M/S CH 43 – Flashcard

question

speech center
answer

Broca’s area
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visual center
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occipital lobe
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initiate voluntary movement
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motor cortex of frontal lobe
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process language
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Wernicke’s area
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spatial perception
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parietal lobe
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complicated memory patterns
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temporal lobe
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emotional and visceral patterns
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limbic lobe
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Which factor is most likely to depress nerve cell activity in the patient with a neurologic disorder?
answer

low oxygen saturation and hypoxia
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THe patient has sustained trauma affecting Broca’s area of the brain. Which intervention does the nurse use to assist the patient to compensate for deficits related to damage in this area?
answer

obtain an erasable white board and a pen for communication
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Which type of stroke or stroke damage is most likely to cause problems with respiratory distress related to neurologic function?
answer

involvement of medulla and pons
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With what will the patient with a cerebellar dysfunction most likely need assistance?
answer

buttoning shirt
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substances that pass through the blood-brain barrier (BBB)
answer

oxygen, alcohol, water, anesthetics, carbon dioxide
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substances that are blocked by the barrier
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albumin, most bacteria, many antibiots
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spinal tract function: carry sensations of pain, temperature, pressure
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spinothalamic
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spinal tract function: proprioception
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spinocerebellar
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spinal tract function: vibratory sense
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fasiculus gracilis or cuneatus
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spinal tract function: voluntary movement
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coricospinal
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SNS/PNS: has cell bodies in the gray matter of the spinal cord from S2 to S4
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PNS
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SNS/PNS: lies beside the spinal cord in a chain
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SNS
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SNS/PNS: has some sensory function
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PNS
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SNS/PNS: is part of cranial nerves III, VII, IX, and X
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PNS
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SNS/PNS: causes the heart to pump faster
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SNS
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SNS/PNS: constricts pupils
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SNS
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The nurse is teaching the older adult patient about medication and healthy lifestyle. Which teaching strategy is the best to use with this patient?
answer

allow extra time for teaching and questions
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The nurse is caring for the older adult patient who is identified at Risk for Injury related to altered balance and decreased coordination. Which intervention does the nurse employ for this patient?
answer

instruct the patient to move slowly when changing positions
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The nurse is obtaining baseline information from the older adult patient at risk for a neurologic disorder about his ability to perform activities of daily living (ADLs). Why does the nurse ask whether the patient is right- or left-handed?
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the patient may be somewhat stronger on the dominant side which is expected
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The nurse is taking shift report on several patients with changes in functional health patterns. The levels are based on Gordon’s Functional Assessment. Which level will require the most assistance during the shift?
answer

Level III for feeding
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Which statement is included in an assessment of the patient’s mental status?
answer

appropriateness of clothes to weather conditions
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The older adult patient is brought to the clinic by the family who reports that “Dad doesn’t seem to be quite like himself.” Which behavior is an early sign of a neurologic problem?
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inability to remember a trip that he took last week (short recent term memory)
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In assessing the patient’s cognitive status and ability to make rational decisions, the nurse asks, “What would you do if you saw a fire in the wastebasket?” The patient replies, “Why? Are you trying to burn me to death?” What is the appropriate nursing diagnosis for this patient?
answer

Disturbed thought processes
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Which neurologic disorder is most likely to require hourly sensory assessments of the patient?
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Guillain-Barre syndrom
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cranial nerve: smell
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I: Olfactory
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cranial nerve: vision
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II: Optic
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cranial nerve: eye movement via medial and lateral rectus and inferior oblique and superior rectus muscles
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III: Oculomotor
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cranial nerve: lid elevation via the levator muscle, pupil constriction, ciliary muscles
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III: Oculomotor
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cranial nerve: pupil constriction; ciliary muscles
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III: Oculomotor
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cranial nerve: eye movement via superior oblique muscles
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IV: Trochlear
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cranial nerve: sensation from skin of face and scalp and mucous membranes of mouth and nose; muscles of mastication (chewing)
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V: Trigeminal
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cranial nerve: muscles of mastication (chewing)
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V: Trigeminal
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cranial nerve: eye movement via lateral rectus muscles
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VI: Abducens
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cranial nerve: pain and temperature from ear area; deep sensations from the face; taste from anterior (front) two-thirds of the tongue; muscles of the face and scalp; lacrimal, submandibular, and sublingual salivary glands
answer

