Question 1

A 20-year-old male is admitted to the neuro critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure is recorded at 24 mm Hg. This reading is:

Accepted Answer

This reading is higher than the normal range of intracranial pressure, which is usually between 5-15 mm Hg. A pressure of 20 mm Hg or higher is considered elevated and can indicate significant brain swelling or other complications. A reading of 24 mm Hg indicates the patient has some degree of elevated intracranial pressure.

Question 2

Vasogenic edema is clinically important because:

Accepted Answer

Vasogenic edema is characterized by the breakdown of the blood-brain barrier, leading to an accumulation of fluid in the interstitial space. This can be caused by a variety of conditions, including tumors, infections, and inflammation. It can lead to increased intracranial pressure but does not always result in herniation.

Question 3

A 70-year-old female is being closely monitored in the neuro critical care unit for a severe closed head injury. After 48 hours, her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension?

Accepted Answer

The clinical findings of small and sluggish pupils, widening pulse pressure, and bradycardia are indicative of Stage 3 intracranial hypertension, which is considered a neurological emergency. In this stage, the intracranial pressure is elevated to the point where cerebral blood flow is compromised, leading to brain herniation and death if left untreated. It is important to immediately intervene to reduce the intracranial pressure to prevent further deterioration.

Question 4

Cerebral edema is an accumulation of fluid in the:

Accepted Answer

Cerebral edema is an accumulation of fluid in the brain tissue, which can cause swelling and increased pressure within the skull. This can lead to decreased blood flow and oxygen to the brain, potentially causing damage or even death. Edema in the ventricles or subarachnoid space can also occur, but these are less common locations for cerebral edema. Neuroglia are the supporting cells of the nervous system and do not typically accumulate fluid.

Question 5

Dementia is manifested by:

Accepted Answer

Dementia is characterized by a loss of recent and remote memory, along with other cognitive impairments such as difficulty with language, problem-solving, and attention. While behavioral and emotional changes can occur, they are not the primary manifestation of dementia.

Question 6

A 51-year-old male is admitted to the neuro critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. This condition is known as:

Accepted Answer

The described posture is consistent with decerebrate posturing, which is seen in severe brainstem injury. Decorticate posturing involves flexion at the elbows and wrists, whereas caloric posturing and excitation posturing are not commonly used terms in the clinical setting.

Question 7

A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:

Accepted Answer

The answer of A compensatory alteration in the diameter of...

Question 8

Spinal shock is characterized by:

Accepted Answer

The answer of Spinal shock is characterized by:
...

Question 9

A decrease in cerebral perfusion pressure is related to which of the following changes?

Accepted Answer

A decrease in cerebral perfusion pressure indicates a reduction in the pressure gradient between the arterial blood pressure and the intracranial pressure, which can occur due to an increase in intracranial pressure. An increase in arterial blood pressure or cerebral blood flow would result in an increase in cerebral perfusion pressure. Cerebral artery vasodilation may or may not affect cerebral perfusion pressure, depending on its contribution to cerebral blood flow and changes in intracranial pressure.

Question 10

An infant is diagnosed with noncommunicating hydrocephalus. An immediate concern for this patient is:

Accepted Answer

Noncommunicating hydrocephalus can cause an obstruction in the ventricular system of the brain, leading to an accumulation of cerebrospinal fluid and increased pressure on brain tissue. This pressure can cause interstitial edema, which can be especially concerning in infants whose skulls have not fully fused and may not be able to accommodate the increased pressure. Metabolic, vasogenic, and ischemic edema are not typically associated with hydrocephalus.

Question 11

A 15-year-old female is admitted to the intensive care unit with a severe closed head injury. This diagnosis puts her at risk for:

Accepted Answer

Closed head injuries can lead to cerebral edema due to swelling and increased pressure within the skull.

Question 12

A 40-year-old male complains of abnormal movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is:

Accepted Answer

The symptoms described are indicative of Huntington disease, a progressive neurodegenerative disorder characterized by abnormal movements (chorea) and cognitive decline. Tardive dyskinesia is a movement disorder associated with long-term use of certain medications, hypokinesia is a decrease in voluntary movement, and Alzheimer's disease primarily affects memory and cognitive function rather than movement.

Question 13

Hydrocephalus in adults is most often caused by:

Accepted Answer

Hydrocephalus in adults is most often caused by defective CSF reabsorption, which can occur due to a variety of factors including previous infections, head injuries, brain tumors, or bleeding in the brain. Overproduction of CSF, intercellular edema, and elevated arterial blood pressure can also contribute to hydrocephalus, but are less common causes in adults.

Question 14

A _____ is also known as a senile gait.

Accepted Answer

A basal ganglion gait is often referred to as a senile gait, characterized by a shuffling walk commonly seen in elderly individuals.

Question 15

A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from:

Accepted Answer

Gegenhalten, also known as paratonia, is characterized by resistance to passive movement that varies proportionally with the force applied, which matches the description given in the scenario.

Question 16

A disorder that causes excessive movement is:

Accepted Answer

Hyperkinesia is a disorder that causes excessive movement.

Question 17

A direct consequence of increased intracranial pressure is:

Accepted Answer

Increased intracranial pressure can cause compression of blood vessels, leading to decreased blood flow and brain tissue hypoxia. Choice B (intracranial hypotension) is the opposite of increased intracranial pressure and is not a consequence of it. Choice C (ventricular swelling) may occur as a result of increased intracranial pressure, but it is not a direct consequence. Choice D (expansion of the cranial vault) is a potential result of longstanding increased intracranial pressure, but not a direct consequence.

Question 18

Paralysis of the lower extremities is called:

Accepted Answer

Paralysis of the lower extremities is specifically called paraplegia. Quadriplegia refers to paralysis of all four limbs (the arms and legs), while infraparaplegia and paresthesia do not accurately describe paralysis of the lower extremities.

Quiz 14: Concepts of Neurologic Dysfunction