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We've found 17 Blood Supply To The Brain tests
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?
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
question
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
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
question
________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
question
Hyper___________ means increased cholesterol in the blood.
answer
cholesterolemia
question
A __________ is an abnormal, prolonged heart sound caused by incomplete closure of heart valves.
answer
murmur
question
Rapid, random, inefficient contraction of the atria or ventricles is called:
answer
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:
answer
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
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. Â 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. Â 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. Â 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. Â 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
NE
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). Â 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). Â 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
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.")
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. Â 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
Autosomal-dominant trinucleotide repeat d/o. Chromosome 4. Atrophy of caudate nucleus (loss of GABAergic neurons) leads to enlarged lateral ventricles on CT. Â 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")
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? Â What does it supply?
answer
[Right anterior cerebral artery is labeled below -- top/left] Â Supplies medial surface of the brain, leg-foot area of motor and sensory cortices.
question
Middle cerebral artery: Where is it? Â What does it supply?
answer
[Labeled below at top/left, just beneath right anterior cerebral art.] Â 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? Â What does it supply?
answer
[labeled below along middle/right] Â 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? Â What is associated with this artery?
answer
[labeled below along top/right] Â 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] Â Common area of aneurysm; Causes CN III palsy.
question
Lateral striate: Where are they? Â What do they supply?
answer
[labeled below along middle/right] Â 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? Â What deficits are associated with an infarct here?
answer
[labled below at bottom/right] Â 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]Â 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]Â 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]Â 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]Â [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.")
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What do the lateral corticospinal tract and spinothalamic tract relay? Where are they located? How are they organized?
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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")
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What arteries follow the spinal cord?
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2 Posterior spinal arteries, 1 anterior spinal artery
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Where are the intermediate horn sympathetics found?
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The lateral gray matter of the thoracic [only] spinal cord
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Ascending spinal tracts and synapsing
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They synapse then cross.
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Spinal tract: Dorsal column -- medial lemniscal pathway
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function? Ascending pressure, vibration, touch, and proprioceptive sensation
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Ascending pressure, vibration, touch, and proprioceptive sensation what spinal tract is this?
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Dorsal column -- medial lemniscal pathway
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Spinal tract: Spinothalamic tract
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function? Ascending pain and temperature sensation
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Ascending pain and temperature sensation what spinal tract is this?
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Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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function? Descending vvoluntary movement of contralateral limbs
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Descending vvoluntary movement of contralateral limbs what spinal tract is this?
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Lateral corticospinal tract
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Spinal tract: Dorsal column -- medial lemniscal pathway
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What is the 1st order neuron? Sensory nerve ending --< cell body in dorsal root ganglion --< enters spinal cord, ascends ipsilaterally in dorsal column
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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?
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Dorsal column -- medial lemniscal pathway
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Spinal tract: Spinothalamic tract
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What is the 1st order neuron? Sensory nerve ending (A-delta and C fibers) (cell body in dorsal root ganglion) --< enters spinal cord
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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?
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Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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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
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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?
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Lateral corticospinal tract
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Spinal tract: Dorsal column -- medial lemniscal pathway
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What is the 1st synapse? Ipsilateral nucleus cuneatus or gracilis (medulla)
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Ipsilateral nucleus cuneatus or gracilis (medulla) This is the 1st synapse in which spinal tract?
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Dorsal column -- medial lemniscal pathway
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Spinal tract: Spinothalamic tract
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What is the 1st synapse? Ipsilateral gray matter (spinal cord)
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Ipsilateral gray matter (spinal cord) This is the 1st synapse in which spinal tract?
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Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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What is the 1st synapse? Cell body of anterior horn (spinal cord)
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Cell body of anterior horn (spinal cord) This is the 1st synapse in which spinal tract?
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Lateral corticospinal tract
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Spinal tract: Dorsal column -- medial lemniscal pathway
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What is the 2nd order neuron? Decussates in medulla --< ascends contralaterally in medial lemniscus
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Decussates in medulla --< ascends contralaterally in medial lemniscus This is the 2nd order neuron in which spinal tract?
