Deck 17: Disorders of Neurologic Function

Question 1

Rebleeding after a subarachnoid hemorrhage is a significant risk and occurs most often 4 weeks after the initial hemorrhage.

Answer 1

False

Question 2

What are indications that spinal shock is terminating?

A) Voluntary movement below the level of injury
B) Reflex emptying of the bladder
C) Paresthesia below the level of injury
D) Decreased deep tendon reflexes and flaccid paralysis

Answer 2

Reflex emptying of the bladder

Question 3

Most central nervous system tumors in children are above the tentorium cerebelli.

Answer 3

False

Question 4

Because spinal cord swelling increases the degree of dysfunction,it is difficult to distinguish between permanent and temporary loss of function until the swelling is resolved.

Question 5

In encephalitis,viruses gain access to the central nervous system through blood or peripheral nerves.

Question 6

About half of all people with acquired immunodeficiency syndrome (AIDS)have neurologic complications.

Question 7

_____ are most at risk of spinal cord injury from minor trauma.

A) Children
B) Adolescents
C) Adults
D) Older adults

Question 8

Which disorder has clinical manifestations of a decreased consciousness up to 6 hours,retrograde and post traumatic amnesia,and loss of reflexes with brief bradycardia and transient apnea?

A) Mild concussion
B) Classic concussion
C) Cortical contusion
D) Acute subdural hematoma

Question 9

Why is the edema of the upper cervical cord after spinal cord injury considered life threatening?

A) Because of hypovolemic shock from blood lost during the injury
B) Because of the apnea from the impairment to the diaphragm
C) Because a head injury is more likely to occur during the injury
D) Because of the spinal shock immediately after the injury

Question 10

Radiculopathies are disorders of the roots of spinal nerves.

Question 11

The most severe diffuse brain injury caused by rotational acceleration is most likely to be located:

A) peripheral to the brainstem.
B) in the medial portion of the brainstem.
C) throughout the brainstem.
D) in the diencephalon.

Question 12

Autonomic hyperreflexia is most likely to occur before spinal shock is resolved.

Question 13

Guillain-Barré syndrome causes sensory neuropathy.

Question 14

Tubercular meningitis is on the rise in the United States especially in persons with acquired immunodeficiency syndrome (AIDS).

Question 15

Bacterial meningitis can develop as a consequence of ear or gum infections.

Question 16

Most people with amyotrophic lateral sclerosis live symptom free for at least 10 years following diagnosis.

Question 17

The peripheral nervous system is the main location of lesions in multiple sclerosis.

Question 18

What damage occurs to the brain in classic cerebral concussions?

A) Diffuse cerebral disconnection from the reticular activating system
B) Cerebral edema throughout the cerebral cortex
C) Cerebral edema throughout the diencephalon
D) Disruption of axons extending from the diencephalon and brainstem

Question 19

About 75% of people with myasthenia gravis have pathologic changes in the thymus.

Question 20

In cases of subarachnoid hemorrhage,the intracranial pressure may approach levels of diastolic blood pressure.

Question 21

Which are the most common primary CNS tumors?

A) Microgliomas
B) Neuroblastomas
C) Astrocytomas
D) Neuromas

Question 22

Why does the person who has a spinal cord injury experience faulty control of sweating and radiation causing them to assume the temperature of the air?

A) Because the hypothalamus is unable to regulate body heat as a result of sympathetic nervous system damage
B) Because the thalamus is unable to regulate body heat as a result of sympathetic nervous system damage
C) Because the hypothalamus is unable to regulate body heat as a result of parasympathetic nervous system damage
D) Because the hypothalamus is unable to regulate body heat as a result of damage to spinal nerve roots

Question 23

What is the central component of the pathogenic model of multiple sclerosis?

A) Myelination of nerve fibers in the PNS
B) Demyelination of nerve fibers in the CNS
C) The development of neurofibril tangles in the CNS
D) Inherited autosomal dominant trait with high penetrance

Question 24

A patient was in an automobile accident in which his forehead struck the windshield.In this situation,the coup injury would occur in the _____ region.

A) frontal
B) temporal
C) parietal
D) occipital

Question 25

Which intervertebral disk has herniated for the patient who complains of motor and sensory changes of the lateral lower legs and soles of the feet?

