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Q: What is the term for brief episodes of neurologic deficit caused by temporary interference with blood supply to the brain?

Transient ischemic attacks More test answers on https://studyhippo.com/med-term-final/

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Apical Heart Rate Blood Supply To The Brain Elevated Blood Pressure Nursing Nursing-LPN Self Care Deficit

HESI- Brain Attack (Stroke) – Flashcards 31 terms

Ben Russell

31 terms

Preview

HESI- Brain Attack (Stroke) – Flashcards

question

Which additional clinical manifestations should the RN expect to find if these symptoms Mrs. Jackson has have been caused by a brain attack (stroke)? (Select all that apply)

answer

A. Carotid bruit B. Elevated BP E. Drooling

question

Which assessment finding warrants immediate intervention by the RN? (Select all that apply)

answer

C. Mrs. Jackson only response to painful stimuli D. Positive Babinski's reflex bilaterally E. Pupils are reacting unequally, and she is experiencing sensitivity to light

question

What clinical manifestation further supports this assessment?

answer

D) Global aphasia. Rationale: Global aphasia refers to difficulty speaking, listening, and understanding, as well as difficulty reading and writing. Symptoms vary from person to person. Aphasia may occur secondary to any brain injury involving the left hemisphere. Visual field deficits, spatial-perceptual deficits, and paresthsia of the left side usually occur with right-sided brain attack.

question

Which intervention should the RN implement when preparing Mrs. Jackson and her daughter for this procedure?

answer

B) Explain to the daughter that her mother will have to remain still throughout the CT scan. Rationale: Because head motion will distort the images, Nancy will have to remain still throughout the procedure. Allergies to iodine is important if contrast dye is being used for the CT scan. Premedicating the client to decrease pain prior to the procedure is unnecessary because CT scanning is a noninvasive and painless procedure. Providing an explanation of relaxation exercises prior to the procedure is a worthwhile intervention to decrease anxiety but is not of highest priority.

question

A neurologist prescribes a magnetic resonance imaging (MRI) of the head STAT for a patient. Which data warrants immediate intervention by the nurse concerning this diagnostic test?

answer

C) Right hip replacement. The magnetic field generated by the MRI is so strong that metal-containing items are strongly attracted to the magnet. Because the hip joint is made of metal, a lead shield must be used during the procedure. Elevated blood pressure, an allergy to shell fish, and a history of atrial fibrillation would not affect the MRI.

question

Gail, the daughter states, "I don't understand what a brain attack is. The healthcare provider told me my mother is in serious condition and they are going to run several tests. I just don't know what is going on. What happened to my mother?" What is the best response by the nurse?

answer

B) "Your mother has had a stroke, and the blood supply to the brain has been blocked." Rationale: The nurse can discuss what a diagnosis means. Nancy is unable to make decisions, so the next of kin, her daughter, Gail, needs sufficient information to make informed decisions. The nurse has the knowledge, and the responsibility, to explain Nancy's condition to Gail. The nurse should give facts first, and then address her feelings after the information is provided.

question

Gail begins to cry and states, "Mom was just fine last week when we went out to eat and to a show. I love my mom so much, and I am so scared. She is all I have." How should the RN respond?

answer

B. I know this is scary for you. Would you like to sit and talk?

question

The neurologist diagnosis I'd ask you make a left sided brain attack, stroke. The neurologist determines that Mrs. Jackson is not a candidate for tissue plasminogen activator, tPA. Enoxaparin 1 mg/kg subcutaneously every 12 hours is prescribed. Mrs. Jackson weighs 145 pounds. How many milligrams of Enoxaparin Will the nurse administer in each dose?

answer

66 mg 145/2.2 = 65.9kg x 1mg/kg = approx. 66 mg

question

With a diagnosis of a brain attack, stroke, which priority intervention should the RN include and Mrs. Jackson's plan of care?

answer

C. Keep the head of the bed elevated Maintaining a patent airway is essential to support oxygenation and cerebral perfusion. Elevating the head of the bed 30 degrees aids in preventing the tongue from falling backward and obstructing the airway.

question

The nurse continues to monitor Nancy's condition closely. Which finding would require immediate intervention by the nurse?

answer

A. Nancy's cardiac output is less than 4 L/min The normal range for cardiac output to ensure cerebral blood flow and oxygen delivery is 4 to 8 L/min.

question

Though Nancy's SaO2 potassium level, and telemetry readings are within normal limits for her age, her cardiac output is low. Which nursing interventions would be priority at this time?

answer

A. Monitor level of consciousness With a decreased cardiac output, cerebral perfusion will be affected. This can be reflected in a further decreased level of consciousness. C. Strict intake and output The kidneys use 25% of cardiac output, so when cardiac output is decreased, the kidneys may start failing. Close monitoring is essential. D. Monitor capillary refill every 2-4 hours Decreased cardiac output would affect tissue perfusion, reflected in a capillary refill of greater than 3 seconds. E. Contact physician The physician needs to be notified regarding decreased cardiac output to decide whether to initiate IV fluids if hypovolemia is an issue and to determine other medical interventions.

question

As the nurse assesses Nancy, Gail asks, "Why isn't my mother a candidate for thrombolytic therapy?"

answer

B. "She is not a candidate because of therapeutic time constraints related to this medication." Thrombolytic therapy is contraindicated in clients with symptom onset longer than 3 hours prior to admission. Nancy had symptoms for 24 hours before being brought to the medical center.

question

Which nursing diagnosis has the highest priority?

answer

D. Drooling According to Maslow's Hierarchy of Needs, physiological needs should be addressed first. Therefore, Nancy's dysphagia is the highest priority nursing diagnosis since she is at risk for aspiration.

question

Because Nancy is right-handed and is having difficulty performing activities of daily living with the left arm, the nurse also includes the nursing diagnosis "self-care deficit" in the care plan. Which intervention would the nurse implement to address this nursing diagnosis?

answer

B. Utilize plate guards when Nancy is eating Plate guards prevent food from being pushed off the plate. Using plate guards and other assistive devices will encourage independence in a client with a self-care deficit.

question

Which condition is considered a modifiable risk factor for a brain attack?

answer

A. High cholesterol levels B. Obesity C. HTN D. Hx of A.fib

question

Gail tells the nurse she is going to go outside to smoke a cigarette and will only be gone for a few minutes. Which statement is warranted in this situation?

answer

A. "I should let you know that smoking is a strong risk factor for a brain attack." The nurse should teach Gail that smoking is a modifiable risk factor that could prevent her from having a stroke. Smoking increases the risk for hypertension, which is a risk factor for a stroke.

question

Nancy is experiencing homonymous hemianopsia as a result of her brain attack. Which nursing intervention would the nurse implement address this condition?

answer

B. Place the objects Nancy needs for activities of daily living on the left side of the table. Homonymous hemianopsia is loss of the visual field on the same side as the paralyzed side. This results in the client neglecting that side of the body, so it is beneficial to place objects on that side. Nancy had a left-hemisphere brain attack so her right side is the weak side.

question

Mrs. Jackson is experiencing pain in her right shoulder. The nurse is aware that up to 70% of clients with a brain attack experience severe pain in the shoulder that prevents them from learning new skills. Shoulder function helps clients achieve balance, perform transfer skills, and participate in self-care activities.Which intervention should the nurse implement when addressing this condition?

answer

D. Instruct Mrs. Jackson to clasp the right hand with the left hand and raise both hands above the head This exercise helps prevent "frozen shoulder" and will aid the nurse when moving or positioning the client.

question

Gail tells the nurse, "One of the people in the waiting room was telling me about an operation that her mother had to prevent a stroke. Do you know anything about that?" How should the RN respond?

answer

B. "That procedure is only done with small strokes,not like the one your Mom had." This surgery is indicated for clients with symptoms of transient ischemic attack (TIA), or mild stroke, found to be due to severe carotid artery stenosis or moderate stenosis with other significant risk factors.

question

Which nursing care task should the nurse delegate to the UAP?

answer

D. Give Mrs. Jackson a bed bath and change the bed linens The UAP can assist Nancy with bathing and then change the bed linens. This task does not require professional judgment or expertise

question

Which written documentation should the nurse put in the client's record?

answer

B. PT reported that client became dizzy and was lowered back to the bed with the assistance of a gait belt - This documentation provides the factual data of the events that occurred.

question

Which intervention should the nurse implement to prevent joint deformities?

answer

A. Place Nancy in a prone position for 15 minutes at least 4 times a day This helps to promote hyperextension of the hip joints, which helps prevent knee and hip flexion contractures.

question

Which action should the RN implement to address this situation?

answer

C. Discuss how to use a communication board w/ both Mrs. Jackson and her daughter.

question

Which rehabilitation team member is responsible for evaluating Mrs. Jackson's dysphagia?

answer

B. The speech therapist The speech therapist evaluates the e client's gag reflex and ability to swallow, then makes recommendations regarding feeding techniques and diet.

question

The RN notes that Mrs. Jackson is no longer able to meet her nutritional needs and has lost 10 lbs.A gastrostomy tube is prescribed so that intermittent tube feedings can be administered. Which intervention should the RN implement first?

answer

A. Elevate the head of the bed to a semi-fowler's position during the feeding. Prevents aspiration

question

At what rate would the RN set the infusion pump?

answer

B. 60 ml/hr

question

The RN assesses Mrs. Jackson's apical pulse but cannot hear anything. Which intervention should the RN implement first?

answer

B. Continue to stay at Mrs. Jackson's bedside and hold Gail's hand.

question

The telephone at Mrs. Jackson's bedside starts ringing. The RN answers the phone. The caller is one of Mrs. Jackson's neighbors, wanting to know how Mrs. Jackson is doing. How should the nurse respond?

answer

C. I am sorry, but I am unable to give you any information

question

The RN remains with Gail at Mrs. Jackson bedside. The HCP is called an pronounces Mrs. Jackson's death. Gail tells the RN that Mrs. Jackson wanted to be in organ donor. Which action should the RN implement?

answer

B. Explain that Mrs. Jackson can only be a tissue donor, not an organ donor.

question

Mrs. Jackson was a Roman Catholic so Gail ask for the RN if Mrs. Jackson can receive, the sacrament for the sick. Which action would be most important for the RN to take in the situation?

answer

B. Have a priest perform Mrs. Jackson's anointing of the sick

question

Gail wants to bury her mother beside her father in the local cemetery and tells the RN, I just don't know what I should do. How should the RN respond?

answer

C. You seem really confused about what to do. Would you like to talk about it?

STUDY

AP Psychology Blood Supply To The Brain Consciousness Introductory Psychology Psychology

PSY 2012 – Chapter 5 Quiz – Flashcards 24 terms

Oscar Hall

24 terms

Preview

PSY 2012 – Chapter 5 Quiz – Flashcards

question

The evolutionary/circadian theory of sleep says that sleep _____.

answer

conserves energy and protects us from predators

question

REM sleep is also called _____ because the brain is aroused and active while the person remains nonresponsive and asleep.

answer

paradoxical sleep

question

Which of the following is the CORRECT sequence of sleep stages?

answer

hypnogogic → Stages 1-2-3-4-3-2 - REM

question

The _____ state occurs at the beginning of sleep when you may experience visual, auditory, and kinesthetic sensations.

answer

hypnogogic

question

Darius is sleeping right through the sounds of fire engine and police car sirens right outside his window. It is MOST likely that Darius is _____.

answer

in Stage 4 sleep

question

This is involved in the operation of circadian rhythms. A) hypothalamus B) pineal gland C) suprachiasmic nucleus D) all of these options

answer

D) all of these options

question

Just before sleep, brain waves move from _____ waves, indicating normal wakefulness, to _____ waves associated with drowsy relaxation.

answer

beta; alpha

question

A mental state other than an ordinary waking state, in which there are distinct changes in perception, emotion, memory, thinking, etc. is called alternate _____.

answer

states of consciousness

question

As you read this text, you will likely do best if you _____.

answer

employ controlled processing

question

Scientists study sleep in sleep labs using _____.

answer

EEG recordings

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Mental activities that require minimal attention are called _____ processes.

answer

automatic

question

You are in a sleep lab and have just been hooked up to an EEG, an EMG (for muscle activity), and an EOG (for eye movements). This means the sleep researcher is interested in your _____.

answer

brain waves, facial muscle movements, and eye movements

question

_____ is (are) BEST defined as our awareness of our environments and ourselves.

answer

Consciousness

question

Which of the following is a circadian rhythm?

answer

the sleep-wake cycle

question

Armand is daydreaming, Adele is dreaming while asleep. Which statement is TRUE? A) Armand is semi-conscious, Adele is unconscious. B) Armand is semi-conscious, Adele is in an alternate state of consciousness. C) Both Armand and Adele are in alternate states of consciousness. D) Armand is in an alternate state of consciousness, Adele is unconscious.

answer

C) Both Armand and Adele are in alternate states of consciousness.

question

In mid-sentence, your friend suddenly slumps over on the couch and appears to have entered the REM-stage of sleep. Which of the following is the BEST explanation for your friend's behavior? A) Your friend suffers from epilepsy, and just had a seizure. B) Your friend suffers from narcolepsy and should seek medical attention. C) You are boring, and should take a class in social speaking skills. D) Your friend did not get enough sleep last night, and should go to bed.

answer

B) Your friend suffers from narcolepsy and should seek medical attention.

question

Consciousness _____.

answer

exists on a continuum

question

Melatonin influences _____.

answer

sleep

question

How many cycles of distinct sleep stages do we typically experience during a normal night's sleep?

answer

4-5

question

The idea that dreams are the by-product of random stimulation of brain cells, and that the brain attempts to combine this spontaneous activity into coherent patterns, is known as the _____ hypothesis of dreaming.

answer

activation-synthesis

question

Sleepwalking is MOST likely to occur in _____.

answer

NREM sleep

question

This is NOT a parasomnia.

answer

sleep apnea

question

Which of the following persons is clearly experiencing chronic insomnia? A) Kipp frequemtly cannot fall asleep the night before a final exam. B) Kaula regularly sleeps around 7 hours per night. C) Consuela persistently has difficulty falling or staying asleep. D) George wakes up throughout the night because his neighbors make so much noise.

answer

C) Consuela persistently has difficulty falling or staying asleep.

question

Irvings's doctor prescribed Valium to help him cope with job-related anxiety. He found a less stressful job, and is anxiety-free. However, Irving keeps taking Valium because he likes its effects. He hasn't had to increase the dosage, and he did not have withdrawal symptoms when he forgot to take his pills. It is MOST likely that Irving is _________________.

answer

Psychologically dependent on Valium

STUDY

Amyotrophic Lateral Sclerosis Blood Supply To The Brain Medical Terminology Neurons In The Brain

Med Term Final Test Questions – Flashcards 100 terms

Roman Peck

100 terms

Preview

Med Term Final Test Questions – Flashcards

question

Interview of the parents of 5-year-old Clio revealed that for about the last 24 hours, Clio has been irritable, febrile, vomiting, and experiencing cephalgia. On further examination, nuchal rigidity (stiff neck) was noted. The physician performed a lumbar puncture to measure intracranial pressure and to obtain cerebrospinal fluid for analysis. Results confirmed a diagnosis of bacterial meningitis. Clio was started on antibiotics. Which term means inflammation of the membranes surrounding the brain and spinal cord?

answer

meningitis

question

The suffix -phasia means:

answer

speech

question

Magnetic resonance imaging and computed tomography confirmed that Mr. Hullinger has a malignant glioma that is surgically inaccessible. He is scheduled for stereotactic radiosurgery. A glioma is an intracranial tumor that arises from the:

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Supportive or connective tissue of the brain

question

The combining form vag/o means:

answer

Vagus Nerve

question

The medical term for a condition of involuntary, spasmodic movements is:

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Dyskinesia

question

What is the term for brief episodes of neurologic deficit caused by temporary interference with blood supply to the brain?

answer

Transient ischemic attacks

question

The medical term for headache is ceph________.

answer

algia

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________cele is the protrusion of the meninges and spinal cord through a defect in the spinal column.

answer

Myelomeningo

question

After losing consciousness, falling, and seizing, Clio, age 5, was brought to the ER by his parents. Two more episodes of tonic-clonic seizures occurred in the ER. Anticonvulsants were started and an EEG ordered. Another term for tonic-clonic seizures is:

answer

Ictal events

question

A fold in the surface of the cerebral cortex is called a:

answer

Gyrus

question

Using high-frequency sound waves to show the structure and movement of the heart chambers and valves is:

answer

Echocardiography

question

A(n) _____________ test is used to find evidence of a heart attack.

answer

cardiac biomarker

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Hyper___________ means increased cholesterol in the blood.

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cholesterolemia

question

A __________ is an abnormal, prolonged heart sound caused by incomplete closure of heart valves.

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murmur

question

Rapid, random, inefficient contraction of the atria or ventricles is called:

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Fibrillation

question

The cause of essential hypertension is:

answer

Not readily apparent or known

question

Damage to the heart valves produces lesions called ___________ that can break off into the bloodstream as ___________, material that travels through the blood.

answer

vegetations, emboli

question

Blocking of an artery by a blood clot is:

answer

Thrombotic occlusion

question

MVP is the abbreviation for:

answer

Mitral valve prolapse

question

The combining form thromb/o means:

answer

Clot

question

DTaP is the abbreviation for:

answer

Diphtheria, tetanus, and pertussis

question

Fine crackling sounds heard during inhalation, caused by excess bronchial tube secretions in the alveoli, are known as ________.

answer

rales

question

X-ray imaging of arteries and veins in the lung after injection of dye into a blood vessel is called a:

answer

Pulmonary angiography

question

A group of occupational-related lung diseases characterized by inflammation, infection, and bronchitis, caused by inhaling substances in the workplace is called __________________.

answer

pneumoconiosis

question

The central portion or area of the chest that separates the lungs is called the:

answer

Mediastinum

question

The physician orders a ventilation-perfusion (V/Q) scan, which reveals abnormalities consistent with a pulmonary embolism. You know a pulmonary embolism means:

answer

A clot forms in a distant vein and travels to the lungs

question

Creation of an opening into the trachea and insertion of a tube to create an airway is a:

answer

Tracheostomy

question

Mediastinoscopy means:

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Visual examination of the central portion of the chest cavity

question

Excessive fluid accumulation in the pleural space due to infection, malignancy, or trauma is called:

answer

Pleural Effusion

question

The combining form epiglott/o means:

answer

Epiglottis

question

The liquid portion of blood is called:

answer

Plasma

question

Unspecialized cells that become specialized when they mature are called:

answer

Stem cells

question

___________ are agranulocytes.

answer

Monocytes

question

________ blood contains only anti-A antibodies.

answer

Type B

question

Mr. Kennedy, who has pernicious anemia, will need lifelong administration of which substance?

answer

Vitamin B12

question

Another term for platelets is:

answer

Thrombocytes

question

White blood cells that do not contain granules in their cytoplasm are ________cytes, or mononuclears.

answer

agranulo

question

Mr. Kennedy is diagnosed with pernicious anemia. In pernicious anemia, RBC production is decreased due to lack of a protein called:

answer

Intrinsic factor

question

Gena Moore, an 18-year-old college student, is seen in the student health center for complaints of fatigue, weakness, and pharyngitis. She is febrile. While performing the physical examination, the practitioner finds painful lymphadenitis. Lab tests revealed an elevated WBC with an increase in atypical lymphocytes, negative throat culture, and the presence of antibodies to EBV. Ms. Moore's most likely diagnosis is:

answer

Mononucleosis

question

A person with Type O blood is a(n):

answer

Universal recipient

question

The medical term for kneecap is:

answer

Patella

question

The suffix -blast means:

answer

Embryonic or immature cell

question

Small channels in compact bone that contain blood vessels are called:

answer

Haversian canals

question

Diagnostic testing for Martha included a muscle biopsy and an EMG. An EMG records:

answer

Strength of muscle contraction

question

The upper part of the pelvic bone is the:

answer

Ilium

question

The combining form humer/o means:

answer

Upper arm bone

question

A set of x-rays of the bones in the spinal column, pelvis, and wrist to detect bone density is called a(n):

answer

Dual-energy x-ray absorptiometry

question

Spongy, porous, trabecular bone is called:

answer

Cancellous bone

question

Surgical repair of a joint is:

answer

Arthroplasty

question

The medical term for slipped disk is:

answer

Herniated disk

question

______________ is a surgical procedure for removing scars associated with acne.

answer

Dermabrasion

question

Mary increased her susceptibility to malignant melanoma by:

answer

Overexposing her skin to the sun

question

_________ refers to ecchymoses and petechiae over any part of the body.

answer

Purpura

question

Ms. King presented to her physician with a reddish "butterfly" rash over her nose and cheeks. After further examination and lab results showing high levels of antibodies in the blood, she is told she has a systemic chronic inflammatory collagen disease. Corticosteroid treatment is begun. Ms. King's diagnosis is:

answer

Systemic lupus erythematosus

question

The combining form adip/o means:

answer

Fat

question

Rotation of a surgical instrument to remove a core of tissue for examination is called:

answer

Punch biopsy

question

A freckle is an example of a(n):

answer

Macule

question

A benign skin neoplasm common in the elderly and characterized by thickened yellow or brown areas of the epidermis is called:

answer

Seborrheic keratosis

question

Sixteen-year-old David visits a dermatologist. The doctor sees a variety of lesions on the face, shoulders, and upper back. The predominant lesions are papules and pustules; several cysts are also visible. David reports that the skin lesions have developed recently and that over-the-counter topical medications have not worked. The physician diagnoses David with:

answer

Vulgaris acne

question

The epidermis is composed of which type of cell?

answer

Squamous epithelial cells

question

The layer of the eye containing rods and cones is the:

answer

Retina

question

The medical term for the eardrum is:

answer

Tympanic membrane

question

Which one of the following ear structures has hair cells that relay sound waves to auditory nerve fibers?

answer

Organ of Corti

question

The surgical incision of the tympanum to relieve the pressure and buildup of fluid in chronic otitis media is called a(n):

answer

Myringotomy

question

Decreased and blurred vision caused by clouding of the lens indicates the presence of:

answer

A cataract

question

Flap of the ear is called the:

answer

Auricle

question

The suffix -tropia means:

answer

To turn

question

Mimi's medical report records an increase in IOP, or intraocular pressure, which would indicate:

answer

Glaucoma

question

The receptor cells responsible for color vision are the:

answer

Cones

question

The medical term for earwax, the substance that lubricates the ear and prevents the entry of foreign particles:

answer

Cerumen

question

The ___________hypophysis is the posterior lobe of the pituitary gland.

answer

neuro

question

This hormone increases blood calcium.

answer

Parathyroid hormone or Parathormone

question

The secretions of the pituitary are controlled by signals transmitted from the:

answer

Hypothalamus

question

Gigantism is caused by:

answer

Hypersecretion of growth hormone by the pituitary before puberty

question

The abbreviation for syndrome of inappropriate antidiuretic hormone is:

answer

SIADH

question

Tony, age 28, reentered the hospital for high-dose chemotherapy and a bone marrow transplant for his leukemia. Bone marrow had been harvested from Tony after his first hospitalization in which he achieved complete remission. This type of bone marrow transplant is called:

answer

Autologous

question

Cancerous tumors are divided into broad groups on the basis of the particular type of tissue from which the tumor cells arise. This is called:

answer

Histogenesis

question

Evaluating the degree of maturity of tumor cells or indication of malignant transformation is called _______ of tumors.

answer

grading

question

Implantation of radioactive seeds directly into the tumor is called:

answer

Brachytherapy

question

Forming small finger-like or nipple-like projections of cells is called:

answer

Papillary

question

The abbreviation for multiple-gated acquisition scan is:

answer

MUGA scan

question

________graphy is a series of x-ray images made to show an organ in depth.

answer

Tomo

question

Radiopharmaceutical drugs can be used to generate an image by mapping their distribution and rate of absorption in the body because they emit:

answer

Gamma rays

question

In _____________, a radiopharmaceutical is given intravenously to obtain a lung scan.

answer

perfusion studies

question

IVP is the abbreviation for:

answer

Intravenous pyelogram

question

FDA is the abbreviation for:

answer

Food and Drug Administration

question

Chemotherapeutic agent A gives 15% tumor kill and chemotherapeutic agent B gives 20%; using the two together gives 35% tumor kill. The combination action is:

answer

Additive

question

The study of subcellular drug interactions is called:

answer

Molecular pharmacology

question

The combination of two drugs causing an effect greater than the sum of each drug alone is called:

answer

Synergism

question

Insulin is a kind of:

answer

Antidiabetic

question

LSD is the abbreviation for ____________, which is a hallucinogen.

answer

lysergic acid diethlyamide

question

The use of self-induced vomiting and misuse of laxatives or enemas to avoid weight gain is called:

answer

Bulimia

question

________philia is recurrent sexual fantasy or arousal in response to objects, activities, or situations not normally considered erotic.

answer

Para

question

TAT is the abbreviation for:

answer

Thematic Apperception Test

question

The combining form schiz/o means:

answer

Split

question

Characteristic symptoms of schizophrenia include all of the following except:

answer

Mania

question

The suffix -leptic means:

answer

To seize hold of

question

The combining form anxi/o means:

answer

Anxious or distressed

question

Clinical psych________ are non-medical professionals trained in the use of tests to evaluate various aspects of a person's mental health and intelligence.

answer

ologists

question

Jared was diagnosed with disorganized type schizophrenia. Disorganized type schizophrenia is primarily marked by:

answer

Disorganized speech and behavior and childish or inappropriate affect

STUDY

Anatomy And Physiology Blood Supply To The Brain Human Anatomy And Physiology 1 Neurons In The Brain

Step 1 First Aid – Neurology – Flashcards 560 terms

Ben Stevenson

560 terms

Preview

Step 1 First Aid – Neurology – Flashcards

question

CNS/PNS origins: Neuroectoderm (gives rise to what?)

answer

CNS neurons Ependymal cells (inner lining of ventricles, make CSF) Oligodendrocytes Astrocytes

question

CNS/PNS origins: Neural Crest (gives rise to what?)

answer

Schwann cells PNS neurons

question

CNS/PNS origins: Mesoderm (gives rise to what?)

answer

M icroglia, like M acrophages, originate from M esoderm

question

Neurons

answer

Comprise nervous system. Permanent cells -- do not divide in adulthood. Large cells w/ prominent nucleoli.

question

Nissl substance

answer

RER found in cell body and dendrites, but not axon of neurons.

question

Astrocytes

answer

Physical support, repair, K+ metabolism, removal of excess NT. Maintenance of BBB. Reactive gliosis in response to injury.

question

Astrocyte marker?

answer

GFAP

question

Microglia

answer

CNS phagocytes. Mesodermal origin. Not readily discernible in Nissle stains. Have small, irregular nuclei and relatively little cytoplasm.

question

What happens to microglia in the presence of tissue damage?

answer

Microglia --(tissue damage)--< large ameboid phagocytic cells

question

What happens to HIV-infected microglia?

answer

HIV-infected microglia fuse to form multinucleated giant cells in the CNS

question

Oligodendria

answer

Each oligodendrocyte myelinates multiple CNS axons (up to 30 each). In Nissle stains, they appear as small nuclei with dark chromatin and little cytoplasm.

question

What is the predominant type of glial cell in white matter?

answer

Oligodendrocytes.

question

What cells are destroyed in multiple sclerosis?

answer

Oligodendrocytes.

question

What do oligodendrocytes look like on H&E?

answer

"Fried Eggs"

question

Schwann cells

answer

Each Schwann cell myelinates only 1 PNS axon. Also promote axonal regeneration. Derived from neural crest.

question

What are the cells that are destroyed in Guillain-Barré syndrome?

answer

Schwann cells.

question

An acoustic neuroma is a type of...? Where is it located?

answer

Acoustic neuroma is a type of Schwannoma. It is typically located in internal acoustic meatus (CN VIII)

question

Sensory receptors/corpuscles: Free nerve endings (C, A-delta fibers) Location? Senses?

answer

In all skin, epidermis, some viscera. Senses pain and temperature.

question

Sensory receptors/corpuscles (location and senses): In all skin, epidermis, some viscera. Senses pain and temperature. Which is this?

answer

Free nerve endings (C, A-delta fibers)

question

Sensory receptors/corpuscles: Meissner's corpuscles Location? Senses?

answer

In glabrous (hairless) skin. Senses dynamic fine touch (e.g., manipulation), adapt quickly.

question

Sensory receptors/corpuscles (location and senses): In glabrous (hairless) skin. Senses dynamic fine touch (e.g., manipulation), adapt quickly. Which is this?

answer

Meissner's corpuscles

question

Sensory receptors/corpuscles: Pacinian corpuscles Location? Senses?

answer

In deep skin layers, ligaments, and joints. Sense vibration, pressure.

question

Sensory receptors/corpuscles (location and senses): In deep skin layers, ligaments, and joints. Sense vibration, pressure. Which is this?

answer

Pacinian corpuscles

question

Sensory receptors/corpuscles: Merkel's disks Location? Senses?

answer

(cup-shaped, unencapsulated) In hair follicles. Sense static touch (e.g., shapes, edges, textures), adapt slowly.

question

Sensory receptors/corpuscles (location and senses): (cup-shaped, unencapsulated) In hair follicles. Sense static touch (e.g., shapes, edges, textures), adapt slowly. Which is this?

answer

Merkel's disks

question

Peripheral nerve layers: Endoneurium

answer

Invests a single nerve fiber (Endo = inner)

question

Peripheral nerve layers: Perineurium

answer

(P erineurium is the P ermeability barrier) Surrounds a fascicle of nerve fibers. (Peri = around) Must be rejoined in microsurgery for limb reattachment.

question

Peripheral nerve layers: Epineurium

answer

Dense connective tissue that surrounds entire nerve (fasicles and blood vessels) (Epi = outer)

question

Neurotransmitters: NE Change in dz? Location of synthesis?

answer

Increased in anxiety, decreased in depression. Made in the locus ceruleus.

question

Increased in anxiety, decreased in depression. Made in the locus ceruleus. What NT is this?

answer

question

Neurotransmitters: Dopamine Change in dz? Location of synthesis?

answer

Increased in schizophrenia, decreased in Parkinson's. Made in the ventral tegmentum and SNc

question

Increased in schizophrenia, decreased in Parkinson's. Made in the ventral tegmentum and SNc What NT is this?

answer

Dopamine

question

Neurotransmitters: 5-HT Change in dz? Location of synthesis?

