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CHSOS 404 Actual Test with Questions & Answers Graded A
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CHSOS 404 Actual Test withQuestions & Answers Graded A
Stroke - ✔✔-sudden focal neurological deficit from a vascular disease
-non traumatic disruption of the blood supply to an area of the brain
-causes - occlusion of cerebral arteries by ischemia (87% of time) or hemorrhage (13%)
-ischemic stroke - results from obstructed blood flow; can lead to ischemia, potentially
irreversible necrosis and cerebral infarction; may also be caused by poor perfusion (shock)
-hemorrhagic stroke - results from intracranial hemorrhage; occurs deep in the parenchyma or near the
surface of brain; often has HTN as an underlying cause
*stroke is a medical emergency that can cause permanent brain damage or death
Aneurysm - ✔✔-refers to localized dilation in a blood vessel wall that can rupture and lead
to hemorrhage
-most ruptures are due to developmental defects (95%)
-a defect in the tunica media (middle layer) can for a protruding sac (saccular or berry aneurysm)
-often go undetected through life
-can result in aneurysmal subarachnoid hemorrhage
-has clinical manifestations that range from mild headache to coma and death
Encephalitis - ✔✔-infection and inflammation of brain tissue or spinal cord
-caused by viruses - equine encephalitis, west nile, herpes, HIV, cytomegalovirus, rabies, and possibly
prion virus
,Meningitis - ✔✔-infection of meninges (membranes that cover brain)
-caused by bacterial infection - streptococcus pneumonia, neisseria meningitidis, haempphilus
influenzae
-also caused by viruses - enteroviruses, coxsackie virus, adenovirus, herpes, HIV, Epstein Barr virus, CMV
Parkinson's disease - ✔✔-degenerative disease of the CNS characterized by movement disorder
- cause - death of dopamine producing cells in substantia nigra of the basal ganglia -
disruption of basal ganglia signals leads to hyper and hypo kinetic disorders
-cause of cell death is not known but is characterized by alpha-synuclein protein in the brain
(Lewie bodies)
-s and s - tremor, bradykinesia, rigidity, postural instability, dementia and depression
Multiple sclerosis - ✔✔-autoimmune attack on myelin of CNS neurons that causes formation
of plaques and destruction of myeline
-s and s - visual changes, muscle weakness, loss of coordination, numbness, and mild
cognitive impairments
-250,000-350,000 cases in US
-more common in women and people of European ancestry who live in a temperate
climate -disease patterns - relapsing-remitting, chronic progressive, and benign
-dx - presence of gamma globulin in cerebral spinal fluid, MRI of patch abnormalities in
myelin -treatment - anti inflammatory agents such as corticosteroids
Spinal cord injury - ✔✔-any injury of the spinal cord caused by trauma instead of
disease -symptoms - vary depending upon site of injury and if nerve roots are damaged -
causes - car accidents, falls, sports injuries, violence
-classification - documents sensory and motor impairments; evaluates sensations in dermatome
and muscle strength on each side of the body
-complete transection - complete loss of motor, sensory, reflex, and autonomic function below level of
injury
-primary injury - occurs at time of accident and is irreversible
,-secondary injury.- follows primary injury and spreads damage
Amyotrophic lateral sclerosis (ALS) - ✔✔-Lou Gehrig's
disease -a condition characterized by loss of motor neurons -
progressive weakness, cramping, and atrophy
-failure of respiratory muscles requires vent support
-pathogenesis is unknown, may involve excess glutamate in synapses
-mutations in the superoxide dismutase gene (SOD1) associated with ALS, suggesting oxidative
stress may contribute to cell death
-no treatment to halt disease
-some drugs (Riluzole) can suppress glutamate in neurons and ameliorate symptoms
Pain - ✔✔-"an unpleasant sensory and emotional experience associated with actual or
potential tissue damage"
-results from an interplay of biologic, cognitive, emotional, social, and cultural
factors -is a leading symptom of disease or injury
-somatogenic - known physiologic cause
-nociceptive - cutaneous, deep somatic, or visceral origins of pain
-neuropathic - pain originating from within an altered nervous system
-psychogenic - no physiologic cause
-acute - response to injury, lasting up to approx 6
months -chronic - longer duration
Nociception - ✔✔-nociceptive pain lies outside the nervous system
-nociception refers to activation of pain fibers and subsequent responses to noxious stimuli
-nociception stimuli that stimulates nociceptors include tissue injury, inflammation, and cell death
caused by mechanical, thermal, or chemical damage
-major causes include trauma, surgery, burns, infection and exposure to toxins
, Modulation of pain - ✔✔-tissue damage sensitizes nociceptive neurons
-the threshold for pain receptors (point at which a stimulus is perceived as pain) may be lowered
by chemical mediators released from damaged
-pain producing substances include potassium, hydrogen, serotonin, histamine, prostaglandins, and
bradykinin
-substance P is released from the nerve terminals and sensitizes nociceptors by causing release of
histamine and serotonin from platelets and mast cells that contribute to inflammation
Fast pain - ✔✔-prickling, stabbing
-carried by A delta fibers (myelinated)
-good localization
Slow pain - ✔✔-burning, aching
-carried by C fibers (unmyelinated)
-poor localization
Cutaneous pain - ✔✔fast pain (paper cut)
Deep somatic pain - ✔✔fast and slow pain (arthritis or sprained ankle)
Visceral pain - ✔✔slow pain (chest pain due to MI)
Referred pain - ✔✔-arises from nociceptors in deep viscera (sensation of pain in left arm during MI)
-may be due to convergence of visceral and cutaneous receptors as these impulses are transmitted
on the same ascending neurons, which causes pain impulses to be indistinguishable by brain
-often the nature of the visceral pain is altered so that even though it is transmitted through the slow
pain C fibers, it is referred to as sharp, burning, and often severe pain on other areas on the skin
Peripheral nerve disorders - ✔✔-different kinds of disorders that can affect one or many nerves
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