Answer the following questions in APA format.
1. Mr. Bowers has the flu and an oral temperature of 101º F. Describe the physiological purposes of fever.
2. Ms. Spinosa is unconscious and has an intracranial pressure (ICP) of 30 mm Hg as a result of a closed head injury. What is the most important index of neurological system functioning in this patient? Explain the process of increasing ICP and discuss possible complications if the pressure is not decreased.
3. 3. Two individuals come to the emergency room with head injuries. One, age 25, has just been in a motor vehicle crash (MVC) and has a temporal lobe injury. The other, age 65, has increasing confusion after falling earlier in the week. How would you differentiate clinically between the individual with an epidural hematoma and the one with a subdural hematoma? Which one of these individuals requires priority surgical treatment?
4. 4. A young child is being evaluated by her pediatrician for an upper respiratory infection. The pediatrician asks the mother if she has been giving the child any acetaminophen during this illness. The mother states that she has not, but she is giving the child aspirin instead. The pediatrician instructs her to discontinue the aspirin immediately and to use only acetaminophen. The mother asks you to explain the rationale for this.
Aging changes in the senses are perceptual changes related to growing older. With age, the way one’s senses (taste, smell, touch, vision, and hearing) are able to give information about the world changes. The senses become less acute, and the person may have trouble distinguishing details.
Sensory changes can have a tremendous impact on your lifestyle. The person may have problems with communication, enjoyment of activities, and social interactions. Sensory changes can contribute to a sense of isolation.
Everyone requires a certain minimum amount of stimulation before a sensation is perceived. This minimum level is called the threshold. Aging increases this threshold, so the amount of sensory input needed to be aware of the sensation becomes greater. Changes in the body part related to the sensation account for most of the other sensation changes.
Hearing and vision changes are the most dramatic, but all senses can be affected by aging. Fortunately, many of the aging changes in the senses can be compensated for with equipment, such as glasses and hearing aids, or by minor changes in lifestyle.
Students often have difficulty understanding how the endolymph in the semicircular canals detects equilibrium changes. The faculty in the physiology department at the University of Utah has used tubular balloons partially filled with water as an effective example. Two balloons are arranged horizontally around the head, two more balloons extend vertically from the front to the back of the head, and another one extends obliquely from front to back. As the head moves in different planes, students can observe the motion of the fluid in the balloons as an analogy to the endolymph movement in the semicircular canals.
There are so many kinds of seizures that neurologists who specialize in epilepsy are still updating their thinking about how to classify them. Usually, they classify seizures into two types, primary generalized seizures and partial seizures. The difference between these types is in how they begin:
Primary generalized seizures
Primary generalized seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Hereditary factors are important in many of these seizures.
Partial seizures begin with an electrical discharge in one limited area of the brain. Some are related to head injury, brain infection, stroke, or tumor, but in most cases the cause is unknown.
One question that is used to further classify partial seizures is whether consciousness (the ability to respond and remember) is “impaired” or “preserved.” The difference may seem obvious, but really there are many degrees of impairment or preservation of consciousness.
Identifying certain seizure types and other characteristics of a person’s epilepsy, like the age at which it begins, allows doctors to classify some cases into epilepsy syndromes. This kind of classification helps us to know how long the epilepsy will last and the best way to treat it.
Chapter 14 has been divided into sections that facilitate a progressive understanding of this information. Disturbances of cognition are differentiated into alterations in arousal, including types of coma and alterations of thought. The summaries included in Tables 14-1 and 14-2 assist you in sequencing the mechanisms and manifestations characterizing types of coma. Levels of arousal are differentiated in Table 14-3 and illustrate progressive stages leading to coma.
Differentiating alterations in arousal from alterations in cognition is often a challenging task. A comparison of Tables 14-3 and 14-9 can help you begin to understand these differences.
The idea that symptoms can be related to alterations in hierarchical structures can be illustrated by changes in breathing patterns, as presented in Table 14-4, or changes in motor function considering pyramidal, extrapyramidal, and motor unit dysfunction (Figure 14-15 and Tables 14-17 and 14-18). Success in understanding the complexities of neurologic dysfunction requires that you be able to associate changes in structure with changes in function.
This concept is difficult for students because of a necessary prerequisite understanding of the sympathetic, parasympathetic, spinothalamic, and corticospinal tracts; cranial nerve function; and baroreceptor function. It is the interaction between these pathways that accounts for the complexity. Figure 15-8 illustrates the normal response pathway: visceral distention → spinothalamic tracts → brain interpretation of sensory input → corticospinal tracts → motor output, autonomic dysreflexia, visceral distention → spinothalamic tract to level of lesion → reflex stimulus to sympathetic outflow → increased blood pressure stimulates carotid sinus receptors → cranial nerve and vagus nerve stimulation → bradycardia → autonomic response to hypertension.
The most difficult aspect of the degenerative neurologic diseases is understanding where in the nervous system they originate. Much of the confusion relates to a lack of understanding of normal nervous system anatomy.
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||09/25/2014 12:00 am