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Chp 10-Nervous Sys 6
Pathologic Conditions: Davi-Ellen Chabner The Language of Medicine 8th Edition
| Question | Answer |
|---|---|
| The glial cells surround the neruons, forming a _____ _____ _____ that prevents many harmful substances in the blood, access to the neurons. | Blood-brain barrier |
| Nerve cells are extremely sensitive to _____ deficiency. | Oxygen |
| Neurologic disorders are classified into these six categories: | 1) Congenital 2) Deenerative, movement, seizure 3) Infectious (meningitis & encephalitis) 4) Neoplastic (tumors) 5) Traumatic 6) Vascular (stroke). |
| Abnormal accumulation of CSF fluid in the brain. | Hydrocephalus. |
| In hydrocephalus, CSF builds up in the _____ of the brain. | Ventricles. |
| To relieve CSF pressure on the brain, a _____ is placed from the ventricles to the _____ or _____. | Shunt, peritoneal space (abdomen), right atrium of the heart. |
| A shunt to drain CSF from the brain to the abdomen is called: | Ventriculoperitoneal. |
| Hydrocephalus in adults can be the result of: | Tumor, infection. |
| The glial cells surround the neruons, forming a _____ _____ _____ that prevents many harmful substances in the blood, access to the neurons. | Blood-brain barrier |
| Nerve cells are extremely sensitive to _____ deficiency. | Oxygen |
| Neurologic disorders are classified into these six categories: | 1) Congenital 2) Deenerative, movement, seizure 3) Infectious (meningitis & encephalitis) 4) Neoplastic (tumors) 5) Traumatic 6) Vascular (stroke). |
| Abnormal accumulation of CSF fluid in the brain. | Hydrocephalus. |
| In hydrocephalus, CSF builds up in the _____ of the brain. | Ventricles. |
| To relieve CSF pressure on the brain, a _____ is placed from the ventricles to the _____ or _____. | Shunt, peritoneal space (abdomen), right atrium of the heart. |
| A shunt to drain CSF from the brain to the abdomen is called: | Ventriculoperitoneal. |
| Hydrocephalus in adults can be the result of: | Tumor, infection. |
| Birth defect from imperfect/incomplete union of vertebral parts. | Spina bifida. |
| Spina bifida occurs in the _____ spinal column. | Lumbar. |
| Spina bifida is also called: | Neural tube defect. |
| Neural tube defect where the defect is covered with skin: | Spina bifida occulta |
| Neural tube defect where the defect is a cyst-like protrusion: | Spini bifida cystica |
| Neural tube defect where the meninges protrode to the outside of the body: | Meningocele |
| Neural tube defect where both spinal cord and meninges protrude. | Myelomeningocele |
| Diagnosing spina bifida during gestation is by these methods: | Alphafetoprotein in blood, imaging methods (ultrasound), and amniocentesis. |
| Hydrocephalus & spina bifida are _____ disorders. | Congential. |
| Brain disorder with progress mental deterioration, personality changes, & impairment of daily function: | Alzheimer disease (AD). |
| Progressive mental deterioration: | Dementia. |
| Alzheimer disease has these characteristics: | Confusion, memory failure, disorientation, restlessness, speech disturbances, anxiety, depression, and emotional disturbences. |
| Alzheimer disease generally begins at what stage of life, and can worsen after age: | Middle life, 70. |
| Alzheimer changes seen on autopsy of the brain: | Atrophy of cortex, widening of sulci, especially in the frontal/temporal regions. |
| Degeneration of neurons & neurofibrillary tangles in the cerebral cortex are seen on: | Microscopy exam of brain on autopsy. |
| Bundles of fibrils in the cytoplasy of a neuron: | Neurofibrillary tangles. |
| Deposits of the protein, _____, occur in neurofibrillary tangles, senile plaques, and blood vessels. | Amyloid. |
| Degenerative disorder of motor neurons in the spinal cord & brain stem. | Amyotrophic lateral sclerosis (ALS). |
| Lou Gehrig disease: | Amyotrophic lateral sclerosis (ALS). |
| Amyotrphic lateral sclerosis symptoms: | weakness/atrophy of muscles in hands, forearms, legs; difficulty swallowing/talking; dyspnea. |
| Chronic brain disorder with recurrent seizure activity. | Epilepsy. |
| An abnormal, sudden excessive discharge of electrical activity within the brain: | Seizure. |
| Seizures are often symptoms of pathologic conditions such as: | Brain tumor, meningitis, vascular disease, or scar tissue from a head injury. |
| What type of seizure is characterized by a sudden loss of consciousness, falling down, tonic contractions, followed by clonic contractions. | Clonic seizures (grand mal or ictal events). |
