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CHAPTER 3 QUIZ Write the letter of the best answer in the space provided. ____ 1 The part of the nervous system that extends throughout the body is called the ____ nervous system. a) peripheral b) ventral c) somatic d) afferent ____ 2. The sympathetic nervous system is also known as the ____ division. (a) feed or breed (b) fight or flight (c) slow or go (d) stand or draw ____ 3. The division of the autonomic nervous system that is responsible for controlling vegetative functions is the ____ nervous system. (a) somatic (b) afferent (c) sympathetic (d) parasympathetic ____ 4. The fundamental unit of the nervous system is the: (a) axion. (b) soma. (c) synaptic terminals. (d) nerve cell, or neuron. ____ 5. The axon is the portion of a nerve cell that: (a) comes in physical contact with another nerve cell. (b) is stimulated by environmental changes. (c) conducts nerve impulses away from the soma. (d) contains most of the metabolic machinery. ____ 6. The membranes covering the brain and spinal cord are collectively called the: (a) dura mater. (b) meninges. (c) pia mater. (d) arachnoid membranes. ____ 7. The portion of the brain that is the seat of consciousness and the center of higher mental functions is the: (a) cerebellum. (b) medulla oblongata. (c) cerebrum. (d) pons. ____ 8. You will find the thalamus, the hypothalamus, and the limbic system inside the: (a) cerebellum. (b) midbrain. (c) corpus callosum. (d) diencephalon. ____ 9. Involuntary actions such as temperature regulation, sleep, water balance, stress response, and emotions are the responsibility of the: (a) cerebellum. (b) midbrain. (c) corpus callosum. (d) diencephalon. ____ 10. A portion of the brain that is NOT considered part of the brainstem is the: (a) mesencephalon. (b) pons. (c) medulla oblongata. (d) cerebellum. ____ 11. The reticular activating system is responsible for: (a) consciousness and the ability to respond to stimuli. (b) posture, equilibrium, and muscle tone. (c) respiratory, cardiac, and vasomotor activity. (d) motor coordination and eye movement. ____ 12. One of the two systems that join at the Circle of Willis is the ____ system. (a) venous sinuses (b) internal jugular (c) vertebrobasilar (d) reticular activating ____ 13. The ____ fibers transmit impulses to the central nervous system from the body. (a) afferent (b) efferent (c) dermerent (d) reflexerent ____ 14. The 12 pairs of ____ nerves originate in the brain and supply nervous control to the head, neck, and certain thoracic and abdominal organs. (a) cranial (b) arachnoid (c) anterolateral (d) hexaxial ____ 15. When stimulated, the sympathetic nervous system: (a) causes a rise in blood sugar. (b) causes an increase in digestive activity. (c) is mediated by the neurotransmitter acetylcholine. (d) is responsible for controlling vegetative functions. ____ 16. A mechanism capable of producing alterations in mental status is a structural lesion. One cause of structural lesions is: (a) hepatic failure. (b) hypoglycemia. (c) brain tumor (neoplasm). (d) anoxia. ____ 17. Any malfunction of or damage to the peripheral nerves is called peripheral: (a) neuropathy. (b) cyanosis. (c) diaphoresis. (d) encephalopathy. ____ 18. You can quickly assess a patient's mental status by using the ____ method. (a) SAMPLE (b) AVPU (c) AEIOU-TIPS (d) OPQRST (e) ____ 19. Abnormal pupils can be an early indicator of increasing intracranial pressure that is compressing cranial nerve: (a) I. (b) II. (c) III. (d) IV. ____ 20. The breathing pattern characterized by a period of apnea that lasts 10-60 seconds, followed by gradually increasing depth and frequency of respirations is called: (a) Kussmaul's respiration. (b) Guillian-BarrŽ respiration. (c) apneustic respiration. (d) Cheyne-Stokes respiration. ____ 21. Ataxic respirations are: (a) intercostal muscle dysfunctions. (b) poor respirations due to CNS damage. (c) prolonged inspirations unrelieved by expirations. (d) lesions caused by hyperventilation. ____ 22. Your patient opens his eyes only when you pinch his shoulder. He has no verbal responses, and withdraws from pain. His Glasgow Coma Score Total is: (a) 2. (b) 3. (c) 4. (d) 6. ____ 23. On the Glasgow Coma Scale, a patient with a total score of ____ or better has an estimated 94% favorable outcome. (a) 8 (b) 7 (c) 6 (d) 5 ____ 24.Cushing's reflex is associated with increasing intracranial pressure and: (a) decreased blood pressure. (b) increased pulse. (c) decreased respirations. (d) decreased temperature. ____ 25. The words ____ and ____ are assigned to the letter "A" in the mnemonic AEIOU-TIPS. (a) airway, altered (b) alert, awake (c) abdomen, acute (d) acidosis, alcohol ____ 26. Stroke is referred to as a "brain attack" because in both a stroke and a heart attack: (a) overabundance of cerebrospinal fluid is produced. (b) a sudden, acute onset is reported by the patient. (c) oxygen deprivation causes damage to affected tissue. (d) a myocardial infarction may result. ____ 27. Studies have proven that ____ and other thrombolytic agents used in the treatment of heart attack are also effective in treating certain occlusive strokes. (a) epinephrine (b) tPa (c) morphine sulfate (d) lidocaine ____ 28.A stroke caused by the gradual development