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Dorsal column -- medial lemniscal pathway
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Spinal tract: Spinothalamic tract
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What is the 2nd order neuron? Decussates at anterior white commissure --< ascends contralaterally
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Decussates at anterior white commissure --< ascends contralaterally This is the 2nd order neuron in which spinal tract?
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Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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What is the 2nd order neuron? Lower motor neuron : leaves spinal cord
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Lower motor neuron : leaves spinal cord This is the 2nd order neuron in which spinal tract?
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Lateral corticospinal tract
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Spinal tract: Dorsal column -- medial lemniscal pathway OR Spinothalamic tract
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What is the 2nd synapse? VPL of thalamus
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VPL of thalamus This is the 2nd synapse in which spinal tract?
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Dorsal column -- medial lemniscal pathway OR Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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What is the 2nd synapse? Neuromuscular junction
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Neuromuscular junction This is the 2nd synapse in which spinal tract?
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Lateral corticospinal tract
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Spinal tract: Dorsal colum -- medial lemniscal pathway OR Spinothalamic tract
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What is the 3rd order neuron? Sensory cortex
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Sensory cortex This is the 3rd order neuron in which spinal tract?
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Dorsal colum -- medial lemniscal pathway OR Spinothalamic tract
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Spinal tract: Lateral corticospinal tract
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What is the 3rd order neuron? N/A (no 3rd-order neuron)
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N/A (no 3rd-order neuron) This is the 3rd order neuron in which spinal tract?
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Lateral corticospinal tract
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Lower vs. Upper motor neuron lesion
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Lower MN lesion = everything lowered (less muscle mass, decr muscle tone, decr reflexes, downgoing toes) Upper MN = everythinig up (tone, DTRs, toes)
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Spinal tract: UMN vs. LMN lesion: Weakness
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What is the 3rd order neuron? Both
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Both
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This is the 3rd order neuron in which spinal tract? UMN vs. LMN lesion: Weakness
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Spinal tract: UMN vs. LMN lesion: Atrophy
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What is the 3rd order neuron? (-) UMN (+) LMN
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(-) UMN (+) LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Atrophy
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Spinal tract: UMN vs. LMN lesion: Fasciculations (muscle twitching)
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What is the 3rd order neuron? (-) UMN (+) LMN
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(-) UMN (+) LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Fasciculations (muscle twitching)
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Spinal tract: UMN vs. LMN lesion: Reflexes
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What is the 3rd order neuron? Increased in UMN Decreaseed in LMN
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Increased in UMN Decreaseed in LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Reflexes
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Spinal tract: UMN vs. LMN lesion: Tone
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What is the 3rd order neuron? Increased in UMN, decreased in LMN
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Increased in UMN, decreased in LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Tone
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Spinal tract: UMN vs. LMN lesion: Babinski sign (upgoing toes -- normal in infants)
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What is the 3rd order neuron? (+) in UMN, (-) in LMN
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(+) in UMN, (-) in LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Babinski sign (upgoing toes -- normal in infants)
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Spinal tract: UMN vs. LMN lesion: Spastic paralysis
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What is the 3rd order neuron? (+) in UMN (-) in LMN
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(+) in UMN (-) in LMN This is the 3rd order neuron in which spinal tract?
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UMN vs. LMN lesion: Spastic paralysis
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Spinal cord lesions: Poliomyelitis and Werdnig-Hoffmann disease What areas are affected? What are the Sx?
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Lower motor neuron lesion only, due to destruction of anterior horns; flaccid paralysis
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Lower motor neuron lesion only, due to destruction of anterior horns; flaccid paralysis What spinal cord lesion is this?
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Poliomyelitis and Werdnig-Hoffmann disease
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Spinal cord lesions: Multiple sclerosis What areas are affected? What are the Sx?
