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WorksheetsBrain Injury and Concussion Worksheet
Total questions: 67
Worksheet time: 36mins
Diffuse axonal injuries (DAIs) of the brain often result in:
Reduced levels of consciousness
Mild but permanent dysfunction
Fine motor tremors
Visual disturbances
What event is most likely to occur to the brain in a classic cerebral concussion?
Brief period of vital sign instability
Cerebral edema throughout the cerebral cortex
Cerebral edema throughout the diencephalon
Disruption of axons extending from the diencephalon and brainstem
Which disorder has clinical manifestations that include decreased consciousness for up to 6 hours, as well as retrograde and posttraumatic amnesia?
Mild concussion
Classic concussion
Cortical contusion
Acute subdural hematoma
What group is most at risk of spinal cord injury from minor trauma?
(a)
The edema of the upper cervical cord after spinal cord injury is considered life threatening because of which possible outcome?
Hypovolemic shock from blood lost during the injury
Breathing difficulties from an impairment to the diaphragm
Head injury that likely occurred during the injury
Spinal shock immediately after the injury
What indicates that spinal shock is terminating?
Voluntary movement below the level of injury
Reflex emptying of the bladder
Paresthesia below the level of injury
Decreased deep tendon reflexes and flaccid paralysis
What term is used to describe the complication that can result from a spinal cord injury above T6 that is producing paroxysmal hypertension, as well as piloerection and sweating above the spinal cord lesion?
Craniosacral dysreflexia
Parasympathetic dysreflexia
Autonomic hyperreflexia
Why does a person who has a spinal cord injury experience faulty control of sweating?
The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
The thalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
The hypothalamus is unable to regulate body heat as a result of damage to the parasympathetic nervous system.
The thalamus is unable to regulate body heat as a result of damage to spinal nerve roots.
Autonomic hyperreflexia-induced bradycardia is a result of stimulation of the:
Sympathetic nervous system to ß-adrenergic receptors to the sinoatrial node
Carotid sinus to the vagus nerve to the sinoatrial node
Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
Bundle branches to the a-adrenergic receptors to the sinoatrial node
A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
L2-L3
L3-L5
L5-S1
S2-S3
Which condition poses the highest risk for a cerebrovascular accident (CVA)?
Insulin-resistant diabetes mellitus
Hypertension
Polycythemia
Smoking
A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli?
Middle cerebral
Vertebral
Posterior cerebral
Anterior cerebral
High-risk sources for the onset of embolic stroke are atrial fibrillation (15% to 25% of strokes), left ventricular aneurysm or thrombus, left atrial thrombus, recent myocardial infarction, rheumatic valvular disease, mechanical prosthetic valve, nonbacterial thrombotic endocarditis, bacterial endocarditis, patent foramen ovale, and primary intracardiac tumors. These are not risk factors for the other options provided. Which type of stroke is most likely to result from these high-risk sources?
Hemorrhagic
Thrombotic
Embolic
Lacunar
Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
Embolic
Hemorrhagic
Lacunar
Thrombotic
Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
Cavernous angioma
Capillary telangiectasia
Arteriovenous angioma
Arteriovenous malformation
Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
Intracranial
Subarachnoid
Epidural
Subdural
In adults, most intracranial tumors are located:
Infratentorially
Supratentorially
Laterally
Posterolaterally
In children, most intracranial tumors are located:
Infratentorially
Supratentorially
Laterally
The most common primary central nervous system (CNS) tumor is the:
Microglioma
Neuroblastoma
Astrocytoma
Neuroma
Meningiomas characteristically compress from:
Within neural tissues
Outside spinal nerve roots
Outside the spinal cord
Within the subarachnoid space
What is the central component of the pathogenic model of multiple sclerosis?
Myelination of nerve fibers in the peripheral nervous system (PNS)
Demyelination of nerve fibers in the CNS
Development of neurofibrillary tangles in the CNS
Inherited autosomal dominant trait with high penetrance
A blunt force injury to the forehead would result in a contrecoup injury to which region of the brain?
Frontal
Temporal
Parietal
Occipital
Spinal cord injuries most likely occur in which region?
