Chapter 10: Stroke, TBI, Concussion, SCI

The spinal cord ends at which anatomical structure, marking the transition from the central nervous system to the peripheral nervous system?

• Medulla oblongata
• Dura mater
• Cauda equina
• Conus medullaris

Answer explanation

The spinal cord terminates at the conus medullaris, typically located around the level of the L1-L2 vertebrae in adults. Below this point, the nerve roots continue as the cauda equina, which is part of the peripheral nervous system. This transition signifies the end of the central nervous system's spinal cord and the beginning of the peripheral nervous system's nerve roots that extend to the lower limbs and pelvic organs.

Which of the following is NOT part of the F.A.S.T. acronym used to recognize signs and symptoms of a stroke?

• Face drooping

• Speech difficulties

• Arm weakness

• Time for rest

Answer explanation

The F.A.S.T. acronym is a tool used to help identify the signs and symptoms of a stroke quickly. It stands for:

• Face drooping: One side of the face may droop or feel numb.

• Arm weakness: One arm may be weak or numb, making it difficult to raise.

• Speech difficulties: Speech may be slurred or hard to understand.

• Time to call emergency services: If any of these symptoms are present, it's critical to seek medical help immediately.

"Time for rest" is not part of the acronym and is misleading, as swift action is necessary in the event of a suspected stroke.

After a spinal cord injury, a patient exhibits paralysis and weakness in all four extremities. This condition is called:

• Hemiplegia
• Paraplegia
• Monoplegia
• Quadriplegia

Answer explanation

Quadriplegia, also known as tetraplegia, is a condition characterized by paralysis and weakness in all four extremities (both arms and legs) due to spinal cord injury, typically occurring at or above the cervical spinal levels. In contrast, paraplegia refers to paralysis affecting only the lower limbs, hemiplegia affects one side of the body, and monoplegia affects a single limb. The extent of paralysis in quadriplegia depends on the level and severity of the spinal cord injury.

After a spinal cord injury, a patient exhibits paralysis and weakness in the lower extremities only. This condition is called:

• Quadriplegia
• Hemiplegia
• Monoplegia
• Paraplegia

Answer explanation

Paraplegia is a condition characterized by paralysis and weakness affecting the lower extremities (legs) due to spinal cord injury, typically occurring at the thoracic, lumbar, or sacral levels. This results in the loss of motor and sensory function below the level of injury while preserving function in the upper extremities. In contrast, quadriplegia affects all four limbs, hemiplegia involves one side of the body, and monoplegia refers to paralysis in a single limb. The impact of paraplegia varies based on the severity and location of the spinal cord injury.

Which of the following statements is true regarding a transient ischemic attack (TIA)?

• A TIA is a permanent loss of brain function due to a stroke.
• A TIA always results in severe and lasting disabilities.
• A TIA is caused by a viral infection in the brain.
• A TIA is a temporary episode of neurological dysfunction caused by an interruption in blood flow to the brain.

Answer explanation

A transient ischemic attack (TIA) is characterized by temporary disruption of blood flow to the brain, leading to symptoms similar to those of a stroke, such as weakness, numbness, or difficulty speaking. However, these symptoms typically resolve within minutes to hours, usually lasting less than 24 hours. TIAs are important warning signs, indicating an increased risk of a subsequent stroke, and prompt medical evaluation is essential to reduce that risk. The other statements are false: TIAs are not caused by permanent blockages, their symptoms do not last longer than 24 hours, and they are associated with noticeable symptoms.