Neurology and Mental Health Practice Flashcards

One hundred practice flashcards covering neurology and mental health topics including anatomy, assessment, Alzheimer's disease, Parkinson's disease, migraines, seizures, and meningitis based on the lecture material.

What are the motor nerve cells that carry signals away from the CNS to the cells in the PNS?

Efferent neurons

Which neurons are specialized to send impulses towards the CNS and away from the PNS?

Afferent (sensory) neurons

What is the name of the basic unit of the nervous system?

The neuron

Which part of a neuron receives an impulse from another neuron, potentially causing excitation or inhibition?

Dendrites

What are the three components that make up each neuron?

A cell body (soma), dendrites, and a single axon

What is the outer layer of the meninges called?

Dura mater

What is the innermost layer of the meninges called?

Pia mater

Where is the subdural space located within the brain's protective layers?

Between the dura mater and the arachnoid layer

In which space does the cerebrospinal fluid (CSF) circulate?

Subarachnoid space

Which space is located between the skull and the outer layer of the dura mater?

Epidural space

What is the name of the dura mater fold that lies between the cerebral hemispheres and the cerebellum?

Tentorium

What is the major relay station or central switchboard for the central nervous system?

Thalamus

Which part of the diencephalon plays a major role in autonomic nervous system (ANS) control and cognition?

Hypothalamus

Which part of the diencephalon regulates emotion and contributes to smooth voluntary motor function?

Epithalamus

What is the largest part of the brain, responsible for intelligence, creativity, and memory?

Cerebrum

What structure joins the right and left hemispheres of the cerebrum?

Corpus callosum

What group of neurons at the base of the cerebrum helps regulate motor function?

Basal ganglia

Which lobe of the cerebral cortex contains the primary motor area and Broca speech center?

Frontal lobe

Which lobe is responsible for understanding three-dimensional spatial relationships and perception of body parts?

Parietal lobe

In which lobe is the Wernicke area for language comprehension located?

Temporal lobe

Which lobe contains the primary visual center of the brain?

Occipital lobe

What is the main function of the cerebellum regarding limb movement?

It enables a person to keep an extremity from overshooting an intended target

Which structures are included in the brainstem?

Midbrain, pons, and medulla

What system of special cells throughout the brainstem controls awareness and alertness?

Reticular activating system (RAS)

Which physiological barrier exists because cerebral capillary endothelial cells are joined tightly together?

Blood-brain barrier (BBB)

What ring-like structure at the base of the brain is formed by the joining of cerebral arteries?

Circle of Willis

Which area of the brainstem serves as the cardiac-slowing and respiratory center?

Medulla

Which part of the brainstem contains the cardiac acceleration and vasoconstriction centers?

Pons

What is the location of the periaqueductal gray, which may abolish pain when stimulated?

Midbrain

How many pairs of spinal nerves exit from the spinal cord?

$31$ pairs

What is the breakdown by region of the $31$ pairs of spinal nerves?

$8$ cervical, $12$ thoracic, $5$ lumbar, $5$ sacral, and $1$ coccygeal

Where do the sympathetic nervous system (SNS) cells originate in the spinal cord?

Gray matter from $T1$ through $L2$ or $L3$

Which part of the ANS is referred to as the craniosacral division?

The parasympathetic nervous system

What is the primary function of the sympathetic nervous system?

Stimulating functions for fight or flight, such as heart and respiratory rate

What is the function of Cranial Nerve I (Olfactory)?

Smell

Which cranial nerve is responsible for central and peripheral vision?

Cranial Nerve II (Optic)

Cranial Nerve III (Oculomotor) is responsible for which physiological response besides eye movement?

Pupil constriction

Which cranial nerve controls the superior oblique muscles for eye movement?

Cranial Nerve IV (Trochlear)

What are the two primary functions of Cranial Nerve V (Trigeminal)?

Sensory perception from the face/scalp and muscles of mastication (chewing)

Which eye muscle is controlled by Cranial Nerve VI (Abducens)?

Lateral rectus muscle

Cranial Nerve VII (Facial) provides taste sensation to which part of the tongue?

Anterior two-thirds of the tongue

What is the primary function of Cranial Nerve VIII (Vestibulocochlear)?

Hearing

Which cranial nerve involves the parotid glands and taste from the posterior one-third of the tongue?

Cranial Nerve IX (Glossopharyngeal)

Which cranial nerve provides parasympathetic-motor innervation to the thoracic and abdominal viscera?

Cranial Nerve X (Vagus)

Which muscles are controlled by Cranial Nerve XI (Accessory)?

Sternocleidomastoid and trapezius muscles

What is the function of Cranial Nerve XII (Hypoglossal)?

Skeletal muscles of the tongue for swallowing

In older adults, where is the greatest loss of brain weight typically located?

White matter of the frontal lobe

Which cells in the CNS are responsible for cell-mediated immune response and deteriorate with age?

Microglia

What is the earliest and most reliable indication that central neurologic function has declined?

A decrease in level of consciousness (LOC) and orientation

What does the acronym AVPU stand for in level of consciousness assessment?

Alert, Voice responsive, Pain responsive, Unresponsive

When assessing pupils, which two cranial nerves are being evaluated for reaction?