A) L2-L3
B) L3-L5
C) L5-S1
D) S2-S3

Question 26

Where are most intracranial tumors located in adults?

A) Above the tentorium cerebelli
B) Below the tentorium cerebelli
C) Laterally
D) Posterolaterally

Question 27

Of the following people,who are at highest risk for a cerebrovascular accident?

A) White women over 65 years of age
B) Black women over 65 years of age
C) Black men over 65 years of age
D) White men over 65 years of age

Question 28

A patient was in an automobile accident in which his forehead struck the windshield.In this situation,the contrecoup injury would occur in the _____ region.

A) frontal
B) temporal
C) parietal
D) occipital

Question 29

Which clinical finding is almost diagnostic for an arteriovenous malformation?

A) Systolic bruit over the carotid artery
B) Decreased level of consciousness
C) Hypertension with bradycardia
D) Diastolic bruit over the temporal artery

Question 30

A patient who has a right hemisphere cerebrovascular accident caused by an emboli has left-sided paralysis and reduced sensation of the left foot and leg.What is the location of the emboli?

A) Right middle cerebral artery
B) Right vertebral artery
C) Right posterior cerebral artery
D) Right anterior cerebral artery

Question 31

What sequence causes bradycardia that occurs during autonomic hyperreflexia?

A) Stimulation of the sympathetic nervous system to ß-adrenergic receptors to the sinoatrial node
B) Stimulation of the carotid sinus to the vagus nerve to the sinoatrial node
C) Stimulation of the parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
D) Stimulation of the bundle branches to the

Question 32

Atrial fibrillation,rheumatic heart disease and valvular prosthetics are risk factors for which type of stroke?

A) Hemorrhagic
B) Thrombotic
C) Emboli
D) Lacunar

Question 33

What complication is occurring for a person who has a spinal cord injury above T6 and who is experiencing paroxysmal hypertension and has piloerection and sweating above the spinal cord lesion?

A) Craniosacral dysreflexia
B) Parasympathetic dysreflexia
C) Autonomic hyperreflexia
D) Healing of the spinal cord lesion

Question 34

Which clinical manifestation is characteristic of cluster headaches?

A) Aura before the headache with photophobia and nausea and vomiting
B) Severe unilateral tearing,burning,or temporal pain
C) Gradual onset of bilateral pain with sensation of a tight band around the head
D) Throbbing headache with intermittent burning sensation

Question 35

What are the initial clinical manifestations associated with acute spinal cord injury?

A) Headache,bradycardia,and elevated blood pressure
B) Confusion,irritability,and retrograde amnesia
C) Loss of deep tendon reflexes and flaccid paralysis
D) Hypotension,neurogenic shock,and tachycardia

Question 36

Where are most intracranial tumors located in children?

A) Above the tentorium cerebelli
B) Below the tentorium cerebelli
C) Laterally
D) Posterolaterally

Question 37

Vasogenic edema with increased capillary permeability occurs after what type of stroke?

A) Embolic
B) Hemorrhagic
C) Lacunar
D) Thrombotic

Question 38

Which cerebral vascular disorder causes meningeal irritation,photophobia,and positive Kernig positive Brudzinski signs?

A) Intracranial hemorrhage
B) Subarachnoid hemorrhage
C) Epidural hemorrhage
D) Subdural hemorrhage

Question 39

Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?

A) Cavernous angioma
B) Capillary telangiectasis
C) Arteriovenous angioma
D) Arteriovenous malformation

Question 40

What are characteristics of meningiomas?

A) They compress from within neural tissues.
B) They compress spinal nerve roots.
C) They compress from outside the spinal cord.
D) They compress from the subarachnoid space.

Question 41

Which areas of the spinal cord are more easily injured?

A) Cervical and thoracic regions
B) Thoracic and lumbar regions
C) Lumbar and sacral regions
D) Cervical and lumbar regions

Question 42

Match the terms with the corresponding descriptions.
Meningitis

A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection

Question 43

After a cervical spinal cord injury,the patient's body temperature fluctuates markedly.What is the most accurate explanation of this phenomenon?

A) The patient probably has developed bilateral pneumonia or a urinary tract infection.
B) The patient's sympathetic nervous system has been damaged disturbing thermal control.
C) The patient also sustained a head injury that damaged the hypothalamus that regulated temperature.
D) The patient has septicemia from an unknown source.

