cognitive systems
-Cognitive cerebral functions require a functioning _____ (RAS)
reticular activating system
the reticular formation
- the reticular formation extends through the central core of the _____, _____, and _____
- it is an intricate system composed of _____ in what is otherwise _____
medulla oblongata pons midbrain loosely clustered neurons white matter
Direct destruction of the reticulating activation system (RAS)
- _____ disorders produce a decline in _____ through a direct destruction of the RAS and its pathways.
- The most common cause of direct destruction is _____, but _____, _____, _____, _____, and _____ injury also may cause brainstem destruction by _____ compression.
Infratentorial arousal cerebrovascular disease demyelinating diseases neoplasms granulomas abscesses head tissue
alterations in arousal
pattern of breathing
-_____: Lower brainstem centers regulate breathing pattern
-_____: Abnormal rhythm of breathing with alternating periods of hyperventilation and apnea
Posthyperventilation apnea
Cheyne-Stokes respirations
Posthyperventilation apnea (PHVA)
- With normal breathing, a neural center in the forebrain (_____) produces a _____ breathing pattern. When consciousness decreases, _____ regulate the breathing pattern by responding only to changes in _____ levels.
- This irregular breathing pattern is called _____
- Rhythmic breathing returns when the carbon dioxide PCO2 level returns to _____.
cerebrum rhythmic lower brainstem centers PaCO2 PHVA normal
Cheyne-Stokes
-Cheyne-Stokes respiration is an abnormal rhythm of breathing (_____ breathing) that alternates between _____ and _____.
periodic
hyperventilation
apnea
Alterations in Arousal motor responses -\_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_ Involve the medulla. Vomiting without nausea indicates the direct involvement of the \_\_\_\_\_ mechanism (or \_\_\_\_\_ obstruction).
-Vomiting, yawning, and hiccups are complex reflexlike _____ responses that are integrated by _____ mechanisms in the _____ brainstem. Vomiting often accompanies CNS injuries that involve the _____
Vomiting yawning hiccupping central neural pyloric motor neural lower vestibular nuclei
Brain Death (Total Brain Death)
Brain death criteria:
-Completion of all appropriate, _____
-_____ (absence of motor and reflex responses)
0No spontaneous _____ (apnea)
-No _____ function
-Isoelectric (flat) electroencephalography (EEG) for _____ hours.
therapeutic procedures Unresponsive coma respirations brainstem 6 to 12
cerebral death
survivors of cerebral death
-Emerge into a _____
diagnostic criteria for a vegetative state
-Include the return of professed vegetative (_____) functions
- _____ cycles
- normalization of _____ and _____ system functions
vegetative state autonomic Sleep-wake respiratory digesive
delirium
Clinical manifestations
-Autonomic nervous system overactivity
-Typical development of over _____ days, most commonly in _____ units, _____, or during withdrawal from _____ (e.g., alcohol, narcotic agents)
2 to 3
critical care
postsurgically
central nervous system (CNS) depressants
dementia clinical manifestations
- _____
- _____
- _____
memory
speech
decision making
alzheimers disease
Pathophysiology
-No known cause
-_____ plaques, _____ tangles, as well as _____ and _____ losses in the brain, characterize Alzheimer disease.
Amyloid
neurofibrillary
neuronal
synaptic
seizure disorders
- Seizure: Is a sudden, _____ alteration of brain function caused by an abrupt _____, disorderly discharge of _____.
- Diseases and conditions associated with seizure disorders
- -Although the _____ may be supplemented with the remaining options, it remains the pivotal tool for establishing the cause of a seizure disorder.
transient
explosive
cerebral neurons
history
The most critical aspect in correctly diagnosing a seizure disorder and establishing its cause is _____
health history
seizure disorders
types:
-_____: Neurons unilaterally
-_____
Partial (focal) seizures
Status Epilepticus
Status Epilepticus
-Is a _____.
-A state of continuous _____ lasting more than _____ minutes, or second seizure is experienced before the person has fully _____ from the preceding seizure, or a single seizure lasts longer than _____ minutes. Resulting in _____ of the brain.
medical emergency seizures 5 regained consciousness 30 hypoxia
Partial (focal) seizures
-Focal (partial) Jacksonian seizures most often begin in the _____ and _____ and then progressively spread to other body parts.
face
fingers
Complex partial seizure
-A complex partial seizure results is impaired _____, as well as the inability to respond to _____
consciousness
exogenous stimuli
alterations in movement
huntingtons disease
-expansion of a _____ repeat stretch within the Huntingtin gene results in a different (_____) form of the protein, which gradually damages cells in the brain
- Rare, _____ hereditary-degenerative disorder; _____ arm on chromosome _____
- Severe degeneration of the _____ (_____ and _____ nuclei) and _____.
CAG triplet mutant autosomal dominant short 4 basal ganglia caudate putamen frontal cerebral cortex
parkinson disease
- Severe degeneration of the _____ (_____) involving the dopaminergic nigrostriatal pathway
- -Loss of _____ in the _____ causes the below signs:
- -_____: Cogwheel, plastic
- -_____ and akinesia
- -Resting _____
- -_____: Postural fixation, equilibrium, righting
- -_____ symptoms
- -Cognitive-affective symptoms and _____
basal ganglia corpus striatum dopaminergic-pigmented neurons substantia nigra Rigidity Bradykinesia tremor Postural abnormalities Autonomic-neuroendocrine dementia
In Parkinson disease the basal ganglia influence the hypothalamic function to produce this clinical manifestations
- _____
- _____
- _____
-Fragmented _____, _____, muscle _____ and _____
Inappropriate diaphoresis Gastric retention Urinary retention sleep depression stiffness bradykinesia
motor neuron diseases
examples
-_____
Amyotrophic lateral sclerosis
Amyotrophic LateralSclerosis
treatment
-Administer _____ (_____), an _____ which is standard treatment that prolongs life for months but does not _____.
riluzole (Rilutek)
antiglutamate
cure
