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Pathophysiology for Nursing > Unit 2 Module 2: Neurology > Flashcards

Unit 2 Module 2: Neurology Flashcards

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1
Q

Pathological changes with a stroke t/f: cellular injury and death

A

true

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2
Q

status epilepticus: hyper or hypo tension

A

hypotension

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3
Q

Parkinson’s symptom related to dysphagia

A

difficulty swallowing (drooling)

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4
Q

What are the three components in the Monro-Kellie hypothesis?

A

blood volume, cerebral spinal fluid, brain tissue

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5
Q

Cog wheel rigidity

A

Hesitation before clicking forward into the next position

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6
Q

t/f: neuritic plaques are outside the neuron

A

true

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7
Q

What are non-clot causes of embolic strokes?

A

fat embolism, air embolism, foreign body

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8
Q

myoclonus

A

brief muscle twitching (often happens while falling asleep)

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9
Q

neuropsychiatric disorders with Parkinson’s

A

mood changes, dementia, hallucinations

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10
Q

Hypoxic or ischemic: stroke

A

hypoxic

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11
Q

What are small vessel local occlusion strokes?

A

lacunar strokes

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12
Q

Which component of Alzheimer’s pathology has the greatest significance?

A

abnormal tau proteins

The presence of abnormal tau is where the focus is. There is a great statement by one of the researchers. Amyloid plaque pulls the trigger and tau protein is the bullet in the gun.

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13
Q

When increased intracranial pressure occurs in the brain, what is the relationship between ICP and arterial pressure?

A

ICP= arterial pressure

this impacts blood flow and the exchange of oxygen. This first starts to happen in stage 3.

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14
Q

Where is dopamine made?

A

substantia nigra of basal ganglia

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15
Q

t/f: All Alzheimer’s disease is hereditary

A

false

Early onset Alzheimer’s disease (diagnosed before the age of 50) has an inheritable genetic component, but this has not been found in all individuals with Alzheimer’s disease.

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16
Q

Parkinson’s symptom related to lack of facial expression

A

mask-like face

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17
Q

Pathological changes with a stroke t/f: local alkalosis

A

false. anaerobic metabolism –> lactic acidosis

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18
Q

Dementia or delirium: consistent behavior at home and at the hospital

A

dementia

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19
Q

atonic

A

loose muscle control

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20
Q

status epilepticus: acidosis or alkalosis

A

acidosis

respiratory acidosis initially, and metabolic acidosis with prolonged seizing

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21
Q

bradykinesia

A

slow moving – difficulty getting started moving, stopping, shuffling gate

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22
Q

tonic

A

muscles become tense or rigid

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23
Q

Pathological changes with a stroke t/f: elevated lymphocytes

A

false: inflammatory cells and cytokine release

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24
Q

What does BE FAST stand for?

A

Balance
Eyes

Face
Arms
Speech
Time

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25
Q

Do stroke symptoms present ipsilaterally or contralaterally?

A

contralaterally

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26
Q

What dysrhythymia causes 25% of all strokes

A

a-fib

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27
Q

status epilepticus: compartment syndrome or rhabdomyolysis

A

rhabdo –> kidney failure

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28
Q

hemineglect

A

inability to react to stimuli on affected side

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29
Q

Pathological changes with a stroke t/f: antioxidant effects

A

false: free radicals and toxic metabolites

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30
Q

What is a CVA

A

death of brain tissue

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31
Q

What is a difficulty expressing or understanding speech

A

aphasia

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32
Q

What is difficulty articulating words (physically)

A

dysarthria

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33
Q

What is a key environmental factor in Parkinson’s development?

A

insecticides

34
Q

Hemorrhagic strokes are [more/less] common and have [better/worse] prognosis

A

Hemorrhagic strokes are [less] common and have [worse] prognosis

35
Q

Parkinson’s autonomic dysfunction symptoms

A

loss of blinking, excessive sweating, drooling, orthostatic blood pressure

36
Q

Pathological changes with a stroke t/f: neuron instability

A

true

37
Q

What does CVA stand for

A

cerebral vascular accident

38
Q

Dementia or delirium: insidious onset

A

dementia

39
Q

t/f: acetylcholine and dopamine reinforce each other

A

false: they balance each other out

40
Q

status epilepticus: hyper or hypo glycemia

A

hypoglycemia

41
Q

Michael J. Fox is typical of Parkinson’s presentation in that

A

he is male (2x more common than female)

42
Q

Pathological changes with a stroke t/f: necrotic core with surrounding penumbra

A

true

necrotic core with surrounding penumbra
anaerobic metabolism--> lactic acidosis
neuron instability
Na/K pump malfunction (no ATP)--> cellular swelling--> cerebral edema (can cause increased ICP)
inflammatory cells and cytokine release
cellular injury and death
free radicals and toxic metabolites
release of glutamate
43
Q

Michael J. Fox is atypical of Parkinson’s presentation in that

A

he was 29 at dx (typically 60-70 years at dx)

44
Q

What does the tau protein contribute to?