Question 44

A patient who sustained a cervical spinal cord injury is scheduled for fusion surgery in 2 days.Suddenly he develops a blood pressure of 250/120,a severe headache,blurred vision,and bradycardia.What is the explanation for these clinical manifestations?

A) He is experiencing acute anxiety regarding his upcoming surgery.
B) He is developing spinal shock.
C) He is developing autonomic hyperreflexia.
D) He is experiencing parasympathetic areflexia.

Question 45

How are multiple sclerosis and Guillain-Barré similar?

A) Both result from demyelination by an immune reaction.
B) Both cause permanent destruction of peripheral nerves.
C) Both result from inadequate production of neurotransmitters.
D) Both block acetylcholine receptor sites at the myoneural junction.

Question 46

MATCHING
Match the terms with the corresponding descriptions.
Accumulation of blood,usually arterial,above dura mater,but beneath the skull

A)Concussion
B)Contusion
C)Extradural hematoma
D)Subdural hematoma
E)Intracerebral hematoma

Question 47

MATCHING
Match the terms with the corresponding descriptions.
May be acute or chronic accumulation of venous blood

A)Concussion
B)Contusion
C)Extradural hematoma
D)Subdural hematoma
E)Intracerebral hematoma

Question 48

MATCHING
Match the terms with the corresponding descriptions.
Bleeding into the brain parenchyma

A)Concussion
B)Contusion
C)Extradural hematoma
D)Subdural hematoma
E)Intracerebral hematoma

Question 49

Which are characteristics of amyotrophic lateral sclerosis (ALS)?

A) It is an autosomal dominant genetic disorder.
B) It results in demyelination of the central nervous system.
C) It results in upper and lower motor neuron degeneration.
D) It is an autoimmune disorder caused by a virus.

Question 50

Match the terms with the corresponding descriptions.
Encephalitis

A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection

Question 51

Which is a characteristic of Guillain-Barré syndrome?

A) It is preceded by a viral illness.
B) It involves a deficit in acetylcholine.
C) It results in asymmetric paralysis.
D) It involves demyelination of the central nervous system nerves.

Question 52

A patient begins having problems with tiredness,weakness,and visual changes.Her diagnosis is multiple sclerosis (MS).Which is the best description of MS?

A) It is a central nervous system demyelination,possibly from an immunogenetic virus.
B) It is an inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder.
C) It is a depletion of dopamine in the central nervous system as a result of a virus.
D) It is a degenerative disorder of lower and upper motor neurons caused by viral-immune factors.

Question 53

Which are characteristics of myasthenia gravis?

A) It is an acute autoimmune disease.
B) It affects the nerve roots.
C) It may result in adrenergic crisis.
D) It causes muscle weakness and fatigability.

Question 54

Match the terms with the corresponding descriptions.
Brain abscess

A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection

Question 55

The type of vascular malformation that most often hemorrhages is:

A) cavernous angiomA.
B) venous angioma.
C) capillary telangiectasis.
D) arteriovenous malformation.

Question 56

MATCHING
Match the terms with the corresponding descriptions.
Produced by epidural hemorrhage and subdural or intracranial hematoma

A)Concussion
B)Contusion
C)Extradural hematoma
D)Subdural hematoma
E)Intracerebral hematoma

Question 57

Match the terms with the corresponding descriptions.
Cryptococcus neoformans

A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection

Question 58

A major contributing process in a cerebrovascular accident (CVA)is the development of atheromatous plaques in cerebral circulation.Where do these plaques most commonly form?

A) In the larger veins
B) Near capillary sphincters
C) At branches of arteries
D) On the venous sinuses

Question 59

In which disorder are acetylcholine receptors antibodies (IgG antibodies)produced against acetylcholine receptors?

A) Guillain-Barré syndrome
B) Multiple sclerosis
C) Myasthenia gravis
D) Parkinson disease

Question 60

MATCHING
Match the terms with the corresponding descriptions.
Moving object striking a stationary head

A)Concussion
B)Contusion
C)Extradural hematoma
D)Subdural hematoma
E)Intracerebral hematoma

Question 61

Match the terms with the corresponding descriptions.
Lyme disease

A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection