Deck 17: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
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Deck 17: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
1
The most severe diffuse brain injury caused by rotational acceleration is most likely to be located in the:
A)diencephalon to the brainstem.
B)medial portion of the brainstem.
C)entire brainstem.
D)diencephalon.
A)diencephalon to the brainstem.
B)medial portion of the brainstem.
C)entire brainstem.
D)diencephalon.
diencephalon to the brainstem.
2
Guillain-Barré syndrome causes muscle weakness that can progressively worsen for up to 4 weeks.
False
3
Which disorder has clinical manifestations that include decreased consciousness for up to 6 hours as well as retrograde and posttraumatic amnesia?
A)Mild concussion
B)Classic concussion
C)Cortical contusion
D)Acute subdural hematoma
A)Mild concussion
B)Classic concussion
C)Cortical contusion
D)Acute subdural hematoma
Classic concussion
4
The peripheral nervous system is the main location of the lesions characteristic of multiple sclerosis (MS).
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5
In cases of subarachnoid hemorrhage, the intracranial pressure (ICP) may approach levels of diastolic blood pressure.
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6
What damage is most likely to occur to the brain in a classic cerebral concussion?
A)Diffuse cerebral disconnection from the reticular activating system
B)Cerebral edema throughout the cerebral cortex
C)Cerebral edema throughout the diencephalon
D)Disruption of axons extending from the diencephalon and brainstem
A)Diffuse cerebral disconnection from the reticular activating system
B)Cerebral edema throughout the cerebral cortex
C)Cerebral edema throughout the diencephalon
D)Disruption of axons extending from the diencephalon and brainstem
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7
About half of all people with acquired immunodeficiency syndrome (AIDS) have neurologic complications.
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8
Which of the following indicate that spinal shock is terminating?
A)Voluntary movement below the level of injury
B)Reflex emptying of the bladder
C)Paresthesia below the level of injury
D)Decreased deep tendon reflexes and flaccid paralysis
A)Voluntary movement below the level of injury
B)Reflex emptying of the bladder
C)Paresthesia below the level of injury
D)Decreased deep tendon reflexes and flaccid paralysis
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9
Bacterial meningitis can develop as a consequence of ear or gum infections.
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10
Myasthenia gravis is characterized by extreme fatigue that improves with rest.
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11
In encephalitis, viruses gain access to the central nervous system (CNS) through blood or peripheral nerves.
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12
_____ are most at risk of spinal cord injury from minor trauma.
A)Children
B)Adolescents
C)Adults
D)Older adults
A)Children
B)Adolescents
C)Adults
D)Older adults
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13
Most people with amyotrophic lateral sclerosis (ALS) can live symptom free for at least 10 years following diagnosis.
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14
Most central nervous system tumors in children are found above the tentorium cerebelli.
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15
Rebleeding after a subarachnoid hemorrhage is a significant risk and occurs most often up to 4 weeks after the initial hemorrhage.
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16
Because spinal cord swelling increases the degree of dysfunction, it is difficult to distinguish between permanent and temporary loss of function until the swelling is resolved.
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17
The edema of the upper cervical cord after spinal cord injury is considered life threatening because of:
A)hypovolemic shock from blood lost during the injury.
B)the apnea from the impairment to the diaphragm.
C)a head injury was more likely to occur during the injury.
D)the spinal shock immediately after the injury.
A)hypovolemic shock from blood lost during the injury.
B)the apnea from the impairment to the diaphragm.
C)a head injury was more likely to occur during the injury.
D)the spinal shock immediately after the injury.
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18
Autonomic hyperreflexia is likely to occur before spinal shock is resolved.
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19
What are the initial clinical manifestations noted immediately after a spinal cord injury?
A)Headache, bradycardia, and elevated blood pressure
B)Confusion, irritability, and retrograde amnesia
C)Loss of deep tendon reflexes and flaccid paralysis
D)Hypertension, neurogenic shock, and tachycardia
A)Headache, bradycardia, and elevated blood pressure
B)Confusion, irritability, and retrograde amnesia
C)Loss of deep tendon reflexes and flaccid paralysis
D)Hypertension, neurogenic shock, and tachycardia
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20
Tubercular meningitis is on the rise in the United States especially in persons with acquired immunodeficiency syndrome (AIDS).
