Module 3
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Questions and Answers

What is the major blood supply source for the visual receptors in the retina?

  • Internal carotid artery
  • Choroid (correct)
  • Central artery of the retina
  • Ophthalmic artery

    • What is a common symptom of decreased perfusion pressure in the head region?

  • Double vision
  • Blurred vision
  • Eye pain
  • Graying-out or blackout of vision (correct)

    • What can cause retinal ischemia?

  • General circulatory collapse (correct)
  • Increased blood pressure
  • Diabetic retinopathy
  • Postural hypotension

    • What is the origin of the ophthalmic artery?

    <p>Internal carotid artery</p> Signup and view all the answers

    What is characterized by transient episodes of monocular visual loss lasting 5 to 10 minutes?

    <p>Amaurosis fugax</p> Signup and view all the answers

    What is the usual duration of symptoms in Multiple Sclerosis?

    <p>Days to weeks</p> Signup and view all the answers

    What is the most common cause of blindness in industrialized countries?

    <p>Diabetic retinopathy</p> Signup and view all the answers

    Which of the following is NOT a common symptom of Multiple Sclerosis?

    <p>Headache</p> Signup and view all the answers

    What is the primary effect of Parkinson's disease on the brain?

    <p>Destruction of the basal ganglia</p> Signup and view all the answers

    What is a common complication of diabetic retinopathy?

    <p>Visual impairment</p> Signup and view all the answers

    What is a possible outcome of cardiopulmonary arrest?

    <p>Permanently decreased visual acuity</p> Signup and view all the answers

    What is the mean age of onset for Parkinson's disease?

    <p>57 years old</p> Signup and view all the answers

    What is the primary goal of treatment for Parkinson's disease?

    <p>Symptom management</p> Signup and view all the answers

    What is the effect of antiparkinson drugs on the brain?

    <p>Increasing dopamine levels</p> Signup and view all the answers

    Which type of brain injury is caused by impact?

    <p>Primary brain injury</p> Signup and view all the answers

    What is the purpose of botulinum toxin injections in treating Parkinson's disease?

    <p>Relieving dystonias</p> Signup and view all the answers

    What is the main reason for the difference in vessel response between older and younger adults?

    <p>Vessel rigidity</p> Signup and view all the answers

    What is the main cause of retinal detachment?

    <p>Traction on the inner sensory layer or a tear in this layer</p> Signup and view all the answers

    Which is a type of retinal detachment?

    <p>Exudative</p> Signup and view all the answers

    What is the purpose of a funduscopic examination of the eye?

    <p>To examine the retinal blood vessels and other aspects of the retina</p> Signup and view all the answers

    What is the significance of ophthalmoscopic examination of the fundus of the eye?

    <p>It allows diagnosis of both metabolic and vascular diseases of the brain and pathologic processes specific to the retina</p> Signup and view all the answers

    What is a common symptom of otitis media in children?

    <p>All of the above</p> Signup and view all the answers

    What is the usual consequence of perforation of the tympanic membrane?

    <p>Purulent material drains into the external auditory canal</p> Signup and view all the answers

    What is the significance of ear pain in otitis media?

    <p>It increases as the effusion accumulates behind the tympanic membrane</p> Signup and view all the answers

    What percentage of strokes are caused by large artery thrombosis?

    <p>20%</p> Signup and view all the answers

    What is the most common symptom of a stroke?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of cholinesterase inhibitors in treating Alzheimer's disease?

    <p>To slow down the progression of the disease</p> Signup and view all the answers

    What is a common predisposing factor for hemorrhagic strokes?

    <p>Both A and B</p> Signup and view all the answers

    What is the usual outcome of a hemorrhagic stroke?

    <p>Most frequently fatal</p> Signup and view all the answers

    What is a major goal of care for patients with Alzheimer's disease?

    <p>Maintaining socialization and providing support for caregivers</p> Signup and view all the answers

    What is a common symptom of otitis media with effusion?

    <p>Sensation of fullness in the ear</p> Signup and view all the answers

    At what age are children most frequently diagnosed with otitis media?