Cervical and thoracic
Thoracic and lumbar
Lumbar and sacral
Cervical and thoracic-lumbar
The most likely rationale for body temperature fluctuations after cervical spinal cord injury is that the person has:
Spinal cord injuries result in disturbed thermal control because the sympathetic nervous system is damaged. Which of the following is the most likely explanation for this complication?
Developed septicemia from posttrauma infection
Sustain sympathetic nervous system damage resulting in disturbed thermal control.
Sustained a head injury that damaged the hypothalamus's ability to regulate temperature.
Developed septicemia from posttrauma infection.
A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia. He reports severe head pain and blurred vision. The most likely explanation for these clinical manifestations is that he is:
Experiencing acute anxiety
Developing spinal shock
Developing autonomic hyperreflexia
Experiencing parasympathetic areflexia
The type of vascular malformation that most often results in hemorrhage is:
Cavernous angioma
Venous angioma
Capillary telangiectasia
Arteriovenous malformation
Atheromatous plaques are most commonly found:
In larger veins
Near capillary sphincters
At branches of arteries
Multiple sclerosis is best described as a(an):
Central nervous system demyelination, possibly from an immunogenetic virus
Inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder
Depletion of dopamine in the central nervous system as a result of a virus
Degenerative disorder of lower and upper motor neurons caused by viral-immune factors
What is the most common opportunistic infection associated with acquired immunodeficiency syndrome (AIDS)?
Non-Hodgkin lymphoma
Kaposi sarcoma
Toxoplasmosis
Cytomegalovirus
It is true that Guillain-Barré syndrome (GBS):
Is preceded by a viral illness.
Involves a deficit in acetylcholine.
Results in asymmetric paralysis.
Is it true that myasthenia gravis:
Is an acute autoimmune disease.
Affects the nerve roots.
May result in adrenergic crisis.
Causes muscle weakness.
In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?
Guillain-Barré syndrome
Multiple sclerosis
Myasthenia gravis
Parkinson disease
Multiple sclerosis and Guillain-Barré syndrome are similar in that they both:
Result from demyelination by an immune reaction.
Cause permanent destruction of peripheral nerves.
Result from inadequate production of neurotransmitters.
Block acetylcholine receptor sites at the myoneuronal junction.
Which clinical manifestation is characteristic of cluster headaches?
Preheadache aura
Severe unilateral tearing
Gradual onset of a tight band around the head
Significant unilateral, temporal pain
Pain lasting from 30 to 120 minutes
What are the initial clinical manifestations immediately noted after a spinal cord injury?
Headache
Bladder incontinence
Loss of deep tendon reflexes
Hypertension
Flaccid paralysis
Match the term with the corresponding description. Meningitis
Complication of mastoiditis
Opportunistic infection
CNS manifestation of tuberculosis
Match the terms with the corresponding descriptions. 39. Encephalitis
A. Complication of mastoiditis
B. Opportunistic infection
C. CNS manifestation of tuberculosis
D. Mosquito-borne viral infection
E. Tick-borne bacterial infection
Match the terms with the corresponding descriptions. 40. Cryptococcus neoformans
Complication of mastoiditis
Opportunistic infection
CNS manifestation of tuberculosis
Mosquito-borne viral infection
Tick-borne bacterial infection
Match the terms with the corresponding descriptions. 41. Brain abscess
Complication of mastoiditis
Opportunistic infection
CNS manifestation of tuberculosis
Mosquito-borne viral infection
Tick-borne bacterial infection
Match the terms with the corresponding descriptions. 42. Lyme disease
Complication of mastoiditis
Opportunistic infection
CNS manifestation of tuberculosis
Mosquito-borne viral infection
Tick-borne bacterial infection
The neural groove closes dorsally during which week of gestational life?
Second
Fourth
Eighth
Twelfth
Which nutritional deficiency in a pregnant woman is associated with neural tube defect (NTD)?
Iron
Zinc
Vitamin C
Folate
Which defect of neural tube closure is most common?
Anterior
Posterior
Lateral
Midline
What is the anomaly in which the soft bony component of the skull and much of the brain is missing?