answer

Decreased in anxiety, depression. Made in the raphe nucleus

question

Decreased in anxiety, depression. Made in the raphe nucleus What NT is this?

answer

5-HT

question

Neurotransmitters: ACh Change in dz? Location of synthesis?

answer

Decreased in Alzheimer's, Huntington's. Made in the basal nucleus of Meynert.

question

Decreased in Alzheimer's, Huntington's. Made in the basal nucleus of Meynert. What NT is this?

answer

ACh

question

What 3 structures form the blood-brain barrier (BBB)?

answer

1.) Tight junctions btw nonfenestrated capillary endothelial cells 2.) Basement membrane 3.) Astrocyte processes

question

Besides the BBB, what are 2 similar barriers?

answer

1.) Blood-testis barrier 2.) Maternal-fetal blood barrier of placenta

question

What happens at the BBB w/ infarction?

answer

Infarction destroys endothelial cell tight junctions, leading to vasogenic edema

question

Glucose and amino acids at the BBB

answer

Cross slowly by carrier-mediated transport mechanism.

question

Nonpolar/lipid-soluble substances at the BBB

answer

Cross rapidly via diffusion.

question

Specialized brain regions w/ fenestrated capillaries and no BBB

answer

Allow molecules in the blood to affect brain function (e.g., area postrema - vomiting center after chemo, OVLT - osmotic sensing) or neurosecretory products to enter circulation (e.g., neurohypophysis - ADH release)

question

Hypothalamus functions

answer

The hypothalamus wears TAN HATS : T hirst and water balance A denohypophysis control N eurohypophysis releases hormones from hypothalamus H unger A utonomic regulation T emperature regulation S exual urges

question

Inputs to the hypothalamus

answer

OVLT (senses change in osmolarity) Area postrema (responds to emetics)

question

Supraoptic nucleus of the hypothalamus

answer

Area that makes ADH.

question

Area that makes ADH.

answer

Supraoptic nucleus of the hypothalamus

question

Paraventricular nucleus of the hypothalamus

answer

Area that makes oxytocin.

question

Area that makes oxytocin.

answer

Paraventricular nucleus of the hypothalamus

question

Lateral area of the hypothalamus

answer

Controls hunger: destruction leads to anorexia. ("If you zap the lateral nucleus, you shrink laterally ") Inhibited by leptin.

question

Ventromedial area of the hypothalamus

answer

Controls satiety: destruction leads to hyperphagia. ("If you zap your ventromedial nucleus, you grow ventrally and medially .") Stimulated by leptin.

question

Anterior hypothalamus

answer

Cooling (Anterior = cooling, or A/C). A nterior is pA rasympathetic.

question

Posterior hypothalamus

answer

Heating (posterior = get fired up / heating). Sympathetic. If you zap your P osterior hypothalamus, you become a P oikilotherm (cold-blooded, like a snake)

question

Septal nucleus of the hypothalamus

answer

area responsible for sexual urges

question

area responsible for sexual urges

answer

Septal nucleus of the hypothalamus

question

Suprachiasmatic nucleus of the hypothalamus

answer

Circadian rhythm. ("You need to sleep to be charismatic [chiasmatic]").

question

Posterior pituitary (neurohypophysis)

answer

Receives hypothalamic axonal projections from supraoptic (ADH) and paraventricular (oxytocin) nuclei. Oxytocin: oxys = quick; tocos = birth.

question

Anterior pituitary aka...?

answer

A nterior pituitary = A denohypophysis

question

Thalamus

answer

Major relay for ascending sensory information that ultimately reaches the cortex.

question

Blood supply to the thalamus

answer

posterior communicating, posterior cerebral, and anterior choroidal arteries.

question

Lateral geniculate nucleus (LGN) of thalamus

answer

(hint: "L ateral for L ight") area of thalamus for visual information.

question

area of thalamus for visual information.

answer

Lateral geniculate nucleus (LGN) of thalamus (hint: "L ateral for L ight")

question

Medial geniculate nucleus (MGN) of the thalamus

answer

(hint: M edial for M usic) Area of the thalamus responsible for auditory information

question

Area of the thalamus responsible for auditory information

answer

Medial geniculate nucleus (MGN) of the thalamus (hint: M edial for M usic)

question

Ventral posterior nucleus, lateral part (VPL) -- of thalamus

answer

part of the thalamus responsible for body sensation (proprioception, pressure, pain, touch, vibration via dorsal columns, spinothalamic tract).

question

part of the thalamus responsible for body sensation (proprioception, pressure, pain, touch, vibration via dorsal columns, spinothalamic tract).

answer

Ventral posterior nucleus, lateral part (VPL) -- of thalamus

question

Ventral posterior nucleus, medial part (VPM) -- of the thalamus

answer

(hint: you put M akeup on your face, and sensory info is relayed through the VPM ) Area of thalamus responsible for facial sensation (via CN V)

question

Area of thalamus responsible for facial sensation (via CN V)

answer

Ventral posterior nucleus, medial part (VPM) -- of the thalamus (hint: you put M akeup on your face, and sensory info is relayed through the VPM )

question

Motor and sensory locations in the thalamus

answer

Motor is anterior to sensation in the thalamus, just like the cortex.

question

Limbic system: Includes what? Responsible for what?

answer

Includes cingulate gyrus, hippocampus, fornix, and mammillary bodies. Responsible for F eeding, F leeing, F ighting, F eeling, and sex (....) (The famous 5 F's )

question

Input to the cerebellum

answer

Receives contralateral cortical input via middle cerebellar peduncle and ipsilateral proprioceptive information via inferior cerebellar peduncle. Input nerves = climbing and mossy fibers.

question

Output from the cerebellum

answer

Provides stimulatory feedback to contralateral cortex to modulate movement. Output nerves = Purkinje fibers output deep to nuclei of cerebellum, which in turn output to cortex via superior cerebellar peduncle.

question

Deep nuclei of the cerebellum

answer

Lateral to medial: D entate, E mboliform, G lobose, F astigial ("D on't E at G reasy F oods")

question

Lateral cerebellum

answer

area of the cerebellum responsible for voluntary movement of extremities

question

area of the cerebellum responsible for voluntary movement of extremities

answer

Lateral cerebellum

question

Medial cerebellum

answer

Area of cerebellum responsible for balance, truncal coordination.

question

Area of cerebellum responsible for balance, truncal coordination.

answer

Medial cerebellum

question

Basal ganglia (overall function)

answer

Important in voluntary movements and making postural adjustments. Receives cortical input, provides negative feedback to cortex to modulate movement.

question

Important in voluntary movements and making postural adjustments. Receives cortical input, provides negative feedback to cortex to modulate movement.

answer

Basal ganglia (overall function)

question

Excitatory pathway of the basal ganglia

answer

Substantia Nigra pars compacta's (SNc's) dopamine binds to D1 receptros in the excitatory pathway, stimulating the excitatory pathway (incr motion). Therefore, loss of dopamine in Parkinson's inhibits the excitatory pathway (decr motion). Key: Grey = stimulatory || Black = inhibitory SNc = Substantia nigra pars compacta GPe = Globus pallidus externus GPi = Globus pallidus internus STN = Subthalamaic nucleus D1 = Dopamine D1 receptor (excitatory) D2 = Dopamine D2 receptor (inhibitory)

question

Inhibitory pathway of the basal ganglia

answer

SNc's dopamine binds to D2 receptros in the inhibitory pathway, inhibiting the inhibitory pathway (incr motion). Therefore, loss of dopamine in Parkinson's dz excites (i.e., disinhibits) the inhibitory pathway (decr motion). Key: Grey = stimulatory || Black = inhibitory SNc = Substantia nigra pars compacta GPe = Globus pallidus externus GPi = Globus pallidus internus STN = Subthalamaic nucleus D1 = Dopamine D1 receptor (excitatory) D2 = Dopamine D2 receptor (inhibitory)

question

Parkinson's disease

answer

Degenerative disorder of CNS associated w/ Lewy bodies (composed of alpha-synuclein) and depigmentation of the substantia nigra pars compacta (loss of dopaminergic neurons). Rare cases have been linked to exposure to MPTP, a contaminant in illicit street drugs. ("TRaP = T remor (at rest), cogwheel R igidity, a nd P ostural instability. You are TRaP ped inside your body.")

question

answer

Parkinson's disease

question

Hemiballismus

answer

Sudden, wild flailing of 1 arm. Characteristic of contralateral subthalamic nucleus lesion. Loss of inhibition of thalamus through globus pallidus. ("Hemiballismus = Half ballistic -- like throwing a baseball")

question

Huntington's dz

answer

Autosomal-dominant trinucleotide repeat d/o. Chromosome 4. Atrophy of caudate nucleus (loss of GABAergic neurons) leads to enlarged lateral ventricles on CT. Chorea, depression, progressive dementia. Sx manifest in affeccted indvls btw ages 20-50. (Expansion of CAG repeats: "C audate loses A Ch and G ABA")

question

answer

Huntington's dz

question

Chorea

answer

Sudden, jerky, purposeless movements. Characteristic of basal ganglia lesion (e.g., Huntington's disease) (Chorea = dancing (Greek). Think choral dancing or choreography)

question

Athetosis

answer

Slow, writhing movements, especially if fiingers. Characteristic of basal ganglia lesion (e.g., Huntington's dz) (Athetos = not fixed (Greek). Think snakelike.)

question

Essential/postural tremor

answer

Action tremor, autosomal dominant. Essential tremor pts often self-medicate w/ alcohol, which decreases the tremor. Tx: beta-blockers.

question

Resting tremor

answer

Not noticeable distally. Seen in Parkinson's ("pill-rolling" tremor)

question

Intention tremor

answer

Slow, zigzag motion when pointing twd a target; associated w/ cerebellar dysfunction.

question

Cerebral cortex: where are the Sylvian fissure vs. Central sulcus?

answer

A: Sylvian fissure is above temporal lobe; central sulcus divides frontal and parietal lobes.

question

Cerebral cortex: What is the arcuate fasciculus?

answer

Connection between Associative auditory cortex (Wernicke's area; dominant hemisphere) and Motor speech area (Broca's area; dominant hemisphere)

question

Cerebral cortex: Where is the primary auditory cortex (Heschel's gyrus)? The primary motor area? The primary sensory area? The premotor area (part of extrapyramidal circuit)?

answer

question

Frontal lobe functions

answer

"Executive functions" Planning, inhibition, concentration, orientation, language, abstraction, judgment, motor regulation, mood. Lack of social judgment is most notable in frontal lobe lesion. ("D amage = D isinhibition" - e.g., Phineas Gage)

question

Homonculus: What is it? What is it used for? What reaches into the Sylvian fissure? The longitudinal fissure?

answer

Topographical representation of sensory and motor areas in the cerebral cortex. Used to localize lesion (e.g., in blood supply) leading to specific defects. For example, lower extremity deficit in sensation or movement indicates involvement of anterior cerebral artery.

question

Brain lesion in: Broca's area

answer

(hint: BRO ca's is BRO ken speech.) Consequence: Motor (nonfluent/expressive) aphasia w/ good comprehension.

question

Motor (nonfluent/expressive) aphasia w/ good comprehension. Where is the lesion?

answer

Broca's area (hint: BRO ca's is BRO ken speech.)

question

Brain lesion in: Wernicke's area

answer

(hint: W ernicke's is W ordy but makes no sense.) Consequence: Sensory (fluent/receptive) aphasia w/ poor comprehension, neologisms.

question

Sensory (fluent/receptive) aphasia w/ poor comprehension, neologisms. Where is the lesion?

answer

Wernicke's area (hint: W ernicke's is W ordy but makes no sense.)

question

Brain lesion in: Arcuate fasciculus (connects Wernicke's to Broca's area)

answer

Consequence: Conduction aphasia; good comprehension, fluent speech, but poor repitition.

question

Conduction aphasia; good comprehension, fluent speech, but poor repitition. Where is the lesion?

answer

Arcuate fasciculus (connects Wernicke's to Broca's area)

question

Brain lesion in: Amygdala (bilateral)

answer

Consequence: Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)

question

Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior) Where is the lesion?

answer

Amygdala (bilateral)

question

Brain lesion in: Frontal lobe

answer

Consequence: Personality changes and deficits in concentration, orientation, and judgment; may havve reemergence of primitive reflexes.

question

Personality changes and deficits in concentration, orientation, and judgment; may havve reemergence of primitive reflexes. Where is the lesion?

answer

Frontal lobe

question

Brain lesion in: Right parietal lobe

answer

Consequence: Spatial neglect syndrome (agnosia of the contralateral side of the world)

question

Spatial neglect syndrome (agnosia of the contralateral side of the world) Where is the lesion?

answer

Right parietal lobe

question

Brain lesion in: Reticular activating system (midbrain)

answer

Consequence: Reduced levels of arousal and wakefulness (e.g., coma)

question

Reduced levels of arousal and wakefulness (e.g., coma) Where is the lesion?

answer

Reticular activating system (midbrain)

question

Brain lesion in: Mammillary bodies (bilateral)

answer

Consequence: Wernicke-Korsakoff syndrome (confusion, confabulation, ophthalmoplegia, ataxia)

question

Wernicke-Korsakoff syndrome (confusion, confabulation, ophthalmoplegia, ataxia) Where is the lesion?

answer

Mammillary bodies (bilateral)

question

Brain lesion in: Basal ganglia

answer

Consequence: May result in tremor at rest, chorea, or athetosis

question

May result in tremor at rest, chorea, or athetosis Where is the lesion?

answer

Basal ganglia

question

Brain lesion in: Cerebellar hemisphere

answer

(hint: cerebellar hemispheres are laterally located, so they affect the lateral limbs) Consequence: Intention tremor, limb ataxia; Damage to the cerebellum results in ipsilateral deficits; Fall toward side of lesion

question

Intention tremor, limb ataxia; Damage to the cerebellum results in ipsilateral deficits; Fall toward side of lesion Where is the lesion?

answer

Cerebellar hemisphere (hint: cerebellar hemispheres are laterally located, so they affect the lateral limbs)

question

Brain lesion in: Cerebellar vermis

answer

(hint: vermis is centrally located, so it affects the central body) Consequence: Truncal ataxia, dysarthria.

question

Truncal ataxia, dysarthria. Where is the lesion?

answer

Cerebellar vermis (hint: vermis is centrally located, so it affects the central body)

question

Brain lesion in: Subthalamic nucleus

answer

Consequence: Contralateral hemiballismus

question

Contralateral hemiballismus Where is the lesion?

answer

Subthalamic nucleus

question

Brain lesion in: Hippocampus

answer

Consequence: Anterograde amnesia -- inability to make new memories

question

Anterograde amnesia -- inability to make new memories Where is the lesion?

answer

Hippocampus

question

Brain lesion in: Paramedian pontine reticular formation (PPRF)

answer

Consequence: Eyes look away from side of lesion

question

Eyes look away from side of lesion Where is the lesion?

answer

Paramedian pontine reticular formation (PPRF)

question

Brain lesion in: Frontal eye fields

answer

Consequence: Eyes look toward lesion.

question

Eyes look toward lesion. Where is the lesion?

answer

Frontal eye fields

question

Aphasia (definition) vs. Dysarthria (definition)

answer

Aphasia is a higher-order inability to speak. vs. Dysarthria is a motor inability to speak.

question

Broca's aphasia

answer

Nonfluent aphasia w/ intact comprehension. Broca's area -- inferior frontal gyrus. ("Bro ca's Bro ken Boca " [boca = mouth in Spanish])

question

Wernicke's aphasia

answer

Fluent aphasia with impaired comprehension. Wernicke's area -- superior temporal gyrus. ("W ernicke's is W ordy but makes no sense." or "W ernicke's = W hat?")

question

Global aphasia

answer

Nonfluent aphasia w/ impaired comprehension. Both Broca's and Wernicke's areas affected.

question

Conduction aphasia

answer

Poor repitition but fluent speech, intact comprehension. Arcuate fasciculus -- connects Broca's and Wernicke's areas.

question

Anterior cerebral artery: what areas of cortex does it supply?

answer

Supplies anteromedial surface of brain [darkest grey]

question

Middle cerebral artery: what areas of cortex does it supply?

answer

Supplies lateral surface of brain [White areas below]

question

Posterior cerebral artery: what areas of cortex does it supply?

answer

Supplies posterior and inferior surfaces [medium grey areas below]

question

Anterior cerebral artery: Where is it? What does it supply?

answer

[Right anterior cerebral artery is labeled below -- top/left] Supplies medial surface of the brain, leg-foot area of motor and sensory cortices.

question

Middle cerebral artery: Where is it? What does it supply?

answer

[Labeled below at top/left, just beneath right anterior cerebral art.] Supplies lateral aspect of brain, trunk-arm-face area of motor and sensory cortices, Broca's and Wernicke's speech areas (on dominant hemisphere), optic radiations.

question

What deficit occurs w/ problems in the middle cerebral artery?

answer

Contralateral face and arm paralysis and sensory loss, aphasia (dominant sphere), left-sided neglect.

question

Posterior cerebral artery: Where is it? What does it supply?

answer

[labeled below along middle/right] Supplies the visual cortex.

question

What deficit is associated with problems in the posterior cerebral artery?

answer

Contralateral homonymous hemianopia with macular sparing.

question

Anterior communicating artery: Where is it? What is associated with this artery?

answer

[labeled below along top/right] Most common site of circle of Willis aneurysm; lesions may cause visual field defects.

question

Posterior communicating artery: Where is it? What is associated with this artery?

answer

[labeled below along middle/left] Common area of aneurysm; Causes CN III palsy.

question

Lateral striate: Where are they? What do they supply?

answer

[labeled below along middle/right] Divisions of the middle cerebral artery that supply the internal capsule, caudate, putamen, and globus pallidus.

question

What deficit is associated with the lateral striate?

answer

"Arteries of stroke"; infarct of internal capsule causes pure motor hemiparesis.

question

Watershed zones of the circle of Willis

answer

Between anterior cerebral/middle cerebral, posterior cerebral/middle cerebral arteries. Damaged in severe hypotension --< upper leg/upper arm weakness, defects in higher-order visual processing.

question

Posterior Inferior Cerebellar Artery (PICA): Where is it? What deficits are associated with an infarct here?

answer

[labled below at bottom/right] Infarcts cause Wallenberg's syndrome (aka lateral medullary syndrome) (nystagmus, ipsilateral ataxia, nausea, vomiting, Horner's syndrome)

question

Basilar artery: Where is it? What would an infarct here cause?

answer

[labeled below along middle/left] Infarct causes locked-in syndrome.

question

In general, strokes of the anterior circle of Willis vs. the posterior circle of Willis

answer

stroke of the anterior circle : General sensory and motor dysfunction, aphasia. stroke of the posterior circle : Cranial nerve deficits (vertigo, visual deficits), coma, cerebellar deficits (ataxia)

question

Anterior spinal artery: Where is it? What defects are associated?

answer

[at bottom of picture, below] Medial medullary syndrome: contralateral hemiparesis (lower extremities), medial lemniscus (decr proprioception), ipsilateral paralysis of hypoglossal nerve

question

Anterior Inferior Cerebellar Artery (AICA) Where is it located? What deficits are associated?

answer

[labeled below in lower right] Lateral inferior pontine syndrome: ipsilateral facial paralysis, ipsilateral cochlear nucleus, vestibular (nystagmus), ipsilateral facial pain and temperature, ipsilateral dystaxia (MCP, ICP)

question

Berry aneurysms: Where do they occur? What is the most common complication?

answer

Occur at the bifurcations in the circle of Willis. Most common site is bifurcation of the anterior communicating artery. Rupture (most common complication) leads to hemorrhagic stroke/subarachnoid hemorrhage.

question

Berry aneurysms: associated with? other risk factors?

answer

Associated with: Adult polycystic kidney dz Ehlers-Danlos syndrome Marfan's syndome Risk factors: Advanced age HTN Smoking Race (higher risk in blacks)

question

Charcot-Bouchard microaneurysms: Associated with? What do they affect?

answer

Associated with chronic HTN Affects small vessels (e.g., in basal ganglia, thalamus)

question

Epidural hematoma

answer

Rupture of middle meningeal artery (branch of maxillary artery), often secondary to fracture of temporal bone. Lucid interval. CT shows "biconvex disk" not crossing suture lines. Can cross falx, tentorium.

question

Subdural hematoma

answer

Rupture of bridging veins. Venous bleeding (less pressure) with delayed onset of Sx's. Seen in elderly individuals, alcoholics, blunt trauma, shaken baby. Crescent-shaped hemorrhage that crosses suture lines. Cannot cross falx, tentorium.

question

Factors predisposing to a subdural hematoma

answer

Brain atrophy Shaking Whiplash

question

Subarachnoid hemorrhage

answer

Rupture of aneurysm (usually berry aneurysm) or an AVM. Pts complain of "worst headache of my life." Bloody or yellow (xanthochromic) spinal tap. 2-3 days afterward, there is a risk of vasospasm (Tx w/ Ca2+ channel blockers).

question

Parenchymal hematoma

answer

Caused by HTN, amyloid angiopathy [see below], DM, and tumor. Typically occurs in basal ganglia and internal capsule.

question

Hemorrhagic stroke

answer

Intracerebral bleeding, often due to aneurysm rupture. May be secondary to ischemic stroke following reperfusion (incr vessel fragility)

question

Ischemic stroke

answer

Emboli block large vessels; etiologies include: atrial fibrillation, carotid dissection, patent foramen ovale, endocarditis. Lacunar strokes block small vessels, are secondary to HTN. Tx: tPA w/in 3 hours.

question

Transient Ischemic Attack (TIA)

answer

Brief, reversible episode of neurologic dysfunction due to focal ischemia. Typically, Sx's last >24 hours.

question

Stroke imaging

answer

Bright on diffusion-weighted MRI in 3-30 minutes [below/left], dark on CT in ~24 hours [below/right] [Images are of a right MCA stroke; diffusion MRI and CT]

question

Dural venous sinuses: Where do they run? What is the sequence?

answer

Venous sinuses run in the dura mater where its meningeal and periosteal layers separate. Cerebral veins --< venous sinuses --< internal jugular vein

question

Where is the supereior sagittal sinus? The confluence of the sinuses? The Occipital sinus? The Transverse and sigmoid sinuses?

answer

The superior sagittal sinus (main location of CSF return via arachnoid granulations) is along the superior/median border of the brain. The confluence of the sinuses is posterior, bringing together the occipital sinus (inferiorly), sagittal sinus (superiorly), transverse sinuses (laterally), and straight sinus (ventrally)

question

Where is the inferior sagittal sinus? The Great cerebral vein (of Galen)? The Straight sinus?

answer

The inferior sagittal sinus runs deep to the superior sagittal sinus in the median line. The great cerebral vein runs inferior to that, and the two sinuses meet at the straight sinus, which feeds into the confluence of the sinuses posteriorly.

question

What is one vein that feeds into the dural venous sinuses?

answer

The Superior ophthalmic vein feeds into the cavernous sinus, which reaches the sup. sagittal sinus and the transverse sinus by way of the Sphenoparietal sinus.

question

Where is CSF made? Where is reabsorbed?

answer

CSF is made by ependymal cells lining the ventricles; it is reabsorbed by venous sinus arachnoid granulations.

question

What connects the lateral to the 3rd ventricle?

answer

The foramen of Munro.

question

What connects the 3rd and 4th ventricles?

answer

The cerebral aqueduct

question

What connects the 4th ventricle and the subarachnoid space?

answer

Foramina of L ushka = L ateral Foramen of M agendie = M edial

question

Hydrocephalus

answer

Accumulation of excess CSF in ventricular system --< increased intracranial pressure; ventricular dilation --< clinical triad of dementia, gait problems, urinary incontenincence. ("Wet, wobbly, and wacky")

question

Normal pressure (communicating) hydrocephalus

answer

Caused by impaired absorption of CSF by arachnoid granulations (e.g., arachnoid adhesions post-meningitis)

question

Obstructive (non-communicating) hydrocephalus

answer

Caused by structual blockage of CSF circulation w/in the ventricular system (e.g., stenosis of the aqueduct of Sylvius)

question

Hydrocephalus ex vacuo

answer

Appearance of increased CSF in atrophy. Intracranial pressure normal, triad not seen.

question

Total # of spinal nerves? Per section?

answer

There are 31 spinal nerves. ("31 like the 31 flavors at Baskin-Robbins") 8 Cervical 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal

question

Numbering of cervical spinal nerves

answer

Nerves C1-C7 exit via intervertebral foramina above the corresponding vertebra. All other nerves exit below .

question

Where does vertebral disk herniation usually occur?

answer

Vertebral disk herniation (nucleus pulposus hernaites through annulus fibrosus) usually occurs btw L5 and S1.

question

How far does the spinal cord extend in adults? The subarachnoid space? Where do you perform a lumbar puncture?

answer

In adults, the spinal cord extends to the loweer border of L1-L2; subarachnoid space extends to lower border of S2. Lumbar puncture is usually performed in L3-L4 or L4-L5 interspaces, at the level of the cauda equina. ("To keep the cord alive , keep the spinal needle btw L3 and L5 ")

question

Where do you get CSF from in a lumbar puncture?

answer

CSF is obtained from lumbar subarachnoid space btw L4 and L5 (at the level of iliac crests)

question

Structures pierced in a lumbar puncture (in order)

answer

1.) Skin/superficial fascia 2.) Ligaments (supraspinous, interspinous, ligamentum flavum) 3.) Epidural space 4.) Dura mater 5.) Subdural space 6.) Arachnoid 7.) Subarachnoid space - CSF (Pia is not pie rced)

question

What do the dorsal columns of the spinal cord relay?

answer

Pressure, vibration, touch, proprioception.

question

How are the dorsal columns of the spinal cord organized?

answer

Medially: fasciculus gracilis (lower body, extremities) Laterally: fasciculus cuneatus (upper body, extremities) ("Dorsal column is organized as you are, with hands at sides. Arms outside, legs inside.")

question

What do the lateral corticospinal tract and spinothalamic tract relay? Where are they located? How are they organized?

answer

Lateral corticospinal tract relays voluntary motor information, is located in the lateral spinal cord. Spinothalamic tract relays pain and temperature, is located antero-laterally. ("L egs are L ateral in L ateral corticospinal, spinothalamic tracts")

question

What arteries follow the spinal cord?

answer

2 Posterior spinal arteries, 1 anterior spinal artery

question

Where are the intermediate horn sympathetics found?

answer

The lateral gray matter of the thoracic [only] spinal cord

question

Ascending spinal tracts and synapsing

answer

They synapse then cross.

question

Spinal tract: Dorsal column -- medial lemniscal pathway

answer

function? Ascending pressure, vibration, touch, and proprioceptive sensation

question

Ascending pressure, vibration, touch, and proprioceptive sensation what spinal tract is this?

answer

Dorsal column -- medial lemniscal pathway

question

Spinal tract: Spinothalamic tract

answer

function? Ascending pain and temperature sensation

question

Ascending pain and temperature sensation what spinal tract is this?

answer

Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

function? Descending vvoluntary movement of contralateral limbs

question

Descending vvoluntary movement of contralateral limbs what spinal tract is this?

answer

Lateral corticospinal tract

question

Spinal tract: Dorsal column -- medial lemniscal pathway

answer

What is the 1st order neuron? Sensory nerve ending --< cell body in dorsal root ganglion --< enters spinal cord, ascends ipsilaterally in dorsal column

question

Sensory nerve ending --< cell body in dorsal root ganglion --< enters spinal cord, ascends ipsilaterally in dorsal column This is the 1st order neuron in which spinal tract?

answer

Dorsal column -- medial lemniscal pathway

question

Spinal tract: Spinothalamic tract

answer

What is the 1st order neuron? Sensory nerve ending (A-delta and C fibers) (cell body in dorsal root ganglion) --< enters spinal cord

question

Sensory nerve ending (A-delta and C fibers) (cell body in dorsal root ganglion) --< enters spinal cord This is the 1st order neuron in which spinal tract?

answer

Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

What is the 1st order neuron? Upper motor neuron: cell body in primary motor cortex | Descends ipsilaterally (thru internal capsule) until decussating at caudal medulla (pyramidal decussation) | Descends contralaterally

question

Upper motor neuron: cell body in primary motor cortex | Descends ipsilaterally (thru internal capsule) until decussating at caudal medulla (pyramidal decussation) | Descends contralaterally This is the 1st order neuron in which spinal tract?

answer

Lateral corticospinal tract

question

Spinal tract: Dorsal column -- medial lemniscal pathway

answer

What is the 1st synapse? Ipsilateral nucleus cuneatus or gracilis (medulla)

question

Ipsilateral nucleus cuneatus or gracilis (medulla) This is the 1st synapse in which spinal tract?

answer

Dorsal column -- medial lemniscal pathway

question

Spinal tract: Spinothalamic tract

answer

What is the 1st synapse? Ipsilateral gray matter (spinal cord)

question

Ipsilateral gray matter (spinal cord) This is the 1st synapse in which spinal tract?

answer

Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

What is the 1st synapse? Cell body of anterior horn (spinal cord)

question

Cell body of anterior horn (spinal cord) This is the 1st synapse in which spinal tract?

answer

Lateral corticospinal tract

question

Spinal tract: Dorsal column -- medial lemniscal pathway

answer

What is the 2nd order neuron? Decussates in medulla --< ascends contralaterally in medial lemniscus

question

Decussates in medulla --< ascends contralaterally in medial lemniscus This is the 2nd order neuron in which spinal tract?

answer

Dorsal column -- medial lemniscal pathway

question

Spinal tract: Spinothalamic tract

answer

What is the 2nd order neuron? Decussates at anterior white commissure --< ascends contralaterally

question

Decussates at anterior white commissure --< ascends contralaterally This is the 2nd order neuron in which spinal tract?

answer

Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

What is the 2nd order neuron? Lower motor neuron : leaves spinal cord

question

Lower motor neuron : leaves spinal cord This is the 2nd order neuron in which spinal tract?

answer

Lateral corticospinal tract

question

Spinal tract: Dorsal column -- medial lemniscal pathway OR Spinothalamic tract

answer

What is the 2nd synapse? VPL of thalamus

question

VPL of thalamus This is the 2nd synapse in which spinal tract?

answer

Dorsal column -- medial lemniscal pathway OR Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

What is the 2nd synapse? Neuromuscular junction

question

Neuromuscular junction This is the 2nd synapse in which spinal tract?

