Chapter 15

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Chapter 15
2011-12-08 14:12:17
Neuro Alterations

Neuro ALterations
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  1. In a blunt head trauma:
    the dura remains intact
  2. In an autombile accident, an individual's forhead struck the windshield. The coup/countercoup injury would be in the
    frontal/occipital bone
  3. In moderate diffuse axonal injury:
    • coma lasts more than 24 hours
    • tearing of axons in the cerebral hemisphere occurs
  4. Most spinal cord injuries occur in the
    cervical and lumbar regions
  5. Injury of the cervical cord may be life threatening because
    diapharagmatic impairment
  6. Autonomic hyperreflexia is characterized by all of the folllowing except
    Autonomic hyperflexia occurs when a stimulation occurs below the level of injury causing an increase in blood pressure ------ therefore pt. would not have hypotension
  7. Intervertebral disk herniation
    in the lumbarsacral area causes pain over the gluteal region and into the calf or ankle
  8. Transient ischemic attacks are (TIA)
    focal neurologic deficits that develop suddenly last for several minutes, and clear within 24 hours....resemble a stroke
  9. Which is a risk factor for the development of CVA's
    • polycythemia vera (bone disease with increase in RBC)
    • hypertension
    • diabetes mellitus
    • hyperhomocysteinemia (high levels of homocysteine in the blood)
  10. Which most typically characterizes the victims of a cerbral embolic stroke
    middle aged individuals with a history of heart disease
  11. Ruptured aneurysms are more likely in
    hemorrhagic cerbrovascular accidents
  12. Which is not a primary intracerbral neoplasm
  13. In bacterial menigitis, the CSF has
    neutrophilic infiltration
  14. Multiple sclerosis involves
    activation of the syncytin gene
  15. Manifestations of subarachnoid hemorrhage include
    • explosive headaches
    • neurologic deficits
  16. How are tramatic brain injuries classified:
    • 1. closed head trauma (blunt)
    • 2. open head trauma (penetrating )
  17. What are the different types of focal brain injury include:
    • 1. Contusion (bruising of the brain)
    • 2. laceration (tearing of the brain tissue)
    • 3. Extradural Hematoma (accumulation of blood above the dura mater)
    • 4. Subdural Hematoma (blood between the dura mater and arachnoid membrane)
    • 5. Intraceberal Hematoma (bleeding in the brain)
    • 6. Open head trauma
  18. Spinal cord injuries:
    • damage to vetebral or neural tissueby compressing tissue, pulling or exerting tension on tissue, or shearing tuissues so that they slide into one another.
    • they may cause spinal shock with cessation of all motor,sensory, reflex, and autonomic functions below any transected area. Loss of motor and sensory function depends on the level of injury
  19. What are the secondary causes of lower back pain
    disk prolapse, tumors, bursitis, synovitis, degenerative joint disease, osteoporosis, fracture, inflammation, and sprain
  20. What is a Herniation
    it is a protrusion of part of the nucleus pulposus and usually affects the lumbosacral disk. The extruded pulposus compresses the nerve root causing pain that radiates along the aciatic nerve course
  21. Cerebrovascular disease:
    Two Types are either ischemia with or without infarction and hemorrhage
  22. Cerebrovascular Accidents (CVA):
    are classified according to pathophsiology and include global hypoperfusion, ischemic (thrombic or embolic), hemorrhagic (intercranial hemorrhages)
  23. Intracranial aneurysms:
    result from defects of the vascular wall and are classified on the basis of form and shape. They are often asymptomatic but the signs vary depending on the location and size.
  24. Arteriovenous Malformation (AVM)
    is a tangled mass of dilated blood vessels.
  25. Subarachnoid Hemorrhage:
    occurs when blood escapes from defective or injured vasculature inot the subarachnoid space. When a vessel tears , blood under pressure is pumped into the subarachnoid space. The blood produces an inflammatory reaction in these tissues.
  26. Classification fo Meningitis:
    • Bacterial which is an infection of the pia mater and arachnoid and of the fluid of the subarachnoid space
    • Aseptic is bleieved to be limited to meninges
    • Fungal is chronic and less common
  27. Encephalitis
    is acute febrile illness of viral origin with nervous system involvement and are most commonly caused by arthropod borne viruses and herpes simplex with meningeal involvement.
  28. The most common neurolgic complications of AIDS:
    • HIV encephalopathy
    • HIV neuropathy
    • HIV myelopathy
    • opportunistic infections, cytmegalovirus, parasitic infection and neoplasms.
    • There may be fiffuse CNS involvemnet, focal pathology and obsturctive hydrocephalus
  29. Multiple Sclerosis
    • is a relatively common degenerative disorder involving CNS myelin. The demyelination is though to result from immunogentic-viral causes.
    • A previous viral insult to the nervous sustem in a gentically susceptible individual yields a subsequent abnormal immune response in teh CNS.
  30. Amyotrophic lateral sclerosis (ALS)
    is a degenerative disorder diffusely involving lower and upper motor neurons. There is upper and lower motor neuron degenration.
  31. Guillian -Barre Syndrome
    is a demyelinating disorder caused by a humoral and cell mediated immunologic reaction directed at the peripheral nerves. Complications include paresis of the legs to complete quadriplegia, respiratory insufficiency, and autonomic nervous system instability.
  32. Myathenia Gravis
    • is a disorder of voluntary muscle characterized by muscle weakness and fatigability. It is considered an autoimmune disease and is associated with an increased incidence of other autoimmune diseases.
    • IgG attack the receptor sites and block acetylcholine causing decreased neuromuscular transmission
  33. Primary Tumors Classification
    • Intracerebral Tumors (astrocytomas, oligodendrogliomas, and ependymomas)
    • Extracerebral Tumors (meningioma or nerve sheath tumors)
  34. Metastatic Tumors:
    can be found inside or outside the brain substance