Chapter 22
Through what area does the cerebrospinal fluid circulate around the brain and spinal cord? in the subarachnoid space
Which is the usual location of language centers? left hemisphere
What would be the effect of damage to the auditory association area in the left hemisphere? inability to understand what is heard
Which applies to corticospinal tract? it is a pyramidal tract for efferent impulses
What is a major function of the limbic system? determines emotional responses
Where are beta-1 adrenergic receptors located? cardiac muscle
What does a vegetative state refer to? depression of the RAS and inability to initiate action
Which is NOT part of the criteria for a declaration of "brain death"? presence of any head injury
What is the best definition of aphasia? inability to comprehend or express language appropriately
What is an early indicator of increased intracranial pressure? decreasing responsiveness
What is the rationale for vomiting with increased intracranial pressure? pressure on the emetic center in the medulla
What is the typical change in blood pressure with increased intracranial pressure? increasing pulse pressure
A brain tumor causes a headache because the tumor stretches the meninges and blood vessels wall
Which of the following causes papilledema? increased pressure of CSF at the optic disc
What is the effect of an enlarging brain abscess on cardiovascular activity? systemic vasoconstriction and slower heart rate
As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of the pressure on the:
PNS fiber in cranial nerve III
Which indicates that CSF is normal? clear and colorless fluid
Which is TRUE about malignant brain tumors? primary brain tumors metastasize outside the CNS
Which would be the expected effect of a tumor developing in the inferior part of the left frontal lobe? weakness in the ride side of the face
Why are focal or generalized seizures an early indication of a brain tumor? surrounding inflammation stimulates neurons to discharge spontaneously
Which of the following is a TRUE statement about transient ischemic attacks? they often warn of potential cerebrovascular accidents
What is the probable source of the embolus causing a CVA? common carotid artery
Collateral circulation is most likely to be present when a CVA results from: development of an atheroma
All apply to CVA EXCEPT maximum necrosis and infarction develop within several hours of onset
What would be the effect of infarction owing to obstruction in the right anterior cerebral artery? contralateral weakness in the leg, impaired spatial relationships
In the weeks following CVA, why might some neurological function return?
1. presence of collateral circulation
2. immediate therapy to dissolve thrombi and maintain perfusion
3. reduced inflammation in the area
4. development of alternative neuronal pathways
Which is NOT true about berry aneurysms in the brain? rupture causes signs of circulatory shock
In a case of bacterial meningitis, where does swelling and purulent exudate form? involving the pia, arachnoid and surface of the entire brain
What are significant signs of acute bacterial meningitis? severe headache, nuchal rigidity, and photophobia
In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted? bites of mosquitoes and ticks
All of the following apply to tetanus infection EXCEPT: signs of infection include fever, vomiting, stiff neck, and paralysis
In cases of Guillain-Barré syndrome, what does the pathophysiology include? inflammation and demyelination of peripheral nerves, leading to ascending paralysis
How does a depressed skull fracture cause brain damage?
A section of skull bone is displaced below the level of the skull, causing pressure on the brain.
Following a head injury, what is the most likely cause of secondary damage to the brain? hematoma or infection
An epidural hematoma is located between the dura mater and the skull
What does the term otorrhea mean?
CSF leaking from the ear
Why may secondary damage occur shortly after a spinal cord injury? presence of unstable fractures or dislocations of vertebrae catecholamine release in the area causing local vasoconstriction decreased or labile systemic blood pressure
Following a spinal injury at C5, what is the expected effect during the period of spinal shock? possible periods of apnea
Following an injury at L2 to L3, what would indicate recovery from spinal shock? spastic paraplegia
What are the signs of autonomic dysreflexia in a person with cervical spinal injury? sudden marked increase in blood pressure with bradycardia
Expressive aphasia is most likely to result from damage to: the left frontal lobe
What is the usual result of damage to the right occipital lobe? loss of left visual field
How does the heart rate change as intracranial pressure increases? rate decreases
Which statement best describes herniation resulting from increased intracranial pressure? displacement of brain tissue downward toward the spinal cord
Which type of cerebrovascular accident has the poorest prognosis? hemorrhagic CVA
Which of the following factors predispose(s) an individual to a cerebrovascular accident?
1. hypertension
3. smoking cigarettes
4. history of coronary artery disease
5. diabetes mellitus
What are the significant early signs of a ruptured cerebral aneurysm? severe headache, nuchal rigidity, and photophobia
Which term refers to a stiff hyperextended neck associated with irritation of spinal nerve roots? nuchal rigidity
With regard to meningitis, choose the correct combination of microbe and the age group commonly affected.
N. meningitides: children and youth
Which of the following statements applies to a lumbar puncture?
It is usually performed at L3-L4.
Which signs are indicative of post-polio syndrome? progressive fatigue and weakness
Which of the following does NOT apply to Reye's syndrome?
There is no permanent damage in the body.
Which type of fracture typically occurs at the base of the skull? basilar The primary reason for seizures frequently occurring with head injuries is: presence of blood irritates the neurons
An accurate assessment of the extent of permanent spinal cord damage can usually be completed: approximately 10 days to 2 weeks following injury if no complications arise
The rabies virus is usually transmitted by: bites from infected animals
Common manifestations of rabies infection include: headache, foaming at the mouth, and difficulty swallowing
Which statement is TRUE about tetanus infection?
Infection usually develops in deep puncture wounds.
Which of the following impairments results from infection by the polio virus? loss of function of motor neurons of the spinal cord and medulla
Herpes zoster can be identified by a typical: unilateral rash and pain along a cranial nerve or dermatome
Which of the following conditions is marked by focal signs? brain abscess
Typical signs of a TIA include: transient muscle weakness in a hand or leg