answer

Lateral corticospinal tract

question

Spinal tract: Dorsal colum -- medial lemniscal pathway OR Spinothalamic tract

answer

What is the 3rd order neuron? Sensory cortex

question

Sensory cortex This is the 3rd order neuron in which spinal tract?

answer

Dorsal colum -- medial lemniscal pathway OR Spinothalamic tract

question

Spinal tract: Lateral corticospinal tract

answer

What is the 3rd order neuron? N/A (no 3rd-order neuron)

question

N/A (no 3rd-order neuron) This is the 3rd order neuron in which spinal tract?

answer

Lateral corticospinal tract

question

Lower vs. Upper motor neuron lesion

answer

Lower MN lesion = everything lowered (less muscle mass, decr muscle tone, decr reflexes, downgoing toes) Upper MN = everythinig up (tone, DTRs, toes)

question

Spinal tract: UMN vs. LMN lesion: Weakness

answer

What is the 3rd order neuron? Both

question

Both

answer

This is the 3rd order neuron in which spinal tract? UMN vs. LMN lesion: Weakness

question

Spinal tract: UMN vs. LMN lesion: Atrophy

answer

What is the 3rd order neuron? (-) UMN (+) LMN

question

(-) UMN (+) LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Atrophy

question

Spinal tract: UMN vs. LMN lesion: Fasciculations (muscle twitching)

answer

What is the 3rd order neuron? (-) UMN (+) LMN

question

(-) UMN (+) LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Fasciculations (muscle twitching)

question

Spinal tract: UMN vs. LMN lesion: Reflexes

answer

What is the 3rd order neuron? Increased in UMN Decreaseed in LMN

question

Increased in UMN Decreaseed in LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Reflexes

question

Spinal tract: UMN vs. LMN lesion: Tone

answer

What is the 3rd order neuron? Increased in UMN, decreased in LMN

question

Increased in UMN, decreased in LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Tone

question

Spinal tract: UMN vs. LMN lesion: Babinski sign (upgoing toes -- normal in infants)

answer

What is the 3rd order neuron? (+) in UMN, (-) in LMN

question

(+) in UMN, (-) in LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Babinski sign (upgoing toes -- normal in infants)

question

Spinal tract: UMN vs. LMN lesion: Spastic paralysis

answer

What is the 3rd order neuron? (+) in UMN (-) in LMN

question

(+) in UMN (-) in LMN This is the 3rd order neuron in which spinal tract?

answer

UMN vs. LMN lesion: Spastic paralysis

question

Spinal cord lesions: Poliomyelitis and Werdnig-Hoffmann disease What areas are affected? What are the Sx?

answer

Lower motor neuron lesion only, due to destruction of anterior horns; flaccid paralysis

question

Lower motor neuron lesion only, due to destruction of anterior horns; flaccid paralysis What spinal cord lesion is this?

answer

Poliomyelitis and Werdnig-Hoffmann disease

question

Spinal cord lesions: Multiple sclerosis What areas are affected? What are the Sx?

answer

Mostly white matter of cervical region; random and asymmetric lesions, due to demyelination; scanning speech, intention tremor, nystagmus

question

Mostly white matter of cervical region; random and asymmetric lesions, due to demyelination; scanning speech, intention tremor, nystagmus What spinal cord lesion is this?

answer

Multiple sclerosis

question

Spinal cord lesions: ALS What areas are affected? What are the Sx?

answer

Combined upper and lower motor neuron deficits with no sensory deficit; both upper and lower motor neuron signs.

question

Combined upper and lower motor neuron deficits with no sensory deficit; both upper and lower motor neuron signs. What spinal cord lesion is this?

answer

ALS

question

Spinal cord lesions: Complete occlusion of the anterior spinal artery What areas are affected? What are the Sx?

answer

Spares dorsal columns and tract of Lissauer; upper throacicc ASA territory is a watershed area, as artery of Adamkiewicz supplies ASA below ~T8

question

Spares dorsal columns and tract of Lissauer; upper throacicc ASA territory is a watershed area, as artery of Adamkiewicz supplies ASA below ~T8 What spinal cord lesion is this?

answer

Complete occlusion of the anterior spinal artery

question

Spinal cord lesions: Tabes dorsalis (tertiary syphilis) What areas are affected? What are the Sx?

answer

Degeneration of dorsal roots and dorsal columns; impaired proprioception, locomotor ataxia

question

Degeneration of dorsal roots and dorsal columns; impaired proprioception, locomotor ataxia What spinal cord lesion is this?

answer

Tabes dorsalis (tertiary syphilis)

question

Spinal cord lesions: Syringomyelia What areas are affected? What are the Sx?

answer

Crossing fibers of spinothalamic tract damaged; bilateral loss of pain and temperature sensation.

question

Crossing fibers of spinothalamic tract damaged; bilateral loss of pain and temperature sensation. What spinal cord lesion is this?

answer

Syringomyelia

question

Spinal cord lesions: Vitamin B12 neuropathy and Friedrich's ataxia What areas are affected? What are the Sx?

answer

Demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts; ataxic gait, hyperreflexia, impaired position and vibration sense.

question

Demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts; ataxic gait, hyperreflexia, impaired position and vibration sense. What spinal cord lesion is this?

answer

Vitamin B12 neuropathy and Friedrich's ataxia

question

Poliomyelitis: Cause? Transmission? Replication? Pathogenesis?

answer

Caused by poliovirus, which is transmitted by fecal/oral route. Replciates in the oropharynx and small intestine before spreading through the bloodstream to the CNS, where it leads to destruction of cells in the anterior horn of the spinal cord, leading in turn to LMN destruction.

question

Poliomyelitis: Sx?

answer

Malaise, hedache, fever, nausea, abdominal pain, sore throat. Signs of LMN lesions -- muscle weakness and atrohphy, fasciculations, fibrillation, and hyporeflexia.

question

Poliomyelitis: Findings?

answer

CSF w/ lymphocytic pleocytosis w/ slight elevation of protein (w/ no change in CSF glucose). Virus recovered from stool or throat.

question

Werdnig-Hoffman dz (aka infantile spinal muscular atrophy)

answer

Autosomal-recessive inheritance; presents at birth as a "floppy baby," tongue fasciculations; median age of death 7 months. Associated w/ degenration of anterior horns. LMN involvement only.

question

Amyotrophic lateral sclerosis (commonly known as Lou Gehrig's dz)

answer

Associated w/ both LMN and UMN signs; no sensory, cognitive, or oculomotor deficits. Can be caused by defect in superoxide dismutase 1 (SOD1), betel nut ingestion.

question

Tabes dorsalis

answer

Degeneration of dorsal columns and dorsal roots due to tertiary syphilis, resulting in impaired proprioception and locomotor ataxia.

question

Associated with Tabes dorsalis

answer

Charcot's joints Shooting (lightning) pain Argyll Robertson pupils (aka "prostitute's pupils" - accomodate, but do not react) Absence of DTRs

question

Friedrich's ataxia: Inheritance? Etiology? Sx? Onset?

answer

Autosomal-recessive trinucleotide repeat disorder (GAA; frataxin gene). Leads to impairment in mitochondrial functioning. Staggering gait, frequent falling, nystagmus, dysarthria, hypertrophic cardiomyopathy. Presents in childhood w/ kyphoscoliosis.

question

Brown-Séquard Syndrome: What is it?

answer

Heisection of the spinal cord

question

Brown-Séquard Syndrome: Findings?

answer

1.) Ipsilateral UMN signs (corticospinal tract) below lesion 2.) Ipsilateral loss of tactile, vibration, proprioception sense (dorsal column) below lesion 3.) Contralateral pain and temperature loss (spinothalamic tract) below lesion 4.) Ipsilateral loss of all sensation at level of lesion 5.) LMN signs (e.g., flaccid paralysis) at level of lesion If lesion occurs above T1, presents w/ Horner's syndrome

question

Horner's syndrome

answer

Sympathectomy of face: 1.) P tosis (slight drooping of eyelid) 2.) A nhidrosis (absence of sweating) and flushing (rubor) of affected side of face 3.) M iosis (pupil constriction) ("PAM is horny [Horner's]) Associated w/ lesion of spinal cord above T1 (e.g., Pancoast's tumor, Brown-Séquard syndrome [cord hemisection], late-stage syringomyelia)

question

3 Neuron pathway involved in Horner's syndrome

answer

The 3-neuron oculosympathetic pathway projects from the hypothalamus to the intermediolateral column of the spinal cord, then to the superior cervical (sympathetic) ganglion, and finally to the pupil, the smooth muscle of the eyelids, and the sweat glands of the forehead and face. Interruption of any of these pathways results in Horner's syndrome.

question

Clinically important landmarks for a pudendal nerve block (to relieve pain of pregnancy)

answer

Ischial spine

question

Clinically important landmarks for Appendix

answer

2/3 of the way from the umbilicus to the anterior superior iliac spine (McBurney's point)

question

Clinically important landmarks for lumbar puncture

answer

Iliac crest.

question

Landmark dermatomes: C2

answer

Posterior half of a skull "cap"

question

Landmark dermatomes: C3

answer

High turtleneck shirt

question

Landmark dermatomes: C4

answer

Low-collar shirt

question

Landmark dermatomes: T4

answer

At the nipple. (T4 at the teat pore )

question

Landmark dermatomes: T7

answer

Xiphoid process

question

Landmark dermatomes: T10

answer

At the umbilicus (important for early appendicitis pain referral) (T10 at the belly butTEN )

question

Landmark dermatomes: L1

answer

At the inguinal ligament ("L1 is IL [I nguinal L igament])

question

Landmark dermatomes: L4

answer

Includes kneecaps

question

Landmark dermatomes: S2, S3, S4

answer

Erection and sensation of penile and anal zones ("S2, 3, 4, keep the penis off the floor")

question

Muscle spindles vs. Golgi tendon organs

answer

Muscle spindles monitor muscle length (help you pick up a heavy suitcase when you didnt know how heavy it was). Golgi T endon organs monitor muscle T ension (make you drop a heavy suitcase you've been holding too long).

question

Muscle spindle: pathway?

answer

In parallel with muscle fibers. Muscle stretch --< intrafusal stretch --< stimulates Ia afferent --< stimulate alpha motor neuron --< reflex muscle (extrafusal) contraction

question

Spindle muscle control: the Gamma loop

answer

CNS stimulates gamma motor neuron --< contracts intrafusal fiber --< increased sensitivity of reflex arc

question

Clinical reflexes and their respective nerve roots: Achilles? Patella? Biceps? Triceps?

answer

Achilles = S1 nerve root Patella = L4 nerve root Biceps = C5 nerve root Triceps = C7 nerve root * Note that they count up in order: S1,2 L3,4 C5,6 C7,8

question

Babinski sign

answer

Dorsiflexion of the big toe and fanning of other toes; sign of UMN lesion, but normal reflex in 1st year of life.

question

Primitive reflexes

answer

Normally disappear within 1st year of life. May reemerge following frontal lobe lesion. Include: Moro reflex, rooting reflex, suckling reflex, Palmar and plantar reflexes, Babinski reflex

question

Moro reflex

answer

Extension of limbs when started

question

Rooting reflex

answer

Movement of head toward one side if cheek or mouth is stroked (nipple seeking)

question

Sucking reflex

answer

Sucking response when roof of mouth is touched

question

Palmar and palantar reflexes

answer

Curling of fingers/toes if palms of hands/feet are stroked

question

Cranial nerves that lie medially at the brainstem

answer

III, VI, XII Remember: 3 (x2) = 6 (x2) = 12

question

Brain stem: could you label these structures?

answer

question

Which cranial nerve arises dorsally and emerges ventrally?

answer

CN IV [see below, CN IV is along left in the middle]

question

Dorsal brainstem structures: Pineal gland

answer

Melatonin secretion, circadian rhythms.

question

Dorsal brainstem structures: superior colliculi

answer

Conjugate vertical gaze center. ("you have your eyes above your ears, and the superior colliculus (visual) is above the inferior colliculus (auditory).")

question

Dorsal brainstem structures: inferior colliculi

answer

Auditory ("you have your eyes above your ears, and the superior colliculus (visual) is above the inferior colliculus (auditory).")

question

Parinaud syndrome

answer

Paralysis of conjugate verticle gaze due to lesion in superior colliculi (e.g., pinealoma)

question

Cranial nerves: Olfactory (CN I) function? type? mnemonic?

answer

Smell (only CN w/o thalamic relay to cortex) S ensory; "S ome" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Smell (only CN w/o thalamic relay to cortex) S ensory; "S ome" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Olfactory (CN I)

question

Cranial nerves: Optic (CN II) function? type? mnemonic?

answer

Sight. S ensory; "S ay" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Sight. S ensory; "S ay" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Optic (CN II)

question

Cranial nerves: Oculomotor (CN III) function? type? mnemonic?

answer

Eye movement (SR, IR, MR, IO), pupillary constriction, accommodation, eyelid opening (levator palpebrae) M otor; "M oney" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Eye movement (SR, IR, MR, IO), pupillary constriction, accommodation, eyelid opening (levator palpebrae) M otor; "M oney" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Oculomotor (CN III)

question

Cranial nerves: Trochlear (CN IV) function? type? mnemonic?

answer

Eye movement (SO) M otor; "M oney" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Eye movement (SO) M otor; "M oney" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Trochlear (CN IV)

question

Cranial nerves: Trigeminal (CN V) function? type? mnemonic?

answer

Mastication, facial sensation. B oth, "B ut" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Mastication, facial sensation.

answer

B oth, "B ut" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."] Trigeminal (CN V)

question

Cranial nerves: Abducens (CN VI) function? type? mnemonic?

answer

Eye movement (LR) M otor; "M y" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Eye movement (LR) M otor; "M y" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Abducens (CN VI)

question

Cranial nerves: Facial (CN VII) function? type? mnemonic?

answer

Facial movement, taste from anterior 2/3rds of tongue, lacrimation, salivation (submandibular and sublingual glands), eyelid closing (orbicularis oculi), stapedius muscle in ear B oth; "B rother" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Facial movement, taste from anterior 2/3rds of tongue, lacrimation, salivation (submandibular and sublingual glands), eyelid closing (orbicularis oculi), stapedius muscle in ear B oth; "B rother" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Facial (CN VII)

question

Cranial nerves: Vestibulocochlear (CN VIII) function? type? mnemonic?

answer

Hearing, balance. S ensory; "S ays" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Hearing, balance. S ensory; "S ays" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Vestibulocochlear (CN VIII)

question

Cranial nerves: Glossopharyngeal (CN IX) function? type? mnemonic?

answer

Taste from posterior 1/3rd of tongue, swallowing, salivation (parotid gland), monitoring carotid body and sinus chemo- and baroreceptors, and stylopharyngeus (elevates pharynx, larynx) B oth; "B ig" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Taste from posterior 1/3rd of tongue, swallowing, salivation (parotid gland), monitoring carotid body and sinus chemo- and baroreceptors, and stylopharyngeus (elevates pharynx, larynx) B oth; "B ig" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Glossopharyngeal (CN IX)

question

Cranial nerves: Vagus (CN X) function? type? mnemonic?

answer

Taste from epiglottic region, swallowing, palate elevation, talking, coughing, thoracoabdominal viscera, monitoring aortic arch chemo- and baroreceptors. B oth; "B rains" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Taste from epiglottic region, swallowing, palate elevation, talking, coughing, thoracoabdominal viscera, monitoring aortic arch chemo- and baroreceptors. B oth; "B rains" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Vagus (CN X)

question

Cranial nerves: Accessory (CN XI) function? type? mnemonic?

answer

Head turning, shoulder shrugging M otor; "M atter" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Head turning, shoulder shrugging M otor; "M atter" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Accessory (CN XI)

question

Cranial nerves: Hypoglossal (CN XII) function? type? mnemonic?

answer

Tongue movement M otor; "M ore" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

question

Which cranial nerve is this? (Function, type, mnemonic) Tongue movement M otor; "M ore" [Mnemonic for type of information carried by CN's: "Some Say Marry Money, But My Brother Says Big Brains Matter Most."]

answer

Hypoglossal (CN XII)

question

Cranial nerve nuclei: Where are they located, generally?

answer

Located in tegmentum portion of brainstem (btw dorsal and ventral portions). Lateral nuclei = sensory M edial nuclei = M otor

question

Cranial nerve nuclei located in the midbrain

answer

Nuclei of CN III and IV

question

Cranial nerve nuclei located in the pons

answer

Nuclei of CN V, VI, VII, and VIII

question

Cranial nerve nuclei located in the medulla

answer

Nuclei of CN IX, X, XI, and XII

question

CN reflexes: Corneal OR Lacrimation (use the same nerves) Afferent? Efferent?

answer

Afferent = V-1 Efferent = VII

question

Afferent = V-1 Efferent = VII What CN reflex is this?

answer

Corneal OR Lacrimation (use the same nerves)

question

CN reflexes: Jaw jerk Afferent? Efferent?

answer

Afferent = V-3 (sensory) Efferent = V-3 (motor)

question

Afferent = V-3 (sensory) Efferent = V-3 (motor) What CN reflex is this?

answer

Jaw jerk

question

CN reflexes: Pupillary Afferent? Efferent?

answer

Afferent = II Efferent = III

question

Afferent = II Efferent = III What CN reflex is this?

answer

Pupillary

question

CN reflexes: Gag Afferent? Efferent?

answer

Afferent = IX Efferent = IX and X

question

Afferent = IX Efferent = IX and X What CN reflex is this?

answer

Gag

question

Vagal nuclei: Nucleus Solitarious

answer

Visceral S ensory information (e.g., taste, baroreceptors, gut distension) CN VII, IX, X ("S olitarius = viS ceral S ensory")

question

Vagal nuclei: Nucleus ambiguous

answer

M otor innervation of pharynx, larynx, and upper esophagus (e.g., swallowing, palate elevation) CN's IX, X, XI ("aM biguous = M otor")

question

Vagal nuclei: Dorsal motor nucleus

answer

Sends autonomic (parasympathetic) fibers to heart, lungs, and upper GI.

question

Cranial nerve and vessel pathways: What exits via the cribiform plate?

answer

CN I

question

Cranial nerve and vessel pathways: What exits via the middle cranial fossa?

answer

CN II-VI, thru the sphenoid bone: 1.) Optic canal : CN II, ophthalmic artery, central retinal vein 2.) S uperior orbital fissure : CN III, IV, V-1, VI, ophthalmic vein 3.) Foramen R otundum : CN V-2 4.) Foramen O vale : CN V-3 5.) Foramen spinosum : middle meningeal artery ("Divisions of CN-V exit owing to S tanding R oom O nly")

question

Cranial nerve and vessel pathways: What exits via the Posterior cranial fossa?

answer

CN VII-XII, thru the temporal and occipital bone: 1.) Internal auditory meatus : CN VII, VIII 2.) Jugular foramen : CN IX, X, XI, jugular vein 3.) Hypoglossal canal : CN XII 4.) Foramen magnum : Spinal roots of CN XI, brain stem, vertebral arteries

question

What/where is the cavernous sinus? What is the route of blood thru it?

answer

A collection of venous sinuses on either side of the pituitary. Blood from eye and superficial cortex | Cavernous sinus | Internal jugular vein

question

What nerves pass through the cavernous sinus?

answer

CN II, IV, V-1, V-2, VI, and postganglionic sympathetic fibers en route to the orbit all pass thru the cavernous sinus. Only CN VI is "free-floating". Cavernous portion of internal carotid artery is also here.

question

What is cavernous sinus syndrome?

answer

Nerves that control extraocular muscles (plus V-1 and V-2) pass thru the cavernous sinus. Therefore, cavernous sinus syndrome (e.g., due to mass effect): ophthalmoplegia, ophthalmic and maxillary sensory loss.

question

CN XII lesion (LMN) What is the defect?

answer

Tongue deviates toward the side of the lesion ("lick your wounds")

question

CN V motor lesion What is the defect?

answer

Jaw deviates toward the side of lesion

question

CN X lesion what is the defect?

answer

Uvula deviates away from side of lesion

question

CN XI lesion what is the defect?

answer

Weakness turning head to contralateral side of lesion. Shoulder droop on side of lesion.

question

Facial lesions: UMN lesion

answer

Lesion of motor cortex or connection btw cortex and facial nucleus. Contralateral paralysis of lower face only, since upper face recives bilateral UMN innervation.

question

Facial lesions: LMN lesion

answer

Ipsilateral paralysis of upper and lower face.

question

Facial lesions: Bell's palsy

answer

Complete destruction of the facial nucleus itself or its branchial efferent fibers (facial nerve proper) Peripheral ipsilateral facial paralysis w/ inability to close eye on involved side. Can occur idiopathically; gradual recovery in most cases.

question

In what dz's/disorders is Bell's palsy seen as a complication?

answer

A IDS L yme dz H erpes zoster S arcoidosis T umors D iabetes ("AL exander graH am Bell with STD ")

question

KLM sounds (kuh, la, mi)

answer

Say it aloud. "Kuh-kuh-kuh" tests palate elevation (CN X - vagus) "La-la-la" tests tongue (CN XII - hypoglossal) "Mi-mi-mi" tests lips (CN VII - facial) ("It would be a K aL aM ity to lose CN X, XII, and VII")

question

Muscles of mastication

answer

3 Muscles close jaw: M asseter, teM poralis, and M edial pterygoid ("M 's M unch") 1 Muscle opens jaw: Lateral pterygoid ("Lateral Lowers" -- [lateral pterygoid]) All above are innervated by the trigeminal nerve (V-3)

question

Muscles with glossus

answer

All muscles with the root glossus in their names (except palatoglossus, innervated by vagus nerve) are innervated by the hypoglossal nerve. Palat : vagus nerve Glossus : hypoglossal nerve

question

Muscles with palat

answer

All muscles with the root palat in their names (except tensor veli palatini , innervated by mandibular branch of CN V) are innervated by vagus nerve. Palat : vagus nerve (except TENS or, who was too TENSE )

question

Inner ear as a "series of tubes"

answer

A series of tubes in the temporal bone (bony labrynth) filled with perilymph (Na+ rich, similar to ECF) that includes cochlea, vestibule, and semicircular canals. W/in the bony labyrinth is a 2nd series of tubes (membranous labyrinth) filled w/ endolymph (K+ risch, similar to ICF) that includes cochlear duct (w/in the cochlea), utricle and saccule (w/in the vestibule), and semicircular canals. *peri = think outside of the cell (Na+), vs. Endo = think inside the cell (K+)

question

Where is the endolymph (of the inner ear) made?

answer

Made by the stria vascularis.

question

What do the utricle and saccule contain? What do they detect?

answer

Contain maculae - detect linear acceleration.

question

What do the semicircular canals contain? What do they detect?

answer

Contain A mpullae, detect A ngular acceleration.

question

Hair cells (of the inner ear): Where are they? What do they do?

answer

Located w/in the organ of Corti. Are the sensory elements in both vestibular apparatus (spatial orientation) and cochlea (hearing).

question

How can you remember where frequencies are sensed along the cochlear membrane?

answer

The cochlear membrane = scuba flipper: narrow/stiff at the base (high frequency), and wide/flexible at the apex (low frequency).

question

Conductive hearing loss

answer

Bone conduction < air conduction on Rinne; Weber localizes to the affected ear.

question

Sensorineural hearing loss

answer

Air conduction < Bone conduction on Rinne; Weber localizes to normal ear.

question

Hearing loss in the elderly

answer

High frequency --< low frequency

question

Could you label this picture?

answer

Answers

question

What are the muscles that make up the iris? What receptors do they have, and what are their effects?

answer

Dilator/radial muscle (alpha1 --< myd riasis [pupillary d ilation]) Sphincter/circular/constrictor muscle (M3 --< miosis [pupillary constriction])

question

Where are the ciliary muscles? What receptors do they have, and what effect?

answer

Shown below/right. M3 --< accomodation

question

Where is aqueous humor made? Where is it reabsorbed? [give the whole pathway]

answer

Aqueous humor is made by ciliary process | Travels past lens to posterior Chamber | Anterior chamber | Trabecular meshwork (absorbs aqueous humor | Canal of Schlemm (collects aqueous humor from trabecular meshwork)

question

Glaucoma (general pathogenesis)

answer

Impaired flow of aqueous humor | Increased intraocular pressure | Optic disk atrophy w/ cupping

question

Open angle glaucoma

answer

Obstructed outflow (e.g., canal of Schlemm); associated w/ myopia, advanced age, African-American race. More common, "silent," painless.

question

Closed angle glaucoma

answer

Obstruction of flow btw iris, lens --< pressure builds up behind iris. Painful, impaired vision. Do NOT give epinephrine.

question

Cataract

answer

Painless, bilateral opacification of lens, leading to decrease in vision. Risk factors: age, smoking, EtOH, sunlight, DM, trauma, infxn.

question

Papilledema

answer

Increased intracranial pressure --< elevated optic disk with blurred margins, bigger blind spot.

question

Innervation of the extraocular muscles?

answer

CN VI innervates the L ateral R ectus CN IV innervates the S uperior O blique CN III innervates the R est Thus, the "chemical formula": LR6 SO4 R3

question

What are the 3 actions of the superior oblique?

answer

It abducts, intorts, and depresses.

question

CN III damage

answer

Eye looks down and out; ptosis, pupillary dilation, loss of accomodation.

question

CN IV damage

answer

Diplopia w/ defective downward gaze

question

CN VI damage

answer

Medially directed eye.

question

Testing extraocular muscles

answer

To test fxn of each muscle, have te pt look in the following directions: [*note that the oblique muscles are tested by looking medially and opposite to what you would expect from "superior" and "inferior"] "IOU : to test I nferior O blique, have pt look U p."

question

Strabismus vs. Amblyopia

answer

Strabismus is misalignment of eyes. Multiple etiologies. Amblyopia is a reduction of vision from disuse in critical period. May be secondary to strabismus, deprivation, unequal refractive errors.

question

What controls pupillary constriction (miosis)

answer

P upillary sphincter muscle, P arasympathetic innervation. Innervation -- CN III from Edinger-Westphal nucleus --< ciliary ganglion.

question

What controls pupillary D ilation (myD riasis)?

answer

RaD ial muscle (aka pupillary D ilator muscle), sympathetic. Innervation -- T1 preganglionic sympathetic --< superior cervical ganglion --< postganglionic sympathetic --< long ciliary nerve.

question

Pupillary light reflex

answer

Light in either retina sends a signal via CN II to pretectal nuclei (dashed lines, below) in midbrain that activate bilateral Edinger-Westphal nuclei; pupils constrict bilaterally (consensual reflex). Result: illumination of 1 eye results in bilateral pupillary constriction.

question

Marcus Gunn pupil

answer

Afferent pupillary defect (e.g., due to optic nerve damage or retinal detachment). Decreased bilateral pupillary constriction when light is shone in affected eye.

question

CN III in cross-section

answer

Center carries output to ocular muscles, affected primarily by vascular disease (e.g., DM) Outside carries parasympathetic output, affected 1st by compression (e.g., PCA berry aneurysm, uncal herniation); use pupillary light reflex in assessment, "blown pupil"

question

Retinal detachment

answer

Separation of neurosensory layer of retina from pigment epithelium | Degeneration of photoreceptors | Vision loss May be secondary to trauma, diabetes.

question

Age-related macular degeneration (ARMD)

answer

Degeneration of macula (central area of retina). Causes loss of central vision (scotomas). "Dry"/atrophic ARMD is slow, causes gradual decrease in vision "Wet" ARMD is rapid, due to neovascularization.

question

Visual field defects: Right anopia What would this look like in the visual field? Where is the lesion?

answer

#1, below

question

#1, below What is this visual field defect called?

answer

Right anopia

question

Visual field defects: Bitemporal hemianopia What would this look like in the visual field? Where is the lesion?

answer

#2, below

question

#2, below What is this visual field defect called?

answer

Bitemporal hemianopia

question

Visual field defects: Left homonymous hemianopia What would this look like in the visual field? Where is the lesion?

answer

#3, below

question

#3, below What is this visual field defect called?

answer

Left homonymous hemianopia

question

Visual field defects: Left upper quadrantic anopia (right temporal lesion) What would this look like in the visual field? Where is the lesion?

answer

#4, below

question

#4, below What is this visual field defect called?

answer

Left upper quadrantic anopia (right temporal lesion)

question

Visual field defects: Left lower quadrantic anopia (right parietal lesion) What would this look like in the visual field? Where is the lesion?

answer

#5, below

question

#5, below What is this visual field defect called?

answer

Left lower quadrantic anopia (right parietal lesion)

question

Visual field defects: Left hemianopia w/ macular sparing What would this look like in the visual field? Where is the lesion?

answer

#6, below

question

#6, below What is this visual field defect called?

answer

Left hemianopia w/ macular sparing

question

Visual field defects: Central scotoma (macular degeneration) What would this look like in the visual field? Where is the lesion?

answer

#7, below

question

#7, below What is this visual field defect called?

answer

Central scotoma (macular degeneration)

question

Internuclear ophthalmoplegia (MLF syndrome)

answer

Lesion in the medial longitudinal fasciculus (MLF) --< medial rectus palsy on attempted lateral gaze. Nystagmus in abducting eye. Convergence normal. Syndrome is seen in many pts w/ multiple sclerosis ("M LF = M S") When looking left, the left nucleus of CN VI fires, which contracts the lateral rectus and stimulates the contralateral (right) nucleus of CN III via the right MLF to contract the right medial rectus.

question

Dementia (defined)

answer

Decreased cognitive ability, memory, fxn, with intact consciousness.

question

Alzheimer's dz: Epidemiology? Groups at increased risk?

answer

Most common cause of dementia in the elderly. Down syndrome pts are at increased risk of developing AD.

question

Alzheimer's dz: genetics?

answer

Familial form (10%) assocaited w/ genes on chromosomes 1, 14, 19 (APOE4 allele; autosomal dominant), and 21 (p-App ) gene.

question

Alzheimer's dz: pathogenesis?

answer

Widespread, accelerated cortical atrophy with decreased ACh. Associated w/ senile plaques (extracellular, beta-amyloid core) and neurofibrillary tangles (intracellular, abnormally phosphorylated tau protein; tangles correlate w/ degree of dementia). May cause amyloid angiopathy --< intracranial hemorrhage.

question

Pick's dz (frontotemporal dementia)

answer

Dementia, aphasia, parkinsonian aspects; Associated w/ Pick bodies (intracellular, aggregated tau protein), frontotemporal lobe atrophy. Spares parietal lobe and posterior 2/3rds of superior temporal gyrus.

