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126 Cards in this Set
- Front
- Back
Afferent nerves
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transmit impulses TOWARD the spinal cord and brain (from nerve receptors to brain).
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Efferent nerves
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transmit impulses AWAY FROM the spinal cord and brain (from brain to target muscles).
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How many pairs of cervical nerves are there?
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8
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How many pairs of lumbar nerves?
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5
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Electrical impulses are carried throughout the body by
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neurons
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The two divisions of the nervous system:
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central, peripheral
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The central nervous system (CNS) includes:
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brain, spinal cord
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Five pairs of the __________ cranial nerves originate in the _________ ____________, an extension of the spinal cord.
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12, medulla oblongata
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Divided into 31 segments:
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spinal cord
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How are the cranial nerves assessed during a neurologic examination?
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By testing the patient's sense of smell, visual acuity, eye movements, muscles of mastication, taste perception, hearing, tongue movements and swallowing and face/jaw muscles.
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When is a neurologic assessment appropriate?
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It is appropriate after head trauma occurs or cranial surgery is performed or when a neourologic disorder, such as a brain tumor, is suspected.
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Treatment of stroke may include this medication?
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Aspirin
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Cause of cerebrovascular accidents?
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Occurs when the brain is damaged by a sudden disruption in the flow of blood to a part of the brain (embolic), or by bleeding inside the head (hemorrhagic) also known as stroke (CVA).
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Also known as stroke
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CVA
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Sudden disruption in the flow of blood to a part of the brain
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embolic CVA
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Bleeding inside the head
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hemorrhagic CVA
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Another name for transient ischemic attack (TIA)
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"Little strokes" or "ministrokes"
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Symptoms of a TIA
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Sudden weakness/numbness unilaterally, dizziness, dysphagia, confusion, difficulty seeing with one eye and/or loss of balance. Sudden onset of a headache.
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Which is more serious, a concussion or a cerebral contusion?
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Cerebral contusion
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Cerebral contusion
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an injury to the brain that involves bruising of the tissue along or just beneath the surface of the brain
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Common complication of a depressed skull fracture
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Epilepsy
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Most frequent cause of depressed skull
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Direct impact on the skull with a blunt object, industrial and automobile accidents are two of the many possible causes.
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Area of the skull involved with a basilar skull fracture
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located on the floor of the cranial vault, in which the head is struck anteriorly or laterally in the midportion.
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Which physical manifestations alert the physician to order images of the cranial vault to investigate for a basilar skull fracture?
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Battle's sign (bruising behind ears), or raccoon eyes (bruising around/under eyes).
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Closed head injury
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the skull is not broken
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Example of Closed head injury
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concussions, contusions
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Open head injury
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the skull is open, injury enters the brain
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Example of Open head injury
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linear, depressed, comminuted, compound, and basilar skull fractures
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Cerebral concussion
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is a bruising of the cerebral tissue that is caused by violent back and forth movement of the head as in an acceleration-deceleration insult.
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Contusion of the brain
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caused by a blow to the head or an impact against a hard surface, as in an automobile accident.
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Depressed skull fracture
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When a portion of the skull is broken and pushed in on the brain, causing injury
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Epidural hematoma
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is a mass of blood that forms between the skull and the dura mater, the outermost of the three meningeal layers that cover the brain.
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Subdural hematoma
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the blood collects or pools between the dura mater and the arachnoid membrane, the second meningeal membrane.
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Paraplegia
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paralysis of the lower extremities and usually the trunk
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Goal of treatment for spinal cord injuries
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restoration of normal alignment and stability of spine; decompression of the spinal cord, nerves, and vertebrae; early rehabilitation; these goals may involve surgery or using specialized medications and procedures.
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Symptoms of degenerative disk disease
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Pain radiating down the nerve path that is burning and constant, and can become intractable. Constant back pain and the severe pain that radiates down one or both legs may be accompanied by loss of some motor functions in the legs. May also experience numbness and tingling associated with weakness
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Function of an intervertebral disk
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They act as a shock-absorbing cushion for the vertebrae and gives the back its flexibility for movement
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Causes of sciatic nerve injury
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Brought about by trauma, degeneration, or rupture of the nucleus pulposus within the intervertebral disks L4 through S3
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Intervertebral disks
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soft pads of cartilage located between the vertebrae that make up the spine
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Before the onset of a headache, many persons who experience migraine headaches have
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visual auras
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Migraine headaches have been treated with these types of therapy
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Sumatriptan (Imitrex), Propranolol (Inderal), Ibuprofen (Motrin)
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Which of the following is not a common therapy of migraine treatment?
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Dipyridamole (Persantine)
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Headaches
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may be acute or chronic and located in the frontal, temporal, or occipital regions of the head
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Tests used to diagnose epilepsy
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EEG, MRI, CT Scan, Cerebral angiography, Skull radiographic film, Blood serum test
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Type of medications that are used to treat epilepsy
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Anticonvulsants, like phenytoin, carbamazepine, valproic acid, divalproex, levetiracetam, gabapentin, phenobarbital, topiramate, and oxcarbazepine.
