NURS 231 Pathophysiology Module 6 Exam: Questions and Answers, Exams of Nursing

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Portage Learning NURS 231

Pathophysiology 2022 Module 6

Exam

Portage Learning NURS 231 Pathophysiology 2022

Module 6 Exam

Score for this quiz: 5 out of 5

Total Questions: 33 List the 2 major divisions of the nervous system and the structures found in each. Your Answer: CNS which contains the brain and the spinal cord peripheral nervous system which contains spinal nerves, cranial nerves and ganglia that are the outside of the peripheral nervous.

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Question 1

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Describe the meninges and their function. Your Answer: the meninges are connective tissue sheets that are surround the brain and the spinal cord. the Pia mater is the innermost layer of the most meninges. it is thin and delicate and contains surface level blood vessel that perfuse the brain and the spinal cord, the second layer of the meninges is the arachnid layer. it encases the entire CNS and it delicate nonvascular and waterproof. cerebrospinal fluid circulate in Andrea just below the arachnoid layer called the subarachnoid space. the third layer of the meninges is know as the dura mater. the dura mater is the a strong continues connective tissue sheath that provides the brain and the spinal cord with most of its protection. The 2 divisions of the nervous system are the central nervous system (CNS) containing the brain and spinal cord and the peripheral nervous system (PNS) containing spinal nerves, cranial nerves, and ganglia that are outside of the PNS.

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Describe how CSF is produced and its function. Your Answer: CFS serves as a cushion for the brain and the spinal cord, protecting them from the outside physical force. it maintain a constant ionic environment that allow for the diffusion of essential nutrient, electrolyte , and metabolic waste product into the extracellular fluid surrounding the CNS neurons. A thin layer of neuroglia cells, collective know as the ependyma, line the ventricles of therein and the central canal of the spinal cord.specialized ependymal cells called the chord plexus project into the ventricles and produce CSF. The meninges are connective tissue sheaths that surround the brain and spinal cord. The pia mater is the innermost layer of the meninges. It is thin and delicate and contains surface level blood vessels that perfuse the brain and spinal cord. The second layer of the meninges is the arachnoid layer****. It encases the entire CNS and is delicate, nonvascular, and waterproof. Cerebrospinal fluid (CSF) circulates in an area just below the arachnoid layer called

the subarachnoid space. The third layer of the meninges is

known as the dura mater****. The dura mater is a strong, continuous connective tissue sheath that provides the brain and spinal cord with most of its protection.

CSF serves as a cushion for the brain and spinal cord protecting them from outside physical force. It maintains a constant ionic environment that allows for the diffusion of essential nutrients, electrolytes, and metabolic waste products into the extracellular fluid surrounding the CNS neurons. A thin layer of neuroglial cells, collectively known as the ependyma , line the ventricles of the brain and the central canal of the spinal cord. Specialized ependymal

cells called the choroid plexus project into the ventricles

and produce CSF. Be familiar with the cranial nerves and their general function. Refer to Table 6. What is the difference between afferent and efferent neurons? Your Answer: Afferent neurons carry signal sensory information from the periphery to the spinal cord and brain while efferent neurons carry motor output from the brain and the spinal cord to periphery

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Question 4

Afferent neurons carry sensory information from the periphery to the spinal cord and brain while efferent neurons carry motor output from the brain and spinal cord to the periphery. Be familiar with each division of the nervous system and their function. Refer to Figure 6. CNS: oligodendrocytes, astrocytes, microglia, and the ependymal cells. PNS: satellite cells and Schwann cells Your Answer: CNS - Oligodendrocytes, astrocytes, microglia, and the ependymal cells PNS- satellite, cells, and Schwann cells List the neuroglial cells of the CNS and PNS.

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Question 5

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Describe each phase of an action potential. Your Answer: phase 1- resting potential, during the resting phase , both sodium and potassium gates are closed phase 2- depolarization, the sodium gates are opener open and sodium rushes into the axon during the depolarization phase of action potential. voltage travels to zero and then up to +40mV phase 3 - repolarization, the sodium gates close, and potassium gates open allowing to rush out of the axon. this returns a negative voltage to the inside of the axon phase 4 - after - polarization also know as hyperpolarization. potassium gates are slow to close ,and there is an undershoot of the potential. the voltage drops below - 70mV and then returns to - 70mV as the resting state is re- stablished.

Phase 1 : Resting Potential : During the resting phase, both sodium and potassium gates are closed. Phase 2 : Depolarization : The sodium gates open, and sodium rushes into the axon during the depolarization phase of the action potential. Voltage travels to zero and then up to +40 mV. Phase 3 : Repolarization : The sodium gates close, and potassium gates open allowing potassium to rush out of the

axon. This returns a negative voltage to the inside of the axon.