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Mostly white matter of cervical region; random and asymmetric lesions, due to demyelination; scanning speech, intention tremor, nystagmus
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Mostly white matter of cervical region; random and asymmetric lesions, due to demyelination; scanning speech, intention tremor, nystagmus What spinal cord lesion is this?
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Multiple sclerosis
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Spinal cord lesions: ALS What areas are affected? What are the Sx?
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Combined upper and lower motor neuron deficits with no sensory deficit; both upper and lower motor neuron signs.
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Combined upper and lower motor neuron deficits with no sensory deficit; both upper and lower motor neuron signs. What spinal cord lesion is this?
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ALS
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Spinal cord lesions: Complete occlusion of the anterior spinal artery What areas are affected? What are the Sx?
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Spares dorsal columns and tract of Lissauer; upper throacicc ASA territory is a watershed area, as artery of Adamkiewicz supplies ASA below ~T8
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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?
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Complete occlusion of the anterior spinal artery
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Spinal cord lesions: Tabes dorsalis (tertiary syphilis) What areas are affected? What are the Sx?
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Degeneration of dorsal roots and dorsal columns; impaired proprioception, locomotor ataxia
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Degeneration of dorsal roots and dorsal columns; impaired proprioception, locomotor ataxia What spinal cord lesion is this?
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Tabes dorsalis (tertiary syphilis)
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Spinal cord lesions: Syringomyelia What areas are affected? What are the Sx?
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Crossing fibers of spinothalamic tract damaged; bilateral loss of pain and temperature sensation.
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Crossing fibers of spinothalamic tract damaged; bilateral loss of pain and temperature sensation. What spinal cord lesion is this?
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Syringomyelia
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Spinal cord lesions: Vitamin B12 neuropathy and Friedrich's ataxia What areas are affected? What are the Sx?
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Demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts; ataxic gait, hyperreflexia, impaired position and vibration sense.
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Demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts; ataxic gait, hyperreflexia, impaired position and vibration sense. What spinal cord lesion is this?
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Vitamin B12 neuropathy and Friedrich's ataxia
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Poliomyelitis: Cause? Transmission? Replication? Pathogenesis?
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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.
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Poliomyelitis: Sx?
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Malaise, hedache, fever, nausea, abdominal pain, sore throat. Signs of LMN lesions -- muscle weakness and atrohphy, fasciculations, fibrillation, and hyporeflexia.
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Poliomyelitis: Findings?
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CSF w/ lymphocytic pleocytosis w/ slight elevation of protein (w/ no change in CSF glucose). Virus recovered from stool or throat.
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Werdnig-Hoffman dz (aka infantile spinal muscular atrophy)
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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.
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Amyotrophic lateral sclerosis (commonly known as Lou Gehrig's dz)
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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.
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Tabes dorsalis
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Degeneration of dorsal columns and dorsal roots due to tertiary syphilis, resulting in impaired proprioception and locomotor ataxia.
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Associated with Tabes dorsalis
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Charcot's joints Shooting (lightning) pain Argyll Robertson pupils (aka "prostitute's pupils" - accomodate, but do not react) Absence of DTRs
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Friedrich's ataxia: Inheritance? Etiology? Sx? Onset?
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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.
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Brown-Séquard Syndrome: What is it?
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Heisection of the spinal cord
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Brown-Séquard Syndrome: Findings?
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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
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Horner's syndrome
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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)
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3 Neuron pathway involved in Horner's syndrome
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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.
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Clinically important landmarks for a pudendal nerve block (to relieve pain of pregnancy)
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Ischial spine
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Clinically important landmarks for Appendix
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2/3 of the way from the umbilicus to the anterior superior iliac spine (McBurney's point)
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Clinically important landmarks for lumbar puncture
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Iliac crest.
