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68WM6 Ph2 Neuro
Nervous System
| Question | Answer |
|---|---|
| loss of ability to recognize familiar objects and persons | agnosia |
| localized dilation of the wall of a blood vessel | aneurysm |
| abnormal neurological condition in which the language function is defective or absent because of an injury to certain areas of the cerebral cortex | aphasia |
| inability to perform purposeful acts or to use objects properly | apraxia |
| abnormal condition characterized by impaired ability to coordinate movement | ataxia |
| slowing down the initiation or execution of movement | bradykinesia |
| double vision | diplopia |
| difficult, poorly articulated speech that results from interference in control of the muscles of speech | dysarthria |
| weak soft, flabby muscles lacking normal muscle tone | flaccid |
| generalized impairment of intellect, awareness, and judgement | global cognitive dysfunction |
| defective vision or blindness in half the visual field | hemianopia |
| paralysis of one side of the body | hemiplegia |
| neurologic condition characterized by increased reflex action | hyperreflexia |
| involuntary rhythmic movements of the eye | nystagmus |
| lesser degree of movement defecit than paralysis | paresis |
| rest period after a seizure | postictal period |
| sensation of spatial position and muscular activity stimuli | proprioception |
| involuntary sudden movement or muscular contraction | spastic |
| perceptually unaware of one side of the body | unilateral neglect |
| loss of brain weight and neurons; altered sleep/wakefulness ratio; decreased ability to regulate body temperature | physiological effects of aging |
| decrease in the velocity of nerve impulses; decreased blood supply to the spinal cord resulting in decreased reflexes | physiological effects of aging |
| decrease in brain metabolism and oxygen utilization, diminished sense of touch and ability for fine motor coordination | physiological effects of aging |
| affected short term memory, increased risk of stroke, dementia, organic brain syndrome, alzheimers | physiological effects of aging |
| headaches, clumsiness, changes in vision, seizures (or worsening if history of seizures), pain, numbness, personality changes, mood swings, fatigue | subjective data on neuro exam |
| orientation (person, place, time, purpose), mood, behavior, general knowledge (president), short and long term memory, attention span, ability to concentrate | mental status data on neuro exam |
| responsiveness to auditory, visual, and tactile stimuli | arousal |
| reflected in orientation to person, place, and time | awarenesss |
| alert, disorientation, stupor, semicomatose, comatose | levels of consciousness |
| often the first signs of increased ICP | lethargy and disorientation |
| gait, coordintion, weakness/strength, reflexes, posture, involuntary movements, paralysis, paresis | motor function on neuro exam |
| identification of common odors tests this cranial nerve | CN I (olfactory) |
| visual acuity and visual fields are tests of this cranial nerve | CN II (optic) |
| pupillary responses and ability to move eyes in a coordinated manner in all directions are tests of these cranial nerves | CN III (oculomotor), CN IV (trochlear), CN VI (abducens) |
| jaw strength, facial sensation, and corneal reflex are asssesments of this cranial nerve | CN V (trigeminal) |
| taste and symmetrical facial movements are tests of this cranial nerve | CN VII (facial) |
| hearing is a function of this cranial nerve | CN VIII (acoustic) |
| taste is a test of this cranial nerve | CN IX (glossopharyngeal) |
| gag reflex is a test of this cranial nerve | CN X (vagus) |
| shoulder and neck movement are tests of this cranial nerve | CN XI (spinal accessory) |
| tongue movement is a test of this cranial nerve | CN XII (hypoglossal) |
| pain, touch, temperature, proprioception, unilateral neglect, hemianopia | sensory and perceptual status on neuro exam |
| most important preprocedure nursing intervention for CT with contrast | check allergies |
| before this diagnostic test a patient should remove all metal clothing/jewelry and be questioned about metal in the body | MRI |
| why should a patient lie flat and still for several hours after lumbar puncture? | to avoid headache |
| used to check for deformities of the spinal cord/meninges, headache nausea and vomiting are common afterward | myelogram |
| important to warn patient about this before injecting intravenous dye | hot, flushing feeling |
| cephalalagia | aching of the head |
| true or false: skull and brain tissues contain sensory nerves and are capable of perceiving pain | false |
| three types of vascular headaches | migraine, cluster, hypertensive |
| three causes of tension headaches | psychological, medical, stress |
| three causes of traction-inflammatory headaches | occlusive vascular structures, infection, temporal arthritis |
