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Nervous System

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