VII: Facial
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cranial nerve: taste from anterior (front) two-thirds of the tongue
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VII: Facial
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cranial nerve: lacrimal, submandibular, and sublingual salivary glands
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VII: Facial
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cranial nerve: hearing; equilibrium (balance)
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VIII: Vestibulocochlear
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cranial nerve: equilibrium (balance)
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VIII: Vestibulocochlear
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cranial nerve: pain and temperature from ear; taste and sensations from posterior (back) one-third of tongue and pharynx; skeletal muscles of the throat; parotid glands
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IX: Glossopharyngeal
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cranial nerve: skeletal muscles of the throat, parotid glands
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IX: Glossopharyngeal
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cranial nerve: taste and sensations from posterior (back) one-third of tongue and pharynx
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IX: Glossopharyngeal
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cranial nerve: muscles of the face and scalp
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VII: Facial
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cranial nerve: pain and temperature from ear; sensations from pharynx, larynx, thoracic, and abdominal viscera; muscles of the soft palate, larynx, and pharynx; thoracic and abdominal viscera; cells of secretory glands; cardiac and smooth muscle innervation to the level of the splenic flexure
answer

X: Vagus
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cranial nerve: sensations from pharynx, larynx, thoracic, and abdominal viscera
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X: Vagus
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cranial nerve: muscles of soft palate, larynx, pharynx, thoracic, and abdominal viscera
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X: Vagus
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cranial nerve: cells of secretory glands, cardiac and smooth muscle innervation to the level of the splenic flexure
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X: Vagus
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cranial nerve: skeletal muscles of the pharyns and larynx and sternocleidomastoid and trapezius muscles
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XI: Accessory
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cranial nerve: skeletal muscles of the tongue
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XII: Hypoglossal
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pneumonic for cranial nerves:
answer

question

Which sensory assessment technique is correct?
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assessment of sharp and dull senses by using a paper clip
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The nurse is caring for several older adult patients in a long-term care facility. In planning care with consideration for the sensory changes related to aging, which intervention does the nurse implement?
answer

increases the ambient lighting because of the decrease in pupil size
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The nurse is taking an initial history on the patient whose chief complaint is a headache that seems to be associated with blurred vision. The patient also reports several chronic health problems. Which chronic condition is most likely to impact neurologic function?
answer

hypertension
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The older adult patient is admitted into a long-term care facility and the nurse is performing a baseline physical assessment that includes neurologic and sensory function. What is the purpose of this assessment?
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determine a level of function for later comparison
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mental/cognitive status assessment: repeat three unrelated words
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new memory
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mental/cognitive status assessment: “What is your birth date?”
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remote memory
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mental/cognitive status assessment: follow simple instructions
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language comprehension
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mental/cognitive status assessment: “What health care providers have you seen during the last year?”
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recent memory
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mental/cognitive status assessment: repeat a series of numbers
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attention span
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mental/cognitive status assessment: “Tell me about your hobbies.”
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cognitive skills
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The nurse is assessing the sensory functions of the patient with Guillain-Barre syndrome (GBS). The nurse makes a clinical judgment to forgo assessing for light touch discrimination. Why does the nurse make this decision?
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patient’s pain and temperature sensations are intact
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The nurse is testing the patient for touch discrimination by touching the patient on both shoulders. What is a normal finding for this assessment?
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pointing to where each shoulder was touched
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motor testing: patient walks across the room and returns
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gait
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motor testing: patient stands, eyes open, feet close together
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equilibrium
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motor testing: patient holds the arms perpendicular to the body, eyes closed
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brainstem integrity
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motor testing: patient grasps and squeezes the nurse’s fingers
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muscle strength
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motor testing: with arms out to the side, the patient touches the nose two to three times
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coordination
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The nurse student is performing a neurologic assessment on the patient who sustained a stroke. The nurse observes the student evaluating grip and hand strength only on the affected side. What is the nurse’s first action?
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remind the student that strength testings needs to be done bilaterally
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The patient is admitted to a rehabilitation center following a stroke that has left him with residual weakness on his left side. The nurse has completed the physical and neurologic assessment. Which documentation note best describes the patient’s progress?
answer