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Landmark dermatomes: C2
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Posterior half of a skull "cap"
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Landmark dermatomes: C3
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High turtleneck shirt
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Landmark dermatomes: C4
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Low-collar shirt
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Landmark dermatomes: T4
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At the nipple. (T4 at the teat pore )
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Landmark dermatomes: T7
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Xiphoid process
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Landmark dermatomes: T10
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At the umbilicus (important for early appendicitis pain referral) (T10 at the belly butTEN )
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Landmark dermatomes: L1
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At the inguinal ligament ("L1 is IL [I nguinal L igament])
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Landmark dermatomes: L4
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Includes kneecaps
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Landmark dermatomes: S2, S3, S4
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Erection and sensation of penile and anal zones ("S2, 3, 4, keep the penis off the floor")
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Muscle spindles vs. Golgi tendon organs
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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).
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Muscle spindle: pathway?
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In parallel with muscle fibers. Muscle stretch --< intrafusal stretch --< stimulates Ia afferent --< stimulate alpha motor neuron --< reflex muscle (extrafusal) contraction
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Spindle muscle control: the Gamma loop
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CNS stimulates gamma motor neuron --< contracts intrafusal fiber --< increased sensitivity of reflex arc
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Clinical reflexes and their respective nerve roots: Achilles? Patella? Biceps? Triceps?
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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
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Babinski sign
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Dorsiflexion of the big toe and fanning of other toes; sign of UMN lesion, but normal reflex in 1st year of life.
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Primitive reflexes
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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
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Moro reflex
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Extension of limbs when started
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Rooting reflex
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Movement of head toward one side if cheek or mouth is stroked (nipple seeking)
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Sucking reflex
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Sucking response when roof of mouth is touched
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Palmar and palantar reflexes
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Curling of fingers/toes if palms of hands/feet are stroked
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Cranial nerves that lie medially at the brainstem
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III, VI, XII Remember: 3 (x2) = 6 (x2) = 12
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Brain stem: could you label these structures?
answer
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Which cranial nerve arises dorsally and emerges ventrally?
answer
CN IV [see below, CN IV is along left in the middle]
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Dorsal brainstem structures: Pineal gland
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Melatonin secretion, circadian rhythms.
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Dorsal brainstem structures: superior colliculi
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Conjugate vertical gaze center. ("you have your eyes above your ears, and the superior colliculus (visual) is above the inferior colliculus (auditory).")
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Dorsal brainstem structures: inferior colliculi
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Auditory ("you have your eyes above your ears, and the superior colliculus (visual) is above the inferior colliculus (auditory).")
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Parinaud syndrome
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Paralysis of conjugate verticle gaze due to lesion in superior colliculi (e.g., pinealoma)
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Cranial nerves: Olfactory (CN I) function? type? mnemonic?
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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."]
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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)
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Cranial nerves: Optic (CN II) function? type? mnemonic?
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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."]
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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)
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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)
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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)
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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
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Cranial nerve nuclei located in the pons
answer
Nuclei of CN V, VI, VII, and VIII
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Cranial nerve nuclei located in the medulla
answer
Nuclei of CN IX, X, XI, and XII
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CN reflexes: Corneal OR Lacrimation (use the same nerves) Afferent? Efferent?
answer
Afferent = V-1 Efferent = VII
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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)
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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
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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")
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Vagal nuclei: Dorsal motor nucleus
answer
Sends autonomic (parasympathetic) fibers to heart, lungs, and upper GI.
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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")
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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")
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CN V motor lesion What is the defect?
answer
Jaw deviates toward the side of lesion
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CN X lesion what is the defect?
answer
Uvula deviates away from side of lesion
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CN XI lesion what is the defect?
answer
Weakness turning head to contralateral side of lesion. Shoulder droop on side of lesion.
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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.
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Facial lesions: LMN lesion
answer
Ipsilateral paralysis of upper and lower face.
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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)
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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+)
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Where is the endolymph (of the inner ear) made?
answer
Made by the stria vascularis.
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What do the utricle and saccule contain? What do they detect?
answer
Contain maculae - detect linear acceleration.
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What do the semicircular canals contain? What do they detect?
answer
Contain A mpullae, detect A ngular acceleration.
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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).
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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).