| unique characteristic of migraines | preceded by prodromal symptroms (aura, parasthesias, etc) |
| common migraine triggers | stress, carbohydrates, iodine, alcohol, MSG/chemical additives, fatigue, caffeine |
| usual length of a cluster headache | 30 min to 2 hours |
| usual location of pain in cluster headach | behind on eye |
| most common type of headache | tension |
| common causes of tension headaches | emotional stress, eyestrain, maintaining a fixed position |
| common headache triggers | tyramine, nitrates, glutamates, vinegar, chocolate, yogurt, alcohol, pork, fermented or marinated foods, cured meat |
| opioid agonist used for headaches | propoxyphene (darvon) |
| classes of medications used as vascular headache suppressants | ergot derivatives, serotonin receptor agonists, beta-blockers |
| these vascular headache suppressants are contraindicated in pregnancy | ergot derivatives |
| produce vasoconstriction by acting as serotonin agonists | selective serotonin receptor agonists (imitrex, zomig) |
| lesions involving perhiperal cutaneous nerves, sensory nerve roots, the thalamus, or central pain tract would result in what type of pain | neurological |
| pain thqat is unbearable and does not respond to treatment | intractable |
| non surgical methods for neurological pain control | TENS, acupuncture, medications, counseling |
| nerve excision | neurectomy |
| cut of a spinal nerve root | rhizotomy |
| cutting a nerve in the spinal cord | cordotomy |
| destruction of a nerve bundle by means of an electric current | percutaneous cordotomy |
| diet appropriate for those with neurological pain | high fiber |
| causes of increased ICp | space occupying lesions, trauma, CSF excess, cerebral edema |
| increased ICP leads to reduced cerebral blood flow leads to vasodilation leads to edema... which leads to: | more increasing ICP |
| signs of brain stem involvement in increased ICP | alteration in respirations, cushing's response, alteration in temperature, loss of brain stem reflexes, papilledema, projectile vomiting, hiccups |
| osmotic diuretic used in treatment if increased ICP | mannitol |
| common degenerative neurological disease of unknown cause, more common in temperate climates characterized by exacerbations and remissions | multiple sclerosis |
| true or false: multiple sclerosis may be genetic | true |
| these cells are found in CSF when the first signs of multiple sclerosis appear but gradually disappear | gamma/delta T cells |
| assessment findings in a patient with MS | nustagmus, muscle weakness/spasms, coordination changes, spastic/ataxic gait, behavior changes, urinary incontinence, difficulty swallowing, intention tremors |
| used at the start of a multiple sclerosis exacerbation, these seem to cause the episode to resolve more rapidly | ACTH, and corticosteriods |
| muscle relaxants sometimes useful in treating spasticity associated with MS | diazepam, dantrolene, baclofen |
| syndrome that is characterized by bradykinesia, increased muscle tone, rigidity, and tremor related to loss of dopamine producing cells | parkinson's disease |
| assessment finding in parkinson's disease | tremor (pill rolling), bradykinesia, rigidity, drooling, constipation, oily skin, scaly red skin |
| what is the cure for parkinson's? | there is not one, treatment is supportive; may eventually get results from human fetal dopamine cell transplant |
| degenerative disorer that affects the cells of the brain and causes impaired intellectual functioning; related to elevated homocysteine levels | alzheimer's disease |
| what is the treatment for alzheimers | prevention by diet to decrease homocysteine may be helpful but there is no cure |
| this stage of alzheimers is characterized by mild memory lapses, difficulty in finding correct word, decreased attention span, and disinterest in surroundings | stage I |
| this stage of alzheimer's is characterized by obvious memory lapses, disorientation to time, loss of personal belongings, confabulation, and getting lost in familiar environments | stage II |
| this stage of alzheimers is characterized by total disorientation, motor problems, inability to perform basic daily activities, and wandering | stage III |
| this stage of alzheimer's is characterized by severe physical and mental deterioration and incontinence | stage IV |
| cholinesterase inhibitors that are used in early stages of alzheimers | donepezil (aricept) galantamine (reminy) rivastigmine (exelon) tacrine (cognex) |
| only drug approved to treat sever alzheimer's | memantine (namenda) |
| neuromuscular disorder characterized by severe weakness of one or more groups of skeletal muscles; may be autoimmune in nature | myasthenia gravis |
| this disease is thought to be caused by antibodies that attach the acetylcholine receptor sites at the neuromuscular junction | myasthenia gravis |