demonstrates 5/5 in left leg and 5/5 in right leg against resistance
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In assessing the patient’s gait and equilibrium, the nurse observes that the patient has Romberg’s sign. What is the most appropriate nursing diagnosis associated with this objective data?
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Risk for Injury related to dysfunctions in awareness of body position
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Which statement about the Glasgow Coma Scale (GCS) is correct?
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it establishes a baseline for eye opening, motor and verbal response
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The nurse is attempting to assess the coma patient’s response to pain. Which technique does the nurse try first?
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speak to the patient and call his or her name using a normal tone of voice
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The nurse is assessing response to painful stimuli in the patient. What is the appropriate length of time to apply the stimulus in the comatose patient
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20-30 seconds
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The nurse is assessing several patients using the GCS. Which factors indicate the most neurologic presentation based on the GCS information.
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eye opening to pain, abnormal flexion, incomprehensible sounds
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The nurse is performing neurologic checks every 4 hours for the patient who sustained a head injury. Which early sign indicates a decline in neurologic status?
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change in level of consciousness
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The student nurse is talking to the patient and family about diagnostic testing. Which statement by the nursing student indicates the need for further study about the understanding of diagnostic procedures?
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You are to have x-rays of the skull. Are you allergic to iodine?
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Which statement about lumbar puncture (LP) is true?
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It is done with the patient in the fetal position
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The nurse is reviewing the results of a lumbar puncture test. Which cerebrospinal fluid (CSF) result does the nurse point out to the physician as a significant abnormal finding? (pg. 948)
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protein 500-700 mg/100 mL
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The patient is scheduled for an EEG. How does the nurse prepare the patient for this diagnostic test?
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keep the patient awake from 2 am until the scheduled test time
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The patient arrives on the unit alert and oriented after undergoing cerebral angiography. The report from the radiology nurse indicates the catheter was inserted into the left femoral artery. For which postprocedural order does the nurse call for clarification? (meaning: not needed/appropriate)
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IV and oral fluid restrictions for a total of 1000 mL/ 24 hours
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The patient is scheduled to have a CT with contrast media and the nurse is reviewing the patient’s laboratory results. Which laboratory result could impact the procedure, prompting the nurse to notify the radiology department and the health care provider?
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creatinine level
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The nurse has instructed the patient and family on information about positron emission tomography (PET). However, the patient is suspected of having early signs of Alzheimer’s disease (AD). Which statement by the patient indicates he did not understand the information?
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“I will be asleep during most of the test; I will get a mild medication to help me relax.”
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Which factors are potential contraindications for having an MRI?
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cardiac pacemaker, implanted infusion pum, ferromagenetic aneurysm clip, confusion or agitation, continuous life support, old tattoos with lead
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The patient is scheduled for a cerebral blood flow evaluation with use of radioactive substance. Which medications does the nurse anticipate the physician will likely withhold from the patient for 24 hours before the test?
answer

central nervous system depressants and stimulants
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Which of the following assessment findings may indicate an urgent condition requiring immediate notification of the provider? (from Key Points)
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dilated and nonreactive pupils
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What is the central nervous system (CNS) composed of?
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brain and spinal cord
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directs the regulation and function of the nervous system and other body systems
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brain
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initiates reflex activity and transmits impulses to and from the brain
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spinal cord
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What is the nervous system composed of?
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central nervous system (CNS) and peripheral nervous system (PNS)
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What is the peripheral nervous system (PNS) composed of?
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12 pairs of cranial nerves, 31 pairs of spinal nerves, and the autonomic nervous system (ANS)
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is made up of 12 pairs of cranial nerves, 31 pairs of spinal nerves, and the autonomic nervous system (ANS)
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peripheral nervous system (PNS)
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is made up of brain and spinal cord
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central nervous system (CNS)
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contains neurons that transmit or conduct nerve impulses and neurogliall cells which have an interdependent role with the neuron
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nervous system
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transmits or conducts nerve impulses
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neurons
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have an interdependent role with the neuron
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neuroglial cells
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some neurons are:
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motor (enabling movement), sensory (enabling sensation), process information or retain information
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neurons’ enabling movemement
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motor
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neurons’ enabling sensation
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sensory
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some process information, some retain information
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neurons
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have either motor or sensory
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neurons
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has enabling movement (motor) and sensation (sensory)
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neurons
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the effect when a neuron receives an impulse from another neuron
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excitation or inhibition as well as conduction of the impulses
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the effect of these are either excitation or inhibition as well as conduction of the impulses
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neurons
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provide protection, structure, and nutrition for the neurons
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neuroglial cells
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neuroglial cells – classified into 4 types
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astroglial cells, ependymal cells, oligodendrocytes, and microglial cells
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neuroglial cells are also part of the:
answer