of a blood clot in a cerebral artery is called a(n): (a) thrombotic stroke. (b) embolic stroke. (c) hemorrhagic stroke. (d) aneurism. ____ 29. Symptoms from a transient ischemic attack (TIA) generally resolve within: (a) 6 hours. (b) 12 hours. (c) 24 hours. (d) 48 hours. ____ 30. When caring for a patient suffering from a nervous system condition or disease, your first priority in patient care is to: (a) administer thrombolytic therapy. (b) assess for any neurological deficits. (c) establish and maintain an adequate airway. (d) apply high-concentration oxygen by nonrebreather mask. ____ 31.A generalized motor seizure which produces a loss of consciousness is known as a(n): (a) absence seizure. (b) tonic-clonic seizure. (c) hysterical seizure. (d) complex partial seizure. ____ 32.The phases of a generalized seizure include all of the following EXCEPT: (a) aura. (b) loss of consciousness. (c) postictal. (d) absence. ____ 33. Management of the seizure patient includes: (e) inserting an oral airway while the patient is seizing. (f) protecting the patient from hitting nearby objects. (g) establishing an IV containing a dextrose solution. (h) holding a tongue blade in the patient's mouth. ____ 34. The term "status epilepticus" refers to a: (a) chronic seizure patient taking anticonvulsant medication regularly. (b) generalized seizure lasting more than 1 minute. (c) two or more seizures with no intervening periods of consciousness. (d) patient experiencing a seizure for the first time. ____ 35. Management of the adult patient in status epilepticus includes administration of: (a) 5-10 mg diazepam IV push. (b) oral glucose if hypoglycemia is present. (c) dextrose, Narcan, and thiamine IV push. (d) sumatriptan and prochlorperazine. ____ 36. A series of one-sided headaches that are sudden, intense, and may continue for 15 minutes to 4 hours is referred to as: (a) syncope headaches. (b) migraine headaches. (c) organic headaches. (d) cluster headaches. ____ 37. Consider a headache a potentially serious condition if the patient describes it as: (a) sudden in onset and "the worst headache of my life." (b) lasting for more than 24 hours. (c) being accompanied by nausea and photosensitivity. (d) dull or achy pain with a feeling of forceful pressure. ____ 38. The term ____ is used to describe the new growth of a tumor. (a) malignant (b) metastasized (c) benign (d) neoplasm ____ 39. The disease that involves inflammation of certain nerve cells followed by demyelination is called: (a) dystonia. (b) muscular dystrophy. (c) multiple sclerosis. (d) Alzheimer's disease. ____ 40. A neural defect that results from the failure of one or more of the fetal vertebrae to close properly during the first month of pregnancy is called: (a) myoclonus. (b) amyotrophic lateral sclerosis (ALS). (c) poliomyelitis. (d) spina bifida. CHAPTER 3 REVIEW Write the word or words that best complete each sentence in the space(s) provided. 1. The central nervous system is made up of the _______________ and _______________ _______________ . 2. The _______________ nervous system extends throughout the body. 3. Voluntary bodily functions are controlled by the _______________ nervous system. 4. The _______________ nervous system controls involuntary bodily functions. 5. The _______________ nervous system is the division of the autonomic nervous system that prepares the body for stressful situations. 6. The _______________ nervous system is the division of the autonomic nervous system that controls vegetative functions. 7. A(n) _______________ is a substance that is released from the axon terminal of a presynaptic neuron upon excitation. 8. The membranes covering and protecting the brain and spinal cord are called the _______________ . 9. The portion of the brain lying beneath the cerebrum and above the brainstem is called the _______________ . 10. The _______________ _______________ is the lower portion of the brainstem, connecting the pons and the spinal cord. It contains major centers for control of _______________ , _______________ , and _______________ activity. 11. The system responsible for consciousness is the _______________ _______________ system. 12. _______________ fibers transmit impulses to the central nervous system from the body, while _______________ fibers carry impulses from the central nervous system to the body. 13. There are 12 pairs of _______________ nerves that extend from the lower surface of the brain. 14. The _______________ nervous system is often referred to as the "fight-or- flight" system, and the _______________ nervous system is referred to as the "feed-and-breed" system. 15. Anoxia, diabetic ketoacidosis, and renal failure are among the various causes of _______________ - _______________ states, which can produce diffuse depression of both sides of the cerebrum. 16. Brain tumor, intracranial hemorrhage, parasites, and trauma are among the causes of _______________ _______________ , which are capable of producing alterations in mental status. 17. Any malfunction or damage of the peripheral nerves is called _______________ _______________ . 18. The "A" in the mnemonic _______________ means the patient is alert and aware of his surroundings. 19. Breathing characterized by a prolonged inspiration that is unrelieved by expiration attempts is called _______________ respiration. 