Deck 16: Alterations in Cognitive Systems, Cerebral Hemodynamics and Motor Function

Question 1

Vomiting is associated with CNS injuries that compress which anatomic location(s)?

A)Vestibular nuclei in the lower pons and medulla oblongata
B)Floor of the third ventricle
C)Vestibular nuclei in the midbrain
D)Diencephalon

Answer 1

Vestibular nuclei in the lower pons and medulla oblongata

Question 2

Vegetative state is another term for locked-in syndrome.

Answer 2

False

Question 3

During a generalized seizure the clonic phase begins as inhibitory neurons in the cortex, anterior thalamus, and basal ganglia to reduce the cortical excitation.

Answer 3

True

Question 4

Huntington disease (HD) is inherited as an autosomal dominant trait with high penetrance.

Question 5

Upper motor neuron paralysis affects the pyramidal motor neurons by creating flaccid paralysis.

Question 6

Posthyperventilation apnea (PHVA) ceases and rhythmic breathing is resumed when levels of arterial:

A)carbon dioxide increase.
B)carbon dioxide become normal.
C)oxygen increase.
D)oxygen decrease.

Question 7

The reticular activating system provides arousal to the cerebral hemispheres.

Question 8

The tonic phase of a generalized seizure is characterized by alternating contractions and relaxation of muscles.

Question 9

Excess cerebrospinal fluid within the cranial vault, subarachnoid space, or both is called cerebral edema.

Question 10

The most critical index of nervous system function or dysfunction is motor response.

Question 11

The general pathophysiologic mechanisms underlying cognitive network deficits are compression and ischemia.

Question 12

Which is a description of Cheyne-Stokes respirations?

A)A sustained deep rapid, but regular pattern of breathing
B)A smooth increase in rate and depth followed by a gradual smooth decrease in rate and depth
C)A prolonged inspiratory period followed gradually by a short expiratory period
D)A completely irregular breathing pattern with random shallow, deep breaths and irregular pauses

Question 13

Brain death has occurred when there is no discernible evidence of cerebral hemisphere function or function of the brainstem's vital centers for 1 to 6 hours.

Question 14

In 66% of cases, the etiology of epilepsy is not identified.

Question 15

The neural center that controls normal breathing is believed to be located in the brainstem.

Question 16

Which is an example of a disease process producing diffuse cortical dysfunction?

A)Cerebrovascular accident (CVA)
B)Encephalitis
C)Cerebral neoplasm
D)Cerebral emboli

Question 17

Which disease process is infratentorial?

A)Cerebellar neoplasm
B)Encephalitis
C)Parkinson disease
D)Cerebral neoplasm

Question 18

Cognitive operations cannot occur without the _____ functioning.

A)pons
B)medulla oblongata
C)reticular activating system
D)cingulate gyrus

Question 19

In posthyperventilation apnea (PHVA), respirations stop after hyperventilation followed by the return of rhythmic breathing.What stimulus causes the hyperventilation?

A)High arterial carbon dioxide
B)Low arterial oxygen
C)Normal arterial carbon dioxide
D)High arterial oxygen

Question 20

Criteria for brainstem death are the same for children as for adults, but with a longer observation period.

Question 21

What is the best prognostic indicator of recovery of consciousness or functional outcome?

A)Glasgow Coma Scale
B)Glasgow Outcome score
C)Etiology of injury and time since onset of coma
D)Pupillary reaction and reflective eye movements

Question 22

The most critical aspect in diagnosing a seizure disorder and establishing its cause is:

A)computed tomography (CT) scan.
B)cerebrospinal fluid analysis.
C)skull x-ray films.
D)health history.

Question 23

_____ is the loss of speech or the loss of comprehension of spoken or written language.

A)Agnosia
B)Aphasia
C)Akinesia
D)Dysphasia

Question 24

A sudden, explosive, disorderly discharge of cerebral neurons is termed:

A)reflex.
B)seizure.
C)epilepsy.
D)convulsion.

Question 25

What type of cerebral edema occurs when there is increased permeability of capillary endothelium after injury to the vascular structure?

A)Cytotoxic
B)Interstitial
C)Vasogenic
D)Ischemic

Question 26

What are the areas of the brain that mediate several cognitive functions, including vigilance, reasoning, and executive functions?

A)Limbic
B)Prefrontal
C)Parietal
D)Occipital

Question 27

Subarachnoid hemorrhage causes communicating hydrocephalus by obstructing:

A)the cerebrospinal fluid flow between the ventricles.
B)the cerebrospinal fluid flow into the subarachnoid space.
C)blood flow to the arachnoid villi.
D)the absorption of cerebrospinal fluid by the arachnoid villi.

