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What part of the brain stem maintains arousal “awakeness”?
Reticular activating system (RAS)
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What occurs during central herniation?
Downward displacement of cerebral hemispheres compressing midbrain structures
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What is an example of diffuse axonal injury?
Shaken baby syndrome is an example
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Describe manifestations of expressive dysphasia
Can receive, but not express communication,poorly articulated simple speech
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What are manifestations of basilar or vertebral arteries cerebrovascular accidents?
Gait disturbances (ataxia), dysphagia,vertigo, & diplopia
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What is a concussion?
Only confusion and amnesia after diffuse brain injury
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What is the most important indicator of brain function?
Level of consciousness
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What is Cheynes-Stokes respirations? or
What breathing pattern is expected with damage to the cortex?
Breathing pattern with periods of apnea between normal breaths
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What is ataxic breathing?
Breathing pattern expected with damage to the pons or upper medulla oblongata
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What is compliance?
Increase in one component of the cranium is offset by reducing the volume of one of the other components
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What is a classic cerebral concussion?
Diffuse cerebral disconnection from RAS with loss of consciousness <6 hrs
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What are early warning signs prior to rupture of cerebral aneurysm?
Profound headache,photophobia & stiff neck prior to rupture
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What causes double vision after a basilar artery stroke?
Impairment of cranial nerves III, IV, and VI after a basilar artery stroke
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What is the pathophysiology of diffuse brain injury?
All brain cells fire at once releasing glutamate and triggering release of potassium
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What is a cortical contusion?
Bruising of cortical tissue causing immediate loss of consciousness for no more than 5 minutes
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What is abnormal extension?
Movement expected when assessing a client with damage to the midbrain
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What finding from an eye assessment is expected when the client has a right uncal herniation?
After shining a light in the eyes, the right pupil is dilated, the left pupil constrict
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What is an epidural hematoma?
Collection of blood above the dura from an artery
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What are semi-modifiable risk factors for a cerebrovascular accident (brain attack or stroke)?
Atherosclerosis, diabetes mellitus, hypertension, hyperlipidemia, & atrial fibrillation
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What causes dysphagia after a basilar artery stroke?
Impairment of cranial nerves IX and X after a basilar artery stroke
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What are clinical manifestations of meningitis (bacterial)?
Chills & fever, headache, backache, stiff neck,nausea & vomiting,photophobia
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What are manifestations of impaired carotid circulation?
Contralateral hemiplegia, & hemisensory, visual field defects &neglect syndrome
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What is a subdural hematoma?
Intracranial hematoma that develops in 24 hours to 2 weeks or more
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What finding from an eye assessment is expected when the client has a central herniation?
After shining a light into the eyes, both pupils are dilated
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What is the pathogenesis of seizures?
Excessive and autonomous firing of cerebral neurons
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What is the pathogenesis of Parkinson disease?
Dopamine from substantia nigra in the basal ganglia is depleted
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What is meningomyelocele?
Sac-like structure protrudes thru a vertebral defect containing meninges, spinal cord, and CSF
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What is Guillain Barre?
Inflammatory demyelinating disease of the peripheral nervous system
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What are manifestations of Guillain Barre?
Progressive ascending paralysis beginning in the legs,may involve respiratory muscles
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What is the pathophysiology of multiple sclerosis?
Autoimmune disorder in which myelin in central nervous system is destroyed.
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What are manifestations of Parkinson disease?
Bradykinesia, rigidity, resting tremor , and masked facies with no change in consciousness
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What is an absence seizure?
A seizures in which the client has a short lapse of consciousness (about 5 - 10 sec)
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What is a tonic-clonic seizure?
A seizure in which there is loss of consciousness withbody stiffness alternating with muscle spasms
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What are manifestations of spastic cerebral palsy?
Hypertonic and exaggerated deep tendon reflexes seen in children
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What are manifestations of multiple sclerosis?
Manifestations are highly variable from visual impairment to paralysis with fatigue being a common one.
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What are manifestations of Bell’s palsy?
Unilateral facial weakness, facial droop and diminished eye blink
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What is Bell’s palsy?
Paralysis or paresis of the 7th cranial nerve (facial)
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What occurs in the secondary cascade of spinal cord injury?
Hemorrhage and edema result ischemia and necrosis of the spinal cord.
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What is a definition of hydrocephalus?
Abnormal accumulation of cerebrospinal fluid in the subarachnoid space
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What is status epilepticus?
One seizure after another without a period of recovery
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What is a characteristic of a partial seizure?
Seizure activity that is restricted to one hemisphere
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What is the cause of obstructive hydrocephalus?
Impaired flow of cerebrospinal fluid between the 3rd and 4th ventricles.
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What are manifestations of spinal shock after spinal cord injury?
Flaccid paralysis,anesthesia below injury level, transient drop in BP
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What are manifestations of a lumbar herniated nucleus pulposus
Pain radiates along the sciatic nerve when client coughs or sneezes
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What is the pathogenesis of myasthenia gravis?
Destruction of acetylcholine receptors by an autoimmune process
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What is a cause of autonomic dysreflexia (hyperreflexia)?
Full bladder of client with spinal cord injury stimulates sympathetic nervous system.
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What is a cause of communicating hydrocephalus?
Impaired absorption of cerebrospinal fluid due to subarachnoid hemorrhage.
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What are manifestations of complex partial seizures?
Client displays automatisms (continue doing what you were doing at time of seizure)
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What is the pathogenesis of Alzheimer disease?
Development of neurofibrillary tangles and amyloid deposits in the form of senile plaques. Normal tau proteins are altered and nerve cells degenerate around an amyloid core.
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What is meningocele?
Sac-like cyst filled with CSF protrudes thru a defective vertebrae.
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What are manifestations of autonomic hyperreflexia?
Severe HTN, bradycardia headache, sweating & flushing
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What are manifestations of bulbar myasthenia gravis (CN IX, X, XI, XII)?
Dysphagia, aspiration and pneumonia
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