    <p>Between 3 months and 3 years</p> Signup and view all the answers

    What is a significant risk factor for otitis media?

    <p>Smoking in the house</p> Signup and view all the answers

    Why are infants more prone to otitis media?

    <p>Due to their shorter and more horizontal eustachian tube</p> Signup and view all the answers

    Which of the following can reduce the risk of otitis media?

    <p>Elimination of household smoking</p> Signup and view all the answers

    What percentage of the total resting cardiac output is received by the brain?

    <p>15-20%</p> Signup and view all the answers

    What type of pain originates in deep body structures such as muscles, tendons, and joints?

    <p>Deep somatic pain</p> Signup and view all the answers

    What is the primary difference between surface pain and visceral pain?

    <p>Type of damage that causes pain</p> Signup and view all the answers

    What is the term for pain that is perceived at a site different from its point of origin?

    <p>Referred pain</p> Signup and view all the answers

    What is the consequence of unmet metabolic demand in nervous tissue?

    <p>Rapidly leads to clinically observable signs and symptoms</p> Signup and view all the answers

    What percentage of oxygen consumption is attributed to the brain?

    <p>15-20%</p> Signup and view all the answers

    What type of pain persists longer than might be reasonably expected after an inciting event?

    <p>Chronic pain</p> Signup and view all the answers

    What is the characteristic of chronic pain?

    <p>Sustained by factors that are both pathologically and physically remote from the originating cause</p> Signup and view all the answers

    What abnormality is indicated by reduced numbers of synaptic structures on neurons in the prefrontal cortex?

    <p>Dendritic spine density reduction</p> Signup and view all the answers

    What is the primary effect of the destruction of the nigrostriatal pathway in Parkinson's disease?

    <p>Reduced dopamine concentrations in the striatum</p> Signup and view all the answers

    Which neurobiological factor is associated with the development of depressive disorder?

    <p>All of the above</p> Signup and view all the answers

    Which tracts are affected in Multiple Sclerosis, leading to abnormalities in gait and coordination?

    <p>Cerebellar tracts</p> Signup and view all the answers

    What is a characteristic of strabismus?

    <p>Abnormality of eye coordination or alignment</p> Signup and view all the answers

    What is the primary goal of treatment for Parkinson's disease?

    <p>To manage symptoms</p> Signup and view all the answers

    What is the usual duration of symptoms in Multiple Sclerosis?

    <p>Days to weeks</p> Signup and view all the answers

    What is a characteristic of amblyopia?

    <p>Lazy eye</p> Signup and view all the answers

    What is the purpose of botulinum toxin injections in treating Parkinson's disease?

    <p>To alleviate dystonias</p> Signup and view all the answers

    What is a possible biologic theory associated with depressive disorder?

    <p>HPA axis hyperactivity</p> Signup and view all the answers

    What is a common symptom of Multiple Sclerosis?

    <p>Abnormal gait</p> Signup and view all the answers

    What is a characteristic of neuroimaging in people with depression who have experienced early abuse?

    <p>Hippocampal hypertrophy</p> Signup and view all the answers

    What is a neurologic disorder involved in the development of mood disorders?

    <p>All of the above</p> Signup and view all the answers

    What is the effect of antiparkinson drugs on the brain?

    <p>Increase the functional ability of the underactive dopaminergic system</p> Signup and view all the answers

    What is a category of Multiple Sclerosis?

    <p>All of the above</p> Signup and view all the answers

    What role does dopamine play in depression?

    <p>Contributory role</p> Signup and view all the answers

    What is the primary mechanism by which the retina receives oxygen?

    <p>Supply from the choroid via the vascular system</p> Signup and view all the answers

    What is a common consequence of retinal ischemia in survivors of cardiopulmonary arrest?

    <p>Permanent decrease in visual acuity</p> Signup and view all the answers

    What is the typical age range for which diabetic retinopathy is the leading cause of newly reported cases of blindness?

    <p>20-74 years</p> Signup and view all the answers

    What is the duration of visual loss in amaurosis fugax?