Anencephaly
Myelodysplasia
Cranial meningocele
Hydrocephaly
The most common cause of obstructive hydrocephalus in infants is:
Obstructed arachnoid villi
Stenosis of the aqueduct of Sylvius
Excessive production of cerebrospinal fluid
Impaired cerebrospinal fluid circulation in the subarachnoid space
What is the term for a herniation or protrusion of brain and meninges through a defect in the skull?
Encephalocele
Arachnoidocele
Meningocele
Cephalocele
What is the result of a Chiari type II malformation associated with a myelomeningocele?
Upward displacement of the cerebellum into the diencephalon
Motor and sensory lesions below the level of the myelomeningocele
Downward displacement of the cerebellum, brainstem, and fourth ventricle
Generalized cerebral edema and hydrocephalus
Prompt surgical repair of a myelomeningocele is critical to best prevent:
Infection
Paralysis
Mental retardation
Additional nervous system damage
Which body system is the largest site for human immunodeficiency virus (HIV) infection in infants and children?
Central nervous system
Gastrointestinal system
Integumentary system
Musculoskeletal system
An infant diagnosed with hydrocephalus is observed to demonstrate:
Shrunken ventricles
Bulging fontanels
Retarded head growth
Decreased production of cerebrospinal fluid
Gait disturbances and instability are characteristic of which form of cerebral palsy?
Spastic
Dyskinetic
Ataxic
Biochemical
Children with phenylketonuria (PKU) are unable to synthesize:
Essential amino acid, phenylalanine, to tyrosine
Renin, erythropoietin, and antidiuretic hormone
Aldosterone, cortisol, and androgens
Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine
Benign febrile seizures are characterized by:
A temperature lower than 39° C
Respiratory or ear infections
Onset after the fifth year of life
Episodes lasting 30 minutes or longer
What is the most common general symptom of a localized childhood brain tumor?
Poor bonding
Increased intracranial pressure
Delayed extinction of newborn reflexes
Failure to thrive
The tonic neck reflex observed in a newborn should no longer be obtainable by:
2 years
1 year
10 months
5 months
What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra?
Encephalocele
Meningocele
Spina bifida occulta
Myelomeningocele
What test is performed on amniotic fluid and maternal blood to test for neural tube defect?
Total protein
Culture
a-fetoprotein
C-reactive protein
The clinical manifestations of dyskinetic cerebral palsy include:
Increased muscle tone and prolonged primitive reflexes
Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
Scoliosis, contractures, and stiffness of trunk muscles
Jerky uncontrolled and abrupt fine musculoskeletal movements
Which musculoskeletal deformities are associated with myelomeningocele?
Extra digits on feet
Clubfoot
Dislocation of the hips
Scoliosis
Kyphosis
True microcephaly can be caused by: (Select all that apply.)
Autosomal gene alterations
Prenatal physical abuse of the mother
X-linked gene alterations
Toxic-induced chromosomal defects
Maternal anorexia
Which statements regarding the term myelodysplasia are true? (Select all that apply.)
Myelodysplasia is used to define a defect in the formation of the spinal cord.
It can be used to refer to brain anomalies involving missing brain tissue.
Myelodysplasia correctly includes encephaloceles.
It is used to describe a herniation of brain and meninges through a defect in the skull.
Myelodysplasia can be used to refer to a form of spina bifida.
Neuroblastoma originates in the ________.
neural crest that normally forms the sympathetic ganglia and adrenal medulla
bone marrow
pancreatic islets
thyroid gland
Ependymoma develops in the ________.
fourth ventricle
cerebral cortex
basal ganglia
cerebellar hemisphere
Medulloblastoma develops in the ________.
vermis of the cerebellum and may extend to the fourth ventricle
frontal lobe of the cerebrum
pons of the brainstem
temporal lobe of the cerebrum
Craniopharyngioma originates from the ________.
pituitary or hypothalamus
pineal gland
cerebellum
optic chiasm
Cerebellar astrocytoma causes _______ symptoms such as nystagmus.
unilateral
bilateral
systemic
peripheral