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21
Which clinical finding is considered a diagnostic indicator for an arteriovenous malformation (AVM)?
A)Systolic bruit over the carotid artery
B)Decreased level of consciousness
C)Hypertension with bradycardia
D)Diastolic bruit over the temporal artery
A)Systolic bruit over the carotid artery
B)Decreased level of consciousness
C)Hypertension with bradycardia
D)Diastolic bruit over the temporal artery
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22
Which clinical manifestation is characteristic of cluster headaches?
A)Aura before the headache with photophobia and nausea and vomiting
B)Severe unilateral tearing, burning, or temporal pain
C)Gradual onset of bilateral pain with sensation of a tight band around the head
D)Throbbing headache with intermittent burning sensation
A)Aura before the headache with photophobia and nausea and vomiting
B)Severe unilateral tearing, burning, or temporal pain
C)Gradual onset of bilateral pain with sensation of a tight band around the head
D)Throbbing headache with intermittent burning sensation
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23
In adults most intracranial tumors are located:
A)above the tentorium cerebelli.
B)below the tentorium cerebelli.
C)laterally.
D)posterolaterally.
A)above the tentorium cerebelli.
B)below the tentorium cerebelli.
C)laterally.
D)posterolaterally.
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24
A right hemisphere embolic cerebrovascular accident has resulted in left-sided paralysis and reduced sensation of the left foot and leg.The vessel most likely affected by the emboli is the right _____ artery.
A)middle cerebral
B)vertebral
C)posterior cerebral
D)anterior cerebral
A)middle cerebral
B)vertebral
C)posterior cerebral
D)anterior cerebral
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25
What complication is occurring for a person who has a spinal cord injury above T6 and is experiencing paroxysmal hypertension as well as piloerection and sweating above the spinal cord lesion?
A)Craniosacral dysreflexia
B)Parasympathetic dysreflexia
C)Autonomic hyperreflexia
D)Healing of the spinal cord lesion
A)Craniosacral dysreflexia
B)Parasympathetic dysreflexia
C)Autonomic hyperreflexia
D)Healing of the spinal cord lesion
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26
What is the central component of the pathogenic model of multiple sclerosis?
A)Myelination of nerve fibers in the PNS
B)Demyelination of nerve fibers in the CNS
C)Development of neurofibrillary tangles in the CNS
D)Inherited autosomal dominant trait with high penetrance
A)Myelination of nerve fibers in the PNS
B)Demyelination of nerve fibers in the CNS
C)Development of neurofibrillary tangles in the CNS
D)Inherited autosomal dominant trait with high penetrance
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27
Which cerebral vascular disorder causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
A)Intracranial hemorrhage
B)Subarachnoid hemorrhage
C)Epidural hemorrhage
D)Subdural hemorrhage
A)Intracranial hemorrhage
B)Subarachnoid hemorrhage
C)Epidural hemorrhage
D)Subdural hemorrhage
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28
A blunt force injury to the forehead would result in a contrecoup injury to the _____ region.
A)frontal
B)temporal
C)parietal
D)occipital
A)frontal
B)temporal
C)parietal
D)occipital
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29
Meningiomas characteristically compress:
A)from within neural tissues.
B)spinal nerve roots.
C)from outside the spinal cord.
D)from the subarachnoid space.
A)from within neural tissues.
B)spinal nerve roots.
C)from outside the spinal cord.
D)from the subarachnoid space.
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30
A herniation of which disk would likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
A)L2-L3
B)L3-L5
C)L5-S1
D)S2-S3
A)L2-L3
B)L3-L5
C)L5-S1
D)S2-S3
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31
What sequence causes autonomic hyperreflexia-induced bradycardia?