    <p>5-10 minutes</p> Signup and view all the answers

    What is the primary cause of retinal detachment?

    <p>Separation of the visual receptors from the choroid</p> Signup and view all the answers

    What is the consequence of edema and ischemic death of retinal neurons?

    <p>Permanent decrease in visual acuity</p> Signup and view all the answers

    What is the significance of internal carotid or common carotid stenosis?

    <p>It is associated with intermittent retinal ischemia</p> Signup and view all the answers

    What is the ranking of diabetic retinopathy as a cause of blindness in industrialized countries?

    <p>First</p> Signup and view all the answers

    What is the primary reason for the increased risk of otitis media in infants?

    <p>Their eustachian tube is shorter and more horizontal</p> Signup and view all the answers

    Which of the following is a characteristic of children who are more likely to develop otitis media?

    <p>They are overweight or obese</p> Signup and view all the answers

    What is the significance of visible air-fluid level with or without bubble in otitis media with effusion?

    <p>It is a sign of otitis media with effusion</p> Signup and view all the answers

    What can reduce the risk of contracting otitis media?

    <p>Exclusive breast-feeding until 6 months of age</p> Signup and view all the answers

    What does smoking in the house increase the risk of?

    <p>It increases the risk of otitis media</p> Signup and view all the answers

    Study Notes

    Multiple Sclerosis

    • Areas commonly affected by MS include the optic nerve, corticobulbar tracts (speech and swallowing), corticospinal tracts (muscle strength), cerebellar tracts (gait and coordination), spinocerebellar tracts (balance), medial longitudinal fasciculus (conjugate gaze function of the extraocular eye muscles), and posterior cell columns of the spinal cord (position and vibratory sensation)
    • Symptoms may include parathesias, optic neuritis, diplopia, or specific types of gaze paralysis, as well as abnormal gait, bladder and sexual dysfunction, vertigo, nystagmus, fatigue, and speech disturbance
    • MS has four categories: Relapsing-remitting, secondary progressive, primary progressive, and progressive relapsing

    Parkinson's Disease

    • Degenerative disorder of basal ganglia function characterized by variable combinations of tremor, rigidity, akinesia/bradykinesia, and postural changes
    • Mean onset is 57 years old
    • People with Parkinson's disease often have excessive sweating, sebaceous gland secretion, and salivation due to the influence of the basal ganglia on the autonomic nervous system
    • Cognitive dysfunction may also be present
    • Treatment must be highly individualized, with no cure available, only symptom management

    Brain Injury and Stroke

    • Primary brain injuries are caused by impact, while secondary brain injuries result from subsequent complications
    • Five main mechanisms of stroke subtypes include large artery thrombosis (20%), small penetrating artery thrombosis disease (25%), cardiogenic embolism (20%), cryptogenic stroke (30%), and other (5%)
    • Hemorrhagic stroke is often fatal and commonly results from the spontaneous rupture of a cerebral blood vessel, especially in older adults with hypertension

    Clinical Manifestations of Stroke

    • Symptoms are determined by the affected cerebral artery, brain tissue supplied by the vessel, and collateral circulation
    • Symptoms are always sudden in onset, focal, and usually one-sided, and may include facial droop, arm weakness, slurred speech, unilateral numbness, vision loss, language disturbance, and sudden unexplained imbalance or ataxia

    Alzheimer's Disease

    • Diagnosis can only be confirmed by microscopic examination of tissue obtained from a cerebral biopsy or at autopsy
    • Diagnosis is based on clinical findings, with neuroimaging and metabolic screening used to exclude other conditions
    • There is no curative treatment, but medications may slow progression and improve depression, agitation, or sleep disorders
    • Cholinesterase inhibitors can slow disease progression by potentiating available acetylcholine and inhibiting acetylcholinesterase
    • Two major goals of care are maintaining socialization and providing support for caregivers

    Retinal Detachment

    • Separation of the neurosensory retina from the pigment epithelium, occurring when traction on the inner sensory layer or a tear allows fluid to accumulate between the two layers
    • Four types of retinal detachments: exudative, traction, rhegmatogenous, and combined traction/rhegmatogenous
    • Intermittent retinal ischemia can accompany internal carotid or common carotid stenosis, and amaurosis fugax is characterized by transient episodes of monocular visual loss lasting 5-10 minutes