Question 28

The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to the:

A)lower midbrain.
B)pontine area.
C)supratentorial.
D)cerebral area.

Question 29

Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position?

A)Diencephalon dysfunction
B)Oculomotor cranial nerve dysfunction
C)Dysfunction of the tectum
D)Pontine dysfunction

Question 30

Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of increased:

A)dopamine.
B)gamma-aminobutyric acid (GABA).
C)norepinephrine (NE).
D)acetylcholine.

Question 31

Which are clinical manifestations caused by damage to the lower pons?

A)Abnormal flexion with or without extensor response of the lower extremities
B)Abnormal extension response of the upper and lower extremities
C)Abnormal extension response of the upper extremities and flexion of the lower extremities
D)Abnormal flaccid response in the upper and lower extremities

Question 32

With receptive dysphasia (fluent), the individual is able to:

A)respond in writing, but not in speech.
B)speak back, but not comprehend speech.
C)comprehend speech, but not respond verbally.
D)respond verbally, but not comprehend speech.

Question 33

Which description is consistent with a complex partial seizure?

A)Alternative tonic and clonic movements
B)Consciousness is impaired as well as the ability to respond to exogenous stimuli
C)Focal motor movement without loss of consciousness
D)One seizure followed by another in less than 1 minute

Question 34

A seizure that starts in the fingers and progressively spreads up the arm and extends to the leg is known as a(n) _____ seizure.

A)simple partial
B)focal
C)psychomotor
D)aversive

Question 35

Which edema is most often seen with noncommunicating hydrocephalus?

A)Metabolic
B)Interstitial
C)Vasogenic
D)Ischemic

Question 36

Which dyskinesia involves involuntary movements of the face, trunk, and extremities?

A)Paroxysmal
B)Tardive
C)Hyperkinesia
D)Cardive

Question 37

Status epilepticus is considered a medical emergency because of the:

A)loss of consciousness.
B)development of cerebral hypoxia.
C)possibility of a head injury during the seizures.
D)decrease in brain metabolism.

Question 38

Which is a characteristic of brainstem death?

A)Vegetative state
B)Comatose
C)Apnea
D)Locked-in syndrome

Question 39

Normal intracranial pressure is _____ mm Hg.

A)5 to 15
B)7 to 20
C)12 to 14
D)80 to 120

Question 40

Cerebral edema is an increase in the fluid content of the:

A)ventricles.
B)brain tissue.
C)neurons.
D)meninges.

Question 41

Diagnostic criteria for a vegetative state (VS) include:

A)absence of eye opening.
B)lack of subcortical responses to pain stimuli.
C)roving eye movements with visual tracking.
D)return of autonomic functions such as gastrointestinal function.

Question 42

What causes stage 1 of intracranial hypertension? Stage 1 intracranial hypertension is caused by the:

A)loss of autoregulation that normally maintains constant blood flow during changes in cerebral perfusion pressure (CPP).
B)displacement of cerebrospinal fluid (CSF) followed by compression of the cerebral venous system.
C)vasoconstriction of the cerebral arterial system with reciprocal increase in systemic blood pressure.
D)compression of the medulla oblongata in the brainstem by herniation of the cerebral cortex.

Question 43

It is observed that a person with a severe closed head injury has all four extremities in rigid extension and forearm hyperpronation and legs with plantar extension.This finding is documented as __________ posturing.

A)decorticate
B)decerebrate
C)spastic
D)cerebellar

Question 44

Which neurologic disorder is characterized by cortical nerve cell processes that have become twisted and dilated?

A)Dementia syndrome
B)Delirium
C)Alzheimer disease
D)Parkinson disease

Question 45

The body compensates to a rise in intracranial pressure by first displacing:

A)cerebrospinal fluid (CSF).
B)arterial blood.
C)venous blood.
D)cerebral cells.

Question 46

Dilation of the ipsilateral pupil following uncal herniation is the result of pressure on which of the following cranial nerves?

A)Optic (CN I)
B)Abducens (CN VI)
C)Oculomotor (CN III)
D)Trochlear (CN IV)

Question 47

What pathologic alteration produces tremors at rest, rigidity, akinesia, and postural abnormalities?