blood-brain barrier and help regulate cerebrospinal fluid (CSF)
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a part of the blood-brain barrier and help regulate cerebrospinal fluid (CSF)
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neuroglial cells
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observation/assessment: What to note during introduction?
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pt’s appearance and speech, affect, and motor function
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observation/assessment: What to ask patient to determine its associate with current health problem and to evaluate their ability to perform ADLs?
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pt’s medical history
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observation/assessment: Ask about this since some disease occur more often in certain cultural groups or with genetic influence.
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family medical history esp. stroke or myocardial infarction
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observation/assessment: What to establish prior to subsequent comparison which is important
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baseline data
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observation/assessment: Compare each assessment with baseline and?
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differences between right and left sides along with upper and lower extremities
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observation/assessment: During an organized head-to-toe physical assessment, this is what to begin?
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mental stauts
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observation/assessment: How to determine level of consciousness (LOC)?
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by observing responsiveness and awareness
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observation/assessment: the first indication that central neurologic function has declined
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a change in LOC
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observation/assessment: tested to establish a baseline from which to compare progress or deterioration when the patient has a suspected problem affecting these
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cranial nerves
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observation/assessment: assessment of sensory function is reserved for patients having problems affecting these
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spinal cord or spinal nerves such as trauma, intervertebral disk disease, Guillain Barre syndrome, tumor, infection, stenosis, or transverse myelitis
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observation/assessment: components of the sensory assessment
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pain, superficial and deep sensation, light touch, proprioception
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observation/assessment: What to observe throughout the physical assessment?
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for any involuntary tremors or movements
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observation/assessment: What to measure?
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pt’s muscle strength, equality, and strength against resistance
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observation/assessment: These are assessed by also testing muscles
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cerebral motor or brainstem integrity
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observation/assessment: can be evaluated through assessment of fine coordination of muscle activity, coordination, gait, and equilibrium
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cerebellar function
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observation/assessment: routinely tested
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deep tendon reflexes of the biceps, triceps, brachioradialis, and quadriceps muscles and of the Achilles tendon
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observation/assessment: the cutaneous or superficial reflexes normally tested
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plantar reflexes and sometimes abdominal reflexes
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observation/assessment: When is a rapid neurologic assessment or a “neuro check” completed?
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when pt is admitted on an emergent basis, as part of ongoing pt assessment, and in the event of a sudden change in neurologic status
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observation/assessment: nurses collect and document data related to:
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level of consciousness, orientation, movement of arms and legs, pupil size and reaction to light
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observation/assessment: What to check for when assessing eyes
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size, shape, reaction, to light
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what does PERRLA stand for?
answer

question

used reliably to help describe the patient’s level of consciousness
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Glasgow Coma Scale
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Glasgow Coma Scale assesses what?
answer

question

other signs of altered mental status
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complaints of headache, restlessness, irritability or unsual quiet, slurred speech, and a change in the level of orientation
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Late signs of neurologic deterioration that warrants an immediate call the the provider
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decerebrate or decorticate posturing or pinpoint or dilated and nonreactive pupils
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answer

decerebrate
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answer

decorticate posturing
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used to determine bony fractures, curvatures, bone erosion, bone dislocation, and possible calcification of soft tissue
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x-rays (of skull and spine)
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#1 priority in head trauma and multiple injuries
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rule out cervical spine fracture
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done using contrast to visualize the cerebral circulation to detect blockages in the arteries or veins in the brain, head, or neck
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cerebral angiography (or arteriography)
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distinguishes bone, soft tissue, vascular system, and ventricular system, and fluids such as cerebrospinal fluid (CSF) or blood
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CT scan (computed tomography scanning)
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what else can be identified?
answer

