Central Nervous System: Case Study

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Central Nervous System: Case Study - Quiz

Welcome to the 21st Century electronic classroom for Advanced Human and Physiology class. You can find additional resources on my science web site Mitchell's Cosmic Adventure. Com. While case studies cannot provide specific guidance for the management of successive patients, they are a record of clinical interactions.
You will need to locate the Google Document file on my website. Here will need to read the case study: Spinal Cord Injury, the patient is Thomas (Tommy) Potter. It is under the Nervous System TAB and then select Central Nervous System - Patient Medical History!
Read moreThis test has a T. E. M. (Test Exam Mode) setting that doesn't reveal the answer during the test period. A report and certificate will be printed for each attempt. Each attempt will randomly generate a new set of 20 questions and answers. This is a method to cover all the material and increase your testing ability.
Good Luck on this case study and your studies in Human Anatomy & Physiology!


Questions and Answers
  • 1. 

    What activity was Thomas (Tommy) Potter, a 20-year old college student performing to send him to emergency Trauma Center for treatment?

    • A.

      Riding a bicycle

    • B.

      Rock climbing

    • C.

      Jogging on campus

    • D.

      Playing tennis

    • E.

      Painting the ceiling of his campus apartment

    Correct Answer
    B. Rock climbing
    Explanation
    Thomas (Tommy) Potter, a 20-year-old college student, was sent to the emergency Trauma Center for treatment because he was rock climbing.

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  • 2. 

    After you gathered initial information from this patient concerning his activities on campus.  Please check all to which apply to Mr. Potter.  

    • A.

      Bowling

    • B.

      Basketball

    • C.

      Tennis

    • D.

      Rock climbing

    • E.

      Golf

    • F.

      Skiing

    Correct Answer(s)
    B. Basketball
    D. Rock climbing
    Explanation
    The correct answer is Basketball and Rock climbing. This is based on the information provided in the question, which asks to check all the activities that apply to Mr. Potter. Since the question does not provide any additional information or context, we can only assume that the activities listed are the ones that Mr. Potter is involved in. Therefore, the correct answer would be Basketball and Rock climbing.

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  • 3. 

    Which one of the following explanations best describes the changes in Thomas's vital signs?

    • A.

      Lying on his back during transport

    • B.

      The level and extent of injury

    • C.

      Anxiety related to the injury

    • D.

      Lack of Mobility during transport

    Correct Answer
    B. The level and extent of injury
    Explanation
    The correct answer is "The level and extent of injury." This explanation best describes the changes in Thomas's vital signs because the level and extent of injury can have a direct impact on a person's vital signs. Depending on the severity of the injury, vital signs such as heart rate, blood pressure, and respiratory rate may fluctuate or become abnormal. Therefore, it is important to consider the level and extent of injury when assessing changes in vital signs.

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  • 4. 

    Tommy Potter is a 20-year old college student, who was rock climbing and fell _____ meters to the ground. Please round to one tenth of a decimal.

    Correct Answer
    3.5
    Explanation
    Tommy Potter, a 20-year old college student, fell from an unspecified height while rock climbing. The answer provided is 3.5 meters, rounded to one tenth of a decimal.

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  • 5. 

    How tall is Tommy Potter in ______centimeters?  Please round to one tenth of a centimeter.

    Correct Answer
    177.8
    Explanation
    Tommy Potter's height is 177.8 centimeters.

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  • 6. 

    What was Thomas Potter's skin condition in the emergency room?  Please check all which applies to this patient.

    • A.

      Sweaty

    • B.

      Dry

    • C.

      Warm

    • D.

      Cold

    • E.

      Good color

    • F.

      Poor color

    Correct Answer(s)
    B. Dry
    C. Warm
    F. Poor color
    Explanation
    Thomas Potter's skin condition in the emergency room was dry, warm, and had poor color. This means that his skin lacked moisture, felt warm to the touch, and had a pale or abnormal coloration.

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  • 7. 

    Paramedics applied a cervical collar at the scene of the accident, placed him on a backboard and immobilized his head. Mr. Potter asked a paramedic why he could feel just a little sensation in some parts of his arms and legs. The paramedic's response would be based on the understanding that:   (HINT: this is a multiple answer question.)

    • A.

      A concussion is causing these transient signs

    • B.

      The autonomic nervous center in the cerebellum was injured

    • C.

      C5 and C6 injury would be consistent with these sensations

    • D.

      Brain pathways are too complex to respond to his question

    • E.

      Damage to this patent's cervical region is in question

    Correct Answer(s)
    C. C5 and C6 injury would be consistent with these sensations
    E. Damage to this patent's cervical region is in question
    Explanation
    The paramedic would explain that the sensation in some parts of Mr. Potter's arms and legs is consistent with an injury to the C5 and C6 vertebrae in his cervical region. This is because the nerves that innervate these areas originate from the spinal cord at the C5 and C6 levels. Therefore, damage to these vertebrae could result in altered sensation in the corresponding areas. Additionally, the paramedic would mention that the extent of damage to Mr. Potter's cervical region is still uncertain and requires further investigation.

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  • 8. 

    Damage to the spinal cord will affect the function of the nervous from the point of injury upward.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Damage to the spinal cord will affect the function of the nervous system from the point of injury downward, not upward. This is because the spinal cord is responsible for transmitting signals between the brain and the rest of the body, and damage to it can disrupt this communication. Therefore, any injury to the spinal cord will result in a loss of function in the areas of the body below the point of injury.