    Otitis Media

    • Acute onset of otalgia, fever, irritability, otorrhea, hearing loss, and evidence of middle ear inflammation and effusion
    • Children older than 3 may experience rhinorrhea, vomiting, and diarrhea
    • Ear pain increases as the effusion accumulates behind the tympanic membrane, and perforation may occur, allowing purulent material to drain into the external auditory canal
    • Risk factors include smoking in the house, prematurity, daycare attendance, unimmunized status, bottle-feeding, and family history of otitis media
    • Structural immaturity contributes to the increased risk in infants and young children

    Metabolic Requirements of Nervous Tissue

    • Nervous tissue has a high rate of metabolism, with the brain receiving 15% to 20% of the total resting cardiac output and consuming 20% of its oxygen.
    • The brain cannot store oxygen or engage in anaerobic metabolism, making it susceptible to interruptions in blood or oxygen supply, leading to clinically observable signs and symptoms.

    Somatosensory Function, Pain, Headache, and Temperature Regulation

    • Acute pain is elicited by injury to body tissues and activation of nociceptive stimuli at the site of local tissue damage, and generally resolves when the underlying pathologic process has resolved.
    • Chronic pain persists longer than might be reasonably expected after an inciting event and is sustained by factors that are both pathologically and physically remote from the originating cause.
    • Types of pain include cutaneous pain (arising from superficial structures), deep somatic pain (originating in deep body structures), and visceral pain (originating in visceral organs).

    Disorders of Neural Function

    Multiple Sclerosis

    • MS can affect areas such as the optic nerve, corticobulbar tracts, corticospinal tracts, cerebellar tracts, spinocerebellar tracts, medial longitudinal fasciculus, and posterior cell columns of the spinal cord.
    • Symptoms may include parathesias, optic neuritis, diplopia, abnormal gait, bladder and sexual dysfunction, vertigo, nystagmus, fatigue, and speech disturbance.
    • The disease can be categorized into four types: relapsing-remitting, secondary progressive, primary progressive, or progressive relapsing.

    Parkinson's Disease

    • Parkinson's disease is a degenerative disorder of basal ganglia function, characterized by variable combinations of tremor, rigidity, akinesia/bradykinesia, and postural changes.
    • The disease results from progressive destruction of the nigrostriatal pathway, leading to a reduction in striatal concentrations of dopamine.
    • Symptoms also include excessive sweating, sebaceous gland secretion, and salivation, as well as cognitive dysfunction.

    Mechanisms of Brain Injury

    • Primary brain injuries occur due to impact, and neuroimaging suggests several functional abnormalities, including loss of cortical gray matter, abnormal cortical thinning, and reduced numbers of synaptic structures on neurons.

    Neurocognitive Disorders

    • Mood disorders, such as depression, can be linked to ongoing inflammation in the body.
    • Neuroimaging indicates smaller hippocampal volumes and hippocampal hypertrophy in people who have depression and have experienced early abuse.
    • Dopamine plays a role in depression.

    Disorders of Special Sensory Function

    Disorders of Eye Movement

    • Strabismus refers to any abnormality of eye coordination or alignment that results in loss of binocular vision.
    • Amblyopia, also known as lazy eye, can result from retinal detachment or decreased perfusion pressure in the head region.

    Disorders of Hearing and Vestibular Function

    • Otitis media with effusion symptoms include intermittent ear pain, sensation of fullness in the ear, complaint of hearing loss, dizziness, and decreased tympanic membrane mobility.
    • Risk factors for otitis media include smoking in the house, prematurity, daycare attendance, and a family history of otitis media.
    • Structural immaturity contributes to the increased risk of otitis media in children.

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    Description

    This quiz covers the areas of the body commonly affected by Multiple Sclerosis, including the optic nerve, corticobulbar tracts, and cerebellar tracts. It also covers the symptoms and effects of MS on the body.

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