A)Stimulation of the sympathetic nervous system to ß-adrenergic receptors to the sinoatrial node
B)Stimulation of the carotid sinus to the vagus nerve to the sinoatrial node
C)Stimulation of the parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
D)Stimulation of the bundle branches to the a-adrenergic receptors to the sinoatrial node
A)Stimulation of the sympathetic nervous system to ß-adrenergic receptors to the sinoatrial node
B)Stimulation of the carotid sinus to the vagus nerve to the sinoatrial node
C)Stimulation of the parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
D)Stimulation of the bundle branches to the a-adrenergic receptors to the sinoatrial node
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32
Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
A)Embolic
B)Hemorrhagic
C)Lacunar
D)Thrombotic
A)Embolic
B)Hemorrhagic
C)Lacunar
D)Thrombotic
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33
In children most intracranial tumors are located:
A)above the tentorium cerebelli.
B)below the tentorium cerebelli.
C)laterally.
D)posterolaterally.
A)above the tentorium cerebelli.
B)below the tentorium cerebelli.
C)laterally.
D)posterolaterally.
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34
Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
A)Cavernous angioma
B)Capillary telangiectasia
C)Arteriovenous angioma
D)Arteriovenous malformation
A)Cavernous angioma
B)Capillary telangiectasia
C)Arteriovenous angioma
D)Arteriovenous malformation
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35
Why does a person who has a spinal cord injury experience faulty control of sweating?
A)The hypothalamus is unable to regulate body heat as a result of sympathetic nervous system damage.
B)The thalamus is unable to regulate body heat as a result of sympathetic nervous system damage.
C)The hypothalamus is unable to regulate body heat as a result of parasympathetic nervous system damage.
D)The hypothalamus is unable to regulate body heat as a result of damage to spinal nerve roots.
A)The hypothalamus is unable to regulate body heat as a result of sympathetic nervous system damage.
B)The thalamus is unable to regulate body heat as a result of sympathetic nervous system damage.
C)The hypothalamus is unable to regulate body heat as a result of parasympathetic nervous system damage.
D)The hypothalamus is unable to regulate body heat as a result of damage to spinal nerve roots.
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36
The most common primary central nervous system tumor is the:
A)microglioma.
B)neuroblastoma.
C)astrocytoma.
D)neuroma.
A)microglioma.
B)neuroblastoma.
C)astrocytoma.
D)neuroma.
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37
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
A)Hemorrhagic
B)Thrombotic
C)Embolic
D)Lacunar
A)Hemorrhagic
B)Thrombotic
C)Embolic
D)Lacunar
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38
A man was in an automobile accident in which his forehead struck the windshield.A blunt force injury to the forehead would result in a coup injury to the _____ region.
A)frontal
B)temporal
C)parietal
D)occipital
A)frontal
B)temporal
C)parietal
D)occipital
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39
Spinal cord injuries are most likely to occur in which of the following regions?
A)Cervical and thoracic
B)Thoracic and lumbar
C)Lumbar and sacral
D)Cervical and lumbar
A)Cervical and thoracic
B)Thoracic and lumbar
C)Lumbar and sacral
D)Cervical and lumbar
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40
Of the following people, who is at highest risk for a cerebrovascular accident (CVA)?
A)White women older than 65 years of age
B)Black women older than 70 years of age
C)Black men older than 65 years of age
D)White men older than 70 years of age
A)White women older than 65 years of age
B)Black women older than 70 years of age
C)Black men older than 65 years of age
D)White men older than 70 years of age
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41
In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?
A)Guillain-Barré syndrome
B)Multiple sclerosis
C)Myasthenia gravis
D)Parkinson disease
A)Guillain-Barré syndrome
B)Multiple sclerosis
C)Myasthenia gravis
D)Parkinson disease
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42
Myasthenia gravis:
A)is an acute autoimmune disease.
B)affects the nerve roots.
C)may result in adrenergic crisis.
D)causes muscle weakness.
A)is an acute autoimmune disease.
B)affects the nerve roots.
C)may result in adrenergic crisis.
D)causes muscle weakness.
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43
Match the terms with the corresponding descriptions.
Brain abscess
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
Brain abscess
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
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44
A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia.He reports severe head pain and blurred vision.The most likely explanation for these clinical manifestations is that he is:
A)experiencing acute anxiety.
B)developing spinal shock.
C)developing autonomic hyperreflexia.
D)experiencing parasympathetic areflexia.
A)experiencing acute anxiety.
B)developing spinal shock.
C)developing autonomic hyperreflexia.
D)experiencing parasympathetic areflexia.
