Lecture test 5 Neurology

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  1. Pt. arrives at the ER with her daught after having a fall. Daughter expressed concern b/c her mother has been misidentifying objects for the last 3 day, she has also been experiencing sudden blindness. What part of the brain has MOST LIKELY been affected?
    Occipital lobe. BLINDNESS would be the key identifier.
  2. What does cerebral blood flow depend on?
    Gravity and Blood pressure. - Aging patients will have decreased blood flow.
  3. An abnormal movement marked by alternating contraction and relaxation of a muscle occuring in rapid succession is BEST described as what?
    Clonus- be able to recognize "foot bouncing" occurs
  4. After a CVA involving the parietal-occipital area of the brain, what might a patient have trouble with?
    Copying a letter would be difficult- APHASIA
  5. The innermost layer of the brain meniges, which extends into the brain folds like saran wrap
    Pia mater- know that it "hugs" the brain
  6. What can result from stroke or spinal cord injury which can cause a loss of voluntary control with increased muscle tone, hyperactive muscle reflexes, and no muscle atrophy?
    Upper motor neuron lesion
  7. Patient is having difficulty swallowing, slurred speech, and no gag reflex. Which nerve has MOST LIKELY been affected?
    Cranial nerve X- Vagus
  8. Patient is having problems d/t impairment of cranial nerve VIII. Which tests would have helped to determine this diagnosis?
    Weber, Romberg, and the whisper test
  9. When having a patient move his tongue from side to side against a tongue depressor, what cranial nerve are you assessing?
    Cranial Nerve XII- Glossopharyngeal
  10. Pt. has been in a coma for 48 hours following an automobile accident. What test would the doctor order to evaluate brain function?
    EEG/ Electroencephalogram
  11. When assessing a patients response to stimuli, what test would you most likely use?
    Glasgow coma scale. LOC-3=unresponsive/15=normal
  12. After a seizure a pt. might be confused and hard to aroue after sleeping for hours. What might the pt be suffering from?
    Post-Ictal state
  13. What test is used to diagnose Meningitis?
    Lumbar puncture
  14. What is the earliest sign of increased cranial pressure? (ICP)
    A change in LOC; ex- Drowsiness, confusion, restlessness
  15. When doing an assessment of altered LOC, what are you assessing for?
    Mental status, cranial nerve function, cerebellar function, reflexes, and motor and sensory function. (associate an assessment of LOC with Glasgow Coma Scale)
  16. You have a pt hemorrhaging from the nose and blood under the conjunctiva. The pt also has ecchymosis over the mastoid and drainage of CSF from the ears. What head injury is suspected?
    Basilar skull fx
  17. a T1 spinal cord injury could cause what life-threatening complication?
    Respiratory failure
  18. People living in close quarters are more susceptible to this and having a stiff neck or red "rash spots" on the chest or extremities are the two main symptoms
    Bacterial Meningitis-Assessment tests used are the Kernig and Brudzinski
  19. A patient has a history of fatigue, depression, weakness, numbness, difficulty with coordination, loss of balance, and pain. What condition might the patient be suffering from?
    Multiple Sclerosis- Associate MS with intention Tremors
  20. What is the treatment window for thromolytic therapy administration for a pt suffering an ischemic stroke?
    Three hours
  21. What is the treatment for viral encephalitis?
  22. A pt who has spinal cord injury presents symptoms of a pounding headache, profuse sweating, nasal congestion, goose-bumps, and bradycardia. What might the patient be experiencing?
    Autonomic dysreflexia
  23. What is the most common cause of death in SCI?
    Secondary conditions such as pneumonia or pulmonary emboli
  24. Which test is used to detect hypoxia in secondary TBI?
  25. Spinal shock
    Reflexive activity is affected BELOW the level of injury- Flaccid extremities
  26. Guillain Barre Syndrome clinical manifestations
    ASCENDING- begins in the lower extremities, patent may not be able to take a deep breath
  27. How do you detect expressive aphasia?
    Ask the pt to smile and look for facial drooping on either side. Patients often understand what they are told but cannot speak
  28. How long does a reoccuring migrain last?
    48-72 hours- associate Aura, visual changes, and nausea are symptoms
  29. What is the most common cause of subarachnoid hemorrhage?
    A leaking aneurism- Signs are a severe headache and vomiting
  30. What nerve is affected by Bell's palsy?
    Cranial nerve VII- Unilateral
  31. Hemorrhagic stroke
    You can diagnose this by performing a CT scan which will show blood in the brain
  32. 3 things to include in your ROUTINE NEUROLOGIC ASSESSMENT
    Glascow Coma Scale, Pupil Reaction and Vital Signs?