| diagnosed by having the patient look upward for 2 to 3 minutes and observing for ability to keep eyes open | myasthenia gravis |
| degenerative disorder that is commonly treated with thymectomy | myasthenia gravis |
| what is the antidote for pyridostigmine bromide? | atropine |
| what are signs and symptoms of cholinergic overdose | increased secretions, bradycardia, nausea, vomiting, sweating, diarrhea |
| also known as Lou Gehrig's disease | amyotrophic lateral sclerosis |
| characterized by degeneration of the motor neurons of the spinal cord and brain stem | amyotrophic lateral sclerosis |
| symptoms of amytrophic lateral sclerosis | weakness, dysarthria, dysphagia, muscle wasting, fasciculations |
| the terminal phase of amyotrophic lateral sclerosis usually results in death due to this | respiratory paralysis/failure/infection |
| only medication used in the treatment of amyotrophic lateral sclerosis | riluzole (rilutek) |
| genetically transmitted disease; affects 50% of the offspring of affected persons | huntington's |
| believed to be caused by overactivity of the dopamine pathway; symptoms are opposite of parkinson's | huntington's |
| signs ans symptoms of huntington's | abnormal, excessive involuntary movements |
| medication classes used in the treatment of huntington's | antipsychotics, antidepressants, antichoreas |
| conditions that predispose a person to seizures | fever, electrolyte imbalance, uremia, brain tumor, drug/alcohol withdrawal, hypoxia, trauma/injury |
| most common type of seizures, characterized by a loss of consciousness for several minutes and tonic clonic movements and a postictal period | tonic clonic/grand mal |
| seizures characterized by sudden impairment in LOC with little or no tonic/clonic movement; no postictal period | absence/petit mal |
| seudyre similar to absence but lasting longer and associated with hallucinations/illusions and postictal period | psychomotor |
| this type of seizure occurs mostly in patients with structural brain disease; usually starts with localized muscle spasms | jacksonial (local or partial) |
| seizure characterized by a sudden involutary contraction of a muscle group with no aura and no LOC | myclonic |
| seizure characterized but unconsciousness and generalized tonelessness | akinetic |
| categories of anticonvulsants | barbiturates, benzodiazepines, hydantoins, valproates |
| barbiturates used in the managemnt of grand mal seizures | pentobarbital, phenobarbitol |
| benzodiazepines used in the management of petit mall, myoclonic, and akinetic seizures, and alcohol withdrawals | clonazepam, clorazepate |
| benzodiazepine used in the management of status epilepticus | diazepam |
| hydantoins used in the management of seizures | fosphenytoin, phenytoin (dilantin) |
| valproates used in the management of absence seizures | divalproex sodium (depakote), valproate sodium, valproic acid |
| a brief episode of abnormal electrical activity in the brain | seizure |
| sudden, violent, involuntary series of contractions of a group of muscles that may be paroxysmal and apisodic | convulsion |
| a group of neurological disorders characterized by recurrent episodes of convulsive seizures, sensory disturbances, abnormal behavior, loss of consciousness, or all of these | epilepsy |
| a sensation, as in light or warmth, which may precede an attack of migrain or an epileptic seizure | aura |
| a medical emergency characterized by contiual seizures occurring without interruptions | status epilecticus |
| the rest period of variable length that followes a seizure | postictal period |
| caused by degeneration of or pressure on the fifth cranial nerve | trigeminal neuralgia |
| pain in trigeminal neuralgia usually extends only to this point | midline of the face |
| drugs used for trigeminal neuralgia pain | tegretol, dilantin, depakene, neurontin |
| injection of this into the trigeminal nerve sometimes provides relief of pain | absolute alcohol |
| thought to be an inflammatory process involving the facial nerve, maybe be related to herpes simplex virus | bell's palsy |
| characterized but abrupt onset of numbness or a feeling of stiffness or drawing sensation of the face | bell's palsy |
| usually started immediately following onset of bell's palsy | corticosteriods |
| can be used for treatment of bells palsy if herpes simplex is suspected to be the cause | acyclovir, valtrex, famvir |
| primary brain tumors | gliomas, meningiomas, pituitary tumors, neuromas |
| surgical opening through the skull where the bone is replaced following surgery | craniotomy |
| removal of part of the scull without replacing it | craniectomy |
| inflammation of the meninges | meningitis |
| this sign of meningitis involves flexion of the neck; if positive the hips and knees also flex | brudziski's sign |
| this sign of meningitis is an inability to extend the leg when the thigh is flexed | kernig's sign |