question

Lewy body dementia

answer

Parkinsonism with dementia and hallucinations. Caused by alpha-synuclein defect.

question

Creutzfeldt-Jakob dz (CJD)

answer

Rapidly progressive (wks-mos) dementia w/ myoclonus, spongiform cortex; associated w/ prions.

question

"Other" causes of dementia

answer

Multi-infarct (2nd most common cause of dementia in the elderly) Syphilis HIV Vitamin B12 deficiency Wilson's dz

question

Multiple sclerosis: What is it?

answer

Autoimmune inflammation and demyelination of CNS (brain and spinal cord).

question

Multiple sclerosis: How do pts present? What is the course of the dz?

answer

Pts can present with: optic neuritis (sudden loss of vision) MLF syndrome (internuclear ophthalmoplegia) Hemiparesis Hemisensory Sx's Bowel/bladder incontinence. Relapsing and remitting course.

question

Multiple sclerosis: Who is affected?

answer

Most often affects women in their 20s and 30s; more common in whites.

question

Findings in multiple sclerosis

answer

Elevated protein (IgG) in CSF. Periventricular plaques (areas of oligodendrocyte loss and reactive gliosis) w/ preservation of axons.

question

Charcot's triad of MS

answer

Charcot's traid of MS is a SIN : S canning speech I ntention tremor (+I ncontinence, I nternuclear ophthalmoplegia) N ystagmus

question

Tx for multiple sclerosis

answer

Beta-interferon or immunosuppressant therapy. Symptomatic Tx for neurogenic bladder, spasticity, and pain.

question

Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy) What is it/what are the main Sx?

answer

Inflammation and demyelination of peripheral nerves and motor fibers of ventral roots (sensory effect less severe than motor), causing symmetric ascending muscle weakness beginning in distal lower extremities. Facial paralysis in 50% of cases. Autonomic fxn may be severely affected (e.g., cardiac irregularities, HTN, or hypotension).

question

Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy) What is the prognosis?

answer

Almost all pts survive; the majority recover completely after wks to months.

question

Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy): Findings?

answer

Elevated CSF protein w/ normal cell count (albuminocytologic dissociation). Elevated protein --< papilledema.

question

Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy): is associated with...?

answer

Associated with infxns --< autoimmune attack of peripheral myelin due to molecular mimicry (e.g., Campylobacter jejuni or herpesvirus infxn), inoculations, and stress, but no definitive link to pathogens.

question

Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy): Management/Tx?

answer

Respiratory support is critical until recovery. Additional Tx: plasmapheresis, IV immune globulins.

question

Progressive multifocal leukoencephalopathy (PML)

answer

Demyelination of CNS due to destruction of oligodendrocytes. Associated w/ JC virus and seen in 2-4% of AIDS pts (reactivation of latent viral infxn). Rapidly progressive, usually fatal.

question

Acute disseminated (postinfectious) encephalomyelitis

answer

Multifocal perivenular inflammation and demyelination after infxn (e.g., chickenpox, measles) or certain vaccinations (e.g., rabies, smallpox)

question

Metachromatic leukodystrophy

answer

Autosomal-recessive lysosomal storage dz, most commonly due to arylsulfatase A deficiency. Builup of sulfatides leads to impaired production of myelin sheath.

question

Charcot-Marie Tooth disease (aka hereditary motor and sensory neuropathy HMSN)

answer

Group of progressive hereditary nerve d/o's related to defective production of proteins involved in the structure and fxn onf peripheral nerves or the myelin sheath.

question

Seizure

answer

Characterized by synchronized, high-frequency neuronal firing. Variety of forms.

question

Partial seizures

answer

1 area of brain. Most commonly originates in the mesial temporal lobe. Often preceded by seizure aura; can secondarily generalize.

question

2 types of partial seizures

answer

1.) Simple partial (consciousness intact): motor, sensory, autonomic, psychic 2.) Complex partial (impaired consciousness)

question

Generalized seizures

answer

Diffuse.

question

5 Types of generalized seizures

answer

1.) Absence (petit mal) - blank stare 2.) Myoclonic - quick, repetitive jerks 3.) Tonic-clonic (grand mal) - alternating stiffening and movement 4.) Tonic - stiffening 5.) Atonic - "drop" seizures (falls to floor); commonly mistaken for fainting

question

Epilepsy

answer

A d/o of recurrent seizures (febrile seizures are not epilsepsy)

question

Causes of seizures by age: Children?

answer

Genetic Infxn (febrile) Trauma Congenital Metabolic

question

Causes of seizures by age: Adults?

answer

Tumors Trauma Stroke Infxn

question

Causes of seizures by age: Elderly?

answer

Stroke Tumor Trauma Metabolic Infxn

question

Headache (definition)

answer

Pain due to irritation of structures such as dura, cranial nerves, or extracranial structures, not brain parenchyma itself.

question

Migrain headache

answer

4-72 hours of unilateral pulsating pain w/ nausea, photophobia, or phonophobia. +/- "aura" of neurologic Sx before HA, including visual dsensory, speech disturbances. Due to irritation of CN V and release of substance P, CGRP, vasoactive peptides.

question

Tension headache

answer

< 30 minutes of bilateral steady pain. Not aggravated by light or noise; no aura.

question

Cluster headache

answer

Repetitive brief headaches characterized by unilateral periorbital pain associated w/ ipsilateral lacrimation, rhinorrhea, Horner's syndrome. Much more common in males.

question

"Other" causes of headache

answer

Subarachnoid hemorrhage ("worst headache of my life") Meningitis Hydrocephalus Neoplasia Arteritis

question

Vertigo (definition)

answer

Illusion of movement, not to be confused w/ dizziness or lightheadedness.

question

Peripheral vertigo

answer

More common type. Inner ear etiology (e.g., semicircular canal debris, vestibular nerve infxn, Meniere's dz). Positional testing --< delayed horizontal nystagmus.

question

Central vertigo

answer

Brain stem or cerebellar lesion (e.g., vestibular nuclei, posterior fossa tumor). Positional testing --< immediate nystagmus in any direction; may change directions.

question

Neurocutaneous disorders: Sturge-Weber syndrome

answer

Congenital d/o w/ port-wine stains and ipsilateral leptomeningeal angioma. Can cause glaucoma, seizures, hemiparesis, and mental retardation. Occurs sporadically.

question

Neurocutaneous disorders: Tuberous sclerosis

answer

Hamartomas in CNS, skin, organs; cardiac rhabdomyoma, renal agiomyolipoma, subependymal giant cell astrocytoma, MR, seizures, hypopigmented "ash leaf spots," sebaceous adenoma, shagreen patch. Autosomal dominant.

question

Neurocutaneous disorders: Neurofibromatosis type I (von Recklinghausen's disease)

answer

Café-au-lait spots Lisch nodules (pigmented iris hamartomas) Neurofibromas in skin. Autosomal dominant

question

Neurocutaneous disorders: von Hippel-Lindau dz

answer

Cavernous hemangiomas in skin, mucosa, organs; renal cell carcinoma hemangioblastoa in retina, brain stem, cerebellum. Autosomal dominant.

question

Primary brain tumors

answer

Clinical presentation due to mass effects (e.g., seizures, demential, focal lesions); Primary tumors rarely undergo metastasis. The majority of adult primary tumors are supratentorial, while the majority of childhood primary tumors are infratentorial. Note: half of adult brain tumors are metastases (well circumscribed; usually present at the gray-white junction).

question

Adult peak incidence tumors: Glioblastoma multiforme (grade IV astrocytoma)

answer

Most common primary brain tumor. Prognosis grave; > 1yr life expectancy. Found in cerebral hemispheres. Can cross corpus callosum ("butterfly glioma" [below]) Stain astrocytes for GFAP. "Pseudopalisading" pleomorphic tumor cells -- border central areas of necrosis and hemorrhage [above/right]

question

answer

Glioblastoma multiforme (grade IV astrocytoma)

question

Adult peak incidence tumors: Meningioma

answer

2nd most common primary brain tumor. Most often occurs in convexities of hemispheres and parasagittal region. Arises from arachnoid cells external to brain. Resectable. Spindle cells concentrically arranged in a whorled pattern; psammoma bodies (laminated calcifications).

question

answer

Meningioma

question

Adult peak incidence tumors: Schwannoma

answer

3rd most common primary brain tumor. Schwann cell origin; often localized to CN VIII --< acoustic schwannoma. Resectable. Bilateral schwannoma found in neurofibromatosis type II.

question

Adult peak incidence tumors: Oligodendroma

answer

Relatively rare, slow groing. Most often in frontal lobes. Chicken-wire capillary pattern. Oligodendrocytes = "fried egg" cells -- round nuclei w/ clear cytoplasm. Often calcified in oligodendroglioma.

question

Adult peak incidence tumors: Pituitary adenoma

answer

Most commonly prolactinoma. Bitemporal hemianopia (due to pressure on optic chiasm) and hyper- or hypopituitarism are sequelae. Rathke's pouch.

question

Childhood peak incidence tumors: Pilocytic (low-grade) astocytoma

answer

Usually well circumscribed. In children, most often found in posterior fossa. May be supratentorial. GFAP positive. Benign; good prognosis. Rosenthal fibers -- eosinophilic, corkscrew fibers.

question

Usually well circumscribed. In children, most often found in posterior fossa. May be supratentorial. GFAP positive. Benign; good prognosis. Rosenthal fibers -- eosinophilic, corkscrew fibers. What tumor does this describe?

answer

Pilocytic (low-grade) astocytoma

question

Childhood peak incidence tumors: Medullo-blastoma

answer

Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle, causing hydrocephalus. Rosettes or perivascular pseudorosette pattern cells. Radiosensitive.

question

answer

Medullo-blastoma

question

Childhood peak incidence tumors: Ependymoma

answer

Ependymal cell tumors most commonly found in 4th ventricle. Can cause hydrocephalus. Poor prognosis. Characteristic perivascular pseudorosettes. Rod-shaped blepharoplasts (basal ciliary bodies) found near nucleus.

question

answer

Ependymoma

question

Childhood peak incidence tumors: Hemangioblastoma

answer

Most often cerebellar; associated w/ von Hippel-Lindau syndrome when found w/ retinal angiomas. Can produce EPO --< secondary polycythemia. Foamy cells and high vascularity are characteristic.

question

Most often cerebellar; associated w/ von Hippel-Lindau syndrome when found w/ retinal angiomas. Can produce EPO --< secondary polycythemia. Foamy cells and high vascularity are characteristic. What tumor does this describe?

answer

Hemangioblastoma

question

Childhood peak incidence tumors: Craniopharyngioma

answer

Benign childood tumor, confused w/ pituitary adenoma (can also cause bitemporal hemianopia). Most common childhood supratentorial tumor. Derived from remnants of Rathke's pouch. Calcification is common (tooth enamel-like).

question

answer

Craniopharyngioma

question

Herniation syndromes: Cingulate (subfalcine) herniation under falx cerebri

answer

Can compress anterior cerebral artery. #1 below:

question

Can compress anterior cerebral artery. #1 below: What herniation syndrome is this?

answer

Cingulate (subfalcine) herniation under falx cerebri

question

Herniation syndromes: Downward transtentorial (central) herniation

answer

#2 below

question

#2 below What herniation syndrome is this?

answer

Downward transtentorial (central) herniation

question

Herniation syndromes: Uncal herniation

answer

(hint: Uncus = medial temporal lobe) #3 below:

question

#3 below: What herniation syndrome is this?

answer

Uncal herniation (hint: Uncus = medial temporal lobe)

question

Herniation syndromes: Cerebellar tonsillar herniation into the foramen magnum

answer

#4 below:

question

#4 below: What herniation syndrome is this?

answer

Cerebellar tonsillar herniation into the foramen magnum

question

Hernation syndromes: what is the biggest danger?

answer

Coma and death result when these hernations compress the brain stem.

question

Clinical signs of uncal herniation: Ipsilateral dilated pupil/pstosis

answer

Stretching of CN III (innervates levator palpebrae)

question

Clinical signs of uncal herniation: Contralateral homonymous hemianopia

answer

Compression of ipsilateral posterior cerebral artery

question

Clinical signs of uncal herniation: Ipsilateral paresis

answer

Compression of contralateral crus cerebri (Kernohan's notch)

question

Clinical signs of uncal herniation: Duret hemorrhages -- paramedian artery rupture

answer

Caudal displacement of brain stem.

question

Epinephrine Class of drug? Mechanism? SE's?

answer

alpha-agonist. Decreases aqueous humor synthesis due to vasoconstriction. SE: mydriasis, stinging; do not use in closed-angle glaucoma.

question

Brimonide Class of drug? Mechanism? SE's?

answer

alpha-agonist. Decreased aqueous humor synthesis. SE: no pupillary or vision changes.

question

Timolol, betaxolol, carteolol Class of drug? Mechanism? SE's?

answer

beta-blockers. Decrease aqueous humor secretion SE: no pupillary or vision changes.

question

Acetazolamide Class of drug? Mechanism? SE's?

answer

Diuretic. Decrease aqueous humor secretion due to decreased HCO3- (via inhibition of carbonic anhydrase) SE: no pupillary or vision changes.

question

Pilocarpine, carbachol, physostigmine, echothiophate Class of drug? Mechanism? SE's?

answer

Cholinomimetics Increase outflow of aqueous humor; contract ciliary muscle and open trabecular meshwork; use pilocarpine in emergencies; very effective at opening canal of Schlemm. SE: Miosis, cyclospasm.

question

Latanoprost (PGF-2alpha) Class of drug? Mechanism? SE's?

answer

Prostaglandin. Increases outflow of aqueous humor. SE: darkens color of iris (browning).

question

Opioid analgesics (list)

answer

Morphine Fentanyl Codeine Heroin Methadone Meperidine Dextromethorphan

question

Mechanism of opioid analgesics

answer

Act as agonists at opioid receptors (mu = morphine, delta = enkephalin, kappa = dynorphin) to modulate synaptic transmission -- open K+ channels, close Ca2+ channels, leading to decrease in synaptic transmission.

question

Clinical toxicity of opioid analgesics

answer

Pain cough suppression (dextromethorphan) diarrhea (loperamide and diphenoxylate) acute pulmonary edema maintenance programs for addicts (methadone)

question

Toxicity of opioid analgesics

answer

Addiction Respiratory depression Constipation Miosis (pinpoint pupils ) Additive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Toxicity treated w/ naloxone or naltrexone (opioid receptor antagonist).

question

Mechanism of butorphanol

answer

Partial agonist at opioid mu receptors, agonst at kappa receptors.

question

Clinical use of butorphanol

answer

Pain; causes less respiratory depression than full agonists.

question

Toxicity of butorphanol

answer

Causes withdrawal if on full agonist.

question

Mechanism of tramadol

answer

Very weak opioid agonist; also inhibits serotonin and NE reuptake (works on multiple neurotransmitters -- "tram it all " in).

question

Clinical use of tramadol

answer

Chronic pain.

question

Toxicity of tramadol

answer

Similar to opioids. Decreases seizure threshold.

question

Epilepsy drugs: Phenytoin Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used in partial seizures (simple and complex). 1st line drug for Tonic-clonic seizures. 1st line drug for prophylaxis of status seizures. Mechanism: increased Na+ channel inactivation.

question

Used in partial seizures (simple and complex). 1st line drug for Tonic-clonic seizures. 1st line drug for prophylaxis of status seizures. Mechanism: increased Na+ channel inactivation. What epilepsy drug does this describe?

answer

Phenytoin

question

Epilepsy drugs: Carbamezepine Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). 1st line drug for tonic-clonic seizures. Mechanism: increases Na+ channel inactivation. *Also 1st line drug for trigemnial neuralgia.

question

Used for partial seizures (simple and complex). 1st line drug for tonic-clonic seizures. Mechanism: increases Na+ channel inactivation. *Also 1st line drug for trigemnial neuralgia. What epilepsy drug does this describe?

answer

Carbamezepine

question

Epilepsy drugs: Lamotrigine Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: blocks VG-Na+ channels.

question

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: blocks VG-Na+ channels. What epilepsy drug does this describe?

answer

Lamotrigine

question

Epilepsy drugs: Gabapentin Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: increases GABA release. *Also used for peripheral neuropathy.

question

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: increases GABA release. *Also used for peripheral neuropathy. What epilepsy drug does this describe?

answer

Gabapentin

question

Epilepsy drugs: Topiramate Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: blocks Na+ channels, increases GABA action

question

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: blocks Na+ channels, increases GABA action What epilepsy drug does this describe?

answer

Topiramate

question

Epilepsy drugs: Phenobarbital Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: increases GABA-A action. *1st line in pregnant women, children.

question

Used for partial seizures (simple and complex). May be used for tonic-clonic seizures. Mechanism: increases GABA-A action. *1st line in pregnant women, children. What epilepsy drug does this describe?

answer

Phenobarbital

question

Epilepsy drugs: Valproic acid Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

Used for partial seizures (simple and complex). 1st line drug for tonic-clonic seizures. May also be used in absence seizures. Mechanism: increases Na+ channel inactivation, increases GABA concentration. *Also used for myoclonic seizures.

question

answer

Valproic acid

question

Epilepsy drugs: Ethosuximide Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

1st line drug for absence seizures. Mechanism: blocks thalamic T-type Ca2+ channels.

question

1st line drug for absence seizures. Mechanism: blocks thalamic T-type Ca2+ channels. What epilepsy drug does this describe?

answer

Ethosuximide

question

Epilepsy drugs: Benzodiazepines (diazepam or lorazepam) Use in partial seizures (simple/complex)? Use in generalized seizures (Tonic-clonic/absence/status)? Mechanism? Notes?

answer

1st line for acute status seizures. Mechanism: increase GABA-A action. *Also used for seizures of eclampsia (1st line to prevent seizures of eclampsi is MgSO4)

question

1st line for acute status seizures. Mechanism: increase GABA-A action. *Also used for seizures of eclampsia (1st line to prevent seizures of eclampsi is MgSO4) What epilepsy drug does this describe?

answer

Benzodiazepines (diazepam or lorazepam)

question

toxicity of epilepsy drugs: Toxicity of Benzodiazepines

answer

Sedation Tolerance Dependence

question

toxicity of epilepsy drugs: Toxicity of Carbamazepine

answer

Diplopia Ataxia Blood dyscrasias (agranulocytosis, aplastic anemia) Liver toxicity Teratogenesis Induction of cytochrome P-450

question

toxicity of epilepsy drugs: Toxicity of ethosuximide

answer

GI distress Fatigue Headache Urticaria Stevens-Johnson syndrome ("EFGH = E thosuximide, F atigue, G I, H eadache")

question

toxicity of epilepsy drugs: Stevens-Johnson syndrome

answer

prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing.

question

toxicity of epilepsy drugs: Toxicity of phenobarbital

answer

Sedation Tolerance Dependence Induction of cytochrome P-450

question

toxicity of epilepsy drugs: Toxicity of phenytoin

answer

Nystagmus Diplopia Ataxia Sedation Gingival hypreplasia Hirsutism Megaloblastic anemia Teratogenesis SLE-like syndrome Induction of cytochrome P-450

question

toxicity of epilepsy drugs: Toxicity of valproic acid

answer

GI distress rare but fatal hepatotoxicity (measure LFTs) Neural tube defects in fetus (spina bifida) Tremor Weight gain. Contraindicated in pregnancy.

question

toxicity of epilepsy drugs: Toxicity of lamotrigine

answer

Stevens-Johnson syndrome

question

toxicity of epilepsy drugs: Toxicity of Gabapentin

answer

Sedation Ataxia

question

toxicity of epilepsy drugs: Toxicity of Topiramate

answer

Sedation Mental dulling Kidney stones Weight loss

question

Mechanism of phenytoin

answer

Use-dependent blockade of Na+ channels; inhibition of glutamate release from excitatory presynaptic neuron.

question

Clinical use of phenytoin

answer

Tonic-clonic seizures. Also a class IB antiarrhythmic.

question

Toxicity of phenytoin

answer

Nystagmus, ataxia, diplopia, sedation, SLE-like syndrome, induction of cytochrome P-450. Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia (decreased folate absorption). Teratogenic (fetal hydantoin syndrome).

question

Mechanism of barbiturates (phenobarbital, pentobarbital, thiopental, secobarbital)

answer

Facilitate GABA-A action by increasing duration of Cl- channel opening, thus decreasing neuron firing. ("BarbiDURAT e [increased DURAT ion]")

question

Clinical use of barbiturates (phenobarbital, pentobarbital, thiopental, secobarbital)

answer

Sedative for anxiety, seizures, insomnia, induction of anestheisa (thiopental)

question

Toxicity of of barbiturates (phenobarbital, pentobarbital, thiopental, secobarbital)

answer

Dependence, additive CNS depression effects w/ EtOH, respiratory or CV depression (can lead to death), drug interactions owing to induction of liver microsomal enzymes (cytochrome P-450). Tx overdose w/ Sx managment (assist respiration, increase BP) Contraindicated in pregnancy.

question

Mechanism of benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

answer

Facilitate GABA-A action by increasing frequency of Cl- channel opening. Decreases REM sleep. Most have long half-lives and active metabolites. ("FRE enzodiazepines [increased FRE quency]")

question

Short acting benzodiazepines

answer

TOM thumb T riazolam O xazepam M idazolam. Highest addictive potential.

question

Clinical use of benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

answer

Anxiety, spasticity, status epilepticus (lorazepam and diazepam), detoxification (especially EtOH withdrawal - DTs), night terrors, sleep walking.

question

Toxicity of benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

answer

Dependence, additive CNS depression effects w/ EtOH. Less risk of respiratory depression and coma than w/ barbiturates. Tx overdose w/ flumazenil (competitive antagonist at GABA receptor)

question

General principles of anesthetics: CNS drugs must be...?

answer

CNS drugs must be lipid soluble (cross the BBB) or be actively transported.

question

General principles of anesthetics: Solubility and drug effect?

answer

Drugs with low solubility in blood = rapid induction and recovery times. Drugs with high solubility in lipids = high potency = 1 / MAC (where MAC = Minimum Alveolar Concentration at which 50% of the population is anesthetized. Decreases w/ age). e.g., N2O has low blood and lipid solubility, and thus fast induction and low potency. Halothane, in contrast, has high lipid and blood solubility, and thus high potency and slow induction.

question

Inhaled anesthetics (list)

answer

Halothane Enflurane Isoflurane Sevoflurane Methoxyflurane Nitrous oxide

question

Mechanism of inhaled anesthetics

answer

Unknown!

question

Effects of inhaled anesthetics

answer

Myocardial depression Respiratory depression Nausea/emesis Increased cerebral blood flow (decreased cerebral metabolic demand)

question

Toxicity of inhaled anesthetics

answer

Hepatoxicity (halothane) Nephrotoxicity (methoxyflurane) Proconvulsant (enflurane) Malignant hyperthermia (rare) Expansion of trapped gas (nitrous oxide)

question

IV anesthetics (list)

answer

B arbiturates B enzodiazepines Arylcyclohexylamins (K etamine) Opiates Propofol ("BB K ing on OPIATES POPO ses FOOL ishly")

question

Barbiturates (as IV anesthetics)

answer

Thiopental -- high potency, high lipid solubility, rapid entry into brain. Used for induction of anesthesia and short surgical procedures. Effect terminated by redistribution from brain. Decreased cerebral blood flow.

question

Benzodiazepines (as IV anesthetics)

answer

Midazolam most common drug used for endoscopy; used adjuctively w/ gaseous anesthetics and narcotics. May cause severe postoperative respiratory depression, decr BP (Tx overdose w/ flumazenil), and amnesia.

question

Arylcyclohexamines (Ketamine) -- as IV anesthetics

answer

PCP analogs that act as dissociative anesthetics. Block NMDA receptors. Cardiovascular stimulants. Cause disorientation, hallucination, and bad dreams. Increase cerebral blood flow.

question

Opiates (as IV anesthetics)

answer

Morphine, fentanyl used w/ other CNS depressants during general anesthesia.

question

Propofol (as an IV anesthetic)

answer

Used for rapid anesthesia induction and short procedures. Less postoperative nausea than thiopental. Potentiates GABA-A.

question

Local anesthetics (list)

answer

Esters Procaine, cocaine, tetracain Amides lI docaI ne, mepI vacaI ne, bupI vacaI ne ("amI des have 2 I 's in their names)

question

Mechanism of local anesthetics

answer

Block Na+ channels by binding to specific receptors on inner portion of channel. Preferentially bind to activated Na+ channels, so most effecctive in rapidly firing neurons. Tertiary amine local anesthetics penetrate membrane in uncharged form, then bind to ion channels in charged form.

question

3 principles of local anesthetics

answer

1.) In infected (acidic) tissue, alkaline anesthetics are charged and cannot penetrate membrane effectively. More anesthetic is needed in these cases. 2.) Order of nerve blockade: Small-diameter fibers < large diameter. Myelinated fibers < unmyelinated fibers. Overall, size factor predominates over myelination such that: small myelinated fibers < small unmyelinated fibers < large myelinated fibers < large unmyelinated fibers. Order of loss: pain (lose first) < temperature < touch < pressure (lost last). 3.) Except for cocain, given w/ vasoconstrictors (usually epinephrine) to enhance local action: decreased bleeding, increased anesthesia by decreasing systemic concentration.

question

Clinical use of local anesthetics

answer

Minor surgical procedures, spinal anesthesia. If allergic to esters, give amides.

question

Toxicity of local anesthetics

answer

CNS excitation, severe cardiovascular toxicity (bupivacaine), HTN, hypotension, and arrhytmias (cocaine)

question

Neuromuscular blocking drugs (generally)

answer

Used for muscle paralysis in surgery or mechanical ventilation. Selective for motor (vs. autonomic) nicotinic receptor.

question

Depolarizing neuromuscular blocking drugs

answer

Succinylcholine (complications include hypercalcemia and hyperkalemia) Reversal of blockade: Phase I (prolonged depolarization) -- no antidote. Block potentiated by cholinesterase inhibitors. Phase II (repolarized but blocked) -- antidote consists of cholinesterase inhibitors (e.g., neostigmine)

question

Nondepolarizing neuromuscular blocking drugs

answer

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium. Competitive: compete w/ ACh for receptors. Reversal of blockade: neostigmine, edrophonium, and other cholinesterase inhibitors.

question

Uses of dantrolene

answer

Used in Tx of malignant hyperthermia, which is caused by the concomitant use of inhalation anesthetics (except N2O) and succinylcholine. Also used to Tx neuroleptic malignant syndrome (a toxicity of antipsychotic drugs)

question

Mechanism of dantrolene

answer

Prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle.

question

What is Parkinson's dz due to (that is addressed by anti-PD drugs)? What agents are used?

answer

Parkinsonism is due to loss of dopaminergic neurons and excess cholinergic activity. "BALSA" B romocriptine A mantadine L evodopa (with carbidopa) S elegiline (and COMT inhibitors) A ntimuscarinics

question

Parkinson's dz drugs, strategy: Agonize dopamine receptors Agents?

answer

Bromocriptine (ergot alkaloid and partial dopamine agonist) Pramipexole Ropinirole

question

Parkinson's dz drugs, strategy: Increase dopamine Agents?

answer

Amantadine (may increase dopamine release); also used as an antiviral against influenza A and rubella; toxicity = ataxia. L-dopa/carbidopa (converted to dopamine in the CNS)

question

Parkinson's dz drugs, strategy: Prevent dopamine breakdown Agents?

answer

Selegiline (selective MAO type B inhibitor); Entacapone, Tolcapone (COMT inhibitors)

question

Parkinson's dz drugs, strategy: Curb excess cholinergic activity Agents?

answer

Benz tropine (A ntimuscarinic; improves tremor and rigidity but has little effect on bradykinesia). ("Tx your tremor before you drive your Mercedes-BENZ ")

question

For Tx of essential familly tremors?

answer

Use beta-blocker.

question

Mechanism of L-dopa (levodopa)/carbidopa

answer

Increase level of dopamine in brain. Unlinke dopamine, L-dopa can cross BBB and is converted by dop decarboxylase in the CNS to dopamine.

question

Clinical use of L-dopa (levodopa)/carbidopa

answer

Parkinsonism

question

Toxicity of L-dopa (levodopa)/carbidopa

answer

Arrhythmias from peripheral conversion to dopamine. Long-term use can --< dyskinesia following administration, akinesia btw doses. Carbidopa, a peripheral decarboxylase inhibitor, is given w/ L-dopa in order to increase the bioavailability of L-dopa in the brain and to limit peripheral SE's.

question

Mechanism of selegiline

answer

Selectively inhibits MAO-B, thereby increasing the availability of dopamine.

question

Clinical use of selegiline

answer

Adjunctive agent to L-dopa in Tx of Parkinson's dz.

question

Toxicity of selegiline

answer

May enhance adverse effects of L-dopa.

question

Mechanism of Sumatriptan

answer

5-HT[1B/1D]* agonist. Causes vasoconstriction, inhibition of trigeminal activation and vasoactive peptide release. Half-life is > 2 hours. [*the "1B/1D" in brackets is subscript]

question

Clinical use of sumatriptan

answer

Acute migraine, cluster HA attacks.

question

Toxicity of Sumatriptan

answer

Coronary vasospasm (contraindicated in pts w/ CAD or Prinzmetal's angina) Mild tingling.

question

Alzheimer's drugs: Memantine mechanism?

answer

NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca2+)

question

Alzheimer's drugs: Memantine Toxicity?

answer

Dizziness, confusion, hallucinations.

question

Alzheimer's drugs: Donepezil mechanism?

answer

Acetylcholinesterrase inhibitor

question

Alzheimer's drugs: Donepezil Toxicity?

answer

Nausea, dizziness, insomnia.

STUDY

Anatomy Blood Supply To The Brain Blood Supply To The Heart High Blood Pressure Nutrition Risk Factors For Cardiovascular Disease Social Support Network

CH 15 and 16 Practice Quiz – Flashcards 10 terms

Gracie Stone

10 terms

Preview

CH 15 and 16 Practice Quiz – Flashcards

question

Exercise alters blood fat levels by

answer

raising HDL levels.

question

When cancer cells enter the lymph or blood system,

answer

they can form secondary tumors elsewhere.

question

All of the following CVD risk factors can be changed, EXCEPT

answer

family history of CVD.

question

Techniques for early detection of prostate cancer include a digital rectal exam and

answer

a prostate-specific antigen (PSA) blood test.

question

Sigmoidoscopy or colonoscopy is recommended to screen for ____________ cancer.

answer

colon and rectal

question

The large artery that receives blood from the left ventricle and distributes it to the rest of the body is called the

answer

aorta.

question

Cancers arising from connective and fibrous tissues such as bone, cartilage, or muscle are called

answer

sarcomas.

question

Cardiovascular disease in children is usually the result of

answer

congenital heart defect.

question

Obesity increases a persons risk of

answer

breast and colon cancers.

question

The type of stroke that is caused by a rupture of blood vessels is called

answer

hemorrhagic.

