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73 Cards in this Set

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  • Back
alertness with orientation to person, place and time
consciousness
inability to think clearly
confusion
impaired awareness of person, place or time
disorientation
slowed vocalization and decreased motor skills present
lethargy
awakening in response to continual stimulation
obtundation
decreased spontanous movements and vocalization in response only to vigorous stimuli
stupor
no vocalization and no arousal to any stimulus
coma
psychogenic arousal is when:
an individual appears unconscious but is psychologically awake
a defect in the recognition of form and nature of objects
agnosia
an impairment in the comprehension or production of language
dysphasia
What are the two major types of dysphasia?
expressive (or fluent): trouble communicating
and receptive (or nonfluent): trouble understanding
difficulty communicating or translating thoughts into meaningful speech or writing indicates damage in what are of the brain?
Broca's area
difficulty understanding the speech of others or written material, indicates damage to what area of the brain?
Wernicke's area
loss of voluntary movement despite consciousness and normal peripheral nerve and muscle function
hypokinesia
paresis
weakness or partial loss of muscle function
paralysis
complete loss of muscle function
bradykinesia
voluntary movements are slower than normal, often difficult to start
akinesia
\decreased voluntary movements
What are the three major groups of causes of altered levels of arousal?
structural, metabolic, and psychogenic
What LOC is seen with injury to the diencephalon?
impaired consciousness (confusion, disorientation, lethargy, and/or obtundation)
What LOC is seen with injury to the midbrain?
stupor to coma
What LOC is seen with injury to the pons?
coma
What LOC is seen with injury to the medulla oblongata?
coma
What level of brain injury would result in pupils that are small and reactive and intact oculocephalic and oculovestibular reflexes?
diencephalon
What level of brain injury would result in pupils that are midposition fixed and impaired oculocephalic and oculovestibular reflexes?
midbrain, pons, medulla oblangata
What sort of muscle tone would be expected with injury to the medulla oblongata?
flaccidity
What sort of muscle tone would be expected with injury to the midbrain or the pons?
decebrate posturing
What sort of muscle tone would be expected with injury to the diencephalon?
decorticate posturing, some purposeful movement in respose to pain, and combative movement
What level of brain injury results in Cheyne-Stokes respiration?
injury to the diencephalon
What level of brain injury results in neurogenic hyperventilation?
injury to the midbrain
What level of brain injury results in apneustic respirations?
injury to the pons
What level of brain injury results in ataxic respirations?
injury to the medulla oblongata
What are ataxic respirations?
an abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea
What is neurogenic hyperventilation?
an abnormal pattern of breathing characterized by deep and rapid breaths
What are apneustic respirations?
an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release
What are Cheyne-Stokes respirations?
an abnormal pattern of breathing characterized by periods of breathing with gradually increasing and decreasing tidal volume interspersed with periods of apnea
What is cerebral death?
irreversible coma; death of the cerebral hemispheres, though cerebellum and brain stem are still functioning, allowing the brain to maintain body's homeostasis
What is brain death?
irreversible brain damage so extensive that the brain can no longer maintain the body's internal respiratory and cerebral vascular functions; involves the destruction of brain stem and cerebellum
What is epilepsy?
seizure activity that recurs in the absence of tx; caused by genetic mutations that result in chemical imbalances or abnormal nerve connections
What is an epileptogenic focus?
a group of neurons, lacking afferent stimulation, with hypersensitive plasma membranes;
they are more easily activated by hyperthermia, hypoxia, hypoglycemia, hyponatremia, repeated sensory stimulation, and certain sleep phases
What are the two phases of a grand mal seizure?
tonic and clonic
What is the tonic phase of a grand mal seizure?
neural excitation in the epileptogenic focus spreads to the subcortical, thalamic, and brain stem areas; results in increased muscle tone and loss of consciousness
What is the clonic phase of a grand mal seizure?
rhythmic, alternating contractions and relaxation of muscles; begins as inhibitory neurons in the cortex, anterior thalamus, and basal ganglia begin to inhibit the cortical excitation
Seizures that are confined to one brain hemisphere; do not result in a loss of consciousness
simple partial seizures
What are the differences between partial and generalized seizures?
partial seizures: originate in a small group of neurons in one hemisphere

generalized seizures: simultaneous disruption of normal brain activity in both hemispheres from the onset
What are the two types of generalized seizures?
absence seizures and tonic-clonic (grand mal) seizures
Characteristics of Jacksonian seizure d/o
simple partial seizure
no change in consciousness
disturbances in motor capacity
Characteristics of psychomotor seizure d/o
complex partial seizure
loss of consciousness with automatisms
dyscognitive states, loss of awareness
Characteristics of Grand Mal seizure d/o
generalized seizure
loss of consciousness
major tonic-clonic movement
Characteristics of absence seizure d/o
generalized seizures without convulsions
transient loss of consciousness
blank spells, akinetic seizure (drop attack), myoclonic jerks
The three most common pathological mechanisms that cause cognitive disorders are:
1) direct destruction of brain tissue caused by ischemia and hypoxia

2) indirect destruction of brain tissue caused by compression

3) damage to tissues caused by toxins and chemicals
What is selective attention deficit?
the inability to select appropriately from available, competing environmental stimuli for conscious processing
Waht is anterograde amnesia?
inability to form new memories
What is retrograde amnesia?
the loss of past memories
What characterize executive function deficits?
difficulty planning, managing time, remembering, remaining focused, and moderating impulsive behavior
What is an acute confusional state?
the inability to maintain a coherrant stream of thought or action, usually due to drug intoxication or nervous system disease
What is dementia?
the loss of more than one cognitive or intellectual function (orientation, vigilance, recent or remote memory, language, reasongin, etc.)
What are the two types of cortical dementia?
amnesiac dementia: loss of recent memory
cognitive dementia: loss of remote memory
What characterizes subcortical dementia?
· slowed thought processes

· personality changes

· loss of motor function
Loss of consciousness occurs when there is injury to the:
cerebral cortex
The period of time immediately following a seizure is the:
postictal phase
The displacement of the temporal lobe into the tentorial notch resulting in brain stem compression is know as a(n):
uncal herniation
A decrease in cerebral perfusion pressure (CPP) is related to what physiological change?
Decrease in arterial blood pressure
A increase in cerebral perfusion pressure (CPP) is related to what physiological change?
Increased cerebral blood flow
Excess cerebrospinal fluid (CSF) accumulation in the ventricles or subarachnoid space is a condition called:
hydrocephalus
the maintenance of abnormal posture through muscular contractions
dystonia
What produces rigidity?
tonic reflex activity
Flexion of the upper extremities with adduction combined with extension and internal rotation of the lower extremities is a motor response known as:
decorticate posturing
Lack of motor tone
Atonia
Increased leakage of plasma proteins into the brain tissue
Vasogenic cerebral edema
Tumor arising from cells that line the ventricles and those that are involved in CSF production
ependymoma
tumors arisisng from the neuroglial cells that fill the spaces between neurons and surround blood vessels
astrocytoma/glioblastoma
slow-growing tumor arising from neuroglial cells that deposit myelin in the CNS
oligodendroglioma