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Conductive hearing loss
answer
Bone conduction < air conduction on Rinne; Weber localizes to the affected ear.
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Sensorineural hearing loss
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Air conduction < Bone conduction on Rinne; Weber localizes to normal ear.
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Hearing loss in the elderly
answer
High frequency --< low frequency
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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
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Open angle glaucoma
answer
Obstructed outflow (e.g., canal of Schlemm); associated w/ myopia, advanced age, African-American race. More common, "silent," painless.
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Closed angle glaucoma
answer
Obstruction of flow btw iris, lens --< pressure builds up behind iris. Painful, impaired vision. Do NOT give epinephrine.
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Cataract
answer
Painless, bilateral opacification of lens, leading to decrease in vision. Risk factors: age, smoking, EtOH, sunlight, DM, trauma, infxn.
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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
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What are the 3 actions of the superior oblique?
answer
It abducts, intorts, and depresses.
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CN III damage
answer
Eye looks down and out; ptosis, pupillary dilation, loss of accomodation.
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CN IV damage
answer
Diplopia w/ defective downward gaze
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CN VI damage
answer
Medially directed eye.
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Testing extraocular muscles
answer
To test fxn of each muscle, have te pt look in the following directions:Â [*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."
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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.
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What controls pupillary constriction (miosis)
answer
P upillary sphincter muscle, P arasympathetic innervation. Innervation -- CN III from Edinger-Westphal nucleus --< ciliary ganglion.
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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.
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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.
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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.
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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"
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Retinal detachment
answer
Separation of neurosensory layer of retina from pigment epithelium | Degeneration of photoreceptors | Vision loss May be secondary to trauma, diabetes.
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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.
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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
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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
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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
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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)
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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)
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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
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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)
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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")Â 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.
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Dementia (defined)
answer
Decreased cognitive ability, memory, fxn, with intact consciousness.
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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.
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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.
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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.
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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.
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Lewy body dementia
answer
Parkinsonism with dementia and hallucinations. Caused by alpha-synuclein defect.
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Creutzfeldt-Jakob dz (CJD)
answer
Rapidly progressive (wks-mos) dementia w/ myoclonus, spongiform cortex; associated w/ prions.
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"Other" causes of dementia
answer
Multi-infarct (2nd most common cause of dementia in the elderly) Syphilis HIV Vitamin B12 deficiency Wilson's dz
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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.
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Multiple sclerosis: Who is affected?
answer
Most often affects women in their 20s and 30s; more common in whites.
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Findings in multiple sclerosis
answer
Elevated protein (IgG) in CSF. Periventricular plaques (areas of oligodendrocyte loss and reactive gliosis) w/ preservation of axons.
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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
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Tx for multiple sclerosis
answer
Beta-interferon or immunosuppressant therapy. Symptomatic Tx for neurogenic bladder, spasticity, and pain.
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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).
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Guillan-Barre syndrome (acute inflammatory demyelinating polyradiculopathy) What is the prognosis?
answer
Almost all pts survive; the majority recover completely after wks to months.
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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.
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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.
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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.
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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
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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
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Causes of seizures by age: Adults?
answer
Tumors Trauma Stroke Infxn
question
Causes of seizures by age: Elderly?
answer
Stroke Tumor Trauma Metabolic Infxn
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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.
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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
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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.
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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).
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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
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] What tumor does this describe?
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
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). What tumor does this describe?
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.
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Adult peak incidence tumors: Oligodendroma
answer
Relatively rare, slow groing. Most often in frontal lobes. Chicken-wire capillary pattern. Â 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
Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle, causing hydrocephalus. Rosettes or perivascular pseudorosette pattern cells. Radiosensitive. What tumor does this describe?
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
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. What tumor does this describe?
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
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). What tumor does this describe?
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:Â 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:Â 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
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. What epilepsy drug does this describe?
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.
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.
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
CT
question
during ______ high frequency so
answer
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
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
close
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
#1
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
4
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
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
2
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
3
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
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.."