| extreme hyperextension of the neck and arching of the back associated with meningitis | opisthotonos |
| should you suction a patient with meningitis? | only if the MD specifically ordrs it |
| the onset of encephalitis is faster or slower than meningitis? | slower |
| signs and symptoms of encephalitis | headache, fever, stiff neck, nausea and vomiting, irritability, photophobia |
| most common and deadly cause of encephalitis | herpes simplex virus |
| characterized by widespread inflammation and demyelination of of the perhipheral nervous system resulting in numbness and paralysis progressing from lower extremeties upward | guillian-barre syndrome |
| autoimmune disorder in which antibodies attack shwann cells resulting in a sudden onset of weakenss, numbeness, tingling, and eventually paralysis | guiillian-barre syndrome |
| true or false: guillian-barre is mostly self limiting, and usually resolves on its own. | true |
| pus or purulient material iin the brain | brain abcess |
| true or false: brain abcesses usually get better on their own | false, brain abcess is deadly if untreated |
| this type of skull fracture is an incomplete break, typically seen as a line on xray | linear |
| this type of skull fracture results from blunt trauma and causes an indentation | depressed |
| this type of skull fracture occurs when the bone is shattered into two or more fragments or pieces | comminuted |
| this type of fracture exists when an there is an open wound over the fracture site | compound |
| these head injuries bleed profusely, but are not usually reflective of significant injury | laceration |
| violent jarring or shaking that results in a disturbannce of brain function | concussion |
| damage to brain tissue and nerve fibers | contusion |
| caused by hemorrhage above the dura mater | epidural hematoma |
| caused by hemorrhage below the dura mater | subdural hematoma |
| bleeding into the brain tissue | intracerebral hematoma |
| signs of basilar skull fracture | battle signs, raccoon eyes |
| also called stroke or brain attack | cerebrovascular accident |
| most common ischemic stroke | thrombotic stroke |
| caused when an embolus travels upward into cerebral circulation and lodges in a vessel | embolic stroke |
| CVA that happens as a result of bleeding into brain | hemorrhagic stroke |
| localized dilation of the wall of a lood vessel usually caused by atherosclerosis or HTN | aneurysm |
| anticoagulation therapy is contraindicated in which type of stroke? | hemorrhagic |
| t-PA is given for how long after onset of thrombolytic stroke? | 24 hours |
| procedure used if stroke is caused by atherosclerosis of the carotid artery | carodtid endarterectomy |
| also called cervical shock | areflexia |
| flexion/extension injuries of the spine are seen most commonly with this MOI | whiplash |
| a flexion/rotation injury is caused by | twisting of the spinal cord |
| body takes on temperature of the environment | polkilothermia |
| signs and symptoms of spinal shock | vasodilation, decreased BP, bradycardia, decreased respirations, flaccis paralysis, warm dry skin, bowel and bladder distension, lack of perspiration below injury site |
| exaggerated sympathetic nervous system response occuring in patients with cord injuries at T6 and above | autonomic dysreflexia (hyperreflexia) |
| signs of autonomic dysreflexia | bradycardia, hypertension, headache, piloerection, blurredvision, pupil dilation, anxiety, nausea, nasal stuffiness |
| two most common causes of autonomic dysreflexia | full bladder, impacted feces |
| spinal injury at this point results in inability to breathe independently or move anything below the neck | C1-C3 |
| spinal injury here allows some retained movement of the shoulders and can breathe independently with respiratory support but cannot use hands | C4-C5 |
| an injury at this level results in incomplete quadriplegia with some elbow, arm and wrist movement; can't feel anything below midchest | C6-C8 |
| injury at this level result in paralysis below the waist with control of the hands retained; stability of the trunk is still decreased | T1-T6 |
| injury at this level results in paraplegia with control of hands, functional intercostals, and increased respiratory reserve | T7-T12 |
| an injury at this level results in impaired ability to abduct hips and lack of sensation below lower abdomen | L1-L2 |
| injury at this level results in impairment of knee and ankle movement and lack of sensation below upper thigh | L3-L5 |
| injury in this area results in bowel and bladder dysfunction | S1-S5 |
| defect in the curvature of the eyeball surface | astigmatism |
| opacity/clouding of the lens | cataract |
| inflammation of the conjunctiva | conjunctivitis |
| surgery to freeze the borders of a retinal hole with a frozen-tip probe | cryosurgery |
| disorder of the retinal blood vessels characterized by hemorrhage and microaneurisms, leading to total retinal detachment and blindness | diabetic retinopathy |