  33. Which of these is NOT a function of the frontal lobe?
    Visual interpretation
    Motor function
    Visual interpretation
  34. Name the lobe of the brain that is essential to a person's awareness of body positioning in space, size, shape discrimination, and left- right orientation
    Parietal lobe- The awareness of your body without having to look is called proprioception
  35. After a pt's accident, his only complaint is that he is unable to understand his favorite classical music composer. What area of the brain has most likely been affected?
    Temporal lobe- Arterial bleed
  36. Which portion of the brain acts primarily as a relay station for all sensation EXCEPT smell?
  37. What part of the autonomic nervous system controls body temp and sleep cycle
  38. What mixed cranial nerve controls facial sensation?
    Cranial nerve V
  39. What forms the Blood Brain Barrier?
    Endothelial cells
  40. Which of the following tests would NOT be used to assess neurologic function?
    CT scan
  41. Pt has flexion of the upper extremities, internal rotation of the lower extremities, and plantar flexion of the feet. What posture response is this?
    Decoritaciate posturing
  42. Cushing's respnse is seen when there is significant
    Reduced blood flow
  43. A neurologic deficit that deprives the brain of glucose and oxygen that typically lasts less than one hour and is manifested by a sudden loss of motor, sensory, or visual function is what?
  44. A collection of blood between the dura and the brain, most often caused by trauma or a rupture of an aneurysm is known as what?
    Subdural hematoma
  45. Pt was taken to the ER after sustaining a head injury. During the pts examination he briefly loss conciousness followed by a lucid interval in which the pt was awake and conversing with the nursing staff pt then became increasingly restless, agitated, and vonfused as the condition progressed to a coma. What type of hematoma would this be?
    Epidural hematoma- epidural hematoma= getting hit in the head
  46. Clear, colorless fluid that is produced in the choroid plexus of the ventricles and circulates around the surface of the brain and spinal cord
  47. A pt comes in with S/S of immediate coma, no lucid interval, decortiate and decerbrate posturing and global cerebral edema. What did the pt most likely come in with?
    Diffuse Axonal Injury- Severe head trauma
  48. What vertebrae's are most frequently involved with a spinal injury? Why?
    • Vervical 5,6 7
    • Thoracic-12
    • Lumbar-1
    • Because there is a greater range of mobility in the vertebral column. car accidents are the number one cause of spinal injury
  49. What is the most common cause of a traumatic brain injury?
  50. Parkinson's Disease- 3 things in normal assessment
    • Pill rolling tremor
    • Shuffling gait
    • Difficulty swallowing
  51. CVA- presenting symptoms
    • Facial drooping
    • Slurred speech
    • Decreased LOC
    • Disorientation
  52. Early manifestations of ICP?
    Restlessness and confusion
  53. A lumbar puncture is risky if there is a presence of what?
    Intracranial mass lesion
  54. Primary risk factor for a hemorrhagic stroke?
    Elevated BP/Hypertension
  55. How do you assess the Hypoglossal cranial nerve?
    tongue mov't
  56. People with SCI are at increased risk for what complication? What do they die from?
  57. Population with higest death rates for TBI?
    Males >75
  58. What are intention tremors
  59. Decreased cerebral flow is normal in the aging process, True or false?
  60. The frontal love is responsible for
    concentration, thought, information, memory and motor
  61. Parietal lobe
    sensory lobe, sense position in space
  62. Temporal lobe
    Auditory, sound, language, music
  63. Occipital lobe
    visual interpretation and memory
  64. CNS is in accessible to many substances that circulate in the blood. This barrier is formed by endothelial cells of the brain's capillaries that make tight junctions. Acts as a "filter" and a protective function
    Blood-Brain barrier
  65. Perfusion study that captures cerebral blood flow, tissue composition and oxygen metabolism; evaluating brain function- used to detect Alzheimer's disease, brain tumors, epileptic lesions...
    SPECT single proton emission computed tomography
  66. Computer based nuclear imaging
    Patient either inhales a radioactive gas, or is injected with a radioactive substance taht emits positively charged partices- provides 2 dimensional views
    Produces images of actual organ functioning 
    Permits measurment of blood flow
    PET scan- Positron Emission Tomography
  67. In a lumbar puncture, the needle is usually inserted into the subarchnoid space, between the __ and __ or the __ and __ vertebrae
    3rd and 4th or 4th and 5th
  68. Akinetic mutism
    Unresponsive to the environment, no voluntary movements
  69. Persistent Vegetative state
    Unresponsive, with sleep-wake cycles, devoid of cognitive mental function
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Lecture test 5 Neurology
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