Patho test 3

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sensorineural hearing loss is due to

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1

sensorineural hearing loss is due to

something is wrong with middle or inner ear or auditory nerves

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2

keratitis

inflammation of the cornea, often caused by HSV

begins superficially, may go deeper

eye pain, redness, photophobia, feeling of foreign body in eye

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3

aphasia

loss of ability to understand or express speech, caused by brain damage

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4

expressive aphasia

the individual can understand words, but can not respond back with speech, Broca’s area is affected

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5

receptive aphasia

unable to comprehend speech, Wernicke’s area is affected

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6

ischemic stroke

caused by a thrombus or embolus that lodges in a cerebral artery and blocks blood flow to the brain tissue

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7

cerebral infarction

the death of brain cells

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8

hemorrhagic stroke

caused by rupture and hemorrhage of a cerebral artery, leading to compression and toxicity of brain cells and loss of cerebral blood flow

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9

TIA

“mini-stroke” a disruption of cerebral circulation with neurological deficits that are reversible and last for less than 24 hours

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10

Neurological deficits

brain cell death leads to loss of function

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11

carotid stenosis

arteriosclerosis (plaque build up) of the carotid artery (a common cause of ischemic stroke)

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12

lacunar infarcts

small areas in the brain that endure ischemia from occluded tiny blood vessels

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13

subarachnoid hemorrhage

a specific type of cerebral hemorrhage occurs when an arterial branch in the subarachnoid space ruptures

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14

anoxic encephalopathy

causes decreased levels of consciousness

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15

cushing’s triad (hemorrhagic stroke)

irregular respiratory rate, bradycardia, and hypertension(widen pulse pressure)

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16

What is the olfactory nerve?

number one of the cranial nerves, it is sensory, and its function is smell

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17

what is the optic nerve?

number 2 of the cranial nerves, it is sensory, and its function is vision

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18

what is the oculomotor nerve?

number 3 of the cranial nerves, it is motor and its function is extra-ocular movements and pupil response

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19

what is the trochlear nerve?

number 4 of the cranial nerves, it is motor and its function is extra-ocular movement

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20

what is the trigeminal nerve?

number 5 of the cranial nerves, it is mixed and its function is facial sensations, chewing

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21

what is the abducens nerve?

number 6 of the cranial nerves, it is motor and its function is extra-ocular movements

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22

what is the facial nerve?

number 7 of the cranial nerves, it is mixed and its function is facial expressions and taste over 2/3 of the tongue

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23

what is the auditory/ vestibulocochlear nerve?

number 8 of the cranial nerves, it is sensory and its function is hearing and equilibrium

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24

what is the glossopharyngeal nerve?

number 9 of the cranial nerves, it is mixed and its function is elevation of pharynx in swallowing and taste of 1/3 of tongue

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25

what is the vagus nerve?

number 10 of the cranial nerves, it is mixed and its function is gag reflex and parasympathetic control of body

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26

what is the accessory nerve?

number 11 of the cranial nerves, it is motor and its function is turn the head and shrug

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27

what is the hypoglossal nerve?

number 12 of the cranial nerves, it is motor and its function is tongue movement

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28

motor nuerons _____

descend

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29

sensory nuerons _____

ascend

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30

damage on the right side of the brain will present injury on what side of the body

left side of the body

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31

what is the midbrain responsible for ?

auditory and visible responses, motor movement

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32

what is the pons responsible for?

arousal and sleep

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33

what is the medulla oblongata responsible for?

HR, respiratory function

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34

what is the circle of willis?

base of the brain, most common site for aneurysms

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35

if the patient is having loss of consciousness than we know they are having a ______ stroke

hemorrhagic

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36

what stroke can be caused by atrial fibrillation?

ischemic

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37

what stroke can be caused by hypertension?

hemorrhagic stroke

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38

what can happen if the hemorrhage is large?

hematoma and clot form because blood gets stationary in skull

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39

what does FAST stand for?

F: facial drop

A: arm weakness

S: speech difficulty

T: time to call 911

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40

what is the traditional diagnosis for epilepsy?

2 unprovoked seizures at least 24 hrs apart

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41

focal seizure

located within 1 cerebral hemisphere

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42

generalized seizure

involve both hemispheres

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43

clonic movement

sustained rhythmical jerking

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44

atonic movement

limbness

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45

myoclonus movement

muscle twitching

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46

nonmotor symptoms of seizure

starting spells with no movement, just staring off into space

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47

what is an aura?

sensation people get before a seizure

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48

what is the ictal period

time when the seizure is occurring

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49

what is the post ictal period

after the seizure is complete

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50

what is the interictal period

if multiple seizures occur in short time, this is the time between seizures

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51

after seizure has ended, place patient on their ______ side

left

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52

primary headaches characteristics

  • arise independently of any other medical illness or traumatic cause

  • ex) tension type, migraine

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53

Secondary headaches characteristics

  • caused by another primary condition

  • ex)head injury, tumors, vascular problems

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54

what is the tension type headache?