tumors, infarctions, hemorrhage, hydrocephalus (?), and bone malformations
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involves administering congtrast dye intravenously to identify blood vessel abnormalities such as blockages or narrowing and aneurysms
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CT angiography
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produces better images used to determine normal and abnormal anatomy
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MRI (magnetic resonance imaging)
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provides information about the function of the brain specifically glucose and oxygen metabolism and cerebral blood flow
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PET scan (positron emission tomography)
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uses a radioharmaceutical agent that enables radioisotopes to cross the blood-brain barrier
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SPECT (single-photon emission computed tomography)
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noninvasive imaging technique used to measure the magnetic fields produced by electrical activity to localize brain function in action
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magnetoencephalography
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used to identify nerve and muscle disorders as well as spinal cord disease
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electromyography
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records the electrical activity of the cerebral hemispheres and is performed to determine the origin of seizure activity, determine cerebral function in pathologic conditions, differentiate between organic and hysterical or feigned blindness or deafness, monitor cerebral activity during surgical anesthesia, diagnose sleep disorders, and determine brain death
answer

electroencephalography
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performed to determine the origin of seizure activity, determine cerebral function in pathologic conditions, differentiate between organic and hysterical or feigned blindness or deafness, monitor cerebral activity during surgical anesthesia, diagnose sleep disorders, and determine brain death
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electroencephalography
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records the electrical activity of the cerebral hemispheres
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electroencephalography
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measure the electrical signals generated by hearing, touch, or sight to assess sensory nerve problems and confirm conditions such as multiple sclerosis, brain tumor, acoustic neuromas, and spinal cord injury
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evoked potentials or evoked responses
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evoked potentials or evoked responses measure the electrical signals that are generated by what
answer

hearing, touch, or sight (to assess sensory nerve problems)
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evoked potentials or evoked responses measure the electrical signals generated by hearing, touch, or sight to assess sensory nerve problems and to confirm conditions such as
answer

multiple sclerosis, brain tumor, acoustic neuromas, and spinal cord injury
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can be measured in many areas of the brain with the use of radioactive substances especially for cerebral vasospasm
answer

cerebral blood flow
question

used to obtain pressure readings, obtain cerebrospinal fluid (CSF), check for spinal blockage attributable to a spinal cord lesion, inject contrast medium or air for diagnostic study, inject spinal anesthetics or other medications, and reduce mild increased intracranial pressure (ICP) in certain conditions
answer

lumbar puncture (LP/spinal tap)
question

another term for spinal tap
answer

lumbar puncture (LP)
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because of the danger of sudden release of CSF pressure, a lumbar puncture is contraindicated in patients with?
answer

suggestive or increased intracranial pressure
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can be evaluated by using a transcranial Doppler which uses sound waves to measure blood flow through the arteries
answer

intracranial hemodynamics
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uses sound waves to measure blood flow through the arteries
answer

Doppler
question

what is particularly valuable
answer

evaluating cerebral vasospasm or narrowing or arteries
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used to diagnose neuromuscular disorders and may also reveal if a person is a carrier of a defective gene
answer

muscle or nerve biopsies
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used to diagnose neuromuscular disorders
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muscle or nerve biopsies
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may also reveal if a person is a carrier of a defective gene
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muscle or nerve biopsies
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When having an angiography, check for this and if present, notify radiologist immediately!
answer

bleeding at the injection site (after angiography)
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What to do if bleeding at the injection site is present after an angiography?
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Notify the radiologist immediately
question

what to check for prior to an MRI?
answer

ferromagnetic devices: pacemakers, vascular stents, and implanted pumps
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what to do for older adults who typically have recent memory loss
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reinforce teaching and using teaching aids
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what to do before a diagnostic testing for neurologic structure and cuntion
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explain what pts should expect
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encourage patients who have received contrast media or isotopes to do this
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drink fluids to increase elimination of the material
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What does the complex nervous system control?
answer

mobility, sensation, and cognition
question

innervates many other body systems to make them function
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autonomic nervous systems (ANS)
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part of the ANS that stimulate the detrusor muscle to contract when the urinary bladder is full
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sacral spinal nerves
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can impair the human needs for mobility, sensation, and cognition
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health problems involving trauma and diseases of the brain
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major divisions of the nervous system
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central nervous system (CNS) and peripheral nervous system (PNS)
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major components of the CNS
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brain and spinal cord
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composes the PNS
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12 pairs of cranial nerves, 31 pairs of spinal nerves, and ANS
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ANS is further subdivided
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sympathetic and parasympathetic fibers
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nervous system contains two types of cells
answer