| removal of the eyeball | enucleation |
| protrusion of the eyeball | exopthalmos |
| elevated pressure in the eye | glaucoma |
| farsightedness | hyperopia |
| inflammation of the cornea | keratitis |
| implatation of a donor cornea | keratoplasty |
| substance that contracts the pupil | miotic |
| substance that dilates the pupil | mydriatic |
| nearsightedness | myopia |
| surgery that uses partial thickness, radial incisions in the cornea, leaving an uncut optical center | radial keratotomy |
| separation of the retina from the choroid | retinal detachment |
| decreasedtear secretion and increased tear evaporation with dry mouth | sjogren's syndrome |
| assessment of visual acuity | snellen's test |
| removal of the stapes from the inner ear and insertion of the graft and prosthesis | stapedectomy |
| inability of the eyes to focus in the same direction | strabismus |
| used to detect defect of the macular area of the retina | amsler's chart |
| equipment used to measure the degree of forward placement of the eye | exopthalmetry |
| used to examine the conjunctiva, lens, vitreous humor, iris, and cornea | slit lamp |
| uses a burst of air to test intraocular pressure | applantation tonometer |
| measures tear volume produced during a fixed time period | schmirmer tear test |
| to be legally blind, one's corrected vision must be equal to or worse than | 20/200 |
| if visual field is reduced by 20 degrees, the person is considered to be | legally blind |
| elongation of the eyeball, refractory error focuses light in front of the retina | mypoia (nearsightedness) |
| refractory error where rays of light entering the eye are brough into focus behind the retina | hyperopia (farsightedness |
| acut infection of eyelid margins or sebaceous glands of the eyelashes | hordeolum (stye) |
| inflammation of the eyelid margins | blepharitis |
| inflammation of the cornea resulting from injury, irritants, allergies, viral infections, congenital syphilis, smallpox, or dirty contact lenses | keratitis |
| inward turning of the eyelid | endotropion |
| outward turning of the eyelid | ectropion |
| condition of aging retina characterized by slow loss of central and near vision, most common cause of vision loss in people over 60 | macular degeneration |
| abnormal condition of elevated pressure within the eye | glaucoma |
| progressive glaucoma that is caused by obstruction to drainage channels of aqueous humor | open angle glaucoma |
| glaucoma that is caused by abrupt angle change of the iris, causing rapid vision loss and dramatic symptoms | closed angle glaucoma |
| external auditory canal | pinna/auricle |
| a subjective noise sensation heard in one or both ears; ringing or tinkling sounds in the ear | tinnitus |
| the sensation that the outer world is revolving about oneself or that one is moving in space | vertigo |
| test is performed by placing the stem of a vibrating tuning fork in the center of the patient's forehead or on the maxillary incisors | weber's test |
| direct visualization of the external auditory canal and the eardrum | otoscopy |
| infection of the external ear and adjacent skin | otitis externa |
| fluid from an infection, allergy, or tumor that collects in the middle ear as a result of obstruction of the auditory tube | otitis media |
| an inflammation of the labyrinthine canals of the inner ear | labyrinthitis |
| a condition characterized by chronic progressive deafness caused by the formation of spongy bone, with resulting ankylosis of the stapes, causing tinnitus, and then deafness | otosclerosis |
| disturbance of the semicircular canals that results in tinnitus and unilateral deafness | menier's disease |
| removal ov the stapes of the middle ear and inserion of a graft and prosthesis | stapedectomy |
| any of several operative procedures on the eardrum or ossicles of the middle ear designede to restore or improve hearing in patients with conductive hearing loss | tympanoplasty |
| a surgical incision of the eardrum performed to relieve pressure and release purulent exudates from the middle ear | myringotomy |
| caused by any disease or injury that interferes with conduction of sound waves to the inner ear | conductive hearing loss |
| results from malfunction of the inner ear, vestibulocochlear nerve, or auditory center of the brain | sensorineural hearing loss (nerve deafness) |
| combination of conductive and sensorineural pathology of hearing loss | mixed hearing loss |
| hearing loss that is present from birth or early infance | congenital hearing loss |
| hearing loss that has no organic or anatomical cause | functional hearing loss |
| hearing loss as a result of damage to auditory pathways in the brain | central hearing loss |
| this should be restricted from the diet in meniere's disease | sodium |
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