most common type of primary headache, bilateral pain

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55

what is the migraine headache?

throbbing period headaches that worsen with movement, most common in young women

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56

what is trigeminal autonomic cephalgia?

excruciating one sided headache, most common in male 25-50 years. Signs are blood shot eyes, tearing of eyes, clear fluid coming out of nose, eyelid edema

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57

what is a sinus headache?

caused by a sinus infection, fever and discharge from nose, pain worsens when patient leans over

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58

brain tumor headache

dull and constant, worse pain on the side of with the tumor, pain starts locally then becomes generalized

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59

sign of brain tumor headache

change in prior headache patterns, headache worsens with change of body positioning

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60

what is parkinson’s disease?

progressive loss of Dopamine-producing cells in the substania nigra

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61

what is the pathophysiology of parkinson’s disease?

acetylcholine stimulates muscle movement while dopamine has an inhibitory affect. In parkinson’s there is a dopamine depletion causing uncontrolled acetylcholine leading in muscle tremors.

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62

what is the classic triad for parkinson’s?

  • bradykinesia

  • resting tremor (“pill rolling”)

  • muscle rigidity

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63

what does TRAP stand for?

T: tremor at rest

R: Rigidity

A: Alkinesia

P: postural/ gait instability

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64

what is ALS (Lou Gehrig’s Disease)?

progressive loss of UMN and LMN, sensory neurons and cognitive function intact but no motor.

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65

what is multiple sclerosis?

demyelinating disorder, characterized by remissions and exacerbation. During remission the myelin heals. Both sensory and motor neurons affected

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66

what is progressive multiple sclerosis?

where no remission occurs

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67

characteristics of huntington’s disease

appears between ages 30 to 50 with progression for 10 to 20 years. Gene mutation on chromosome 4 disrupts the protein huntingtin

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68

what are common clinical manifestations of Huntington’s?

Dyskinesia (difficult movement), chorea(dancelike movements), athetosis(twisting and writhing), depression, slowed though process

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69

What is guillian- Barre syndrome?

occurs after infection, acute inflammatory demylination, recovery is steady over weeks and months, weakness varies from mild to complete paralysis

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70

What is myasthenia Gravis?

Autoimmune disease, attack of actylecoline receptors

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71

____% of patient with myasthenia gravis have thymus gland hyperplasia (increase in cell growth)

70

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72

myastenia gravis is present in two ways:

ocular form and general form

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73

myasthenia gravis manifestations

repetitive notions, true muscle fatigue

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74

what is normal intracranial pressure?

5-15 mm Hg

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75

alertness

highest level of conciousness

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76

lethargy

individual sleepy but can be aroused easily

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77

obtunded or stuporous

difficult to arouse state, with little or no interaction with environment

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78

coma

lowest level of consciousness, no interaction with environment

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79

coup-contrecoup injury:

brain strikes one side of skull, rebounds, and strikes the other side

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80

T or F: if there is a disruption in the blood flow to the brain then ICP can be altered

true

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81

vasogenic cerebral edema is a

shearing stress

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82

cytotoxic cerebral edema

reduced oxygen

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83

decreased ICP can happen from

hypertonic IV, respiratory alkalosis, craniectomy, low BP

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84

apnea

not breathing

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85

transtentorial (uncal) herniation:

temporal lobe (uncus) forced through the tentorial notch compressing brain tissue

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86

duration of unconsciousness assessment assesses for what

how long were they knocked out

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87

the glasgow coma scale

lowest GCS: 3

Highest GCS: 15

**The lowest the scale the worse the outcome

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88

decorticate coma posturing

flexed arms, clenched fists, rigid legs. indicates corticospinal tract damage

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89

decerebrate coma posturing

arms held straight outward with toes pointed downward. indicates upper brainstem damage

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90

what is the norm for deep tendon reflex scale

2+

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91

diffuse axonal injury

one of the most common TBI widespread damage to brain tissue, widespread damage to brain tissue. Diffuse swelling on neuronal axons.

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92

concussion

traumatic force causes disruption in brain

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93

simple concussion

  • resolved without complication

  • may take up to 10 days

  • less likely to have less of consciousness

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94

complex concussion

  • symptoms may persist for longer

  • longer loss of consciousness (greater than 1 min)

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95

retrograde amnesia

before

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96

antegrade amnesia

after

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97

what is post concussion syndrome?

symptoms that last longer than 3 weeks

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98

cerebral contusion characteristics

  • bruise of brain tissue

  • scattered areas of bleeding on brain surface

  • cerebral edema around contusion within 48 to 72 hours

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99

Cerebral contusion signs and symptoms

  • severe headache

  • dizziness

  • vomiting

  • INCREASED SIZE OF ONE PUPIL ( tells us what side the damage is on)

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100

a contusion is a medical emergency when there is

decreased HR, decreased respiration, hypertension, can not be awakened

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