| Stiffening of muscles: | Tonic contractions. |
| Twitching & jerking movements of the limbs: | Clonic contractions. |
| Convelsions are often preceded by an: | Aura. |
| Examples of aura: | Dizziness, numbness, visual, and/or olfactory disturbances. |
| A minor form of seizure consisting of momentary clouding of consciousness & loss of awareness of the person's surroundings. | Absence seizures (petit mal). |
| Meds for control of epileptic seizures are called: | Anticonvulsants. |
| After seizures, neurologic symptoms such as weakness: | Postictal events. |
| The Greek term meaning "laying hold of" is the source of what word: | Epilepsy. |
| Disorder marked by degenerative changes in the cerebrum, leading to abrupt involuntary movements & mental deterioration: | Huntington disease. |
| Huntington disease symptoms: | Personality changes, choreic (dance-like) movements, (uncontrollable, irregular, jerking movements of the arms & legs, facial grimacing). |
| DNA testing shows the genetic defect for Huntington disease on: | Chromosome 4. |
| Treatment of Huntington: | Symptom management - no cure available. |
| Treatment of ALS: | None known. |
| Condition with destruction of the myelin sheath on neurons in the CNS & its replacement by plaques of sclerotic (hard) tissue. | Multiple sclerosis (MS). |
| A leading cause of neuro disability in 20-40 year old-s: | Multiple sclerosis (MS). |
| MS is a chronic disease marked by long periods of stability called _____ and worsening called _____. | Remission, relapse. |
| Loss of meylin insulation: | Demyelination. |
| _____ prevents the conduction of nerve impulses through the axon | Demyelination. |
| Causes paresthesias, muscle weakness, unsteady gait, and paralysis. | Demyelination (condition of multiple sclerosis). |
| In MS there may be _____ and _____ disturbances. | Visual (blurred/double vision), speech. |
| What diagnostic study shows scared myelin (plaques): | MRI |
| Multiple sclerosis etiology: | Unknown, but probably an autoimmune disease orlymphocytes reacting against myelin. |
| Multiple sclerosis treatment: | Disease modifying drugs (DMD) can slow the progression by preventing the immune system from destroying myelin. |
| An autoimmune neuromuscular disorder characterized by weakness of voluntary muscles (attached to bones): | Myasthenia gravis (MG). |
| Myasthenia gravis is a chronic _____ disorder. | Autoimmune. |
| In MG, antibodies block the ability of _____ to transmit the nervous impluse from nerve to muscle cell. | Acetylcholine (neurotransmitter). |
| Myasthenia gravis symptoms: | Onset is gradual, with ptosis of upper eyelid, double vision (diplopie) and facial weakness. |
| Myasthenia gravis treatment: | Therapy to reverse symptoms includes anticholinesterace drugs, corticosteriods, and immunosuppressive drugs. |
| Anticholinesterace drugs work by: | Inhibits the enzyme that break down acetylcholine. |
| Corticosteriod med to treat MG: | Prednisone. |
| Immunosuppressive drugs to treat MG: | Azathioprine, methotrexate, cyclophosphamide. |
| Surgical treatment used in MG: | Thymectomy. |
| Paralysis means: | Palsy: Partial or complete loss of motor function. |
| Partial paralysis and lack of muscular coordination caused by loss of oxyten or blood flow to the cerebrum during pregnancy, or in the perinatal period. | Cerebral palsy. |
| Paralysis on one side of the face can be caused by: | Bell's palsy. |
| Bell's palsy cause: | Viral infection. |
| Bell's palsy treament: | Antiviral drug to treat virus, and nerve swelling. |
| Degeneration of neurons in the basal ganglia, occurring later in life - leading to tremors, weakness of nuscles, & slowness of movements. | Parkinson disease (parkinsonism). |
| Parkinson disease cause: | Deficiency of dopamine (a neurotransmitter). |
| Dopamine is made by cells in the _____ _____. | Basal ganglia. |
| Motor disturbances in PD include: | Stooped posture, shuffling gait, muscle stiffness/rigidity, dyskinesias, & hand tremor. |
| Parkinson disease treatment: | Palliative treatment with levodopa + carbidopa (Sinemet) to increase dopamine levels. |
| Experimental treatment is implantation of fetal brain tissue containing dopamine-producing cells for which disease? | Parkinson disease (parkinsonism). |
| Involuntary, spasmodic twitching movements; uncontrollable vocal sounds; inappropriate words. | Tourette syndrome. |
| Involuntary movements are called: | Tics. |
