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68WM6 Ph2 Neuro

Nervous System

QuestionAnswer
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
Created by: ewoff85