neurons and neuroglial cells
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transmit or conduct nerve impulses
answer

neurons
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have an interdependent role with the neuron
answer

neuroglial cells
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basic unit of the nervous system
answer

neurons
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transmits impulses or “messages”
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neurons
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What is the effect when a neuron receives an impulse from another neuron?
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excitation or inhibitation
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What does each neuron have?
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a cell body or soma, short, branching processes called dendrites, and a single axon
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a cell body
answer

soma
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short, branching processes
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dendrites
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What does each dendrite do?
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synapses with another cell body, axon, or dendrite and brings information to the cell body from other neurons (afferent pathway)
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brings information to the cell body from other neurons
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afferent pathway
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sends messages from the neuron’s cell body to other neurons through an axon
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efferent pathway
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How many axon is attached to each neuron that may extend long distances, often down the entire spinal cord?
answer

only one
question

covers many axons
answer

myelin sheath
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a white, lipid covering
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myelin sheath
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appear whitish, therefore also called white matter
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myelinated axons
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have a grayish cast and are called gray matter
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nonmyelinated axons
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myelinated axons have these gaps in the myelin
answer

nodes of Ranvier
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play a major role in impulse conduction
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nodes of Ranvier
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when the myelin is impaired, the impulses cannot travel fromthe brain to the rest of the body such as in pts with this
answer

multiple sclerosis
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the enlarged, distal end of each axon
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synaptic or terminal knob
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mechanisms within the synaptic or terminal knobs
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manufacturing, storing, and releasing a neurotransmitter
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what does each neuron produce?
answer

a specific neurotransmitter substance or chemical (acetylcholine or serotonin) that can either enhance or inhibit the impulse but not do both
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two distinct types of synapses that trasmits impulses to their eventual destination through synapses or spaces between neurons
answer

neuron to neuron and neuron to muscle (or gland)
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between the terminal knob and the next cell is a small space
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synaptic cleft
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makes up the synapse
answer

the knob, the cleft, and the portion of the cell to which the impulse is being transmitted
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factors that affect the transmission of an impulse
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distance and strength
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strength of the stimulus can also be influenced by other mechanisms
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inhibition by another neuron, inadequate supply of transmitter substance, and extracellular fluid (ECF) changes
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can quickly depress nerve cell activity
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lack of oxygen or the effects of hypnotics and anesthesia
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also affects the neuron transmission
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changes in the pH of ECF
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excites nerve cells
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alkalosis
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increased nerve cell activity occurs with the use of
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some drugs such as caffeine (in coffee), theophylline (in tea and some asthma drugs), and thebromine (in cocoa)
question

vary in size and shape and provide protection, structure, and nutrition for the neurons
answer

neuroglial cells
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neuroglial cells are classified into four types
answer

astroglial cells, ependymal cells, oligodendrocytes, and microglial cells
question

also part of the blood-brain barrier and help regulate cerebrospinal fluid (CSF)
answer

neuroglial cells
question

composed of the brain, which directs the regulation and function of the nervous system and all other systems of the body, and spinal cord, which starts reflex activity and transmits impulses to and from the brain
answer

central nervous system (CNS)
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directs the regulation and function of the nervous system and all other systems of the body
answer

brain
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starts reflex activitiy and transmits impulses to and from the brain
answer

spinal cord
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protective covering of the brain and spinal cord
answer

meninges
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outside layer of brain
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dura mater
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located between the dura mater and the arachnoid, middle layer
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subdural space
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middle layer of brain
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arachnoid
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most inner layer
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pia mater
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situated between the arachnoid and pia mater where CSF circulates
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subarachnoid space
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referred to as the epidural space that is located between the skull and outer layer of the dura
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a potential space
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also extends down the spinal cord and is important in the delivery of epidural analgesia and anesthesia
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epidural space ( a potential space)
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also lies between the cerebral hemispheres and cerebellum
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dura (tentorium)
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another name for dura that also lies between the cerebral hemispheres and cerebellum
answer