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Types of seizures that may occur
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Classified as partial or generalized; (More than 30 types)
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partial seizures
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do not involve the entire brain but arise from a localized area in the brain
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generalized seizures
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can cause a diffuse electrical abnormality within the brain and include absence and tonic-clonic attacks
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absence attacks
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are also known as petit mal seizures, consist of a brief change in the level of consciousness indicated by staring, blinking, or blankly staring, with loss of awareness of surroundings. may only last a few seconds and can occur many times a day if not treated
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tonic-clonic attacks
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are also known as grand mal seizures where may begin with loud cry, followed by falling to the ground and loss of consiousness
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tonic phase of tonic-clonic attacks
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the body stiffens, and the tongue may be bitten, patient can become cyanotic if it last long
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clonic phase of tonic-clonic attacks
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the generalized rhythmic muscle spasms occur followed by relaxation
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status epilepticus
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occurs when one seizure follows another one with no recovery of consciousness between attacks
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Status epilepticus
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This occurs when one seizure follows another one with no recovery of consciousness between attacks; requires medical emergency that requires immediate anticonvulsant to prevent cerebral anoxia, hyperpexia, vascular collapse, and even death!
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Partial seizures
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do not involve the entire brain but arise from a localized area in the brain
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Treatment of choice for epilepsy
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Anticonvulsant medications
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Not considered a medication for the treatment of epilepsy
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Gemfibrozil (Lopid)
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Medications for the treatment of epilepsy
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Phenobarbital, Valproic acid (Depakote), Phenytoin (Dilantin)
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Drug combinations frequently used in the treatment of Parkinson's disease
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Carbidopa/levodopa (Sinemet)
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Drug combinations NOT frequently used in the treatment of Parkinson's disease
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Phenytoin/phenobarbital, Diazepam/lorazepam (Valium and Ativan), Atenolol/hydrochlorothiazide (Tenormin and Hydrodiuril)
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Patients with amyotrophic lateral sclerosis (ALS)
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have difficulty with speech, chewing, swallowing, breathing, and eventually require a ventilator
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Signs of early meningitis
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Vomiting and a headache that increases in intensity with movement or shaking of head, (nuchal rigidity) stiff neck that resists any sideways or flexion-extension movements of the head. Positive Kernig's sign (resistance to leg extension after flexing the thigh on the body) and Brudzinski's sign (neck flexion causes flexion of the hips from a supine position) indicates meningeal irritation; Deep tendon reflexes increase, and the patient exhibits irritability, photophobia, and hypersensitivity of the skin
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nuchal rigidity
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stiff neck that resists any sideways or flexion-extension movements of the head
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Positive Kernig's sign
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resistance to leg extension after flexing the thigh on the body
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Brudzinski's sign
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neck flexion causes flexion of the hips from a supine position
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Encephalitis is usually the result of a bite from which insect?
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infected mosquito
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Possible treatments for a brain abscess
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Intravenous antibiotics to resolve infection, Mannitol or steroids to reduce cerebral edema,Surgical drainage of abscess to relieve intercranial pressure & to culture organism. Additional tx. is supportive
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Why a lumbar puncture is contraindicated if the patient has a brain abscess
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The resulting increased intracranial pressure may cause the brainstem to herniate, with the consequence of death
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Symptoms of Guillain-Barre' syndrome
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Numbness and tingling of the feet and hands at onset followed by increasing muscle pain and tenderness, progressive muscle weakness and paralysis usually start in the lower extremities and move up the body in 24-72 hours, (descending weakness and paralysis is possible) respiratory insufficiency and difficulty swallowing are possible
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Vaccines that have helped eliminate cases of poliomyelitis
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Sabin vaccine and Salk vaccine
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Statistics for overall 5-year survival of all types of brain tumors
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For all types of brain tumors combined is 33%; this ranks among the lowest survival rates for all types of cancer. Children under age 14 having a much higher survival rate than adults
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Poor prognosis indicators of brain tumors include
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a high tumor grade, presence of mental changes at the time of diagnosis, large tumor size, and inability to fully resect the tumor during surgery
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Possible routes through which the poliomyelitis virus may enter the body
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By way of the nose and throat then crossing into the GI tract and reproduces in the lymphoid tissue
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How are primary brain tumors classified?
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Histologically according to the type of cell
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Race having the highest incidence of brain tumors
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Caucasians
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Efferent nerves transmit impulses
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Away from the brain and spinal cord
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Afferent nerves
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Transmit impulses toward the brain and spinal cord
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Possible causes of Peripheral Neuritis
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Chronic alcohol intoxication, toxicity, and infectious disease
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TIA
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Temporary episode of impaired neurologic functioning caused by a lack of blood flow to a portion of the brain
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Paraplegia
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is paralysis that involves loss of motor and sensory control of the trunk and Two extremities.