STUDY

Blood Supply To The Brain

Pathophysiology Chapter 4 Cancer – Flashcards 20 terms

Jacob Herring

20 terms

Preview

Pathophysiology Chapter 4 Cancer – Flashcards

question

Cancer is the _______ most common cause of death in the United States.

answer

second

question

Benign tumors are ____, and remain localized.

answer

not life threatening, grow slowly

question

Benign tumors have a _____.

answer

smooth surface and are symmetrical

question

Malignant tumors have a _____ like appearance and an irregular surface.

answer

crab

question

Malignant tumors are_____.

answer

no encapsulated, making excision more difficult

question

Malignant tumors of the supportive tissues are named with the prefix that designates the cell or tissue of origin followed by the term____.

answer

sarcoma

question

An osteosarcoma is a malignant tumor of ____.

answer

bone

question

The most common important risk factor for cancer is _______.

answer

growing older

question

Cigarette smoking causes about _____ of all cancer deaths in the United States.

answer

30%

question

The _____ increases the risk for cancers of the cervix, penis, vagina, anus, and vuluva.

answer

human papillomavirus

question

______ secret chemicals that cause pores to form in the membrane of abnormal cells, leading to cell death.

answer

natural killer cells

question

Uncontrolled cell division is the result of _____ in genes that play a role in cell division.

answer

mutations

question

_____ tell genes when to divide.

answer

oncogenes

question

______ causes uncontrolled cell divison that may result in cancer.

answer

tumor suppressor genes

question

______ tell cells when not to divide.

answer

tumor suppressor genes

question

mutation in the four genes that are responsible for the cell divison can be _____.

answer

inherited or acquired

question

more than 50% of all cancers involve an acquired mutation in the tumor suppressor gene ______/

answer

p53

question

_______ is the use of xrays to form a still or moving picture of the inside body.

answer

radiography

question

______ is a scanning type of radiography that creates a 3D picture of the inside of the bdy

answer

question

during ______ high frequency so

answer

STUDY

Anatomy Benign And Malignant Tumors Blood Supply To The Brain Health Science Risk Factors For Cardiovascular Disease

Exam 5 – Flashcard 75 terms

Christine Brunetti

75 terms

Preview

Exam 5 – Flashcard

question

The heart's ________ chambers work together to circulate blood throughout the body.

answer

four

question

In which age group is CVD significantly more prevalent among men than among women?

answer

20 to 39 year olds

question

What is the number one cause of death for women in the United States?

answer

Cardiovascular Disease

question

The upper chambers of the heart are called the

answer

Atria

question

Which vessels carry blood away from the heart, to other regions of the body?

answer

Arteries

question

Which blood vessels permit the exchange of oxygen, carbon dioxide, nutrients, and waste products with body cells?

answer

Capillaries

question

James was diagnosed with atherosclerosis, which is

answer

a buildup of plaque on the inner lining of an artery.

question

Julie's grandmother has "thickening" of her arteries caused by fatty deposits, cholesterol, and other substances deposited in the blood vessels. What is the medical term for this?

answer

Atherosclerosis

question

When atherosclerosis occurs in a limb, it is called

answer

peripheral artery disease.

question

A number of conditions including atherosclerosis can lead to ischemia, which is

answer

reduced oxygen supply to a body part or organ.

question

Ana is traveling overseas. Why is it advisable that she routinely moves and stretches her legs during her 10-hour flight?

answer

To prevent blood from pooling in her legs

question

Damage to an area of the heart muscle caused by the lack of blood supply is called

answer

a heart attack

question

Another name for a heart attack is

answer

myocardial infarction.

question

What is the role of collateral circulation?

answer

It allows an affected heart muscle to cope with damage

question

Common symptoms of a heart attack include all of the following except

answer

extreme hunger.

question

Susan's aunt suffered from a cerebrovascular accident. What is the common name for this medical problem?

answer

Stroke

question

The leading risk factor for stroke is

answer

Hypertension

question

Many strokes are preceded days, weeks, or months earlier by

answer

transient ischemic attacks.

question

When administering the 60-second test for a stroke, you should ask the person to

answer

smile; raise both arms; and repeat a simple sentence.

question

Dominique felt a sudden numbness on the left side of her face, she had trouble walking, and she was unable to speak in any understandable fashion. Which of the following cardiovascular diseases is Dominique probably experiencing right now?

answer

A stroke

question

Hypertension refers to

answer

a sustained high blood pressure.

question

Systolic blood pressure refers to pressure applied to the walls of the arteries when

answer

the heart contracts.

question

When the heart relaxes, the pressure on the arterial walls decreases. This is called the

answer

diastolic pressure

question

Michelle's grandmother has high systolic blood pressure but normal diastolic blood pressure. What type of hypertension does she have?

answer

Isolated systolic

question

For the average person, a healthy blood pressure is

answer

110/80

question

Tim's grandfather takes nitroglycerin when he feels a crushing pain in his heart caused by ischemia. This pain is known as

answer

Angina pectoris.

question

Sandra takes nitroglycerin tablets prescribed to treat her angina. What does this drug do to relieve the pain?

answer

It dilates the veins.

question

Eric often complains of a racing heart, even though he is not exercising or anxious. What is the medical term for his condition?

answer

Tachycardia

question

An arrhythmia is

answer

an irregular, inefficient heart rhythm.

question

Congestive heart failure is a condition in which the heart

answer

is unable to maintain its pumping strength and adequate blood flow.

question

If you have had heart pooling which enlarges the heart, fluid accumulation in the lungs, and reduction of blood circulation, you have most likely been diagnosed with

answer

Congestive heart failure.

question

When a baby is born with a cardiovascular defect it is referred to as

answer

a congenital heart defect.

question

What maternal diseases during pregnancy can cause a congenital heart defect?

answer

Rubella

question

When Larry went for a physical exam, he had gained a great deal of weight; his waist measurement was 50 inches and his blood pressure was greatly elevated. The results of his blood work revealed elevated blood glucose and elevated cholesterol with an HDL of 20. Larry has an increased risk of CVD due to

answer

Metabolic syndrome (MetS).

question

Which of the following is associated with metabolic syndrome (MetS)?

answer

Insulin resistance

question

Zach eats a high-fat diet. His diet will not only raise his cholesterol levels, but research shows that a diet high in saturated fat and trans fats can also

answer

make the blood more viscous.

question

Which of the following total cholesterol readings is within the desirable range?

answer

185 mg/dL

question

The goal of managing cholesterol levels to reduce cardiovascular risks is

answer

raising HDL, but lowering LDL.

question

How fat is distributed on the body contributes to the risk of heart disease. What body shape is considered a higher risk?

answer

Apple

question

The ethnic group in the United States with the highest overall rate of heart disease is

answer

White

question

Which of the following amino acids, when present in blood at high levels, is associated with CVD?

answer

Homocysteine

question

What is the test that measures the electrical activity of the heart called?

answer

Electrocardiogram

question

Diagnosis and treatment with thrombolysis for a blocked coronary artery may prevent or minimize damage if it is delivered

answer

within 1 to 3 hours after a heart attack.

question

George is undergoing a medical procedure that produces three-dimensional images of the heart as blood flows through. This procedure is called

answer

positron emission tomography (PET) scan.

question

Coronary bypass surgery is performed to bypass a clogged coronary artery to

answer

transport blood to the heart tissue.

question

Which of the following procedures to correct a blockage carries fewer risks than bypass surgery but has a higher rate of reoccurrence?

answer

Angioplasty

question

Donna was diagnosed with cancer. Cancer is a group of diseases characterized by

answer

uncontrolled growth and spread of abnormal cells.

question

John was told that the tumor in his brain is malignant. This means that the tumor is

answer

cancerous.

question

Diabetes can result in weight loss because

answer

body cells can't use glucose so it is excreted.

question

Different forms of the same gene are known as

answer

alleles.

question

A complex acid molecule in the nucleus of a cell that stores all of the programming codes that the body uses is

answer

DNA

question

When a cell prepares to divide, its DNA organizes into 46 distinct bundles called

answer

chromosomes.

question

Which of the following is a risk factor for infection that you can control?

answer

Personal hygiene

question

Barry, who has a really bad cold, coughs into his bare hand. He uses the same hand to grab the pole in the subway car to steady himself as the car goes around a tight corner. Several minutes later, Donny, who is perfectly healthy, grabs the same pole as Barry. Later that morning, Donny itches his eye with the hand that grabbed the pole. A day or two later, Donny has a really bad cold. If Donny got his cold from Barry, then you would say that the pathogen was transmitted by

answer

indirect contact.

question

Which of the following is a common bacterial condition?

answer

Staphylococcal infections

question

Gregor has been diagnosed with West Nile virus. Which of the following is most likely the way he contracted the disease?

answer

He was bitten by an infected mosquito.

question

What percentage of antibiotic production today is used to treat sick animals living in crowded feedlots and to encourage growth in livestock and poultry?

answer

70%

question

Rhonda developed a post-operative infection and was prescribed a course of antibiotics that was supposed to last 10 days. She felt so good after 6 days that she stopped taking the rest of her medicine. Is Rhonda contributing to the growing antibiotic resistance of many bacteria?

answer

Yes. By not finishing the complete course of antibiotics, she's made it possible for the surviving bacteria to build immunity to the drugs used to treat them.

question

Why are some bacteria and microorganisms referred to as "superbugs"?

answer

They have become resistant to the drugs used at one time to treat them.

question

When Terry and Kim have vaginal and/or oral sex, they use latex condoms and dental dams. On the continuum of risk for STIs, where do they fall?

answer

Moderate-risk behavior

question

Bill, Kelly, and Lynn are sexually active (though not with each other). Bill has had 15 sexual partners, Kelly has had 11, and Lynn has had 6. Based solely on the number of sexual partners each has had, who is at a greater risk for contracting an STI?

answer

Bill

question

If you contract an STI but do not seek treatment, which of the following are possible consequences?

answer

Sterility and blindness

question

Mark uses a latex condom and a water-based lubricant when he has vaginal, anal, or oral sex. Kristy, on the other hand, engages in unprotected anal sex. Lisa prefers rubbing, kissing, and mutual masturbation. Based solely on their sexual behaviors, who is at a greater risk for contracting an STI?

answer

Kristy

question

Sarah, who lives in the United States, has been infected with HIV. According to statistics from the Centers for Disease Control (CDC), which of the following is the most likely source of her infection?

answer

High-risk heterosexual contact

question

Todd, who lives in the United States, has been infected with HIV. According to statistics from the Centers for Disease Control (CDC), which of the following is the most likely source of his infection?

answer

Male-to-male sexual contact

question

Brian is concerned that he may have been exposed to HIV, so he has decided to go to the student health center for a blood test known as the ELISA. What does the ELISA measure?

answer

Whether or not antibodies have formed in reaction to HIV

question

Peter is concerned that he may have contracted an STI because urination has become really painful. Which of the following statements is most likely true?

answer

Peter could have either chlamydia or gonorrhea.

question

Anita is sexually active. She's not concerned about having contracted an STI because she has none of the symptoms (e.g., vaginal discharge or painful urination). Which of the following statements is most likely true?

answer

Anita could have either chlamydia or gonorrhea.

question

Chris is pregnant and has chlamydia. She has not been treated for the chlamydia because she doesn't know she has it and is asymptomatic. Chris could pass the disease to her child during delivery, leading to which of the following conditions?

answer

Conjunctivitis

question

Rob has a prominent chancre on his penis. Which stage of syphilis is this?

answer

Primary syphilis

question

Sarah contracted syphilis in her early 20s, but it went untreated until she developed lesions called gummas. What stage of syphilis is this?

answer

Latent syphilis

question

If Adrienne has genital herpes and is pregnant, which of the following is probably her best course of action for preventing her child from getting infected from her?

answer

Delivery by cesarean section

question

Genital warts are caused by a group of viruses known as HPV. What does HPV stand for?

answer

Human papillomavirus

question

The typical incubation period for genital HPV is 6 to 8 ________ after contact.

answer

weeks

question

Donna has been diagnosed with a yeast infection. Which of the following is another name for the same disease?

answer

Candidiasis

STUDY

Average Life Expectancy Blood Supply To The Brain Evidence Based Medicine Health Psychology Healthy People 2020 Randomized Clinical Trials Transient Ischemic Attacks Wellness World Health Organization

Health 1000 Unit 2 Test – Flashcards 96 terms

Larry Charles

96 terms

Preview

Health 1000 Unit 2 Test – Flashcards

question

According to the World Health Organization (WHO) ________ is not merely an absence of disease or infirmity, but a state of complete physical, mental, and social well-being

answer

health

question

T or F: In 1900, the average life expectancy in America was half of what it is today.

answer

True

question

Infectious communicable diseases are transmitted from one person to another through a series of steps or links, called the __________________________ .

answer

chain of infection

question

T or F: Infectious communicable diseases have been replaced by chronic degenerative diseases (heart disease, cancer, and stroke) as the leading causes of death in the U.S.

answer

True

question

Keep in mind that we don't just want to live longer, we want to live ___________ longer.

answer

healthier

question

Improving wellness will probably involve _________________

answer

changing behavior

question

Health is a ______________, not something you just "get"

answer

process

question

In most cases, those who are healthy and thriving in later years set the stage for good health by making it a priority in their _______________ years.

answer

early

question

Inadequate ____________________ is one of the most commonly reported impediments to academic success.

answer

sleep

question

successful aging starts ______________

answer

now

question

With the development of _____________ and ____________ , life expectancy increased dramatically as premature deaths from infectious diseases decreased. As a result, ____________ diseases such as heart disease and cancer became leading causes of death.

answer

vaccines, antibiotics chronic

question

Healthful choices increase your ___________ life expectancy—the number of years of full health you enjoy without disability, chronic pain, or significant illness. One aspect of healthy life expectancy is _________________________________ (HRQoL), a concept that focuses on the impact of health on physical, mental, emotional, and social function. Closely related to this is ,_______________, which assesses the positive aspects of a person's life, such as positive emotions and life situations.

answer

healthy, health related quality of life, well-being

question

Achieving wellness means attaining the _______________ level of well-being for your unique limitations and strengths, emphasizing the balanced integration of mind, body, and spirit.

answer

optimal

question

Today, the words ___________ and __________ are often used interchangeably to describe the dynamic, ever-changing process of trying to achieve one's potential in each of the six interrelated dimensions of health: physical, social, intellectual, emotional, spiritual, and environmental.

answer

health and wellness

question

Today, health and wellness mean taking a positive, _______ attitude toward life and living it to the fullest

answer

proactive

question

Public health experts refer to the factors that influence health as _____________________ , a term the U.S. Surgeon General defines as "the range of personal, social, economic, and environmental factors that influence health status.

answer

determinants of health

question

List the Healthy People 2020 Determinants of Health that impact the health of individuals and communities

answer

individual behavior, biology and genetics, social factors, health services, and policymaking

question

__________ disease causing agents, are everywhere. we inhale them, we swallow them, rub them in our eyes, and are constantly in a hidden highstakes battle with them

answer

pathogens

question

Despite the constant bombardment by pathogens, our ____________ are usually adept at protecting us.

answer

immune system

question

Most infectious diseases are ________ , or caused by the interaction of several factors inside and outside the person. For an infection to occur, three key conditions known as the epidemiological triad of disease must be met. The _______ , ________, and ___________ must be conducive to overcoming the body's elaborate defense systems.

answer

multifactorial; agent, host, environment

question

To reduce your risk of infectious disease, limit exposure to pathogens, ________ regularly, get enough ________, _____ less, and optimize _______

answer

exercise, sleep, stress, eating

question

Bacteria evolve and develop ways to survive drugs that previously killed them. Some microorganisms that were easily dealt with a few decades ago are becoming " ________________" that cannot be stopped with existing medications.

answer

superbugs

question

To reduce your risk of antibiotic resistance, be responsible with ________ , use ________ soap when washing your hands, and avoid _______ treated with antibiotics.

answer

medications, regular, food

question

To gain entry into your body, pathogens much overcome _________ that prevent them from entering, mechanisms that ________ organisms, and substances that counteract the _______ that these organisms pose.

answer

barriers, weaken, threat

question

our most critical early defense system is our _______

answer

skin

question

______ is a condition of being able to resist a particular disease by counteracting the substance that produces the disease

answer

immunity

question

Any substance capable of triggering an immune response—a virus, bacterium, fungus, parasite, toxin, tissue or cell from another organism, or even chemicals from the environment—is called an .

answer

antigen

question

when a pathogen breaches initial, outer defenses, the body responds by forming _____ specific to that antigen, which are designed to destroy or weaken it

answer

antibodies

question

in cell-mediated immunity, after a successful attack on a pathogen, some attacker T and B cells are preserved as __________ enabling the body to recognize and respond quickly to subsequent attacks by the same kind of organism. Once people have survived certain infectious diseases, they will likely not develop them again

answer

memory t and b cells

question

the 4 cardinal signs of _________ are redness, swelling, pain, and heat

answer

inflammation

question

in addition to inflammation, another frequent indicator of infection is ________, which stimulates the body to produce more white blood cells and provides an environment that destroys some disease causing organisms

answer

fever

question

a _______ consists of killed or weakened versions of a disease-causing microorganism or an antigen that is similar to but less dangerous then the disease antigen. The dose given produces antibodies against future attacks without actually causing the __________ (or by causing a very minor case of it)

answer

vaccine, disease

question

T or F: vaccines are a form of natural acquired immunity

answer

false

question

an increasing number of chronic diseases are being linked to the _______ that occurs certain pathogens invade. avoiding infections and their inflammatory side effects now has the added benefit that is may help you avoid chronic diseases later

answer

inflammation

question

T or F: Although there are several known species of bacteria (and many more unknown) only just over 100 are known to cause disease in humans

answer

True

question

Patient ________ and _______ prescription practices have contributed to a generation of "super bugs" as weaker bacteria have been killed and successive generations of bacteria mutate to become resistant.

answer

misuse, improper

question

_____ quarters, such as college dorms, are prime breeding grounds for some contagious diseases

answer

question

______ are incapable of carrying out any life processes on their own

answer

viruses

question

some viruses have _________ (the length of time required to develop fully and cause symptoms in their hosts) that last for years, which delays diagnosis

answer

incubation periods

question

Drug treatment for viral infections is _________ because drugs powerful enough to kill viruses generally kill the hosts cells too

answer

limited

question

Colds are __________ (always present to some degree) throughout the world, with increasing prevalence in colder weather as people spend more time indoors. Otherwise healthy people carry cold viruses in their noses and throats most of the time, held in check until immune defenses are _________

answer

endemic, weakened

question

It is possible to "catch" a __________—through airborne transmission, touching skin-to-skin, or mucous membrane contact—and the hands are the greatest avenue for transmitting colds and other viruses.

answer

cold

question

once a person gets the flu, treatment is __________ -focused on relief of symptoms, rather than cure.

answer

palliative

question

T or F: The best way to avoid the flu is to get an annual vaccination (flu shot) against it.

answer

True

question

Flu shots take 2 to 3 weeks to become effective, so it's best to get shots in the ______, before the flu season begins.

answer

fall

question

Fungal diseases typically transmit via physical contact, so avoid going _____________ in public showers, hotel rooms, and other areas where fungus may be present, and use care in choosing where you go for pedicures

answer

barefoot

question

as stated in class, _______ is key when it comes to risk factors that can affect our health bc it is easier to make minor changes now than have to make major changes later

answer

Moderation?

question

Both cardiovascular disease (CVD) and cancer are _______ diseases, meaning they are prolonged, do not resolve spontaneously, and are rarely cured completely.

answer

chronic

question

The good news is that in many cases, _________ factors can be changed or modified to decrease disease risks for both CVD and cancer.

answer

lifestyle

question

CVD are diseases associated with the _________________ and _____________

answer

heart, blood vessels

question

The best defense against CVD is to reduce your risks and _________ it from developing in the first place

answer

prevent

question

At rest, the average adult heart beats ___ to ____ times per minute; a well-conditioned heart may beat only ___ to ____ ties per minute to achieve the same results

answer

70 to 80; 50 to 60

question

If your resting heart rate is routinely in the high _____ or _____, it may indicate that you are out of shape or suffering from some underlying illness

answer

80s or 90s

question

__________ measures how hard blood pushes against the walls of vessels as your heart pumps

answer

blood pressure

question

hypertension (high blood pressure) is known as the "_________________" because it has few clear symptoms

answer

silent killer

question

T or F: Normal blood pressure varies depending on age, weight, and physical condition.

answer

True

question

More and more people (over 30% of the population) are considered to be _____________ meaning that their blood pressure is above normal, but not yet in the hypertentive range.

answer

prehypertensive

question

Heart disease ranks _________ among causes of death in the United States.

answer

question

______________ thickening and hardening of arteries, is a condition that underlies many cardiovascular health problems.

answer

arteriosclerosis

question

as ______________ accumulates, it adheres to the inner lining of the blood vessels. Vessel walls become narrow and may eventually _________ flow or rupture

answer

plaque, block blood

question

________________ is the leading cause of disability in people over the age of 50.

answer

peripheral artery disease (PAD)

question

Of all the major cardiovascular diseases, coronary heart disease (CHD) is the greatest _____________

answer

killer

question

T or F: Because of treatment delays, women are more likely to have heart damage and to die from a heart attack than are men of the same age.

answer

true

question

Although angina pectoris is not a heart attack, it is an ___________ of underlying heart disease.

answer

indicator

question

Like heart muscle, brain cells require a continuous supply of ________________ and when it is interrupted, a stroke can occur.

answer

oxygen

question

more _____________ people are having strokes than ever before, possibly due to increased obesity and hypertension.

answer

young

question

Many strokes are preceded days, weeks, or months earlier by ____________________ , brief interruptions of the blood supply to the brain that cause only temporary impairment. These often indicate an impending major stroke.

answer

transient ischemic attacks (TIAs)

question

The earlier a stroke if recognized and treatment started (best results within the first ________ hours), the more effective that treatment will be.

answer

1-2

question

The acronym FAST stands for facial __________, arm ________ , _________ difficulty, and time to act and ______________ .

answer

droop, weakness, speech, call 911

question

A cluster of combined cardiometabolic risks labeled as _______________________ is believed to increase the risk for atherosclerotic heart disease by as much as three times the normal rates.

answer

syndrome x, insulin resistance syndrome, or metabolic syndrome

question

_________ you choose today and over the coming decades can actively reduce or promote your risk for CVD

answer

behaviors

question

to reduce your risk of CVD, it is recommended to avoid _________, cut back on fat and cholesterol, maintain a healthy __________, ________ regularly, manage ___________, and control diabetes and blood pressure.

answer

tobacco, weight, exercise, stress

question

T or F: The foods you eat play a major role in your CVD risk.

answer

true

question

cancer is the abnormal, _____ growth of cells, which, if left untreated can ultimately cause death

answer

uncontrolled

question

by definition, the term cancer applies only to _________ tumors

answer

malignant

question

______ cancer is the leading cause of cancer death

answer

lung

question

T or F: Smoking is the number one risk factor for lung cancer and cardiovascular disease.

answer

True

question

_____________ detection is the key to the successful treatment of breast and testicular cancer.

answer

early

question

______ cancer is the most common form of cancer in men ages 15-55

answer

testicular

question

_______ cancer is the most common cancer of all when cases of the highly curable forms are included in the count

answer

skin

question

UV radiation from the ______ is the main cause of skin cancer

answer

sun

question

anytime a mole undergoes sudden or progressive ______/_______, you should immeadiately bring it to the attnetion of ur health care provider

answer

changes/ growth

question

the ABCD's of melanoma are __________, __________, _________ and ________

answer

Asymmetry, border, color, and diameter

question

T or F: most tumors are malignant

answer

false

question

Malignant tumors are usually not enclosed in a protective capsule like benign tumors and can therefore spread to other organs. This process, known as _________________makes some forms of cancer particularly aggressive and difficult to treat.

answer

metastasis

question

_______________ of the cancer cases that occur in developed countries are related to overweight or obesity, physical inactivity, and/or poor nutrition.

answer

1/3

question

Nearly 100 percent of women with cervical cancer have evidence of ____________ —a virus believed to be a major cause of cervical cancer.

answer

HPV human papilloma virus

question

Cancers are grouped into four broad categories based on the type of tissue from which each arise. ________ occur in epithelial tissues (tissues covering body surfaces and lining most body cavities.

answer

carcinomas

question

_____________ occur in the mesodermal, or middle, layers of tissue—for example, in bones, muscles, and general connective tissue.

answer

sarcomas

question

________________ develop in the lymphatic system—the infection-fighting regions of the body

answer

lymphomas

question

____________ is cancer of the blood-forming parts of the body, particularly the bone marrow and spleen.

answer

leukemia

question

In the US, __________ cancer accounts for 1 in every 3 cancer diagnoses in women. You can reduce your risk by maintaining a healthy weight, drinking less than one alcoholic beverage daily, and exercising regularly.

answer

breast

question

There is no such thing as a "_____________" tan because a tan is visible evidence of UV-induced skin damage.

answer

safe

question

According to the American Cancer Society, tanned skin provides only about the equivalent of sun protection factor (SPF) ______sunscreen—much too weak to be considered protective.

answer

question

Cancer of the __________ is the most frequently diagnosed cancer in American males today, excluding skin cancer, and is the second leading cause of cancer deaths in men after lung cancer.

answer

prostate

question

The _________ cancer is diagnosed, the better the prospect for survival. Make a realistic assessment of your own risk factors; avoid behaviors that put you at risk; and increase healthy behaviors, such as improving your diet and exercise levels, reducing stress, and getting regular ___________

answer

earlier, checkups

STUDY

Blood Supply To The Brain Inflammation Of The Brain Inflammation Of The Liver Oncology Pathophysiology

Ch 12 Reducing Your Risk of Cancer – Flashcards 77 terms

Jose Escobar

77 terms

Preview

Ch 12 Reducing Your Risk of Cancer – Flashcards

question

Cancer is the #what leading cause of death in the US?

answer

question

Five year survival rate

answer

% of people in study or treatment group who are alive 5 years after they were diagnosed w or treated for cancer In general, has gone up bc better at treating and curing

question

Each year, how many new cases diagnosed?

answer

1.7 million

question

What % of new cases will be alive 5 years from now?

answer

68% All cancers combined

question

What % mortality worldwide

answer

13%

question

is it a chronic disease?

answer

Yes but you can be cured Still long lasting, expensive, low survival rates

question

Where can cancer develop?

answer

Any part of the body

question

Remission

answer

Temporary or permanent period when cancer is responding to treatment and under control Leads to the disappearance of the signs and symptoms of cancer No longer spreading Patients who are cured show no subsequent cancer in their bodies and can expect to live a long and productive life

question

Cancer

answer

Large group of diseases characterized by uncontrolled growth and spread of abnormal cells Cells are programmed to divide and die--something goes wrong-- damage surrounding cells or travel around body

question

Neoplasm

answer

A new growth of tissue that serves no physiological function and results from uncontrolled, abnormal cellular development Mass of cells

question

Tumor

answer

Neoplasmic mass that grows more rapidly than surrounding tissue

question

Biopsy

answer

Microscopic examination of tissue to determine whether cancer is present Diagnoses cancer

question

Benign

answer

Harmless Refers to noncancerous tumor Enclosed in capsule Growth can potentially pose problems--block intestines, seizure in brain Consist of ordinary looking cells enclosed in fibrous shell or capsule that prevents them from spreading

question

Malignant

answer

Very dangerous or harmful Refers to a cancerous tumor Not enclosed in a shell and can spread to other organs in process called metastasis Malignant cells disrupt RNA and DNA, producing mutant cells

question

Metastasis

answer

Process by which cancer spreads from 1 area to dif areas If catch tumor before it spreads--better survival rate

question

Mutant Cells

answer

Differ in form, quality, or function from normal cells Abnormal DNA

question

Lifetime risk

answer

Probability that an individual, over course of lifetime, will develop cancer

question

Relative risk

answer

Strength of relationship between risk factors and a particular cancer

question

Genetic and physiological risks

answer

Genetic predisposition Oncogenes Hereditary predisposition

question

Genetic predisposition

answer

Influenced by environment--can determine if predisposed genes will develop

question

Oncogenes

answer

Suspected cancer-causing genes Typically stay dormant but can be activated based on environment Factors that can turn them on: carcinogens, inc age

question

Reproductive and Hormonal Risks

answer

Reproductive factors on breast cancer and cervical cancers are well documented Some risk factors more likely to cancer: more fertile/more yrs before menopause not having kids having kids late in life

question

Acquired (environmental) risks

answer

Tobacco use Poor nutrition, physical inactivity, obesity Stress and psychosocial risks (stress impacts immune system, body tries to destroy cancerous cells Inflammation, certain infectious agents, certain medical treatments Drug and alcohol consumption Excessive sun exposure and exposure to carcinogens (need exposure for vitamin D but not too much)

question

Carcinogens

answer

Cancer causing agents

question

1.23 relative risk .75

answer

Would be 23% more chance of developing .75 less risk so it'd be a protective factor

question

Inflammation and Cancer Risks

answer

Emerging theory that inflammatory responses play role in cancer development

question

What % of cancers caused by cellular mutations and environmental factors?

answer

90% Occur as a result of inflammation, body not able to kill it

question

Occupational and Environmental Risks

answer

Exposure to asbestos, nickel, chromate, benzene, arsenic, vinyl chloride Exposure to radioactive substances Maybe installing insulation, giving xrays Radiation Chemicals in food (most banned in US, probs not other countries)

question

Big or small % of cancers from occupational and environmental risks?

answer

Small Has dec a lot bc can get sued

question

Ionizing radiation

answer

Only form proven to cause cancer ex: xrays, UV rays, radon

question

Nonionizing radiation

answer

No consistent link w cancer Off cell phones, TV, computer, microwaves

question

Infectious Diseases and Cancer

answer

Hepatitis B and Hepatitis C can cause liver cancer Human Papillomarivus (HPV) can cause cervical cancer high % bc infection

question

What % of all cancers caused by viruses, bacteria and parasites?