A)Atrophy of neurons in the caudate that produce serotonin
B)Atrophy of neurons in the putamen that produce gamma-aminobutyric acid (GABA)
C)Atrophy of neurons in the substantia nigra that produce dopamine
D)Atrophy of neurons in the hypothalamus that produce acetylcholine

Question 48

Uncal herniation occurs when:

A)the hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa.
B)the diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa.
C)the cingulate gyrus shifts under the falx cerebri.
D)a cerebellar tonsil shifts through the foramen magnum.

Question 49

Characteristics of primary motor neuron amyotrophy include:

A)loss of sensation in distal, proximal, or midline muscles.
B)fasciculations and muscle cramps in distal, proximal, or midline muscles.
C)flaccid paralysis with paresthesia in distal, proximal, or midline muscles.
D)spastic paralysis with increased deep tendon reflexes in distal, proximal, or midline muscles.

Question 50

Parkinson disease is a degenerative disorder of the:

A)hypothalamus.
B)anterior pituitary.
C)frontal lobe.
D)basal ganglia.

Question 51

Dementia is characterized by:

A)deficits in attention and coherence of thought.
B)easy distractibility and poor concentration.
C)loss of recent and remote memory.
D)irritability, agitation, and restlessness.

Question 52

Which of the following is the most critical index of nervous system dysfunction?

A)Size and reactivity of pupils
B)Pattern of breathing
C)Motor response
D)Level of consciousness

Question 53

Tactile agnosia is related to injury of the:

A)frontotemporal lobe.
B)parietal lobe.
C)temporal lobe.
D)Broca area.

Question 54

Which assessment finding marks the end of spinal shock?

A)Blood pressure and heart rate return to normal.
B)Spinal reflexes gradually return.
C)Bowel and bladder function return.
D)Deep tendon reflexes diminish and flaccid paralysis is evident.

Question 55

Clinical manifestations of Parkinson disease are caused by a deficit in which neurotransmitter?

A)Gamma-aminobutyric acid (GABA)
B)Dopamine
C)Norepinephrine (NE)
D)Acetylcholine

Question 56

Since his cerebrovascular accident, a man has been denying his left hemiplegia.What term is used to describe this finding?

A)Visual agnosia
B)Anosognosia
C)Amusia agnosia
D)Agraphia agnosia

Question 57

In amyotrophy, paresis and paralysis are segmental.Why is the segmental character of weakness difficult to recognize? The weakness resulting from the segmental paresis and paralysis characteristic of amyotrophy is difficult to recognize because:

A)upper motor neurons are involved.
B)posterior horn cell injury is involved.
C)each muscle is supplied by two or more nerve roots.
D)the person is unable to feel the involved muscles.

Question 58

Dilated and sluggish pupils, widening pulse pressure, and bradycardia are clinical findings evident of which stage of intracranial hypertension?

A)Stage 1
B)Stage 2
C)Stage 3
D)Stage 4

Question 59

Most dysphasias are associated with cerebrovascular accidents involving which artery?

A)Anterior communicating artery
B)Posterior communicating artery
C)Circle of Willis
D)Middle cerebral artery

Question 60

After a cerebrovascular accident, a man is unable to feel and identify a comb with his eyes closed.This is an example of:

A)agraphia.
B)tactile agnosia.
C)anosognosia.
D)prosopagnosia.

Question 61

Match the terms with the corresponding descriptions.
Receptive dysphasia

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia

Question 62

The clinical manifestations of Parkinson disease (PD) include:

A)muscle tremor; slow, rigid movements; and postural abnormalities.
B)muscle weakness, difficulty chewing, and drooping eyelids.
C)decreased memory, depression, and indifference.
D)paralysis and absent sensation below the level of the lesion.

Question 63

Match the terms with the corresponding descriptions.
Expressive dysphasia

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia

Question 64

Match the terms with the corresponding descriptions.
Upper motor neuron disorders

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia

Question 65

Match the terms with the corresponding descriptions.
Decrease in voluntary movement

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia

Question 66

In Parkinson disease (PD) the basal ganglia influences the hypothalamic function to produce which grouping of clinical manifestations?

A)Inappropriate diaphoresis, orthostatic hypotension, constipation, and urinary retention
B)Asymmetric, regular, rhythmic tremors with slow alternating flexion and extension contractions
C)Involuntary contractions of skeletal muscles that impair active and passive movement
D)Bradykinesia of chewing, swallowing, and articulation

Question 67

Match the terms with the corresponding descriptions.
Lower motor neuron disorders

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia

Question 68

Match the terms with the corresponding descriptions.
Abnormal involuntary movement

A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke aphasia
D)Spasticity
E)Akinesia
F)Broca dysphasia