| Tourette syndrome cause: | Unknown, but associated with excess or hypersensitivity to dopamine. |
| Tourette syndrome treatment: | Antipsychotic drugs haloperidol (Haldol) antidepressants, & mood stabilizers. |
| Viral infection affecting peripheral nerves: | Herpes zoster (shingles). |
| Symptoms of blisters & pain along periopheral nerves are caused by a _____ virus. | Herpes. |
| The chicken pox virus, which can later develop into shingles, is herpes _____ _____. | Varicella-zoster. |
| Skin innervation by spinal or cranial nerves is called a: | Dermatome. |
| Inflammation of the meninges; leptomeningitis: | Meningitis. |
| Meningitis cause: | Bacteria (pyogenic meningitis) or virus (aseptic or viral meningitis). |
| Symptoms include: Fever, headache, photophobia, and a stiff neck. | Meningitis. |
| Meningitis is diagnosed by what diagnostic procedure: | Lumbar puncture (LP) - to evaluate the CSF. |
| Meningitis treatment: | Antivirals for the viral form, antibiotics for the moer serious pyogenic form. |
| Brain disease & dementia occuring with AIDS. | Human immunodeficiency virus (HIV) encephalopathy. |
| Neurologic dysfunctions common with AIDS: | HIV encephalopathy; encephalitis, dementia, brain tumors, and other infections. |
| Loss of mental functioning: | Dementia. |
| Abnormal growth of brain tissue & meninges: | Brain tumor. |
| Primary brain tumors usually arise from _____ cells, also called _____; or from the _____ also called _____. | Glial/gliomas; meningiomas. |
| Types of gliomas: | Astrocytoma, oligodendroglioma, ependymoma. |
| Most malignant form of astrocytoma is: | Glioblastoma multiforme. |
| Tumors can cause _____ _____ and _____. | Cerebral edema, hydrocephalus. |
| If CSF presssure is increased, swelling may also occur near the _____ _____. | Optic nerve. |
| Glioma treatment: | Surgery. |
| If glioma is not completely resected, further treatment is by: | Radiotherapy. |
| To reduce post-surgery swelling, _____ may be given. | Steroids. |
| A meningioma is usually a _____ brain tumor surrounded by a _____. | Benign, capsule. |
| Benign tumors can still cause _____ and _____ of the brain. | Compression, distortion. |
| Most brain tumors are metastatic from primary tumors located in the: | Lung, breast, skin (melanoma),kidney, & GI tract. |
| Brain tumors may be _____ or _____ metastatic growths. | Single, multiple. |
| Traumatic brain dysfunction (with brief LOC) after injury. | Cerebral concussion. |
| Severe concussions may lead to: | Coma. |
| Concussion symptoms last _____. | Less than 24 hours. |
| Bruising of the brain tissue as a result of direct traumat to the head. | Cerebral contusion. |
| Cerebral contusion symptoms last _____. | More than 24 hours. |
| Hematomas may occur with (concussion or contusion). | Contusion. |
| Types of hematomas from cerebral contusion: | Subdural, epidural. |
| Hematomas may lead to _____. | Permanent brain injury. |
| Permanent brain injury can include: | Altered memory, altered speech, development of epilepsy. |
| Disruption in the normal blood supply of the brain: | Cerebrovascular accident (CVA). |
| A stroke is also known as a: | Cerebrovascular accident or cerebral infarction. |
| A CVA is caused by: | Loss of oxygen to the brain. |
| Three types of stroke: | 1) Thrombotic, 2) Embolic, 3) Hemorrhagic. |
| In atherosclerosis, blood vessels become blocked over time. This type of CVA is called: | Thrombotic. |
| Short episodes of neurologic dysfunction due to occlusion of blood vessels: | Transient ischemic attack (TIA). |
| When a thrombus breaks free, its called an embolus and blocks an artery to the brain. very suddenly. This type of CVA is called: | Embolic. |
| When blood vessels break/bleed, this type of stroke can be fatal: | Hemorrhagic. |
| Small hemorrhagic CVAs can result in _____ recovery with only _____ disability. | Good, slight. |
| Hemorrhagic CVA in older patients is usually caused by: | Advancing age, atherosclerosis, or HTN. |
| Hemorrhagic CVA in younger patients is usually caused by: | Skull fracture or ruptured arterial aneurysm. |
| Major risk factors for CVA: | Primary: HTN, diabetes, smoking, heart disease. Additional: Obesity, substance abuse, elevated cholesterol. |
| Thrombotic CVA medication treatment: | Anticoagulant drugs. Tissue plasminogen activator (tPA) is started within 3 hours of onset. |
| Thrombotic CVA surgical treatment: | Carotid endarterectomy. |
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