Deck 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction

Question 1

A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet?

A)L2 to L3
B)L3 to L5
C)L5 to S1
D)S2 to S3

Answer 1

L5 to S1

Question 2

A healthcare professional is caring for a patient who has a spinal cord injury at T5. The patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the spinal cord lesion. How does the professional chart this event?

A)Craniosacral dysreflexia
B)Parasympathetic dysreflexia
C)Autonomic hyperreflexia
D)Retrograde hyperreflexia

Answer 2

Autonomic hyperreflexia

Question 3

Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?

A)Intracranial
B)Subarachnoid
C)Epidural
D)Subdural

Answer 3

Subarachnoid

Question 4

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 damage to the sympathetic nervous system.
B)The thalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
C)The hypothalamus is unable to regulate body heat as a result of damage to the parasympathetic nervous system.
D)The thalamus is unable to regulate body heat as a result of damage to spinal nerve roots.

Question 5

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

Question 6

A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for?

A)Teaching school aged children bicycle safety
B)Teaching stretching to high school athletes
C)Teaching adults good body mechanics for lifting
D)Teaching older adults how to prevent trip-and-fall events

Question 7

A person has been diagnosed with multiple sclerosis and asks the healthcare professional to explain the disease. What description by the professional is most accurate?

A)Myelination of nerve fibers in the peripheral nervous system (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

Question 8

Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?

A)Hemorrhagic
B)Thrombotic
C)Embolic
D)Lacunar

Question 9

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

Question 10

In adults, how are most intracranial tumors located?

A)Infratentorially
B)Supratentorially
C)Laterally
D)Posterolaterally

Question 11

What do diffuse axonal injuries (DAIs) of the brain often result in?

A)Reduced levels of consciousness
B)Mild but permanent dysfunction
C)Fine motor tremors
D)Visual disturbances

Question 12

A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient?

A)Blood pressure
B)Respirations
C)Pulse
D)Temperature

Question 13

What is the most common primary central nervous system (CNS) tumor?

A)Microglioma
B)Neuroblastoma
C)Astrocytoma
D)Neuroma

Question 14

A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli?

A)Middle cerebral
B)Vertebral
C)Posterior cerebral
D)Anterior cerebral

Question 15

A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?

A)Insulin-resistant diabetes mellitus
B)Hypertension
C)Polycythemia
D)Smoking

Question 16

In children, how are most intracranial tumors located?

A)Infratentorially
B)Supratentorially
C)Laterally
D)Posterolaterally

Question 17

What indicates 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

Question 18

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

Question 19

Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?

A)Sympathetic nervous system to b-adrenergic receptors to the sinoatrial node
B)Carotid sinus to the vagus nerve to the sinoatrial node
C)Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
D)Bundle branches to the a-adrenergic receptors to the sinoatrial node

Question 20

What event is most likely to occur when a person experiences a closed head injury?

A)Brief period of vital sign instability
B)Cerebral edema throughout the cerebral cortex
C)Cerebral edema throughout the diencephalon
D)Disruption of axons extending from the diencephalon and brainstem

Question 21

Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what?

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.

Question 22

A blunt-force injury to the forehead would result in a contrecoup injury to which region of the brain?

A)Frontal
B)Temporal
C)Parietal
D)Occipital

Question 23

A blunt-force injury to the forehead would result in a coup injury to which region of the brain?

A)Frontal
B)Temporal
C)Parietal
D)Occipital

Question 24

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

Question 25

Where are atheromatous plaques most commonly found?

A)In larger veins
B)Near capillary sphincters
C)At branches of arteries
D)On the venous sinuses

Question 26

What does a healthcare professional explain to a student about myasthenia gravis?

A)It is an acute autoimmune disease.
B)It affects the nerve roots.
C)It may result in adrenergic crisis.
D)It causes muscle weakness.

Question 27

Spinal cord injuries occur most frequently in which region?

A)Cervical and thoracic
B)Thoracic and lumbar
C)Lumbar and sacral
D)Cervical and thoracic lumbar

Question 28

A patient who sustained a cervical spinal cord injury 2 days ago suddenly develops severe headache and blurred vision. What should the healthcare professional do?

A)Give the patient a glass of cool water.
B)Give the patient some pain medication.
C)Take the patient's blood pressure and pulse.
D)Facilitate the patient having a head CT scan.

Question 29

What are the initial clinical manifestations immediately noted after a spinal cord injury? (Select all that apply.)

A)Headache
B)Bladder incontinence
C)Loss of deep tendon reflexes
D)Hypertension
E)Flaccid paralysis

Question 30

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best?

A)It is often preceded by a viral illness.
B)It is due to a genetic defect in acetylcholine.
C)It could be caused by a brain tumor.
D)It is often transmitted by family pets.

Question 31

What is the type of vascular malformation that most often results in hemorrhage?

A)Cavernous angioma
B)Venous angioma
C)Capillary telangiectasia
D)Arteriovenous malformation

Question 32

A patient has AIDS and reports fever, clumsiness, difficulty with balance and walking, and trouble speaking. What treatment does the healthcare professional educate the patient about?

A)Radiation therapy
B)Chemotherapy
C)Oral pyrimethamine
D)Surgery

Question 33

Which clinical manifestations are characteristic of cluster headaches? (Select all that apply.)

A)Preheadache aura
B)Severe unilateral tearing
C)Gradual onset of a tight band around the head
D)Can be associated with vomiting
E)Pain lasting from 20 to 120 min