Phase 4 : After-polarization, also called hyperpolarization. Potassium gates are slow to close, and there is an undershoot of the potential. The voltage drops below - 70mV and then returns to - 70mV as the resting state is re-established. Describe 3 ways in which neurotransmitters are removed from the synaptic cleft. Your Answer: A neurotransmitter can be broken down by enzymatic activity into inactivity substance. A neurotransmitters can be down back into the presynaptic neuron by a process know a as reuptake A neurotransmitter can be diffuse into the intercellular fluid until its concentration is too low to elicit a postsynaptic response.

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Question 7

A neurotransmitter can be broken down by enzymatic activity into inactive substances. A neurotransmitter can be drawn back into the presynaptic neuron by a process known as reuptake****. A neurotransmitter can diffuse into the intercellular fluid until its concentration is too low to elicit a postsynaptic response. Beta waves Your Answer: beta waves What type of EEG wave is associated with REM sleep?

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Question 8

Alpha waves are characteristic of which stage of sleep? Your Answer:

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Question 9

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Compare and contrast NREM and REM sleep regarding muscle tone, vital signs, and brain activity. Your Answer: NERM sleep account for most of the sleep cycle 80 85 % and it is characterized by slow EEG waves it begins when first person becomes drowsy and can be divided into 4 distinct stages stage 1 - is a brief transitional stage that occurs between wakefulness and falling asleep. at this point a person can easily aroused with light sensory input for example speaking their name. during this stage of sleep people may experience hyping myoclonic jolting movement. stage one also serve as transition between sleep cycles stage 2 - is a longer period of deeper sleep lasting approximately 10 - 25 minutes. theta waves are present in this stage 3 sleep with high frequency waves know as as sleep spindles interspersed. these spindles seem to play a role in the formation few new memories and solidifying knowledge taken during wakefulness. stage 3 and stage 4 - are period of deep sleep. stage 3 - last only few minutes before transition into stage 4. stage 4 - last 20 - 40 minutes. delta waves are predominately presents enthuse phases of sleep. vital sings all decrease , and body is fully relaxes. stage 1 Stage 1

rem sleep accounts for 20 - 25%of total sleep it is characterized by rapid eye movement , decrease muscular tone and cream. during this phase of sleep, incoming sensory input is blocked, the brain simply cannot process it. however, internalized sensory tracts are stimulated allowing previously formed memories to replay in ones mind. in contrast to NERM sleep, vital sings such as heart rate blood pressure and respiratory increase, and the brain activity is high. studies have shown that adequate time spent in REM sleeps necessary for normal physiology and psychologic function during periods of wakefulness. REM deprivation has been associated with anxiety, decrease concentration, and behavior changes. breathing pattern changes with stages of sleep. in stage 1 and 2 NERM sleep as well as in REM sleep, breathing is irregular ,and brief periods of apnea often observe around 5 - 15 seconds. during stages 3 and 4 of deep sleep, breathing become regular. dreams and their purpose are not fully understood. studies have suggested that dreams play a vital role in memory processing as well as learning. while dreams occur in all stages of sleep, most of the dreams occur in stage 1 and 2, when one is first falling asleep, and in REM sleep. Dreams that occur in REM sleep tend to be emotionally driven and carry associations with ones life. Nightmares typically occur in the deeper of stage 3 and 4 During NREM sleep, muscle tone is moderate; vital signs and brain activity are decreased. During REM sleep, muscle tone decreases; vital signs and brain activity increase.

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A patient with diagnosis of Alzheimer’s disease is able to function independently at home, but their family reports that they have trouble planning and executing everyday tasks that used to come easy to them e.g. paying their bills. What stage of Alzheimer’s disease are they in? Your Answer: Mild Alzheimer's Early or Mild Alzheimer’s Late or Severe Alzheimer’s Your Answer: sever Alzheimer's A patient with a diagnosis of Alzheimer’s disease has no awareness of their surroundings and is completely dependent for all ADLs. What stage of Alzheimer’s disease are they in?

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Question 12

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Question 13

List 3 non-medicinal interventions that can be used to address sleep changes in someone with Alzheimer’s disease. Your Answer: 1 - keep a regular routine during the day 2 - avoid caffeine intake altogether if possible but certainly in the afternoon and evening 3 - discourage watching television right before bed Any of the following are correct: Keep a regular routine during the day Encourage daily exercise that is earlier in the day and not close to bedtime Avoid caffeine intake altogether if possible but certainly in the afternoon and evening Discourage watching television right before bed Make sure the room environment is familiar and comfortable for the individual Provide the person with any security object that is a source of comfort to them What is the main difference between focal and generalized seizures? Your Answer:

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Question 14

focal seizures affect one specific part of the brain in one hemisphere. generalize seizures affect both hemispheres of the brain Focal seizures affect one specific part of the brain in 1 hemisphere. Generalized seizures affect both hemispheres of the brain. Aura is a sensation or movement that feels different or “off,” and is often described as a warning sign that a seizure is about to occur. Your Answer: Aura is a sensation or movement that feels different or off and is often describe as warning sign that a seizure is about to occur Describe the phenomenon of aura.