CN II and III

How is Cranial Nerve VII (Facial) assessed by a nurse?

By checking facial symmetry while observing the patient's face

Which two cranial nerves are checked together to assess swallowing?

CN IX and X

What are the three categories assessed in the Glasgow Coma Scale (GCS)?

Eye opening, motor response, and verbal response

What total score on the Glasgow Coma Scale (GCS) indicates a patient is comatose?

$7$ or less

A decrease of how many points in the GCS total is considered clinically significant?

$2$ or more points

What abnormal posturing involves the flexion of arms, wrists, and fingers with internal rotation?

Decortication

What abnormal movement is characterized by body spasms bowing forward and is associated with brainstem dysfunction?

Decerebration

What term defines the loss of sensory comprehension and the inability to recognize familiar stimulation?

Agnosia

What is the term for the inability to find words?

Anomia

What is the term for the impairment in performing familiar movements?

Apraxia

What is the most common type of dementia?

Alzheimer's disease

What is the cause of Vascular Dementia?

Strokes or other vascular disorders that decrease blood flow to the brain

What are the classic pathophysiological changes seen in Alzheimer's disease?

Neurofibrillary tangles and neuritic plaques

What is the most well-established genetic factor for Alzheimer's disease in white populations?

Apolipoprotein E (APOE)

What is often one of the first symptoms of Alzheimer's disease?

Short-term memory impairment

What is the term for increased confusion seen in Alzheimer's patients at night or when light is inadequate?

Sundowning

At what stage of Alzheimer's disease is a patient typically independent in ADLs but may lose their sense of smell?

Early-stage AD

In which stage of Alzheimer's does a patient typically become incontinent and encounter visuospatial deficits?

Moderate-stage AD

In later stages of AD, what do CT scans typically show in the brain?

Cerebral atrophy, vascular degeneration, ventricular enlargement, wide sulci, and shrunken gyri

What diagnostic marker in the CSF supports an Alzheimer's diagnosis when its levels decrease?

Amyloid beta protein precursor (soluble) (sBPP)

What therapy involves acknowledging a patient's feelings and concerns without overcorrecting their reality?

Validation therapy

Which drug class is approved for treating the symptoms of Alzheimer's disease?

Cholinesterase inhibitors

Why are psychotropic drugs often considered chemical restraints in dementia patients?

Because they decrease mobility and the patient's self-management ability

What is the Pain Assessment in Advanced Dementia Instrument (PAINAD) used for?

To assess pain in noncommunicative patients

When assessing for decision-making capacity in AD, what four processes must be evaluated?

Understanding the situation, appreciating the situation, reasoning ability, and making appropriate choices

What are the four cardinal symptoms of Parkinson's disease?

Tremor, muscle rigidity, bradykinesia/akinesia, and postural instability

What is the non-motor sign of Parkinson's involving small handwriting?

Micrographia

Symptoms of Parkinson's appear when dopamine levels decrease to what percentage of usual levels?

$70\%$ to $$80\%

Why do Parkinson's patients experience orthostatic hypotension and drooling?

Loss of sympathetic nervous system influence on the heart and blood vessels

What abnormal proteins deposit in the brains of patients with PD, causing movement problems?

Lewy bodies

In Stage $1$ of Parkinson's disease, where are resting tremors usually noticed?

In one arm (unilateral)

What term describes the Parkinson's symptom where patients feel as though they are stuck to the floor?

Freezing

What is the purpose of a DaT scan?

To confirm abnormalities in dopamine transmission in the basal ganglia via SPECT

The wearing-off phenomenon in PD is characterized by alternating periods of what?

Good mobility (on periods) and altered mobility (off periods)

Why should Parkinson's medications like carbidopa/levodopa be given before meals?

To increase absorption and transport across the blood-brain barrier

What is a drug holiday in the context of Parkinson's disease?

A period of up to $10$ days where the patient receives no drug therapy for PD to reset response

In Deep Brain Stimulation (DBS), where is the pulse generator typically placed?

Under the skin, similar to a cardiac pacemaker

Which classification of migraine occurs on at least $15$ days of the month?

Chronic migraine

Which phase of a classic migraine includes flashing lights and numbness of the lips or tongue?

Aura phase

Why is caffeine often included in migraine medications?

It narrows blood vessels by blocking adenosine, which dilates vessels

What severe side effect must patients report immediately when taking triptan drugs?

Angina (chest pain) or chest discomfort

What is a tonic-clonic seizure?

A generalized seizure involving a stiffening phase (tonic) followed by rhythmic jerking (clonic)

What is the postictal phase of a seizure?

The period after the seizure characterized by fatigue, acute confusion, and lethargy

What therapeutic drug level range is desired for phenytoin?

$10$-$20$ mcg/mL

What is the medical definition of status epilepticus?

A prolonged seizure lasting longer than $5$ minutes or repeated seizures over $30$ minutes

What is the drugs of choice for treating status epilepticus?

IV-push lorazepam or diazepam

Any single seizure lasting longer than how many minutes can potentially cause death?

$10$ minutes

What is the priority care action for a patient in convulsive status epilepticus?

Establishing an airway

Inflammation of which specific meningeal layers characterizes meningitis?

Pia mater and arachnoid