answer

10%

question

Categories of cancer

answer

Carcinomas Sarcomas Lymphomas Leukemias

question

Carcinomas

answer

Epithelial tissues are most common cancer sites Epithelial: cover body surfaces, line body cavities-skin, throat, lungs Solid tumors- precise radiation to treat it

question

Sarcomas

answer

Occur in mesodermal/middle layers of tissues (bones, muscles, general connective tissues) Less common than carcinomas but when develop are more dangerous, spread faster Solid tumors

question

Lymphomas

answer

Develop in lymphatic system Solid tumors

question

Leukemias

answer

Cancers of the blood-forming parts of the body (bone marrow, spleen) Non solid tumors so treat differently

question

Lung Cancer primary risk factor

answer

Smoking, including secondhang smoke

question

What % of lung cancer victims have never smoked?

answer

15%

question

Is this the most dangerous for male or female?

answer

Yes both

question

Symptoms of lung cancer

answer

Persistent cough Blood streaked sputum Chest pain Recurrent attacks of infections like pneumonia or bronchitis

question

Reduce risk of lung cancer by

answer

Avoiding carcinogens--really reduce risk Early prevention Stop smoking

question

Treatment of lung cancer

answer

Depends on stage and includes surgery, chemotherapy, radiation if cancer is localized, surgery is treatment of choice

question

1 year survival rate of lung cancer

answer

41%

question

5 year survival rate of lung cancer

answer

16%

question

Breast cancer probability for women

answer

1 in 8

question

Symptoms of breast cancer

answer

Persistent breast changes patient can recognize

question

Most breast cancer cases fatal?

answer

No bc most are quickly diagnosed

question

Treatments for breast cancer

answer

Range from masectomy (surgery) to various combos of radiation and chemo SERM

question

SERM

answer

Selective estrogen-receptor modulators Control hormonal risks

question

Risk factors for breast cancer

answer

Inc w age Family history of breast cancer Periods that began early and ended late in life Never having had children Sudden weight gain

question

5 year survival rate for breast cancer

answer

98% lower if diagnosed in more advanced stages lot of money goes to research

question

Colon and Rectal cancer # what most common cancer in men and women?

answer

question

Risk factors for colon and rectal cancer

answer

Older age over 50 Obesity Family history Colitis (colon disease)

question

Symptoms of colon and rectal cancer

answer

Bleeding Cramping Pain in lower abdomen Unusual fatigue

question

Warning signs of colon and rectal cancer

answer

Blood in the stool Rectal bleeding

question

Colon and rectal cancer dangerous bc?

answer

Not many symptoms early on

question

Treatment of colon and rectal cancer

answer

Radiation Surgery

question

Protective factors for colon and rectal cancer

answer

regular exercise high fruit and plant based diet healthy weight moderate alcohol

question

Amount of ppl diagnosed w skin cancer in 2013

answer

3. 5 million

question

Highly curable forms of skin cancer

answer

basal or squamous (epithelial tissue--skin)

question

Most common form of cancer in US today?

answer

skin

question

More lethal form of skin cancer

answer

Malignant melanoma

question

Malignant melanoma

answer

A virulent cancer of the melanocytes (pigment producing) of the skin

question

ABCD rule about melanoma

answer

Asymmetry: odd shape Border irregularity: doesn't match Color: not uniform Diameter: size, growing?

question

Can you often spot skin cancer?

answer

yes

question

What % of skin cancers are treated with surgery?

answer

90% Depends on stage--may need dif treatment

question

Treatments for skin cancer

answer

Surgery Radiation Electrodesiccation (destroy by heat) Cyrosurgery (destroy by cold)

question

Skin cancer has hereditary component?

answer

yes

question

Most frequently diagnosed cancer in american males today, excluding skin cancer

answer

prostate cancer

question

Second leading cause of deaths in men

answer

Prostate cancer

question

Symptoms of prostate cancer

answer

Weak or interrupted urine flow Difficulty starting or stopping urination Urge to urinate frequently Blood in urine or pain in low back, pelvis, thighs

question

Prostate

answer

Small gland surrounds urethra

question

Location of prostate

answer

growth can influence urine flow

question

Risk factors for prostate cancer

answer

Age, race, family history Earing more fruits and veggies may help lower risk Over 50--get regular checkups African males higher rates

question

Prostate-Specific Antigen

answer

PSA Antigen found in prostate cancer patients Blood marker of cancer Inc rate diagnosed early bc easy blood test

STUDY

Blood Supply To The Brain Physical Therapist Assistant Physical Therapy

Unit 1: Define P.T. practice, Objectives, APTA structure – Flashcards 17 terms

Roy Johnson

17 terms

Preview

Unit 1: Define P.T. practice, Objectives, APTA structure – Flashcards

question

(1) *Define practice of physical therapy * (as stated by *TX PT Practice Act* & Guide to Physical Therapy Practice)

answer

• "... the examination, treatment, or instruction of human beings to detect, assess, prevent, correct and alleviate physical disability and pain from injury, disease, disorders..."

question

(2) Identify the objectives of physical therapy utilizing the APTA's Model Definition of Physical Therapy for State Practice Acts (5)

answer

1. Examine indiv w/ impairments or other health-related conditions or limitations to determine diagnosis, prognosis and intervention. 2. Alleviate impairment and functional limitations by designing & modifying interventions. 3. Prevent injury, impairments, and limitations 4. Engage in education, research & consultation

question

(10) Describe the history of the APTA

answer

•1921 American Women's physical Therapeutic Association •1922 American Physiotherapy Association •1947 American Physical Therapy Association

question

(11a) Describe the organization of the structure and membership of the APTA *Permanent membership categories*

answer

•Physical therapist, PTA, student categories

question

(11b) Describe the organization of the structure and membership of the Texas Physical Therapy Association (TPTA) *Districts*

answer

•TPTA has 12 Districts so PTs, PTAs and students can attend meetings and have local presentation throughout the state. •

question

(11c) Describe the organization of the structure and membership of the Capitol Area District (CAD)

answer

•The Capital Area District (CAD) was organized in 1981 as a new district for Austin area Physical Therapists and Physical Therapists Assistants who were members of the Texas Physical Therapy Association. The CAD is one of 12 districts in the state of Texas and includes twelve counties: •

question

(12) Validate the benefits of membership in the professional association through the use of examples that would affect a practicing clinician

answer

• • • •

question

(11a) Describe the organization of the structure and membership of the APTA *Districts*

answer

•Most local unit in structure of APTA •(Think counties)

question

(11a) Describe the organization of the structure and membership of the APTA *Chapters*

answer

•State level participation •Proportionate representation @ national level

question

(11a) Describe the organization of the structure and membership of the APTA *Sections*

answer

•National level •Similar areas of interest promote interests of respective section

question

(11a) Describe the organization of the structure and membership of the APTA *Assembly*

answer

•Members of same class/category •May exist @ the state and national level

question

(11a) Describe the organization of the structure and membership of the APTA *House of Delegates/HOD*

answer

•Highest policy-making body of the APTA •Comprised of voting delegates from all chapters and nonvoting delegates

question

(11a) Describe the organization of the structure and membership of the APTA *Board of Directors/BOD*

answer

•Carry out mandates of HOD •Manage affairs of APTA

question

(11b) Describe the organization of the structure and membership of the Texas Physical Therapy Association (TPTA) *Committees*

answer

•10 committees that work together to meet specified needs of member or responsibilities EX: Ethics committee: investigates complaints against members

question

(11b) Describe the organization of the structure and membership of the Texas Physical Therapy Association (TPTA) *SIGS/Special Interest Groups*

answer

Special Interest Groups may be organized within the Chapter to provide a means by which members having a common interest in special areas of physical therapy may meet, confer, and promote the interest of the respective groups.

question

(11b) Describe the organization of the structure and membership of the Texas Physical Therapy Association (TPTA) *Leadership*

answer

-Board of directors for TPTA: Executive Directors -District chairs: 12 total

question

(1) *Define practice of physical therapy * (as stated by TX PT Practice Act & *Guide to Physical Therapy Practice*)

answer

• "...the restoration, maintenance and promotion of optimal physical function and optimal quality of life as it relates to movement and health.."

STUDY

Blood Supply To The Brain Clinical Neuropsychology Motor Vehicle Accidents Prevalence And Incidence Traumatic Brain Injury

COMD 500 Ch. 8 – Flashcards 46 terms

Ken Ericksen

46 terms

Preview

COMD 500 Ch. 8 – Flashcards

question

Aphasia

answer

A language disorder that is acquired sometimes after an individual has developed language competence -"absence of language" -"without language"

question

Comprehensive Definition of Aphasia

answer

-A disturbance in the language system after language has been established or learned -Results from neurological injury to the language-dominant hemisphere of the brain -Included disturbances of receptive or expressive abilities for spoken and written language

question

Considerations of Aphasia

answer

-Not a developmental disorder -Not a psychiatric problem -Not a motor speech disorder

question

Ischemic Strokes

answer

Happen when the blood supply to the brain is blocked because of an occlusion somewhere in the artery -Thrombosis -Embolism

question

Hemorrhagic Strokes

answer

Result when a blood vessel or artery ruptures and excessive amounts of blood enter the brain

question

Risk Factors for Aphasia

answer

Uncontrollable: -Age -Gender -Racial or ethnic background -Family history Controllable: -Hypertension -Diabetes -Tobacco smoking -Alcohol use

question

How is aphasia classified?

answer

-The classification system for the aphasia subtypes is known for taxonomy -It draws upon those characteristics of aphasia that most differentiate disorders from one another

question

Behavioral symptoms of Aphasia

answer

-Some persons with aphasia are unable to initiate speech at all or struggle to get out more than one word at a time -Others can initiate speech well but produce meaningless utterances -Language deficits seen in aphasia are differentiated by their impact on: (1) fluency, (2) comprehension, (3) repetition, (4) naming, (5) reading and writing

question

Subtypes of Aphasia

answer

-Global aphasia -Broca's aphasia -Wernicke's aphasia -Conduction aphasia -Anomic aphasia -Transcortical motor aphasia -Transcortical sensory aphasia

question

Global Aphasia

answer

-Occurs as a result of a large region of brain damage or multiple sites of brain injury in the language-dominant hemispheres -This aphasia syndrome results in deficits across all language modalities, a person is likely to be non-fluent and have poor language comprehension

question

Broca's Aphasia

answer

-Results from damage to the frontal lobe of the brain -Typically produces slowed, halting, and labored speech, yielding what some describe as a telegraphic or robot-like quality -Person exhibits mild to moderate auditory comprehension problems, particularly when messages increase in length and complexity or when contextual cues are removed

question

Wernike's Aphasia

answer

-Results form brain injury to the superior and posterior regions of the temporal lobe, possibly reaching to the parietal lobe of the language-dominant hemisphere -Person produces spontaneous speech that flows well with normal prosody: (1) prosody, (2) logorrhea, (3) neologisms, and (4) jargon

question

Conduction Aphasia

answer

-Results from injury to the temporal-parietal region of the brain, typically a connecting pathway called the arcuate fasciculus -Hallmarks include difficulties with repetition and reading aloud

question

Anomic Aphasia

answer

-Not identified with a specific area of the brain or a site of lesion -Person is fluent and expressive with relatively few deficits in language expression and comprehension with the exception of naming -Most pervasive type of chronic condition, even after treatment, and is the MOST common of aphasia profiles

question

Transcortical Motor Aphasia

answer

-Results from damage to the frontal lobe, typically the superior and anterior portions -Symptoms are similar to Broca's aphasia EXCEPT that these individuals have repetition skills that are far better than their spontaneous speech -Most clients with this syndrome also demonstrate strong performance in oral reading

question

Transcortical Sensory Aphasia

answer

-Results from injuries to the language-dominant hemisphere at the border of the temporal and occipital lobes or the superior region of the parietal lobe -Demonstrate classic symptoms of Wernicke's profile EXCEPT they have stellar repeptition skills -Echolalia

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How is Aphasia Identified and Treated?

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Assessment Process: -Requires a multidisciplinary team -Spontaneous recovery SLP seeks to answer these questions: -Is aphasia present? -What type and where is the site of injury? -What treatment plan should be used? -What is the prognosis? -Any referrals?

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Prognostic Indicators

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Those variables that assist in predicting recovery -Site of the brain injury -Type and size of the injury -Type and severity of aphasia -Handedness -Age -Pre-morbid health -Motivation for treatment Often, prognostic indicators are used to specify treatment

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Treatment of Aphasia in Evidence-Based Practice

answer

The goal of aphasia treatment is to correct or compensate for speech language deficits so that individuals can communicate functionally in their daily routines -Evidence-based practice

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Determining the Treatment Setting

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-Aphasia therapy is not limited to the speech-language pathologist and client working in a clinic or office setting -Therapies should encompass other environments to facilitate carryover and generalization of progress to different settings -A group approach is another consideration for treating aphasia

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Measuring Outcome

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Effective language treatment for persons with aphasia should be measured based on their ability to communicate in real-world situations -Real world communication (i.e. discourse) -Functional outcomes

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Fluency

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A qualitative aspect of communication and speech that is used to describe its forward flow, including its phrasing, intonation, and rate -Fluent speech -Non-fluent speech *Short, choppy phrases *Slow, labored production of speech *Grammatical errors *Telegraphic quality

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Auditory Comprehension

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-The ability to understand spoken language -Can be referred to as language comprehension -Aphasia characterized by comprehension problems can be referred to as receptive aphasia

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Repetition

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The ability to accurately reproduce verbal stimuli on demand -Major factor that differentiates between some aphasia subtypes -Can be seriously compromised

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Naming

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-The ability to retrieve and produce a targeted word during conversation or more structured tasks (aka word retrieval/finding) -Anomia: term used to describe word-finding problems or the inability to retrieve a word -Paraphasia: errors in naming *Semantic (cat->dog) *Phonemic (cat->car) *Neologism (skrit->dog)

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Reading and Writing

answer

-Involves the comprehension and expression of written language -Reading and writing deficits often parallel verbal language deficits *occasionally, reading and/or writing are relatively spared, providing an important path for communication to occur

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Right-hemisphere Dysfuntion

answer

Definition: results from neurological damage to the right cerebral hemisphere -Aphasia can result with left-hemisphere damage -When damage affects the right hemisphere, language and cognition may be impacted, but the symptoms are quite different form those seen with aphasia (cognitive-linguistic disorder)

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Characteristics of RHD

answer

-Anosagnosia -Unilateral neglect -Prosopagnosia -Flat affect -Compromised pragmatics: difficulty understanding jokes/humor; impaired prosody and intonation -A tendency toward using wordy expressions, providing tangential or inaccurate info (may include confabulation) -Difficulty understanding or using higher-level cognitive-linguistic skills -Dysarthria or dysphagia (when neuromuscular systems are compromised)

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Anosagnosia

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Lack of awareness of cognitive-linguistic deficits and possible denial of problem areas

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Unilateral Neglect

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Lack of awareness of the left side of the body and external stimuli to the left side

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Prosopagnosia

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Difficulty recognizing faces

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Identification of RHD

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-Like left-hemisphere injury, right-hemisphere damage requires a comprehensive speech-language assessment as part of an interdisciplinary team assessment -Specialized batteries are available specifically for the RHD population, such as the Mini Inventory or Right Brain Injury (MIRBI) -Can be more difficult to identify, because deficits are less obvious

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Treatment of RHD in Evidence-Based Practive

answer

-Knowledge of treatments for RHD is more limited than that for left-hemisphere damage and aphasia -Initial therapy for RHD targets the management of attention and visual disruptions, since these impact productive treatment activities -Therapy also targets higher-level cognitive-linguistic tasks, such as thinking through functional problems

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Traumatic Brain Injury

answer

Definition: refers to neurological damage to the brain resulting form the impact of external forces -Epidemiology studies show that TBI is a leading cause of death and disability in the US -Given the frequent long-term medical, vocational, and social needs of affected individuals, TBI represents a substantial health care issue in the US

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Characteristics of Traumatic Brain Injury

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-Open head: occurs when the skull and the meninges have been penetrated -Closed head injuries: the brain is jostled within the skull, yielding diffuse brain injury -Polytrauma: mixture of open and closed head injury, multiple medical concerns, and post traumatic stress disorder

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Identification of TBI

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-The SLP works as a member of an interdisciplinary rehabilitation team to plan for treatment following a TBI -The Glasgow Coma Scale (GCS) rates the best-observed response for eye opening, verbal response, and motor response to characterize an individual's functioning form severe to mild TBI 1. eye opening response 2. best verbal response 3. best motor response *Totals score

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Sports Related TBI

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CDC estimates 300,000 sports related TBIs each year -Only included TBIs with loss of consiousness -LoC only account for 8-19.2% of sports related TBIs -Therefore, ~1.6-3.8 million sports related TBIs each year -Athletes tend to under-report: even this estimate may be low!

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Chronic Traumatic Encephalopathy

answer

"Punch drunk syndrome" "Dementia Pugilistica" CTE (Modern) -Professional US football conservatively 3.7% incidence (some evidence for wrestling & hockey) -Main symptoms typically years after career -Histological signs can be seen early in life (i.e. University player Owen Thomas who committed suicide at 21) -Seen in animals and humans with single blast exposure

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TBI Communication: Discourse Impairment

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Macro-linguistic Deficits -Reduced cohesion and coherences -Impaired organization -Problems with story components and grammar Difficulty with Inference -Impaired social cognition Reduced Info and Efficiency -Tangential language -Difficulty identifying communication breakdowns and repairing -Shorter and less complex utterances Reduced initiation and maintenance -Dependent on others to maintain the flow of conversation Micro-linguistic deficits -Meaning within words, phrases, or sentences

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TBI and Communication: EBP

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EBP: cognitive-linguistic therapy (acute, post-acute); intervention to improve social communication skills *Practice guidelines: -Intervention for specific areas of deficit (i.e. reading, word-finding, narrative production) -Treatment intensity is a key factor *Practice options: -Group based intervention for language and social communication deficits -Computer based interventions as an adjunct to clinician guided treatment *Treatment interventions will vary according to an individual's level of impairment as reflected by the Rancho scales -Levels I to III: severe -Levels IV to VI: middle -Levels VII to X: mild

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TBI and Communication: Treatment

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Types of tasks *Social skills training -Pragmatic communication behaviors (listening/starting a convo) -Social perception of emotions and social inferences -Psychotherapy for emotional adjustment -Self instructional training strategies for emotion perception deficits *Narrative/conversation

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Dementia

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Definition: a chronic and progressive decline in memory, cognition, language, and personality resulting from CNS dysfunction -The diagnostic criteria of the American Psychiatric Association identify 3 defining traits: (1) Memory impairment (2) Impairment in cognition skills (3) Presence of aphasia, apraxia, or agnosia

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Causes of Dementia

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-Loss of neurons -Loss of function/communication between neurons -Build up of protein deposits

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Types of Dementia

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-Alzheimer's disease -Vascular dementia -Lewy body dementia -Fronto-temporal dementia -Parkinson's disease -Primary progressive aphasia

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Identification of Dementia

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-A team of professionals evaluates suspected dementia to verify its presence, cause, and course of intervention -Medical testing will rule out other treatable illness that may appear like dementia -More comprehensive testing by the SLP typically involves the complete Arizona Battery for Communication Disorders of Dementia

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Treatment of Dementia

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-Research continue to develop more effective pharmacological treatments to combat degenerative changes associated with dementia -The majority of medications currently approved by the FDA for dementia target those individuals in mild to moderate stages -SLPs often focus on compensatory strategies

STUDY

Blood Supply To The Brain Dementia With Lewy Bodies Fundamentals Of Epidemiology Public Health

Epidemiology 101 Exam 1 – Flashcards 102 terms

Ann Ricker

102 terms

Preview

Epidemiology 101 Exam 1 – Flashcards

question

Questions for Epidemiology

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1. Is it safe to eat the tomatoes? 2. Will I get lung cancer if I smoke? 3. How can youth violence be prevented? 4. What's causing the obesity epidemic? 5. Who's at risk for substance abuse?

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Formal Definition: Epidemic

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"The occurence in a community or region of cases of an illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy"

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Pandemic

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-"An epidemic occurring worldwide, or over a very wide area, crossing international boundaries, and usually affecting a large number of people" -Example: the 1918 influenza (Spanish Flu) -Current: HIV/AIDS -Post: H1N1 (2010) -cases discovered in more than 214 countries worldwide

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Definition of Epidemiology

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-"is concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability, and mortality in populations. Epidemiologic studies are applied to the control of health problems in populations" -causality is important -other societal concerns (bullying, low education rate)

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Key Characteristics of Epidemiology

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-Population Focus -Distribution (where diseases are distributed) -Determinants -Exposures (how much of an exposure) -Outcomes -Expressed in terms of morbidity and mortality -Quantification -Control of Health Problems

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Evolving Concept of Epidemiology as a Liberal Art

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-is interdisciplinary -uses the scientific method -is an observational science

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Descriptive Epidemiology

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-person, place, time to describe outcomes -epidemiologic studies that are concerned with characterizing the amount and distribution of health and disease within a population

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Analytic Epidemiology

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-exposures and health conditions -a type of epidemiology that examines causal (etiologic) hypotheses regarding the association between exposures and health conditions. -proposes and evaluates causal models for etiologic associations and studies them empirically

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Natural Experiments

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- a type of research design in which the experimenter does not control the manipulation of a study factor(s). The manipulation of the study factor occurs as a result of natural phenomena or policies that impact health.

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Hippocrates (460 BC- 370 BC)

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-Greek authority departed from superstitious reasons for disease outbreaks -wrote On Airs, Waters, and Places in 400 BC -suggested disease might be associated with environmental factors

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Black Death (occurred between 1346 and 1352)

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-Of great significance for epidemiology -thought to be caused by a bacterial infection of Yersinia pestis transmitted via flea bites -Claimed up to one-third of population of Europe (20 to 30 million out of 100 million people) -Characterized by: -swollen lymph nodes -fever -apperance of black splotches on the skin

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Paracelsus (1493-1541)

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-one of the founders of the field of toxicology -contributions include: -the dose- response relationship (how much of a toxin for response) -the notion of target organ specificity of chemicals

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John Graunts (1620-1674)

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- published natural and political observations mentioned in a following index, and made upon the bills of mortality (1662) -first to employ quantitative methods (numbers) -known as the Columbus of statistics table

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Ramazzini (1633-1714)

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-founder of the field of occupational medicine -he authored De Morbis Artificum Diatriba (Diseases of Workers), published in 1700

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Sir Percival Pott (1714-1788)

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-first person to describe an environmental cause of cancer -observed that chimeny sweeps had a high incidence of scrotal cancer

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Edward Jenner (1749-1823)

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-developed a method for smallpox vaccination in 1796

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John Snow (1813-1858)

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-described the link between cholera and contaminated water -important epidemiologic discoveries -power of observation and written expression -mapping -data tables -participation in a natural experiment -recommendation of public health measures

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Miasmatic Theory of Disease

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-"...disease was transmitted by a miasm, or cloud, that clung low on the surgace of the earth" -no relationship between microorganisms and disease yet

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William Farr (1807- 1883) "Compiler of Abstracts"

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-developed a more sophisticated system for codifying medical conditions -examined possible linkage between mortality rates and populations density (defined as number of persons per square mile)

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Robert Koch (1843-1910), a German physician

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-Published Die Aetiologie der Tuberkulose in 1882 -postulates demonstrated the association between a microorganism and a disease - 4 postulated 1. the organism must be observed in every case of the disease 2. it must be isolated and grown in pure culture 3. the pure culture must, when inoculated into a susceptible animal, reproduce the disease 4. the organism must be observed in, and recovered from, the experimental animal

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Pandemic Influenza (1918-1919)

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-also known as the Spanish Flu -killed 50 to 100 million persons globablly -field hospitals to treat people on the spot -not as big as black death

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Discovery of penicillin

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-Alexander Fleming (1881-1995) discovered the anti-microbial properties of the mold Penicillium notatum in 1928 -Antibiotic became available toward the end of World War II still use today

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The Contemporary Era (1940 to present)

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-Framingham study (ongoing since 1948) investigates risk factors for coronary heart disease -Epidemic Intelligence Services (EIS) 40's bioterriorism -Publication of U.S. Surgeon General's report, Smoking and Health (1964) identified deleterious effect of smoking upon health -Smallpox eradication (the only disease) -Discovery of the following associations: -human papillomavirus and cervical cancer -bacterium (helicobacter pylori) and peptic ulcers -genetic factors and cancer development

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Historical Use

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-documents the patterns, types, and causes of morbidity and mortality over time -example: decline in infectious disease mortality

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Community Health Use

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-"to diagnose the health of the community and the condition of the people, to measure the true dimensions and distribution of ill-health in terms of incidence, prevalence, disability and mortality..."

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Health Services Use

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-to study the working of health services with a view to their improvement -sample application: operational (operations) research

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Disease Management

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-refers to a method of reducing healthcare costs by providing integrated care for chronic conditions -examples include integrated care for: -heart disease -hypertension -diabetes -also known as self care management

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Risk Assessment Use

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-"to estimate from the group experience what are the individual risks on average of disease, accident and defect, and the chances of avoiding them

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Risk

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-the probability that an event will occur..

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Risk factor

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-an exposure that is associated with a disease, morbidity, mortality, or other adverse health outcome

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Risk assessment

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-a methodology used to provide quantitative measurements of risk to health

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Disease Causality Use

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-in order to assess potential causal associations, criteria must be considered

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Ethics in Research

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-refers to "...norms for conduct that distinguish between... acceptable and unacceptable behavior."

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Adherence to ethical norms in research

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-promotes the aims of research, such as knowledge, truth, and avoidance or error -promotes values that are essential to collaborative work, such as trust, accountability, mutual respect, and fairness -helps to ensure that researchers can be held accountable to the public -helps build public support for research -promotes a variety of other important moral and social values, such as social responsibility, human rights, animal welfare, compliance with the law, and health and safety

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U.S. Public Health Services Syphilis Study at Tuskegee

answer

-syphilis investigation from 1932 to 1972 -purpose was to "...record the natural history of syphilis in hopes of justifying treatment programs for blacks..." -total of 600 African American men participated -399 syphilis cases and 201 syphilis-free controls -never gave informed consent -despite discovery of penicillin, men were never offered treatment -class-action suit filed in 1973

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Ethics Guidelines for Epidemiologists

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-developed by the American College of Epidemiology (ACE) -the following are a few of these guidelines: -minimizing risks and protecting the welfare of research subjects -obtaining the informed consent of participants -submitting proposed studies for ethical review -maintaining public trust -[meeting] obligations to communities

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Counting and Tabulating Cases

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-data cleaning: the review of data for accuracy and completeness -a clean data set contains a group of data that are ready for coding and analysis

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Graphical Presentations

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-used to summarize key aspects of the data set -types of graphs: -bar chart -line graph -pie chart

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Bar Chart

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-frequency of discrete variables

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Line Graph

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-examine trends

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Pie Chart

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-proportion of diseases

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Mathematical formulas

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-Ratio (R) -Rate (r)* -Proportion (p) -Percent (P)

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Ratio

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-defined as "The value obtained by dividing one quantity by another" -types include -rates -proportions -percentages -expressed as X/Y

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Example of a Ratio Calculation

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-with respect to AIDS mortality, the sex ratio of deaths (males to female deaths)= X/Y where: X= 450,451 male Y= 89,895 female the sex ratio = 450,451/89,895= 5 to 1

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Proportion

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-a type of ratio in which the numerator is part of the denominator (ratio it is not) -may be expressed as a percentage

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Example of a Proportion

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-calculate this type of deaths from AIDS that occured among males A= number of deaths from AIDS among males= 450,451 B= number of deaths from AIDS among females= 89,895 TOTAL (A+B) 450,451+89,895 -A/(A+B)= 450,451/540,346=0.8336

question

Percentage

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-a proportion that has been multipled by 100 -the formula is A/(A+B)*100

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Example of a Percentage

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-calculate this type of deaths from AIDS that occurred among males A= number of deaths from AIDS among males= 450,451 B= number of deaths from AIDS among females= 89,895 TOTAL (A+B) 450,451+89,895 -A/(A+B)*100= 450,451/540,346*100= 83.36%

question

Magnitude of a Health Condition

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-proportions and percentages indicate how important a health outcome is relative to the size of a group -consider two separate sorority houses. One house has 100 residents, the other house has 30 residents. If 10 of the women in each house have the flu, what is the magnitude of the health issue in each house? -100 residents-->10/100= 10% -30 residents-->10/30-33.33%

question

Rate

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-also a type of ratio, differs from proportion because the denominator involves a measure of time -used to measure risks associated with exposures and provide information about the speed of development of a disease -used to make comparisons among populations

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General Information Regarding Epidemiologic Measure

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-epidemiologic measures provide the following types of information: -the frequency of a disease or condition -associations between exposures and health outcomes -strength of the relationship between an exposure and a health outcome

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Types of Epidemiologic Measures

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-quantitative terms are useful in epidemiology to characterize the occurrence of disease, morbidity, and mortality in populations -quantitative terms include: -counts -incidences -prevelance

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Count

answer

-refers to the number of cases of a disease or other health phenomenon being studied -reports of single causes may have public health significance -case reports of patients with particularly unusual presentations or combinations of symptoms often spur epidemiologic investigations -example: one case of Ebola virus, smallpox

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Incidence

answer

-refers to the occurrence of new disease or mortality within a defined period of observation (e.g. a week,month,year, or other time period) in a specified population (population at risk) -describe the risks associated with certain exposures

question

Incidence Rate Formula

answer

number of new cases/ total population at risk over a time period x multipler (e.g., 100,000)

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Prevalence

answer

-the number of existing cases of a disease or health condition, or deaths in a population at some designated time -variations: -period -point -lifetime

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Period Prevalence

answer

-all cases of a disease within a period of time -example: -percentage of people in U.S. who has asthma during the past 12 months of any particular year

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Point Prevalence

answer

-all cases of a disease, health condition, or deaths that exist at a particular point in time relative to a specific population from which the cases are derived -smaller period of time for a much smaller group of people

question

Point Prevalence Formula

answer

number of persons ill/ total number in the group at a point in time

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Lifetime Prevalence

answer

-cases diagnosed at any time during the person's lifetime -example: lifetime asthma diagnosis

question

four measures of morbidity (illness) and mortality (death)

answer

-crude rates -case fatality rates -proportional mortality ratio -cause-specific rates

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Crude Rate

answer

-has not been modified -includes a time period during which an event occurred -has limitations -entire population in population of interest frequency of disease over a period of time --------------------------------------------------------- unit size of population

question

Crude Death Rate Calculation

answer

-number of deaths in the U.S. in 2005= 2,448,017 -population of the U.S. as of July 1,2005= 296,410,404 (2,448,017/296,410,404)*1,000=8.25

question

Crude Death Rate

answer

number of deaths in a given year ------------------------------------------------ X100,000 reference population (during midpoint)

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Case Fatality Rate (CFR)

answer

-the number of deaths due to a disease that occur among persons who are afflicted with that disease number of deaths due to disease "X" ---------------------------------------------------- X100 number of cases of disease "X"

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Proportional Mortality Ration (PMR)

answer

-the number of deaths within a population due to a specific disease or cause divided by the total number of deaths in the population mortality due to a specific cause during a timer per ------------------------------------------------------------------ mortality due to all causes during the same time period X100

question

Specific Rates

answer

-three examples are: -cause-specific rates -age-specific rates -sex-specific rates

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Cause-specific rates

answer

-a measure that refers to mortality (or frequency of a given disease) divided by the population size at the midpoint of a time period times a multiplier

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Age-specific rate (R)

answer

-the number of cases per age group of population during a specified time period number of deaths among those aged --------------------------------------------------- X100,000 number of persons who are aged (during time per.

question

Sex-specific rate

answer

-the frequency of a disease in a gender group divided by the total number of persons within that gender group during a time period times a multipler

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Adjusted Rate

answer

-a rate of morbidity or mortality in a population in which statistical procedures have been applied to permit fair comparisons across populations by removing the effect of differences in the composition of various populations -age is a factor used in rate adjustment

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Factors that Affect the Quality of Epidemiologic Data

answer

-quality is determined by the sources used to obtain the data and how completely the data cover the reference population -the quality of data affects the permissible applications of the data and the types of statistical analyses that may be performed -ask the following questions: -what is the nature of the data, including sources and content? -how available are the data? -how complete is the population coverage? -what are the appropriate and inappropriate uses of the data? what are you going to do with it?