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Question 15

Give 2 reasons why it is important for someone with a seizure disorder to regularly see their care team (Neurologist and PCP.)

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Question 16

Your Answer: it is important for the PT with seizure disorder to see regularly his/her neurologist doctor to make sure their medication, and their disorder are control so their no other underlying conditions can interfere with their seizure meds. To make sure their current medication is managing their

seizure disorder and to make sure there aren’t any new

conditions that would require pharmacologic intervention that could interfere with their seizure medication. Dopamine Your Answer: dopamine Parkinson’s disease is characterized by a loss of which neurotransmitter?

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Question 17

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Question 18

What are the 3 hallmark signs of Parkinson’s disease? Your Answer: TRAP 1 - tremor 2 - rigidity bradykinesia posture Tremor, rigidity, bradykinesia Levadopa will cross the blood brain barrier while dopamine does not. Your Answer: Levodopa which can cross the blood brain barrier while domain does not Why is Levadopa given to treat Parkinson’s disease as opposed to dopamine?

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What are the 2 types of strokes? Describe the difference between them. Your Answer: 1 - ischemic stroke - a disruption in blood flow to brain because a vessel is blocked 2 - hemorrhoid spoke a dilution in blood flow to brain because blood vessel is ruptured Ischemic strokes are a disruption in blood flow to the brain as a result of a blocked blood vessel. Hemorrhagic strokes are a disruption in blood flow to the brain as a result of a ruptured blood vessel. Be familiar with risk factors for CVA/stroke Refer to Table 6.

What is a TIA and why are they important?

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Question 21

Your Answer: transient ischemic attacks TIA are often referred to as mini stroke, there is temporary disruption of blood flow and as with an ischemic stroke, is usually due to atherosclerotic blockage in the main feeding arteries to the brain. although a person will experience symptoms, however the symptoms will resolve within 24 hours w/o percent damage to therein. these should not be ignored as they serve as warning sign. most people who experience a TIA will eventually experience stroke. Transient ischemic attacks (TIAs) are often referred to as “mini strokes”. There is a temporary disruption of blood flow as with an ischemic stroke usually due to atherosclerotic blockage in the main feeding arteries to the brain. A person will experience symptoms; however, the symptoms will resolve within 24 hours without permanent damage to the brain. These should not be ignored as they serve as a warning sign. Most people who experience a TIA will eventually experience a stroke.

What type of stroke are tPA drugs used to treat? How soon after the

onset of a stroke must they be administered? Your Answer: tPA are drug used to to treat ischemic stroke and must be administered within 3 - 4.5 hours after the onset of stroke symptoms

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Question 22

tPA drugs are used to treat ischemic strokes and must be administered within 3 - 4.5 hours after the onset of stroke symptoms. Control bleeding and decrease pressure on the brain tissue Your Answer: controlling bleeding and decreasing pressure on the brain tissue What are the goals of acute treatment of a hemorrhagic stroke?

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Question 23

List 2 factors that could contribute to depression. Your Answer: inherited/familiar link chemical imbalance

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Question 24

Any of the following are correct answer: Inherited/familiar link Chemical imbalance Hormonal imbalance/change Stress/Trauma leading to an altered HPA axis Depression with catatonic features Your Answer: depression with catatonic features A “nervous tick” is associated with what specific type of depression?

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Question 25

Hypersomnia is associated with what specific type of depression? Your Answer: atypical depression

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Question 26

Atypical depression One is considered to have insomnia if they experience 3 of the following: Difficulty initiating sleep Difficulty maintaining sleep Waking up too early Chronic nonrestorative or poor sleep Your Answer: difficult initiating sleep difficult maintaining sleep 3 - waking up too early 4 - chronic non restorative or poor sleep List the 4 diagnostic characteristics of insomnia.

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Question 27

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What is sleep hygiene? Your Answer: sleep hygiene involves the establishment of consistent sleep patterns ,sleeping as long as one needs to sleep to feel refresh during the day, creating a comfortable sleeping environment, optimal room temperature avoiding of screen and excessive lights right before bed and avoiding of stimulants severs hours prior to normal bedtime. Sleep hygiene involves the establishment of consistent sleep patterns (going to bed at the same time each night and only sleeping as long as one needs to feel refreshed during the day), creating a comfortable sleeping environment (optimal room temperature), avoidance of screens and excessive light right before bed, and finally, avoidance of stimulants (caffeine) several hours prior to normal bedtime.

What stage of sleep is impaired with a diagnosis of narcolepsy? Your Answer: REM

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Question 29