesion level.
Damage at the following spinal cord segments would result in what effect on ventilation? C1,2,3,4,5,6,7,8 T1-5 T6-12 L1-Co1
No control of ventilatory muscles: C1-C4
Diaphragm control only: C5-C8
Diaphragm and intercostal control: T1-T5, T6-T12 and L1-Co1
Describe spinal shock
Complete loss of all spinal cord functions incl. reflexes, below lesion level immediately following the primary injury and lasting from a few days to a few months
Swelling of the spinal cord is a typical part of which pathological aspect of injury?
Secondary injury
Clinical manifestations of T3 injury
- Loss of bladder, bowel and sexual control
- Paraplegia
- Loss of sensation in lower limbs and trunk
Outline the functional effects of two (2) of the cord syndromes
- Central cord syndrome: motor impairment of mostly upper limbs and bladder/bowel dysfunction and various sensory loss
- Brown-Séquard syndrome: loss of motor function, light touch, proprioception and vibration sensation ipsilateral to the injury, and loss of pain and temp sensation contralateral to the injury
- Anterior cord syndrome: loss of bilateral motor functions and pain and temp sensations
- Posterior cord syndrome: loss of bilateral light touch sensation and proprioception
Lower back pain, paresthesia and muscle weakness in the legs would most likely indicate which of the following?
- Prolapsed disc in lumbar region
- Burner (stingers) syndrome
- Nerve root avulsion
- Cord contusion within thoracic region of spinal cord
Prolapsed disc in lumbar region
Which types of tissues are injured in sprains vs strains?
Sprain: ligament
Strain: muscle and/or tendon
A patient has sprained their ankle and presents with moderate pain, a swollen ankle and slight bruising, but is still able to stand/walk without significant effect on the joint/joint stability. Which severity of sprain do you suspect this patient has suffered?
Grade II, but would still need to be confirmed via imaging
A patient has strained one of their hamstrings and presents with intense pain, obvious swelling and dark purple-red discolouration on the back of the thigh. They are unable to put weight on their affected leg and have very limited knee flexion and hip extension. Which severity of muscle strain do you suspect this patient has suffered?
Grade III, but would still need to be confirmed via imaging
What is a comminuted fracture?
is a break that results in three (3) or more pieces of bone
Which of the following are complications of bone fracture?
Hematoma, malunion, bony callus, hypovolaemic shock, fat embolism, infection
Malunion, hypovolaemic shock, fat embolism, infection
Identify three (3) signs/symptoms of bone fracture.
Pain, swelling, deformity, muscle spasm, impaired sensation, decreased limb function
Identify & describe the four (4) phases of fracture repair.
- Haematoma formation: bleeding from broken ends of bone accumulates at site and swelling occurs
- Soft callus formation: granulation tissue fills the gaps and joins the fragmented ends of bone together; new blood vessels begin forming
- Bony callus formation: bone tissue replaces the granulation tissue
- Remodelling: of bone tissue occurs to bring bone shape back to original, or as close as possible
What are the three types of cartilage and where can you find each type within the skeleton?
- Hyaline cartilage: lines the ends of bones within joints (articular cartilage) and attaches ribs to sternum (costal cartilage)
- Fibrocartilage: between the vertebrae, in the pubic symphysis, within the knee joints
- Elastic cartilage: not associated with skeleton (outer ear and epiglottis)
List the four (4) types of bone cells AND outline the function of each.
- Osteogenic cells: mitotically active cells which generate new bone cells
- Osteoblasts: build the ECM of bone (produce collagen fibers and incorporate mineral salts into ECM)
- Osteoclasts: resorb (breakdown) bone
- Osteocytes: former osteoblasts that now direct the activities of the other bone cells
Describe osteoporosis
Decrease in bone density
- compact bone = porous and thinner
- cancellous bone = decreased integrity
What is the greatest risk associated with osteoporosis?
Bone fracture
Which types of arthritis are autoimmune conditions?
Rheumatoid and ankylosing spondylitis
Which type of arthritis involves the deposition of uric acid crystals into joint tissues?
Gout
Which type of arthritis tends to involve multiple joints, bilaterally?
Rheumatoid arthritis
Ankylosing spondylitis:
A) most commonly affects the joints of the distal limbs
B) typically includes enthesitis (inflammation of ligament/tendon attachment sites)
C) is most commonly associated with ‘wear & tear’, or hard use, of the involved joints
D) is generally considered a condition of aging
B) typically includes enthesitis (inflammation of ligament/tendon attachment sites)
List the epidermal strata
Stratum corneum Stratum lucidum (if present) Stratum granulosum Stratum spinosum Stratum basale
Which of the following skin conditions are caused by an infectious organism?
Cellulitis, acne vulgaris, melanoma, folliculitis, psoriasis, dermatitis, furuncles (boils)
Cellulitis, folliculitis, furuncles (boils)
Which skin condition is characterized by hyperproliferation of keratinocytes and dermal vascular changes
psoriasis
True or false: Furuncles occur when bacterial infection of hair follicles spreads to the dermis
True
Describe cellulitis and outline its key signs & symptoms.
Bacterial infection of the dermis and hypodermis, typically presenting w erythema, swelling, warmth and pain on one leg
Name and describe each type of skin cancer
- Basal cell carcinoma: slow-growing cancer arising in epidermal basal cells
- Squamous cell carcinoma: cancer arising in outer layer keratinocytes that eventually invades the dermis
- Melanoma: aggressive and invasive cancer originating in melanocytes
Which stages of pressure injury are full thickness (i.e. all layers of the skin are injured)?
Stages 3 and 4, possibly unstageable
Outline any three (3) differences between arterial and venous ulcers.
- arterial caused by atherosclerosis/diabetes/arterial thromboembolism whereas venous caused by varicose veins/DVT/venous hypertension
- arterial smaller and deeper whereas venous shallow and large // arterial located on toes, feet, shin (over bony prominences) whereas venous on ankle/over malleoli
- arterial treated w angioplasty/bypass/amputation whereas venous treated by leg elevation/compression stockings/vein ligation