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45
Amyotrophic lateral sclerosis (ALS) is characterized by:
A)an autosomal dominant genetic disorder.
B)demyelination of central nervous system neurons.
C)upper and lower motor neuron degeneration.
D)an autoimmune disorder caused by a virus.
A)an autosomal dominant genetic disorder.
B)demyelination of central nervous system neurons.
C)upper and lower motor neuron degeneration.
D)an autoimmune disorder caused by a virus.
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46
Match the terms with the corresponding descriptions.
Caused most commonly by motor vehicle accidents
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
Caused most commonly by motor vehicle accidents
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
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47
Which of the following best describes multiple sclerosis (MS)?
A)It is a central nervous system (CNS) demyelination, possibly from an immunogenetic virus.
B)It is an inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder.
C)It is a depletion of dopamine in the central nervous system as a result of a virus.
D)It is a degenerative disorder of lower and upper motor neurons caused by viral-immune factors.
A)It is a central nervous system (CNS) demyelination, possibly from an immunogenetic virus.
B)It is an inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder.
C)It is a depletion of dopamine in the central nervous system as a result of a virus.
D)It is a degenerative disorder of lower and upper motor neurons caused by viral-immune factors.
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48
Match the terms with the corresponding descriptions.
Lyme disease
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
Lyme disease
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
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49
The most likely rationale for body temperature fluctuations after cervical spinal cord injury is that the person:
A)has developed bilateral pneumonia or a urinary tract infection.
B)has sympathetic nervous system damage resulting in disturbed thermal control.
C)also sustained a head injury that damaged the hypothalamus's ability to regulate temperature.
D)has developed septicemia from posttrauma infection.
A)has developed bilateral pneumonia or a urinary tract infection.
B)has sympathetic nervous system damage resulting in disturbed thermal control.
C)also sustained a head injury that damaged the hypothalamus's ability to regulate temperature.
D)has developed septicemia from posttrauma infection.
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50
Match the terms with the corresponding descriptions.
Encephalitis
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
Encephalitis
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
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51
Match the terms with the corresponding descriptions.
Cryptococcus neoformans
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
Cryptococcus neoformans
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
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52
Atheromatous plaques are most commonly found:
A)in the larger veins.
B)near capillary sphincters.
C)at branches of arteries.
D)on the venous sinuses.
A)in the larger veins.
B)near capillary sphincters.
C)at branches of arteries.
D)on the venous sinuses.
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53
Guillain-Barré syndrome (GBS):
A)is preceded by a viral illness.
B)involves a deficit in acetylcholine.
C)results in asymmetric paralysis.
D)is an outcome of HIV.
A)is preceded by a viral illness.
B)involves a deficit in acetylcholine.
C)results in asymmetric paralysis.
D)is an outcome of HIV.
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54
The type of vascular malformation that most often results in hemorrhage is:
A)cavernous angioma.
B)venous angioma.
C)capillary telangiectasia.
D)arteriovenous malformation.
A)cavernous angioma.
B)venous angioma.
C)capillary telangiectasia.
D)arteriovenous malformation.
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55
Multiple sclerosis (MS) and Guillain-Barré syndrome (GBS) are similar in that they both:
A)result from demyelination by an immune reaction.
B)cause permanent destruction of peripheral nerves.
C)result from inadequate production of neurotransmitters.
D)block acetylcholine receptor sites at the myoneuronal junction.
A)result from demyelination by an immune reaction.
B)cause permanent destruction of peripheral nerves.
C)result from inadequate production of neurotransmitters.
D)block acetylcholine receptor sites at the myoneuronal junction.
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56
Match the terms with the corresponding descriptions.
May be acute or chronic accumulation of venous blood
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
May be acute or chronic accumulation of venous blood
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
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57
Match the terms with the corresponding descriptions.
Meningitis
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
Meningitis
A)Complication of mastoiditis
B)Opportunistic infection
C)CNS manifestation of tuberculosis
D)Mosquito-borne viral infection
E)Tick-borne bacterial infection
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58
Match the terms with the corresponding descriptions.
Produces immediate but short-lasting unconsciousness
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
Produces immediate but short-lasting unconsciousness
A)Contusion
B)Extradural hematoma
C)Subdural hematoma
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