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
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Uncontrollable: -Age -Gender -Racial or ethnic background -Family history Controllable: -Hypertension -Diabetes -Tobacco smoking -Alcohol use
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How is aphasia classified?
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-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
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Behavioral symptoms of Aphasia
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-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
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Subtypes of Aphasia
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-Global aphasia -Broca's aphasia -Wernicke's aphasia -Conduction aphasia -Anomic aphasia -Transcortical motor aphasia -Transcortical sensory aphasia
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Global Aphasia
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-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
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Broca's Aphasia
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-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
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Wernike's Aphasia
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-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
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Conduction Aphasia
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-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
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Anomic Aphasia
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-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
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Transcortical Motor Aphasia
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-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
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Transcortical Sensory Aphasia
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-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
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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
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-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
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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
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-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
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-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
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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
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"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
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
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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
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-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
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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%
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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%
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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
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-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
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-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
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Incidence Rate Formula
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number of new cases/ total population at risk over a time period x multipler (e.g., 100,000)
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Prevalence
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-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
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-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
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-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
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Point Prevalence Formula
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number of persons ill/ total number in the group at a point in time
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Lifetime Prevalence
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-cases diagnosed at any time during the person's lifetime -example: lifetime asthma diagnosis
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four measures of morbidity (illness) and mortality (death)
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-crude rates -case fatality rates -proportional mortality ratio -cause-specific rates
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Crude Rate
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-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
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Crude Death Rate Calculation
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-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
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Crude Death Rate
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number of deaths in a given year ------------------------------------------------ X100,000 reference population (during midpoint)
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Case Fatality Rate (CFR)
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-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)
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-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
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Specific Rates
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-three examples are: -cause-specific rates -age-specific rates -sex-specific rates
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Cause-specific rates
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-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)
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-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.
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Sex-specific rate
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-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
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-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
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-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
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-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
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-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
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-vital events are deaths, births, marriages, divorces, and fetal deaths -the vital registration system in the United States collects information routinely on those events
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Deaths
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- 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)
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Information included on death certificate data in U.S.
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-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
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-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
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Data from Public Health Surveillance Programs
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-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
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-referes to the systematic and continuous gathering of information about the occurence of diseases and other health phenomena
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Syndromic Surveillance
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-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
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Reportable and notifiable disease statistics
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-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
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Examples of Reportable and Notifiable Disease Statistics
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-sexually transmitted diseases -rubella -tetanus -measles -plague -foodborne disease
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Deficiencies of Reportable and Notifiable Disease Statistics
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-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
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-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)
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-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
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-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)
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-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
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Life expectancy
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number of years that a person is expected to live, at any particular year (e.g., at birth)
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Maternal Mortality
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-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
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number of deaths assigned to causes related to childbirth ------------------------------------------------------X100,000 number of live births
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Infant Mortality Rate
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-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
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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
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-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
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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
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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
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
question
Ataxia
answer
gross lack of coordination of muscle movements, such as staggering gait
question
Dizziness
answer
a word that is often used to describe either lightheadedness or vertigo
question
Dysarthria
answer
motor speech disorder due to weakness, paralysis, or muscular un-coordination, characterized by poor articulation
question
Dysphasia
answer
impairment of speech
question
Fecal incontinence
answer
inability to control one's bowels
question
HA
answer
headache
question
Hemiparesis
answer
weakness on one side of the body
question
Hemiplegia
answer
total paralysis on one side of the body
question
Lightheadedness
answer
the feeling that you are about to faint or "pass out"
question
LOC
answer
loss of consciousness
question
Paresthesias
answer
sensation of tingling, prickling, or numbness of a person's skin
question
Post-ictal
answer
the altered state of consciousness that person enters after experiencing a seizure
question
Saddle anesthesia
answer
loss of sensation restricted to the area of the buttocks and perineum
question
Syncope
answer
temporary loss of consciousness (fainting)
question
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
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
2
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
no
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
AF
answer
atrial fibrilation no p waves
question
VF
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
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
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
related
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
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.