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Representativeness

answer

-also known as external validity -refers to the generalizability of the findings to the population from which the data have been taken

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U.S. Bureau of the Census

answer

-provides data that can be used to define the denominator in rates with respect to official estimates of total population size and subdivisions of the population by geographical area -conducted every ten years

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Vital Registration System and Vital Events

answer

-vital events are deaths, births, marriages, divorces, and fetal deaths -the vital registration system in the United States collects information routinely on those events

question

Deaths

answer

- mortality data are almost complete because deaths are unlikely to go unrecorded in the United States -National Center for Health Statistics (NCHS) compiles and publishes national mortality rates -note that the specified cause may not be entirely accurate -primary cause sometimes unclear -diagnostic criteria may lack consistent standards -some conditions may be unreported because of stigma (AIDS, suicide, overdose)

question

Information included on death certificate data in U.S.

answer

-demographic characteristics (e.g., age) -date and place of death (e.g., hospital) -cause of death (e.g., immediate cause and contributing factors)

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Birth statistics

answer

-include live births and fetal deaths -presumed to be nearly complete -used to calculate birth rates -helpful in understanding birth defects, length of gestation, birth weight, and demographic background of mother -affected by mother's failure to recall events during pregnancy -may miss conditions that were not detected at birth

question

Data from Public Health Surveillance Programs

answer

-three examples are surveillance systems for the following: -communicable and infectious diseases -noninfectious diseases -risk factors for chronic diseases

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Public Health Surveillance

answer

-referes to the systematic and continuous gathering of information about the occurence of diseases and other health phenomena

question

Syndromic Surveillance

answer

-describes "... using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response ." -Boston

question

Reportable and notifiable disease statistics

answer

-by legal statute, physicians and other health-care providers must report cases of certain diseases to health authorities -usually infectious and communicable diseases that might endager a population

question

Examples of Reportable and Notifiable Disease Statistics

answer

-sexually transmitted diseases -rubella -tetanus -measles -plague -foodborne disease

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Deficiencies of Reportable and Notifiable Disease Statistics

answer

-population coverage may be incomplete -no information is available about persons who develop the disease and do not seek medicial attention -infected individual may be asymptomatic -physicians and other providers may fail to fill out proper forms

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Chronic Disease Surveillance: the example of Asthma

answer

-asthma, a highly prevalent disease -asthma surveillance programs -1.asthma prevalence/severity -2. scheduled office visits -3 unscheduled office visits -4 ED/ urgent care -5 hospitalization -6 Morality -7 quality of life -8 cost -9 pharmacy -10 triggers

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Behavioral Risk Factor Surveillance System (BRFSS)

answer

-used by the United States to monitor at the state level behavioral risk factors that are associated with chronic diseases -examples of data collected relate to: -health risks behaviors -preventive health practices -health care access

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Case Registries

answer

-a registry is a centralized database for collection of information about a disease -register refers to the document used to collect the information -examples include: -the National Program of Cancer Registries -The Surveillance, Epidemiology, and End Results Program

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Data from the National Center for Health Statistics (NCHS)

answer

-scope of information is extensive -includes national surveys -immunization history, disabilities, health behaviors -examples of surveys and data collection systems include: -the National Health Interview Survey -National Health and Nutrition Examination Survey (NHANES) -The Vital Statistics System

question

Life expectancy

answer

number of years that a person is expected to live, at any particular year (e.g., at birth)

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Maternal Mortality

answer

-encompasses maternal deaths that result from causes associated with pregnancy -a measure is the maternal mortality rate -lack of personal care, malnutrition, atopic pregnancy, low income, low education

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Maternal Mortality Rate

answer

number of deaths assigned to causes related to childbirth ------------------------------------------------------X100,000 number of live births

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Infant Mortality Rate

answer

-related to inadequate health care and poor environmental conditions -substantial racial and ethnic variations -crude rate since race and ethnicity were not involved

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Infant Mortality rate

answer

number of infant deaths among infants aged 0-365 days during the year ---------------------------------------------------------X1,000 number of live births during the year

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Fetal Mortality

answer

-death of the fetus when it is in the uterus and before it has been delivered -two measures are -fetal death rate -late fetal death rate (after 28 weeks)

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Fetal Death Rate

answer

number of fetal deaths after 20 weeks or more gestation ---------------------------------------------------------X1,000 number of live births+ number of fetal deaths after 20 weeks or more gestation

question

Late Fetal Death Rate

answer

number of fetal deaths after 28 weeks or more gestation ---------------------------------------------------------X1,000 number of live births+ number of fetal deaths after 28 weeks or more gestation

question

Crude Birth Rate

answer

affects the size of the population number of live births within a given period ---------------------------------------------------------X1,000 population size at the middle of that period

question

General Fertility Rate

answer

# of live births within a year -------------------------------------------------X 1,000 # of women aged 15-44 yrs during the midpoint of the year

question

Perinatal Mortality Rate

answer

number of late fetal deaths after 28 weeks or more gestation plus infant deaths within 7 days of birth ---------------------------------------------------------X1,000 number of live births + number of late fetal deaths

question

World Health Organization (WHO)

answer

-provides global infectious disease surveillance -yields data on health indicators (WHOSIS database) -collects mortality data

question

European Union

answer

public health data include social and health inequalities and determinants of health

question

Determinant

answer

a factor or event that is capable of bringing about a change in the health status of a population

STUDY

Altered Mental Status Blood Supply To The Brain Medical Terminology

Medical Terminology (Neurological) – Flashcards 70 terms

Patsy Brent

70 terms

Preview

Medical Terminology (Neurological) – Flashcards

question

AMS

answer

altered mental status - any state of awareness that differs from the normal awareness of a conscious person

question

Aphasia

answer

inability to express oneself through speech

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Ataxia

answer

gross lack of coordination of muscle movements, such as staggering gait

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Dizziness

answer

a word that is often used to describe either lightheadedness or vertigo

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Dysarthria

answer

motor speech disorder due to weakness, paralysis, or muscular un-coordination, characterized by poor articulation

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Dysphasia

answer

impairment of speech

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Fecal incontinence

answer

inability to control one's bowels

question

answer

headache

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Hemiparesis

answer

weakness on one side of the body

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Hemiplegia

answer

total paralysis on one side of the body

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Lightheadedness

answer

the feeling that you are about to faint or "pass out"

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LOC

answer

loss of consciousness

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Paresthesias

answer

sensation of tingling, prickling, or numbness of a person's skin

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Post-ictal

answer

the altered state of consciousness that person enters after experiencing a seizure

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Saddle anesthesia

answer

loss of sensation restricted to the area of the buttocks and perineum

question

Syncope

answer

temporary loss of consciousness (fainting)

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Syncope - near

answer

pre- or near-syncope occurs when individual can remember events during the episode, not a total loss of consciousness

question

Tinnitus

answer

an abnormal noise in the ear, such as a ringing or swishing sound

question

Urinary incontinence

answer

the involuntary excretion of urine

question

Vertigo

answer

a type of dizziness, where there is a feeling of motion when one is stationary

question

Bell's Palsy

answer

a temporary form of facial paralysis that occurs with damage to the nerve that controls movement of the muscles in the face

question

Cerebral Aneurysm

answer

a cerebrovascular disorder in which weakness in the wall of the cerebral artery or vein causes a localized dilation or ballooning of the blood vessel

question

Cerebral Palsy

answer

a neuromuscular condition of hypertonia and spasticity in the muscles of the lower extremities of the human body

question

CVA

answer

cerebrovascular accident (stroke)

question

Dementia

answer

loss of brain function that affects memory, thinking, language, judgment, and behavior

question

Epidural abscess

answer

a collection of pus between the outer covering of the brain and spinal cord and the bones of the skull or spine

question

Epidural hematoma

answer

a type of traumatic brain injury in which a buildup of blood occurs between the dura matter and the skull

question

Epilepsy

answer

brain disorder involving repeated, spontaneous seizures of any type

question

Hydrocephalus

answer

a buildup of fluid inside the skull, leading to brain swelling

question

Meningitis

answer

swelling and irritation (inflammation) of the membranes covering the brain and the spinal cord

question

Parkinson's

answer

a degenerative disorder of the central nervous system that impairs the sufferer's motor skills, cognitive processes, and other functions

question

Peripheral Neuropathy

answer

damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerves or from the side-effects of systemic illness

question

SAH

answer

subarachnoid hemorrhage - sudden bleeding into the subarachnoid space

question

Subdural Hematoma

answer

a collection of blood on the surface of the brain

question

TIA

answer

transient ischemic attack (mini-stroke)

question

A&O

answer

alert and oriented (normal finding: A&O X 3 - person, place and time)

question

Babinski

answer

necrologic test based upon what the big toes does when the sole of the foot is stimulated (normal finding: toes down going)

question

Romberg Test

answer

to test cerebellar function; patient is stood up and asked to close his eyes. A loss of balance is interpreted as a positive Romberg sign

question

Finger-Nose-Finger Test (FNF)

answer

to test cerebellar function; test of coordination in which the patient is asked to alternately touch their nose and the examiner's finger

question

Heel to Shin Test

answer

to test cerebellar function; the patient is asked to touch the heel of one foot to the opposite knee and then drag their heel in a straight line all the way down the front of their shin and back up again

question

Alt rapid hand movements

answer

to test cerebellar function; the patient is asked to strike one hand on the dorsum of the other hand, raise, the hand, turn it over, and then strike it back down as fast as possible

question

Clonus

answer

a series of involuntary muscular contractions due to sudden stretching of the muscle

question

Cranial Nerves

answer

twelve pairs of nerves that emanate from the nervous tissue of the brain (normal finding: CN's II-IV intact, CN's grossly intact)

question

DTRs

answer

deep tendon reflexes, measured on a scale from 1+ to 5+, 2+ is normal

question

Focal neuro deficit

answer

a problem nerve, spinal cord, or brain function that affects a specific location

question

Gag reflex

answer

reflex contraction of the back of the throat, evoked by touching the soft palate

question

Gait

answer

how the person walks; can be shuffling, unsteady, ataxic or if normal will be steady and at a normal pace

question

GCS

answer

Glasgow Coma Scale: a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person. Measure eyes, verbal and motor response (normal is 15)

question

Meningismus

answer

signs and symptoms are headache, neck stiffness

question

Mentation

answer

mental activity; thinking

question

Somnolent

answer

extremely sleepy or drowsy

question

Obtunded

answer

depressed level of consciousness, mentally dulled

question

Motor strength

answer

muscle strength is rates on a scale of 0/5 to 5/5 (BLE and BUE)

question

MAE

answer

moves all extremities

question

Muscle tone

answer

the continuous and passive partial contraction of the muscles

question

Posturing

answer

the involuntary flexion or extension of the arms and legs (normal is no posturing)

question

Pronator drift

answer

the patient is asked to forward flex his arms 90 degrees at the shoulders, supinate his forearms, close his eyes and hold the position. If a forearm pronates then the person is said to have pronator drift to that side

question

Contracture

answer

a shortening of a muscle or joint, usually in response to prolonged hypertonic spasticity in a concentrated muscle area

question

Nuccal rigidity

answer

inability to flex the head forward due to rigidity of the neck muscles

question

Resting tremor

answer

tremor which occurs when a body part is at complete rest again gravity

question

Grand Mal (tonic-clonic) seizure activity

answer

a type of generalized seizure that affects the entire brain

question

Focal seizure activity

answer

seizures which affect only a part of the brain

question

Petit Mal seizure activity

answer

absence seizure

question

Marching seizure activity

answer

a clonic seizure that begins in one area of the body (typically the hand or foot) and moves progressively towards the other side of the body

question

Postictal

answer

the altered state of consciousness that a person enters after experiencing a seizure

question

Sensation

answer

the perception of a stimulus as touch (normal finding: sensation intact, no sensory deficits)

question

EEG

answer

electroencephalogram is a test that measures and records the electrical activity of your brain

question

Head CT

answer

computed tomography (CT) scan of the head

question

Head MRI

answer

magnetic resonance imaging (MRI) scan of the head, not frequently done in the ED

question

Lumbar Puncture

answer

a procedure to collect and look at the cerebrospinal fluid surrounding the brain and spinal cord, also called a spinal tap

STUDY

Blood Supply To The Brain Color Colors Surgical Technology

Surgery and Anesthesia – Flashcards 299 terms

Stephanie Landry

299 terms

Preview

Surgery and Anesthesia – Flashcards

question

What color is the oxygen tank?

answer

green

question

what color is the nitrous oxide tank?

answer

blue

question

what are 5 gasses commonly used in surgery?

answer

oxygen nitrous oxide isofluorine halothane cebofluorine

question

PPM

answer

parts per million

question

What does it mean if you can smell the gas?

answer

It is 15X more than it needs to be

question

what are 6 short term effects of exposure to too much gas?

answer

Headache Nausea Depression Irritable Fatigue Drowsiness

question

What are 5 long term effects of exposure to too much gas?

answer

Reproduction problems Liver problems Kidney problems bone marrow suppression Nervous system problems

question

What gas is the least toxic?

answer

isofluorine

question

How is isofluorine eliminated?

answer

Through lungs

question

How are every other gas besides isofluorine eliminated?

answer

through liver and kidneys

question

What gas is the worst for being hepatotoxic?

answer

Halothane

question

what gas is hard on the kidneys?

answer

metaphane

question

what are 2 neurologic symptoms one can experience when exposed to too much gas?

answer

decreased motor skills short term memory loss

question

NIOSH

answer

National Institute for Occupational Safety and Health Recommend for no gas to exceed 2 ppm when used alone

question

How many air exhanges should be made per hour for proper ventilation?

answer

15-20

question

1 cc of anesthetic forms how much of waste?

answer

200 mL

question

What are 2 ways to reduce exposure of waste of anesthetic gasses?

answer

scavenger system check for leaks

question

What are 2 different scavenger systems?

answer

canister with charcoal (most common) hose that leads to outside

question

What are 2 ways you can tell if there is a leak?

answer

hear it (Oxygen) smell it (gas)

question

What should you do after giving an injection?

answer

wipe with alcohol

question

What is the anesthesia form of ketamine?

answer

teletamine

question

what kind of injectable anesthesia is used on elephants and is 10,000 X more potent than morphine?

answer

Etorphine

question

Xylazine

answer

AKA Rompum injectable anesthesia used on large animals can cause 2nd degree heart block can absorb through skin

question

What is a reversing agent for narcotics?

answer

naloxine

question

What are some important safety tips on how to store and handle gas tanks?

answer

open tank slowly dont try to block leak with hand tanks should be secure and in upright position dont put tanks in heavy traffic area label tank (empty, in use, full etc)

question

Where should an endotracheal tube reach if it is the right size?

answer

the thoracic inlet

question

what are the two types of endotrachael tubes?

answer

Murphy Cole

question

Murphy

answer

Endotrachael tube with cuff and side hole

question

cole

answer

endotrachael tube with no cuff and no side hole commonly used on birds and reptiles

question

what is the purpose of endotrachael tubes?

answer

bypasses oral, nasal cavities, pharynx, and larynx

question

What can happen if the cuff on an endotrachael tube is too tight?

answer

can damage trachea

question

What is the purpose of the side hole on an endotrachael tube?

answer

drains excessive mucus

question

What are 3 advantages of a cuff on an endotrachael tube?

answer

1) decreases dead space 2) prevents animal from aspirating 3) decreases pollution in air

question

What would happen if an endotrachael tube is too far in?

answer

could go in one lung and animal will not go to sleep as well

question

What would happen if endotrachael tube is not in far enough?

answer

too much dead space

question

What are 6 parts of an endotrachael tube?

answer

Murphy eye Machine end Connector - connects to machine Cuff Pilot balloon and valve Measurement of internal diameter and length

question

what are 3 parts of a laryngoscopes?

answer

Handle Blade Light

question

what are 2 types of blades for a laryngoscopes?

answer

Miller (straight) McIntosh (curved)

question

What kind of animal are gas masks used on?

answer

Used mostly on older or fractuous animals

question

What are 4 components of the anesthetic machine?

answer

Compressed gas supply Anesthetic vaporizer Breathing circuit Scavenger system

question

What setting should gas be set on?

answer

question

What if gas is set on 5?

answer

never leave machine!

question

Non rebreathing circuit

answer

Used on small animals (3-7 kg) Not a lot of resistance

question

E tank

answer

Small Need a wrench screws in on a 3 hole port

question

H tank

answer

Large hand turn open fully when in use

question

When should you change the gas?

answer

When the tank pressure gauge is below 500 psi or 150 mL of oxygen

question

Flow meter

answer

How much oxygen is being delivered (Liters) (most on one or below = 1 L/minute)

question

How do you check iso levels?

answer

make sure bubble of vaporizer is half full

question

What are the 2 ways to change concentration?

answer

Increase oxygen rate Change dial

question

pg 114 blue book

answer

check list

question

What are 2 factors that affect vaporizer?

answer

temperature: hot - move faster The lower the oxygen, the more gas you will need (oxygen flow rate)

question

pg 123, 128, 130, 135 blue book

answer

pics and tables

question

What 9 things should be included in the preanesthetic evaluation?

answer

Why they are needing anesthesia history: med history, adverse rxns physical exam age breed temperament type of procedure heavy sedation or general anesthesia experience of surgeon

question

What the 5 categories of patients?

answer

normal mild systemic disease severe systemic disease severe systemic disease with constant threat to die moribund patient (will not live unless operated on)

question

What should you do once a puppy is born?

answer

clean out air ways (rough up) tie off umbilical cord

question

How long does a patient have to fast before surgery?

answer

requires 4 hours unless older then should be overnight

question

What 8 things are needed for an anesthetic plan?

answer

staff equipment needed drugs analgesia pre and post sedation induction and maintenance monitoring emergency protocol

question

What are 3 types of drugs used for pain management in surgery?

answer

local blocks post operative intra operative

question

what drugs can be used post operative and intraoperative?

answer

NSAIDS

question

What are 2 NSAIDS that can be used post or intraoperative?

answer

Rimadyl Metacam

question

Dopram

answer

stimulates respiration can put a drop under tounge of a puppy

question

what gland does oxytocin come from?

answer

posterior pituitary gland

question

What are the 4 major diseases that go through kidneys?

answer

Diabetes Renal Disease Cardiac Disease Liver Disease

question

How should diabetic animals fast before surgery?

answer

Just cut food intake and insulin by half

question

What is one thing that is important when doing surgery on diabetic dogs?

answer

they heal slow

question

What should be monitored with animals with renal disease going into surgery?

answer

Kreatinine and BUN

question

Diarese

answer

urinate a lot

question

What should you make sure of when performing surgery on an animal with cardiac disease?

answer

make sure animal has enough oxygen moniter blood pressure

question

90% of all drugs go through what?

answer

the liver

question

Do you use premeds on critical patients?

answer

question

What are the advantages of premeds?

answer

relaxes animal decreases stress decreases anesthesia

question

What are the disadvantages of premeds?

answer

reaction longer wake up bradycardia

question

Does acepromazine increase the risk of seizures in epileptics?

answer

there is no evidence

question

What premed is yellow in color and a tranquilizer?

answer

acepromazine

question

What may atropine and glycopyrrolate cause?

answer

tachycardia and myocardial hypoxemia

question

what premed is short acting and reduces saliva?

answer

atropine

question

What are 3 premeds?

answer

atropine acepromazine torbegesic

question

which premed is a controlled substance?

answer

torbegesic

question

myocardial hypoxemia

answer

low oxygen in blood in the heart muscle

question

what is the trade name for glycopyrrolate?

answer

Robinal

question

What does atropine cause in horses?

answer

twisting of intestines

question

What are 4 inhalants for anesthesia?

answer

Cevofluorine isofluorine halothane metaphane

question

When do you change soda lime?

answer

color of white turns blue

question

soda lime

answer

what is in the waste container of a scavenger system to absorb expired gasses

question

What are 3 emergency supplies for anesthesia and surgery?

answer

suction lighting crash cart

question

suction

answer

canister that pulls fluid

question

crash cart

answer

emergency drugs and protocols

question

If the heart stops, what emergency drug should be given?

answer

epinephrine

question

What should be recorded every 5 or 10 minutes?

answer

temp pulse respiration

question

What are 6 things considered for patient prep?

answer

IV catheter and fluids Anesthesia monitoring tools Stabilize unstable patients first Manage arrythmias Is blood needed? Pre-oxygenation by mask before induce

question

How do you manage arrythmias?

answer

lidocaine

question

Who do you pre oxygenate before inducing?

answer

older animals

question

What does a capnometer check?

answer

Carbon Dioxide

question

What are 8 anesthesia monitoring tools?

answer

Stethoscope ECG BP thermometer esophageal stethoscope capnometer pulse ox

question

What does a pulse ox check?

answer

oxygen

question

What are 3 things considered as crucial surgery?

answer

old animals young animals invasive surgeries

question

What must you do for crucial surgeries? why?

answer

start on IV for emergency drugs keeps circulation going through organs

question

If you need to turn an animal, how should it be done?

answer

turn animal towards stomach, not towards their back. dont want ET tube to turn in trachaea

question

When do you know its time to remove the endotrachael tube?

answer

when they start swallowing

question

When should you remove the endotrachael tube in brachycephalic animals?

answer

wait until their up walking around

question

How do you remove the endotrachael tube?

answer

deflate cuff just enough to get it out so no foreign material goes into lungs but can come out without damaging trachaea

question

What does monitoring include?

answer

evaluation of oxygen, ventilation, cardiac rate and rhythm, adequate depth of anesthesia, muscle relaxation, BT, and analgesia

question

Use a high oxygen rate when what changes?

answer

when rapid changes in anesthetic depth are needed

question

what is the maintenance typically for oxygen when rapid changes in anesthetic depth are needed?

answer

200-500 mL

question

Why should you keep the pop off valve all the way open?

answer

to prevent popping a lung

question

What are 4 anesthetic complications?

answer

hypoventilation hypotension arrhythmia death

question

how can you tell if an animal is going into hypoventilation under anesthesia?

answer

cyanosis

question

cyanosis

answer

blue gums

question

hypotension

answer

low blood pressure

question

what are 3 ways to detect an arrhythmia?

answer

auscultate ECG pulse, HR, doppler ultrasound

question

How can you tell if an animal has low blood pressure when under anesthesia?

answer

low heart rate pale gums

question

When does recovery start?

answer

when the gas is turned off

question

when do most surgery related deaths occur?

answer

3 hours after surgery

question

What do you record every 5 minutes during recovery?

answer

HR Rhythm RR MMC eye position muscle tone reflexes

question

How often should you check temperature during recovery?

answer

15 minutes

question

What is the most reliable tool when checking vitals?

answer

personal direct contact (stethoscope, pulse, BP, MMC, CRT, smell)

question

SFT

answer

see it feel it trust it

question

What are the 4 places to check pulse?

answer

femoral artery (inside flank area) lingual artery (uner tongue) digital artery (below carpus) heart rate

question

What is the best way to check pulse?

answer

heart rate

question

When should you tell the veterinarian the heart rate is too slow in a large dog?

answer

lower than 50 BPM

question

When should you tell the veterinarian the heart rate is too slow in a small dog?

answer

lower than 70 BPM

question

When should you tell the veterinarian the heart rate is too slow in a cat?

answer

lower than 100 BPM

question

Pulse defecit

answer

HR doesnt match up with pulse blood is not getting to back legs

question

what causes a pulse defecit in cats?

answer

thromboembolis

question

How do you treat a pulse deficit?

answer

treat with blood thinners ex: heparin

question

How do you calculate respiratory rate?

answer

count breaths for 15 sec then x4

question

What is the behavior of stage I of anesthesia?

answer

Disoriented

question

What is the respiration in stage I of anesthesia?

answer

normal 20 - 30 breaths/min

question

What is the cardiovascular function in stage I of anesthesia?

answer

heart rate unchanged

question

What would the response be to surgery in stage I or II of anesthesia?

answer

struggle

question

What is the depth of anesthesia in stage I or II of anesthesia?

answer

not anesthetized

question

What is the eye position in stage I, II or III of anesthesia?

answer

central may be nystagmus note: stage III might have eye rotated

question

nystagmus

answer

eye clicking back and forth

question

what is the pupil size in stage I and III of anesthesia?

answer

Normal

question

Does the pupil respond to light in stage I, II or III of anesthesia?

answer

yes

question

how is the muscle tone in stage I, II and III of anesthesia?

answer

good

question

Is there reflex response in stage I and II of anesthesia

answer

all present may be exaggerated in stage II

question

What is stage II of anesthesia?

answer

Excitement stage

question

What is the behavior of stage II of anesthesia?

answer

Excitement struggling vocalization paddling chewing yawning

question

What is the respiration in stage II of anesthesia?

answer

Irregular may hyperventilate

question

What is the cardiovascular function in stage II of anesthesia?

answer

Heart rate may increase

question

what is the pupil size in stage II of anesthesia?

answer

may be dilated

question

What is stage III: plane 1 of anesthesia?

answer

Light anesthesia

question

What is the behavior of stage III of anesthesia?

answer

Anesthetized

question

What is the respiration in stage III - plane 1 of anesthesia?

answer

Regular 12-20 breaths/min

question

What is the cardiovascular function in stage III - plane 1 and plane 2 of anesthesia?

answer

pulse strong HR > 90 BPM

question

What would the response be to surgery in stage III - plane 1 of anesthesia?

answer

may respond with movement

question

What is the depth of anesthesia in stage III - plane 1 of anesthesia?

answer

light

question

Is there reflex response in stage III - plane 1 of anesthesia

answer

swallowing poor or absent other reflexes present but diminished

question

What stage of anesthesia do we want to be at for surgery?

answer

stage III - plane 2

question

What is stage III - plane 2 of anesthesia?

answer

Medium surgical anesthesia

question

What is the respiration in stage III - plane 2 of anesthesia?

answer

Regular, may be shallow 12-16 breaths/min

question

What would the response be to surgery in stage III - plane 2 of anesthesia?

answer

Heart and respiration rates may increase

question

What is the depth of anesthesia in stage III - plane 2 of anesthesia?

answer

moderate

question

What is the eye position in stage III - plane 2 of anesthesia?

answer

Often rotated vetrally

question

what is the pupil size in stage III - plane 2 of anesthesia?

answer

slightly dilated

question

Does the pupil respond to light in stage III - plane 2 of anesthesia?

answer

sluggishly

question

how is the muscle tone in stage III - plane 2 of anesthesia?

answer

relaxed

question

Is there reflex response in stage III - plane 2 of anesthesia

answer

patellar, ear flick, palpebral and corneal may be present others absent

question

what is stage III - plane 3 of anesthesia?

answer

Deep anesthesia

question

What is the respiration in stage III - plane 3 of anesthesia?

answer

Shallow < 12 breaths/min

question

What is the cardiovascular function in stage III - plane 3 of anesthesia?

answer

HR 60 - 90 BPM CRT increased pulse less strong

question

What would the response be to surgery in stage III - plane 3 or plane 4 or stage IV of anesthesia?

answer

none

question

What is the depth of anesthesia in stage III - plane 3 of anesthesia?

answer

deep

question

What is the eye position in stage III - plane 3 of anesthesia?

answer

usually central may rotate ventrally

question

what is the pupil size in stage III - plane 3 of anesthesia?

answer

moderately dilated

question

Does the pupil respond to light in stage III - plane 3 of anesthesia?

answer

very sluggishly or absent

question

how is the muscle tone in stage III - plane 3 of anesthesia?

answer

greatly reduced

question

Is there reflex response in stage III - plane 3 of anesthesia

answer

all reflexes diminished or absent

question

What is the respiration in stage III - plane 4 of anesthesia?

answer

Jerky

question

What is the cardiovascular function in stage III - plane 4 of anesthesia?

answer

HR < 60 BPM prolonged CRT pale mucous membranes

question

What is the depth of anesthesia in stage III - plane 4 of anesthesia?

answer

Overdose

question

What is the eye position in stage III - plane 4 and stage IV of anesthesia?

answer

central

question

what is the pupil size in stage III - plane 4 and stage IV of anesthesia?

answer

widely dilated

question

Does the pupil respond to light in stage III - plane 4 and stage IV of anesthesia?

answer

unresponsive

question

how is the muscle tone in stage III - plane 4 and stage IV of anesthesia?