tentorium
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helps decrease or prevent the transmission of force from one hemisphere to another and protect the lower brainstem when head trauma occurs
answer

dura (tentorium)
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clinical references that may be made to a lesion or a tumor
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supratentorial (above the tentorium) or infratentorial (below the tentorium)
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parts that compose the brain
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cerebrum, diencephalon, hypophysis (pituitary gland), cerebellum, and brainstem
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joined by the corpus callosum
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right and left hemispheres of the cerebrum
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dominant hemisphere in most people even in many left-handed people
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left hemispheres
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within deeper structures of the cerebrum
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right and left ventricles
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at the base of the cerebrum near the ventricles is a group of neurons called
answer

basal ganglia
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a group of neurons that regulate the human needs for mobility
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basal ganglia
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located in the front lobe that controls voluntary movement
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motor cortex
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also called corticospinal tracts that begin in the motor cortex and travel through the brain before crossing in the medulla
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pyramidal tracts
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this crossing explains how right motor cortex damage affects the movement in the
answer

left side of the body and vice versa such as pts who have cerbral strokes
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another term for lobes
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sulci (fissures)
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divides the cerebrum
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lobes, sulci, fissures
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work together and are connected by nerve fibers
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lobes
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two important speech areas of the cerebrum
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Broca’s area and Wernicke’s area
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soeech area located in the frontal lobe
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Broca’s area
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responsible for the formation of words
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Broca’s area
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language area located in the temporal lobe
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Wernicke’s area
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allows processing of words into coherent thought and understanding of written or spoken words
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Wernicke’s area
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which lies below the cerebrum includes the thalamus, hypothalamus, and epithalamus
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diencephalon
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major relay station or central switchboard
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thalamus
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plays a major role in autonomic nervous system control (controlling temperature and other functions) and intellectual function (cognition)
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hypothalamus
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contains the roof of the third ventricle and the pineal gland
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epithalamus
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pituitary gland
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hypophysis
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has two lobes, each releasing specific hormones into the circulation under the regulation of the hypothalamus
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hypophysis (pituitary gland)
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master gland because of its control of numerous hormonal functions
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pituitary
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actually control its functions, not the the pituitary
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hypothalamus
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receives immediate and continuous information about the condition of the muscles, joints, and tendons
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cerebellum
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cerebellar function enables a person to
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keep an extremity from overshooting an intended target, move from one skilled movement to another in an orderly sequence, predict distance or gauge the speed with whch one to approaching an object, control voluntary movememnt, maintain equilibrium
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unlike the motor cortex, the control of the body is ipsilateral (situated on the same side)
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cerebellar
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the right side of the cerebellum controls
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the right side of the body
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the left side of the cerebellum controls
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the left side of the body
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includes the midbrain, pons, and medulla
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brainstem
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throughout the brainstem which controls awarness and alertness
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special cells that has reticular activating system (RAS)
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this tissue awakens a person from sleep when presented with a stimulus like a loud noise, when there is pain, or when it is time to awaken
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special cells that has reticular activating system (RAS)
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the anterior, middle, and posterior cerebral arteries are joined by small communicating arteries to form a ring at the base of the brain
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circle of Willis
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where does circulation in the brain originate from?
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carotid and vertebral arteries
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Due to the older adults having an altered balance and decreased coordination, remind them to
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move slowly and use caution when ambulating
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check for this after pts have an angiography and if present, call the radiologist immediately
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bleeding
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before an MRI, check for these devices
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pacemakers, vascular stents, and implented pumps
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encourage this for pts who receive contrast media or isotopes
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push fluids to increase elimination of the material
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part of the neurologic assessment
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assess mental status including orientation
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tends to be an early sign of neurologic problesm
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pt’s memory especially recent memory
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evaluate physiological integry by
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sensory and motor abilities, gait, balance, coordination
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the lower the score, the poorer the function
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Glasgow Coma Scale
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measures neurologic function
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Glasgow Coma Scale
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check pupils for size, shape, and reaction and what it should be
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pupils should be equal in size, round and regular in shape, and reactive to light and accomodation
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late signs of neurologic deterioration
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decerebrate or decorticate posturing and pinpoint or dilated nonreactive pupils
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patient positioning during a lumbar puncture
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fetal position
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normal cerebrospinal fluid (CSF)
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clear and colorloess with few cells

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