A

neurofibrillary tangles

45
Q

Pathological changes with a stroke t/f: release of lysine

A

false: release of glutamate

46
Q

What is the body positioning in decorticate posturing?

A

internal rotation, protecting chest

47
Q

Pathological changes with a stroke t/f: Na/K pump malfunction

A

true: Na/K pump malfunction (no ATP)–> cellular swelling–> cerebral edema (can cause increased ICP)

48
Q

dementia or delirium: Family notices that the patient is becoming more and more forgetful. He went to the grocery store and got lost coming home

A

dementia

49
Q

How long is a status epilepticus?

A

5+ minutes, or repeated seizures over 30 minutes

50
Q

Initially after a brain attack (CVA), a client’s pupils are equal and reactive to light. Later the nurse assesses that the right pupil is reacting more slowly than the left and the systolic blood pressure is beginning to increase. The nurse concludes that these signs are suggestive of

A

Increasing intracranial pressure

51
Q

In the Southeastern U.S., we are more prone to…

A

strokes (stroke belt) potentially linked to fried fish

52
Q

Is Alzheimer’s disease a normal part of aging?

A

no

53
Q

dementia or delirium: Patient becomes confused after being admitted to the hospital for hip surgery after falling at home.

A

delirium

54
Q

hemiplegia

A

unilateral paralysis

55
Q

What is beta amyloid protein

A

primary component of neuritic plaques

56
Q

What are the elements of Cushing’s triad

A

Increased blood pressure (but wide gap between systolic and diastolic)
Decreased pulse
Irregular respiratory pattern

57
Q

What is normal intracranial pressure?

A

0-15 mmHg

58
Q

What is the most common type of stroke?

A

thrombotic

59
Q

What are the two types of ischemic stroke?

A

Thrombotic (blood clot) and embolic (blood clot from elsewhere)

60
Q

Typical Parkinson’s posture and gait

A

stooped, reduced arm swing, shuffling gait

61
Q

What is the role of acetylcholine?

A

important for memory formation. 90% below normal in advanced Alzheimer’s

62
Q

Does a brain with cerebral atrophy look plump or shriveled

A

shriveled

63
Q

dementia or delirium: This problem is non-curable and will eventually result in the patient being bed-bound and requiring total care.

A

dementia

64
Q

A patient knows a seizure is coming from a gustatory, visual, or auditory forewarning.

A

aura

Auras are actually partial seizures that proceed a generalized tonic clonic seizure. I always ask seizure patients if they have an aura, to help alert me when I am caring for them.

65
Q

How are seizures grouped?

A
  • motor or non-motor
  • aware or impaired awareness
  • origination area in the brain
66
Q

t/f: Almost all Downs syndrome folks above 45 develop Alzheimer’s

A

true

67
Q

CVA risk factors

A 
Hypertension
Heart disease
Atrial fibrillation
Dyslipidemia
Diabetes mellitus
Oral contraceptives, hormone replacement therapy, illegal drugs like cocaine
Smoking, excessive alcohol use
Migraines
68
Q

After an automobile accident a client who is unconscious and exhibiting decerebrate posturing is brought to the emergency department. When assessing the client, what does the nurse expect to observe?

A

hyperextension of both the upper and lower extremities

69
Q

A client is having a brain attack (CVA) is brought to the emergency department. The vital signs are P 78, R 16, BP 120/80. Notify the practitioner with which vital changes?

A

Lower pulse, widened pulse pressure

70
Q

hemianopia

A

half of vision is blocked

71
Q

What does a bulging fontanel signify in children

A

increased intracranial pressure

72
Q

A [x] is an acute focal neurological deficit from an interruption of blood flow in a cerebral vessel due to thrombi or emboli or bleeding into the brain.

A

stroke
cva
cerebral vascular accident

73
Q

Parkinson’s TRAP

A

Tremor
Rigidity
Akinesia (or bradykinesia)
Postural instability

74
Q

t/f: neurofibrillary tangles are outside the neuron

A

false - inside from disrupted arrangement of tubules

75
Q

clonic

A

jerking

76
Q

How much of our resting cardiac output goes to the brain?

A

1/6

77
Q

hemiparesis

A

unilateral weakness

78
Q

dementia or delirium: The patient was fine last week and now is hallucinating and seeing bugs crawling on the walls.

A

delirium

79
Q

t/f: delirium and dementia are mutually exclusive

A

false

80
Q

The nurse is caring for a client with increased intracranial pressure. Which of the following assessment findings should the nurse report immediately?

[headache, nausea, absence of pupillary response, fever]

A

absence of pupillary response

Absence of pupillary response is always an abnormal finding and in someone with suspected IICP, this should be reported immediately. Vomiting tends to happen early, but it is usually not accompanied by nausea and tends to be projectile in nature.

81
Q

t/f A person who has a seizure disorder always has convulsions

A

false

People with convulsions have seizures, but not all seizures have motor activity like convulsions.

82
Q

Parkinson’s is a [serotonin/dopamine] depletion

A

dopamine

Pathophysiology for Nursing (16 decks)

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