answer

flaccid

question

Is there reflex response in stage III - plane 4 and stage IV of anesthesia

answer

No reflex activity

question

What is the behavior of stage IV of anesthesia?

answer

Moribund

question

What is the respiration in stage IV of anesthesia?

answer

Apnea

question

What is the cardiovascular function in stage IV of anesthesia?

answer

cardiovascular collapse

question

What is the depth of anesthesia in stage IV of anesthesia?

answer

dying

question

What are 2 anticholinergic drugs?

answer

atropine glycopyrrolate

question

Atropine

answer

increase heart rate decreases salivation

question

glycopyrrolate is also known as...

answer

Robinul

question

what are 4 causes of increased heart rate?

answer

anticholinergic drugs ketamine and tiletamine shock pain

question

ketamine

answer

increases heart rate nystagmus

question

what are ketamine and tiletamine considered?

answer

halucinagens

question

when is glycopyrrolate used?

answer

in c-sections last longer

question

how does the blood flow through the heart?

answer

pre cava -> right atrium -> tricuspid valve -> right ventricle -> pulmonary artery -> lungs -> pulmonary vein -> left atrium -> mitral valve -> left ventricle -> body

question

sepsis

answer

dark gums

question

cyanosis

answer

blue gums

question

how do you correct high CRT?

answer

correct by volume of fluids

question

What are 4 causes of hypotension?

answer

hypovolemia cardiac insufficiency excessive vasodilitation (drugs) too deep anesthetic wise

question

what should RR be during anesthesia?

answer

8-20 breaths/min

question

How big of a blood pressure cuff do you use?

answer

40% of circumfrence of arm

question

What happens when their is right sided heart failure?

answer

ascites

question

What happens when there is left sided heart failure?

answer

will affect the lungs

question

What are 5 reflexes that can be checked during anesthesia?

answer

auricular pedal palpebral corneal laryngeal

question

auricular refelx

answer

ear twitch

question

pedal reflex

answer

pinch foot

question

palpebral reflex

answer

medial canthus of eye

question

corneal reflex

answer

touch eyeball

question

Where should muscle tone be checked?

answer

jaw anal

question

What do the eyes do before an animal dies?

answer

they dilate

question

what should be done if the animal stops feeling their foot?

answer

intubate

question

What 3 things can we check to see if we can pass the tube?

answer

jaw tone laryngeal reflex pedal reflex

question

what is normal on a pulse ox?

answer

95-99%

question

where should the sensors go for a pulse ox?

answer

lingual or rectum or under tail

question

what are 4 anesthesia monitoring devices?

answer

pulse ox captometer BP monitor ECG

question

anesthesia monitoring devices

answer

measures how much available hemoglobin saturates oxygen

question

what is normal on a captometer?

answer

35-45 mmHg

question

where does the captometer attach?

answer

endotrachael tube

question

What are 2 uses for a BP monitor?

answer

indirect (USE) direct

question

where do you attach the BP monitor for indirect?

answer

coccygeal dorsal pedal digital arteries

question

where do you attach the BP monitor for direct?

answer

catheter in artery

question

What 3 things do the ECG detect?

answer

PVCs atrial dysfunction (change in P waves) Electrolyte imbalance (change in T waves)

question

PVCs

answer

premature ventricular contractions

question

What 5 breeds have problems with anesthesia?

answer

bulldogs pekinese brachycephalics weimaraners jack russel terriers

question

In america, how many deaths per 1000 dogs and cats occur due to anesthesia?

answer

4.3 deaths/1000 dogs and cats

question

what are 4 reasons for anesthesia related deaths?

answer

#1 human error equipment failure adverse rxns to drugs patient factors

question

what are 6 human erros in anesthetic problems?

answer

no history lack of knowledge of machine incorrect drugs/dosage hurried or preoccupied fatigue inattentive - CRT, RR

question

What are 5 equipment issues that could lead to problems with anesthesia?

answer

CO2 absorbent exhaustion - turns blue No O2 Misassembly of machine ET problems Vaporizer problems - wasnt filled properly

question

What are adverse effects of acepromazine?

answer

decreases BP, HR sluggish ataxia 15 min to take effect

question

what color is ace and what is it considered?

answer

yellow tranquilizer

question

what is an adverse reaction to halothane?

answer

hepatotoxic

question

what is an adverse reaction to xylazine?

answer

2nd degree heart block

question

what might be safer when giving anesthetic agents and why?

answer

multidrug usage because of less concentration of gas used

question

what is a side effect to NO2?

answer

bone marrow suppression

question

What are 2 tests to check for liver disease?

answer

ALT AST

question

What are 8 things to consider when putting geriatric patients under anesthesia?

answer

pre-op tests urinalysis chest x-rays ECG IV fluids need less drugs have longer recovery hypothermia

question

what must you have with a pediatric who is going under anesthesia?

answer

accurate weight

question

what are 4 things to watch when dealing with pediatric patients going under anesthesia?

answer

hypoglycemia dehydration usually 1/2 dose of meds temperature

question

what are 2 types of IV tubes?

answer

micro macro

question

micro IV tube

answer

60 drops/1 mL

question

macro IV tube

answer

15 drops / 1 mL

question

what are 4 things to consider when putting brachycephalic breeds under anesthesia?

answer

alot bradycardia - give atropine pre-oxygenate for 5 mins propofol or ketamine - valium combo leave ET in as long as possible

question

what is one thing to consider with sighthounds going under anesthesia?

answer

increased sensitivity to thiobarbiturates (thiopental)

question

what is 3 things to consider when putting obese animals under anesthesia?

answer

dose - 1/2 between normal and actual (3/4 of normal dose) pre oxygenate bag every 5 seconds, have respiratory difficulty - fat around lungs and heart

question

propofol

answer

can become apneaic wake up fast

question

ketamine

answer

1 cc / 20#

question

what are 8 things to be considered when performing c-sections?

answer

start IVs Use minimal doses - all cross placental barrier clip and prep before sedate if possible decrease general anesthesia by 40% opiods are reversible do not use valium premeds decrease vomiting recover in sternal position

question

what does dopram do in puppies?

answer

stimulates respiration

question

what are 5 things you should or should not do after a puppy is delivered via c-section?

answer

suction blow nose doxapram - dopram dilute atropine do not put back with bitch too quickly

question

HBC

answer

hit by car

question

what 3 things are common in an HBC?

answer

pneumothorax hemorrhage diagphragmatic hernia

question

pneumothorax

answer

collapsed lung

question

diagphragmatic hernia

answer

hole in diaphragm

question

what are 2 drugs you can give for low BP and what do they do?

answer

dopamine - increases HR dobutamine - increases BP

question

what are 4 signs of fluid overload?

answer

crackles in lungs nasal discharge bulging eyes coughing

question

where do you perform a thoracocentesis?

answer

between 7th and 9th rib

question

why do you do a thoracocentesis cranially?

answer

caudal has vessels and nerves

question

what is the most common cardiovascular problem from anesthesia?

answer

bradycardia

question

what is the only way to determine arrythmias?

answer

Run an ECG

question

Preload

answer

Blood returning to heart

question

Afterload

answer

Blood after left heart

question

pg 148-150 in blue book

answer

...

question

PVC

answer

premature ventricular contractions

question

answer

atrial fibrilation no p waves

question

answer

ventricular fibrilation no qrs complexes

question

what drug do you use for 2nd degree heart block?

answer

atropine

question

what drug do you use for V Tachycardia?

answer

lidocaine

question

what drug do you use for sinus arrest?

answer

epinephrine

question

Pleural effusion

answer

fluid between lung and lining of pleural cavity

question

pneumonia

answer

inflammatory condition of lung, especially the air sacs

question

pulmonary edema

answer

abnormal build up of fluid in air sacs of lungs

question

what gas do you not use for respiratory disease?

answer

NO2

question

what is the difference between pneumonia and congestive heart failure?

answer

pneumonia : fluid in lungs congestive heart failure : fluid outside lungs

question

what 5 things should be done with an animal with a diaphragmatic hernia?

answer

PreO2 Head up Rapid induction Intubate rapidly Manual bagging

question

what is a complication with a diaphragmatic hernia?

answer

pneumothorax

question

what 3 things should be done with an animal with renal problems?

answer

Offer water up to 1 hour before surgery IV fluids Reduce drug doses

question

why do you want to reduce drug doses with an animal that has renal problems?

answer

To make sure kidneys excrete

question

what 6 things should be done if animal will not stay anesthetized?

answer

check vaporizer Check ET Is patient apneic? too shallow breathing? check machine, O2 flow rate is patient agonal? Increased RR

question

what should you do if the ET has a leak, if the patient is apneic or if the animal has shallow breathing and they wont stay anesthetized?

answer

bag

question

what should be given if patient is agonal?

answer

dopram

question

what are 11 signs that the patient is too deep?

answer

2 sec bradycardia weak pulse BP < 80 mm HG arrythmias too cold no reflexes flaccid muscle tone dilated pupils

question

what are 13 emergency drugs?

answer

atropine dexamethasone diazepam dobutamine dopamine doxapram epinephrine lidocaine naloxone prednisolone sodium succinate sodium bicarbonate vasopressin yohimbine

question

what are 6 CPR drugs?

answer

atropine epinephrine lidocaine prednisolone sodium succinate sodium bicarbonate vasopressin

question

what are 3 drugs mainly used in practice?

answer

atropine dexamethasone epinephrine

question

what is diazepam for?

answer

seizures

question

what is dobutamine for?

answer

increases BP

question

what is doxapram for?

answer

increases RR

question

what is prednisolone sodium succinate for?

answer

shock

question

what is sodium bicarbonate for?

answer

respiratory acidosis

question

respiratory acidosis

answer

breathing too fast

question

what is vasopressin for?

answer

increases BP

question

what is yohimbine for?

answer

reverses rompum/xylazine

question

how many minutes do you have to CPR an animal?

answer

4 minutes

question

how many people are needed for CPR?

answer

5 needed, 3 minimum

question

what does each person do for CPR?

answer

1 on chest 1 on bag 1 on pulse 1 adm. drugs 1 keeps records

question

what are the ABCDE of CPR?

answer

A - airway B - Breathing C - circulation D - drugs E - ECG

question

what is the most important during CPR?

answer

circulation

question

how often do you do chest compressions for CPR?

answer

every 1-2 seconds

question

how often do you bag during CPR?

answer

every 10-12 seconds

question

what 4 problems can occur during anesthesia recovery?

answer

regurgitation, vomiting, aspiration seizures dyspneic prolonged recovery

question

what are 3 causes of seizures?

answer

ketamine epilepsy hypoglycemia

question

pg 345-347 blue book

answer

...

question

what is the #1 drug for pulmonary edema?

answer

lasix

question

lasix

answer

draws fluid out of kidneys

question

what are the 2 side effects of lasix?

answer

polydipsia polyuria

STUDY

Abnormal Psychology AP Psychology Blood Supply To The Brain Cognitive Psychology Inflammation Of The Brain Medical Terminology Psychology

Honors Psychology Module 7 Glossary Terms – Flashcards 21 terms

Stephen Sanchez

21 terms

Preview

Honors Psychology Module 7 Glossary Terms – Flashcards

question

Amnesia

answer

- a type of memory loss brought on my injury, use of drugs, or severe stress

question

Chunking

answer

- the process of grouping, characterizing, or categorizing information to make recall easier

question

Confabulation

answer

- an individual's tendency to fill in the gaps or holes of a memory

question

Decay

answer

- the fading away of memories over a period of time

question

Encoding

answer

- the transformation process in which the nervous system is able to process and save

question

Episodic Memory

answer

- a memory of a specific event in its entirety; like watching a video playback

question

Flashbulb Memory

answer

- a vivid, lasting memory for how one learned about a shocking or surprising event

question

Forgetting

answer

- when information that had been stored in memory can no longer be retrieved or used

question

Interference

answer

- memories that have been blocked due to a specific situation or circumstance

question

Procedural Memory

answer

- a memory or skill acquired from experience

question

Recall

answer

- the reconstruction of information already stored in memory

question

Recognition

answer

- the ability to recognize using information that an individual has already stored in their memory

question

Relearning

answer

- the idea that if you learn information at a young age it will be easier to recall the information at a later age

question

Repression

answer

- a process by which an individual deliberately blocks traumatic memories

question

Retrieval

answer

- the using of information stored in the memory

question

Schemas

answer

- generalized themes used to make sense of surrounding environments

question

Semantic Memory

answer

- general knowledge memories that are acquirred by individuals

question

Sensory Memory

answer

- information that is gathered from the senses; sight, smell, touch for less than a second

question

Serial Position Effect

answer

- the ability to recall information based on the position of the material; first to last in a list

question

Short Term Memory

answer

- the limited capacity of items to hold in memory and only with repetition or rehearsal; limited to seven items ( + or - 2)

question

Storage

answer

- the maintenance of information while kept in memory

STUDY

Blood Supply To The Brain Lock And Key Model Negative Symptoms Of Schizophrenia Neurochemistry

Final Ch4 Neurochemistry – Flashcards 113 terms

Martha Hill

113 terms

Preview

Final Ch4 Neurochemistry – Flashcards

question

Neurochemistry

answer

focuses on the basic chemical composition and processes of the nervous system

question

Neuropharmacology

answer

is the study of compounds that selectively affect the nervous system.

question

Six criteria for neurotransmitters

answer

1) Exist in presynaptic axon terminals 2) Synthesized in presynaptic cells 3) Released during action potentials 4) Receptors for it exist on PSM. 5) Produces changes in postsynaptic potentials. 6) When blocked, prevents changes.

question

Amines

answer

quaternary amines (acetylcholine) mono amines

question

quaternary amines

answer

(acetylcholine)

question

mono amines

answer

*catecholemines* (norepinephrine, epinephrine, dopamine) *indoleamines* (serotonin, melatonin)

question

Amino acids

answer

(GABA, glutamate)

question

Peptide neurotransmitters

answer

(opioids)

question

Neurotransmitters affect targets by acting on

answer

receptors

question

receptors

answer

protein molecules in the postsynaptic membrane.

question

Ionotropic receptors

answer

are fast-open an ion channel when the transmitter molecule binds

question

Metabotropic receptors

answer

are slow-when activated they alter chemical reactions in the cell, such as a G protein system, to open an ion channel.

question

ligand

answer

is a substance that binds to a receptor

question

A ligand has one of three effects:

answer

agonist antagonist inverse agonist

question

agonist

answer

initiates the normal effects of the receptor.

question

antagonist

answer

blocks the receptor from being activated by other ligands.

question

inverse agonist

answer

initiates an effect that is the opposite of the normal function.

question

Endogenous

answer

from inside

question

Exogenous

answer

from outside

question

4 biogenic amine production sites

answer

Ralphe Nuclie - seratonin Basal Ganglia - dopamine Basal Forebrain - acetocholine Locus Corealeus - epinephrine

question

Acetylcholine

answer

-plays a role in cognition, muscle contractions and the parasympathetic response -Nicotinic and Muscarinic receptors -Produced in midbrain and basal forebrain

question

Dopamine (DA)

answer

-This pathway is important in motor control and pleasure. -This pathway is implemented in to schizophrenia and movement disorders -is found in neurons in: midbrain and basal ganglia

question

Norepinephrine (NE)

answer

-NE is also known as noradrenaline-cells producing it are noradrenergic. Sympathetic response -is released in the Locus coeruleus (pons) and midbrain

question

The CNS has four subtypes of NE receptors-which are all...

answer

metabatropic

question

Serotonin (5HT)

answer

- is implicated in sleep, mood, sexual behavior, and anxiety. -Antidepressants such as Prozac increase 5HT activity, with effects depending on which receptor subtype is affected. -cell bodies are mainly found in the raphe nuclei and its serotonergic fibers project widely.

question

Amino acid transmitters:

answer

Glutamate GABA

question

Glutamate

answer

is the major excitatory neurotranmitter of the CNS

question

GABA

answer

is the major inhibitory neurotranmitter of the CNS

question

Excitotoxicity

answer

neural injury such as stroke may cause excess release of glutamate, which is toxic to neurons

question

Endorphins

answer

-are endogenous opioid peptides -They are produced in the pituitary and hypothalamus during exercise, pain, spicy food consumption and sex

question

binding affinity

answer

is the degree of chemical attraction between a ligand and a receptor.

question

efficacy (or intrinsic activity)

answer

is the ability of a bound ligand to activate the receptor.

question

Agonists

answer

high efficacy

question

Antagonists

answer

have low efficacy

question

Partial agonists or antagonists

answer

produce a medium response regardless of dose.

question

Competitive ligands

answer

are drugs that bind to the same receptor site as the neurotransmitter.

question

noncompetitive ligand

answer

binds instead to a modulatory site on the receptor. -The modulatory site, when bound by a compound, alters the receptor's response.

question

What is a dose-response curve (DRC) ?

answer

is a graph of the relationship between drug doses and the effects. -The DRC is a tool to understand pharmacodynamics-the functional relationship between drugs and their targets.

question

Drug tolerance can develop after

answer

successive treatments have decreasing effects

question

Metabolic tolerance organ systems become...

answer

more effective at eliminating the drug (e.g. alcohol)

question

Functional tolerance

answer

target tissue may show altered sensitivity to the drug (ecstacy)

question

Changes in numbers of receptors can alter sensitivity in the direction ...

answer

opposite to the drug's effects:

question

Neurons down-regulate in response to an agonist drug meaning...

answer

fewer receptors available

question

Neurons up-regulate in response to

answer

an antagonist.

question

Cross-tolerance

answer

is tolerance to a whole class of chemically similar drugs.

question

Withdrawal symptoms

answer

may be caused by drug tolerance.

question

Sensitization

answer

occurs when drug effects become stronger with repeated treatment.

question

bioavailable

answer

free to act on the target-varies with route of ingestion. -Duration of a drug's effect is determined by how it is metabolized.

question

Biotransformation produces active metabolites

answer

that may produce side effects.

question

Neuromodulators

answer

affect either transmitter release or receptor response.

question

Caffeine is an...

answer

exogenous neuromodulator that blocks the effect of adenosine, an endogenous neuromodulator that normally inhibits catecholamine release.

question

transporters

answer

specialized proteins that return the transmitter to the presynaptic membrane.

question

Some drugs affect how long transmitters remain in the synapse, they interfere with...

answer

transporters

question

When drugs affect the breakdown of neurotransmitters they are affecting the

answer

degradation of the drug

question

Cholinesterase inhibitors inhibit the breakdown of what drug

answer

ACh (acetycholine)

question

Antipsychotic (neuroleptic) drugs

answer

a class of drugs to treat schizophrenia

question

Typical neuroleptics

answer

are selective dopamine D2 antagonists.

question

Atypical neuroleptics

answer

block serotonin receptors and may reduce negative symptoms of schizophrenia.

question

Antipsychotic (neuroleptic) drugs, Typical neuroleptics, and Atypical neuroleptics all seem to do what to patients

answer

-reduce motor activity, which helps alleviate major agitation in some patients -They can also give rise to tardive dyskinesia (reversible)

question

Too much dopamine is associated with

answer

psychosis

question

Too little dopamine is associated with

answer

movement disorders

question

Antidepressants

answer

treat depression.

question

Monoamine oxidase (MAO)

answer

inhibitors prevent the breakdown of monoamines at the synapses.

question

Tricyclic antidepressants

answer

increase norepinephrine and serotonin at the synapses by blocking their reuptake into presynaptic axon terminals.

question

Selective serotonin reuptake inhibitors (SSRIs)

answer

- allow serotonin to accumulate in the synapses, with fewer side effects than tricyclics. -like Prozac or Zoloft

question

Anxiolytics, or tranquilizers

answer

reduce nervous system activity.

question

Benzodiazepine agonists act on what?

answer

also known as minor tranquilizers, and act on GABAA receptors

question

GABA receptors have several binding sites, that enhance or inhibit what??

answer

GABA's effects

question

Benzodiazepines bind at an

answer

orphan receptor-no known endogenous ligand

question

Allopregnanolone

answer

a steroid, is elevated during stress and is calming

question

Alcohol's effects are biphasic which means...

answer

an initial stimulant phase followed by a depressant phase

question

Alcohol activates GABAA receptors which increase

answer

social disinhibition, lethergy and loss of motor coordination for 4 hours

question

Alcohol also stimulates dopamine pathways, causing ...

answer

euphoric effects which last for six hours

question

Alcohol abuse damages nerve cells, especially in the ...

answer

frontal lobe, yet some damage is reversible.

question

analgesic

answer

pain killer

question

Opium contains

answer

morphine, an effective analgesic, or painkiller

question

Morphine and heroin are ...

answer

question

morphine and heroin bind to what kind of receptors?

answer

opiates bind to opioid receptors in the brain, especially in the locus coeruleus and the periaqueductal gray.

question

Endogenous opiates

answer

peptides produced in the body that bind to opioid receptors and relieve pain-are also addictive.

question

The brain contains orphan cannabinoid receptors to mediate the effects of

answer

THC and other compounds

question

Endocannabinoids

answer

homologs of marijuana produced in the brain-act as retrograde messengers and may influence neurotransmitter release from the presynaptic neuron.

question

Anandamide

answer

-an endocannabinoid Altered memory formation

question

Anadamide affects include

answer

-Altered memory formation -Appetite stimulation -Reduced pain sensitivity -Protection from excitotoxic brain damage

question

Nicotine from tobacco

answer

-Increases heart rate, blood pressure, hydrochloric acid secretion, and bowel activity -Acts as an agonist on nicotinic ACh receptors in the ventral tegmental area

question

Cocaine, the purified extract, can be used as a

answer

anesthetic

question

cocaine increases

answer

catecholamine stimulation and is highly addictive

question

Dual dependence

answer

is addiction to the effects of the interaction of two drugs.

question

Cocaine blocks which transporters

answer

monoamine transporters-especially dopamine-slows reuptake of neurotransmitters, enhancing their effects.

question

Amphetamine and methamphetamine are what kind of stimulants...

answer

synthetic stimulants that resemble catecholamines in structure. -They cause the release of neurotransmitters even in the absence of action potentials

question

Short-term effects of amphetamines include...

answer

alertness, euphoria, and stamina.

question

Long-term use leads of amphetamines include...

answer

sleeplessness weight loss, and schizophrenic symptoms

question

Hallucinogens

answer

sensory perception and produce peculiar experiences.

question

Phencyclidine (PCP) ) or angel dust,

answer

produces feelings of depersonalization and detachment from reality -Its many side effects include combativeness and catatonia. -PCP has been proposed as a chemical model for schizophrenia.

question

LSD

answer

(acid), mescaline (peyote), and psilocybin (magic mushrooms) have mainly visual effects.

question

what kind of receptor is pcp

answer

NMDA receptor antagonist and stimulates DA release

question

Ketamine (Special K)

answer

is a less potent NMDA antagonist that works in the prefrontal cortex.

question

Ketamine Like PCP

answer

can produce transient psychotic symptoms, at high doses

question

MDMA (Ecstasy) is a

answer

hallucinogenic amphetamine derivative-its major actions are increases in serotonin levels and changes in dopamine and prolactin levels. -Chronic ecstasy use produces persistent effects and damage to serotonin-producing neurons

question

The Moral Model

answer

blames the abuser for a lack of moral character or a lack of self-control

question

The Disease Model

answer

the abuser requires medical treatment; however, an abnormal condition in abusers has not been identified

question

The Physical Dependence Model

answer

called the withdrawal avoidance model, says abusers use drugs to avoid withdrawal symptoms

question

The Positive Reward Model

answer

drug use is a behavior controlled by positive rewards, with no disease

question

Many addictive drugs cause dopamine release in the what part of the brain

answer

nucleus accumbens -Some axons that terminate here originate in the ventral tegmental area (VTA) and are involved in the reward pathway. -The addictive power of drugs may come from stimulating this pathway.

question

People with damage to the insula pathway, a brain region within the frontal cortex.

answer

area have been able to stop smoking effortlessly.

question

Cue-induced drug use

answer

is the increased likelihood of using a drug because factors are present that were also present when the drug was last used.

question

Factors in susceptibility to addiction

answer

-biological-sex, genetic predisposition -Family situation-family breakup, poor relationships, sibling drug users -Personal characteristics-aggressiveness, emotional control -Environmental factors-peer pressure, social factors

question

Medications to treat drug abuse Drugs for detoxification:

answer

benzodiazepines and drugs to help ease withdrawal symptoms

question

Antagonists to the addictive drug

answer

block effects of the abused drug but may produce withdrawal symptoms

question

Agonists or analogs of the addictive drug

answer

-partially activate the same pathways, such as methadone or nicotine patches

question

Reward-blocking medications

answer

block positive reward effects of the abused drug but may produce a lack of all pleasurable feelings

question

Medications that alter drug metabolism-

answer

like *Antabuse*, which makes drinking produce unpleasant side effects

question

Anticraving medications

answer

reduce the appetite for the abused substance

question

immunization

answer

prompts the immune system to remove targeted drugs

STUDY

Alcohol Use Disorder Blood Supply To The Brain Health And Wellness Long Term Damage Nutrition Time Management Skills

Total Wellness – Flashcards 25 terms

Amber Moore

25 terms

Preview

Total Wellness – Flashcards

question

Which of the following statements is an example of negative self-talk? A/ "I wonder why my boss wants to see me. I guess I'll just have to wait and see." B/ "I'll have to start working on my next paper earlier so I can do a better job." C/ "I won the speech contest, but only because none of the other speakers were very good." D/"Too bad I missed that one problem through carelessness, but overall I did pretty well on this test."

answer

C/ "I won the speech contest, but only because none of the other speakers were very good."

question

Which one of the following characteristics is most closely associated with elevated risk of cardiovascular disease? hostility excitability lack of purpose procrastination

answer

hostility

question

The relaxation technique that directly addresses muscle tension is progressive relaxation. visualization. meditation. controlled breathing.

answer

progressive relaxation.

question

Which of the following is NOT a recommended strategy for heading off explosive anger? having a drink reframing your thoughts distracting yourself having a cooling off period

answer

having a drink

question

Which of the following is NOT an example of an effective response to stress? overeating laughing talking meditating

answer

overeating

question

When dealing with stress, compulsive exercise can NOT strengthen your immune system. lead to depression and irritability. lead to fatigue and diminished performance. become an additional stressor.

answer

strengthen your immune system.

question

Which of the following is a characteristic of depression? loss of pleasure in usual activities autonomy increased social interaction loss of memory

answer

loss of pleasure in usual activities

question

Which of the following is an example of a stressor? sweating palms getting a flat tire release of endorphins flushed face

answer

getting a flat tire

question

Which of the following is an example of an effective response to stress? using tobacco drinking alcohol taking drugs learning new time-management skills

answer

learning new time-management skills

question

A good nutritional strategy for coping with stress is to take high-potency vitamins. limit caffeine intake. take amino acid supplements. eat chocolate.

answer

limit caffeine intake.

question

A person who has difficulty expressing emotions, suppresses anger, and feels hopeless has characteristics of which personality type? Type A Type B Type C Type D

answer

Type C

question

Which of the following statements about depression and suicide is FALSE? Severe depression is linked to suicide. A sudden lightening of mood in a depressed person indicates the danger of suicide has passed. Treatments for depression are widely available and highly effective. Talking about suicide and about contemplated methods of suicide is a warning sign of suicide.

answer

A sudden lightening of mood in a depressed person indicates the danger of suicide has passed.

question

Which of the following statements about regular exercise and its ability to help manage stress is FALSE? Exercise enhances one's sense of general well-being. Exercise reduces energy levels. Exercise reduces anxiety levels. Exercise decreases tension.

answer

Exercise reduces energy level

question

Your body begins releasing endorphins, your heart rate accelerates, and your hearing and vision become more acute. You are experiencing the fight-or-flight reaction. homeostasis. a reaction of the somatic nervous system. adaptive energy response.

answer

the fight-or-flight reaction.

question

Progressive relaxation is best described as a cognitive exercise. a form of intellectual development. an activity alternating muscle tension and relaxation. a specialized form of cardiorespiratory endurance training.

answer

an activity alternating muscle tension and relaxation.

question

Stress is best defined as a physical response to an unpleasant event. the general physical and emotional state associated with the stress response. perception of one's circumstances. adaptation to an event, perceived or real.

answer

the general physical and emotional state associated with the stress response.

question

Which of the following describes a person with a Type B personality? ultracompetitive contemplative hostile controlling

answer

contemplative

question

Which term best fits a Type A personality? patient relaxed cynical passive

answer

cynical

question

Which of the following health problems has NOT been linked to uncontrolled stress? Type 1 diabetes tension headaches insomnia ulcers

answer

Type 1 diabetes

question

A good strategy for overcoming insomnia is to sleep in on weekends. not eat a meal or snack for at least 2 hours before bedtime. drink an alcoholic beverage at bedtime to help you relax. use your bed only for sleeping and not for eating, reading, or watching television.

answer

use your bed only for sleeping and not for eating, reading, or watching television.

question

Which of the following is NOT recommended by your text as a time-management strategy? Say no when necessary. Try doing things yourself rather than delegating. Consolidate tasks when possible. Set priorities.

answer

Try doing things yourself rather than delegating.

question

Which of the following does NOT occur during the relaxation response? decreased heart rate increased blood flow to the brain decreased breathing increased blood flow to the muscles

answer

increased blood flow to the muscles

question

Which of the following statements about anger is FALSE? It is better for wellness to be aggressive rather than assertive. If anger is justified, then calm but assertive communication is appropriate. To deal with anger in someone else, respond asymmetrically with calm. Former drug abuse is a warning sign for potential violence.

answer

It is better for wellness to be aggressive rather than assertive.

question

The normal progression for the general adaptation syndrome is alarm, exhaustion, resistance. exhaustion, alarm, resistance. resistance, exhaustion, alarm. alarm, resistance, exhaustion.

answer

alarm, resistance, exhaustion.

question

The parasympathetic division is best defined as a division of the autonomic nervous system that activates during times of arousal, including exercise, and when there is an emergency, such as severe pain, anger or fear. a part of the brain that activates, controls, and integrates autonomic mechanisms, endocrine activities, and many bodily functions. a division of the autonomic nervous system that is in control when you are relaxed and aids in digesting food, storing energy, and promoting growth. the branch of the peripheral nervous system that governs motor functions and sensory information; it is largely under conscious control.

answer

a division of the autonomic nervous system that is in control when you are relaxed and aids in digesting food, storing energy, and promoting growth.

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