20. Poor respirations due to CNS damage, causing ineffective thoracic muscular coordination, are called _______________ . 21. A(n) _______________ posture is one in which the patient presents with the arms flexed, fists clenched, and legs extended. 22. A(n) _______________ posture is one in which the patient presents with stiff and extended extremities and retracted head. 23. A collective change in vital signs associated with increasing intracranial pressure is called _______________ reflex. 24. _______________ syndrome is a condition characterized by loss of memory and disorientation, and is associated with chronic alcohol intake and a diet deficient in thiamine. 25. Ischemic or hemorrhagic lesion to a portion of the brain, resulting in damage or destruction of brain tissue, is called a(n) _______________ . 26. "Brain attacks" are divided into two broad categories: _______________ and _______________ . 27. Seizures that begin as an electrical discharge in a small area of the brain but spread to involve the entire cerebral cortex, causing widespread malfunction, are called _______________ seizures. 28. In the _______________ phase of a generalized seizure, the patient may awaken confused and fatigued. 29. A type of generalized seizure with sudden onset, characterized by a brief loss of awareness and rapid recovery, is called a(n) _______________ seizure. 30. A series of two or more generalized motor seizures without any intervening periods of consciousness is called _______________ _______________ . 31. _______________ is a sedative and anticonvulsant medication used in treating seizures. 32. The term _______________ is used to describe the new growth of a tumor. 33. Alzheimer's disease, muscular dystrophy, and multiple sclerosis are all examples of _______________ _______________ disorders. 34. Lou Gehrig's disease, or _______________ _______________ _______________ , is a progressive degeneration of specific nerve cells that control voluntary movement. 35. Thousands of survivors of _______________ , an infectious, inflammatory viral disease of the CNS that can result in permanent paralysis, require supportive care. TREATMENT IN NERVOUS SYSTEM EMERGENCIES A number of treatments are performed for the patient with CNS problems. For each one described below, give a brief rationale of why the treatment is beneficial. 1. Administration of oxygen 2. Initiating IV normal saline or lactated Ringer's solution (and not 5% dextrose) 3. Determining the blood glucose level 4. Protecting the airway 5. Providing assurance to the patient 6. Monitoring cardiac rhythm NERVOUS SYSTEM ANATOMY AND PHYSIOLOGY Write the word or words that best complete each sentence in the space(s) provided. 1. The fundamental unit of the nervous system is the nerve cell, or _______________ . The nerve cell includes the cell body, which contains the _______________ ; the _______________ , which carry nervous impulses to the cell body; and the _______________ , which transmit nervous impulses away from the cell body. 2. The transmission of impulses in the nervous system resembles the conduction of electrical impulses through the _______________ . When stimulated, _______________ rapidly enters the cell and _______________ rapidly leaves it, producing a positive charge at the entry site. This positive charge, which is called the _______________ _______________ , is subsequently transmitted down the neuron at extremely high velocity. The neuron joins with other neurons at junctions called _______________ . The neurons do not come into direct contact with each other. Instead, upon reaching the junction, the cell causes the release of a chemical _______________ . The chemical associated with the parasympathetic and voluntary nervous systems is _______________ . The chemical found at the terminals of sympathetic nerves is _______________ . 3. The entire central nervous system is covered in protective membranes called the _______________ . The outermost layer is called the _______________ _______________ . The middle layer is known as the _______________ membrane. The innermost layer, directly overlying the central nervous system, is called the _______________ _______________ . Both the brain and the spinal cord are bathed in _______________ fluid. 4. Of the six main divisions of the brain, the largest one is called the _______________ . It consists of _______________ hemispheres and is the seat of _______________ and the center of the higher mental functions. 5. The superior most portion of the brain stem is called the _______________ . It contains the thalamus, the _______________ , and the limbic system. This area is responsible for many involuntary actions, such as _______________ . 6. The _______________ , or the midbrain, controls _______________ _______________ and _______________ _______________ . The _______________ is located between the midbrain and the medulla oblongata and contains connections between the brain and the spinal cord. The _______________ _______________ is the lower portion of the brainstem, connecting the pons and the spinal cord. The _______________ is located in the posterior fossa of the cranial cavity.
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