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Signs of Parkinson's disease
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Pin-rolling tremor of thumb and forefinger, muscular rigidity, mask-like facial expression and shuffling gait
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Routes in which infectious organisms may reach the brain and cause infection
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The blood, penetrating trauma, and infection in adjoining structures such as the ear or sinuses
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Meningitis is an inflammation of the
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Membranes covering the brain and spinal cord
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Poliomyelitis
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Is not diagnosed as frequently as it was before 1960. Is a highly contagious viral disease that affects the anterior horn cells of the gray matter in the spinal cord
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Prognosis for patients with tumors involving the brain is
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Poor
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Migraine headaches
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Are periodic, Are sometimes incapacitating, May be triggered by certain foods in some patients
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Hemiparesis is a paralysis involving
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Either half of the body
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Huntington's Disease is
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An inherited disorder, Characterized by dancelike movements
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Amyotrophic lateral sclerosis causes symptoms of
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Progressive destruction of motor neurons, resulting in muscle atrophy
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ALS
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Amyotrophic lateral sclerosis
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Nerves that transmit impulses toward the brain and spinal cord are
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afferent
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Nerves that transmit impulses away from the brain and spinal cord to the muscles and glands are
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efferent
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Which is NOT likely to cause a cerebrovascular accident (CVA)
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Neuroblastoma
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Which IS likely to cause a cerebrovascular accident (CVA)
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Advancing arteriosclerosis, Cerebral embolism, Cerebral thrombosis
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Vascular disorders that MAY result in a CVA are
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cerebral thrombosis and cerebral emvolism, cerebral hemorrhage
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Transient ischemic attacks (TIAs)/ Ministrokes
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Temporary episodes of impaired neurologic functioning caused by inadequate blood flow to a portion of the brain
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A collection or mass of blood that forms between the skull and the dura mater is termed an
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epidural hematoma
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Contusion
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Bruising of the brain tissues along or just beneath its surface accompanied by symptoms lasting more that 24 hours
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Basilar fracture
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is the result of the bones of the floor of the cranial vault being broken.
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True or False: With an epidural hematoma, the onset of symptoms is delayed as a result of a slower accumulation of blood
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False
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Paraplegia
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Loss of motor and sensory control of the trunk of the body and lower extremities as a result of a spinal cord injury
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Quadriplegia
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Paralysis of all four extremities
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Hemiparesis
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A slight paralysis in either half of the body
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Paraplegia
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Paralysis of the lower half of the body as a result of damage in the lower portion of the spinal cord
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True or False: Spinal stenosis contributes to sciatic pain caused by a narrowing of the spinal canal that causes compression of spinal nerve roots
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True
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True or False: Narrowing of intervertebral spaces on imaging studies may indicate degeneration of an intervertebral disk
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True
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True or False: Another term for herniated disk is ruptured or slipped disk
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True
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Migraines
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Periodic severe headaches that may be completely incapacitating
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Epilepsy
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A chronic brain disorder characterized by sudden episodes of abnormally intense electrical activity in the brain
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Epilepsy
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is an abnormal condition in which there are sudden, transient disturbances of brain function causing seizures
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Parkinson disease is characterized by
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"pill" rolling tremor of thumb and forefinger, muscular rigidity, masklike facial expression, and shuffling gait
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Huntington's chorea
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An inherited disorder in which the individual displays abrupt, bizarre, involuntary, dancelike movements and a decline in mental functions
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ALS
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Condition that involves progressive destruction of motor neurons resulting in muscle atrophy
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Symptoms of meningeal irritation or meningitis
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Nuchal rigidity, headache, and photopia
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Infectious organisms may reach the brain from
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the blood, penetrating trauma, an infection in adjoining structures such as the ear or sinuses
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Meningitis
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Inflammation of the membranes covering the brain and spinal cord
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True or False: The amnesia of transient global amnesia is permanent
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False
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True or False: TIA and transient global amnesia (TGA) are the same thing
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False
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Possible causes of peripheral neuritis
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include chronic alcohol intoxication, toxicity, and infectious diseases
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Peripheral neuritis
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involves degeneration of the nerves outside the CNS and affects the distal muscles of the extremities.
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The patient with toc douloureux or trigeminal neuralgia
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experiences excruciating pain that radiates along the fifth cranial nerve distribution affecting any of the branches
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Bell's palsy
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Unilateral facial paralysis
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Guillain-Barre's syndrome
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An acute rapidly progressive disease of the spinal nerves with progressive muscle weakness and paralysis in a 24 to 72 hour period
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Poliomyelitis
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is a highly contagious viral disease that affects the anterior horn cells of the gray matter in the spinal cord
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Symptoms and signs of brain tumors
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headache, seizures, and cognitive dysfunction, gait disturbances, lethargy, and nystagmus, fever, stiff neck, and unilateral facial paralysis
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True or False: All brain tumors originate in the brain tissue
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False
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