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  • 9. 

    Due to the nature of Tommys injuries, all of the following Central Nervous System functions will be affected except:

    • A.

      Control of posture

    • B.

      Conduction route to the brain

    • C.

      Reflex activity for the spine

    • D.

      Conduction route from the brain

    Correct Answer
    A. Control of posture
    Explanation
    Tommy's injuries are likely to affect all of the listed Central Nervous System functions except for control of posture. Control of posture is primarily regulated by the musculoskeletal system, whereas the other functions listed involve the transmission of signals through the central nervous system. Therefore, it is expected that Tommy's injuries will impact conduction routes to and from the brain, as well as reflex activity for the spine, but control of posture should remain relatively unaffected.

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  • 10. 

    Control of posture is a cerebellar activity, not a spinal cord function.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because control of posture is primarily regulated by the cerebellum, which is a part of the brain. The cerebellum receives sensory information from the body and coordinates muscle activity to maintain balance and posture. While the spinal cord plays a role in transmitting signals from the brain to the muscles, it is not responsible for the overall control and coordination of posture.

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  • 11. 

    Dr. John Babinski was checking Tommy's vital signs and noticed a drop in his blood pressure. What is causing this condition at the time of the emergency?

    • A.

      patient has suffered damage to his spinal cord

    • B.

      Patient has no sensory detection in his arms

    • C.

      Patient has no motor movement in his arms

    • D.

      Patient has no sensory detection in his legs

    • E.

      Patient has no motor movement in his legs

    Correct Answer
    A. patient has suffered damage to his spinal cord
    Explanation
    The drop in blood pressure is likely caused by the patient's spinal cord injury. Damage to the spinal cord can disrupt the communication between the brain and the rest of the body, leading to various physiological changes, including a drop in blood pressure. This is because the spinal cord plays a crucial role in regulating blood pressure by transmitting signals from the brain to the blood vessels and the heart. Therefore, the patient's spinal cord injury is the most likely explanation for the observed drop in blood pressure.

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  • 12. 

    ___ ___ is a combination of areflexia/hyporeflexia and autonomic dysfunction that accompanies spinal cord injury.

    Correct Answer
    Spinal shock
    Explanation
    Spinal shock refers to a combination of areflexia/hyporeflexia (loss or reduced reflexes) and autonomic dysfunction that occurs after a spinal cord injury. This condition is characterized by temporary paralysis and loss of sensation below the level of injury, as well as disruption of autonomic functions such as blood pressure control and bladder and bowel function. Spinal shock usually lasts for a few days to a few weeks after the injury, during which reflexes gradually return and autonomic functions stabilize.

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  • 13. 

    What is spinal shock phase 1?

    • A.

      0 - 1 day: areflexia/Hyporeflexia

    • B.

      1 - 3 days: Initial reflex return

    • C.

      1 - 4 weeks: Hyperreflexia (initial)

    • D.

      1 - 12 weeks: Hyperreflexia, Spasticity

    Correct Answer
    A. 0 - 1 day: areflexia/Hyporeflexia
    Explanation
    During the spinal shock phase 1, which lasts from 0 to 1 day, the individual experiences areflexia/hyporeflexia. This means that there is a lack or decrease in reflexes below the level of the spinal cord injury. Areflexia refers to the absence of reflexes, while hyporeflexia refers to reduced reflex activity. This phase is characterized by a temporary loss of spinal reflexes due to the disruption of nerve pathways caused by the spinal cord injury.

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  • 14. 

    What is spinal shock phase 2?

    • A.

      0 - 1 day: areflexia/Hyporeflexia

    • B.

      1 - 3 days: Initial reflex return

    • C.

      1 - 4 weeks: Hyperreflexia (initial)

    • D.

      1 - 12 weeks: Hyperreflexia, Spasticity

    Correct Answer
    B. 1 - 3 days: Initial reflex return
    Explanation
    During the spinal shock phase 2, which occurs between 1-3 days after the injury, there is an initial return of reflexes. This means that the reflexes that were absent or reduced during the first phase (0-1 day) start to reappear. This indicates that the spinal cord is beginning to recover and regain some function. However, it is important to note that this phase is still characterized by a lack of voluntary movement and muscle control.

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  • 15. 

    What is spinal shock phase 3?

    • A.

      0 - 1 day: areflexia/Hyporeflexia

    • B.

      1 - 3 days: Initial reflex return

    • C.

      1 - 4 weeks: Hyperreflexia (initial)

    • D.

      1 - 12 weeks: Hyperreflexia, Spasticity

    Correct Answer
    C. 1 - 4 weeks: Hyperreflexia (initial)
    Explanation
    During the third phase of spinal shock, which lasts from 1 to 4 weeks after the injury, there is an initial return of reflexes. This means that the reflexes that were absent or reduced during the first phase start to become active again. Hyperreflexia refers to an exaggerated response of the reflexes, which is characteristic of this phase. This initial hyperreflexia is an indication that the nervous system is starting to recover and regain its function.

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  • 16. 

    What is spinal shock phase 4?

    • A.

      0 - 1 day: areflexia/Hyporeflexia

    • B.

      1 - 3 days: Initial reflex return

    • C.

      1 - 4 weeks: Hyperreflexia (initial)

    • D.

      1 - 12 weeks: Hyperreflexia, Spasticity

    Correct Answer
    D. 1 - 12 weeks: Hyperreflexia, Spasticity
    Explanation
    During the fourth phase of spinal shock, which lasts from 1 to 12 weeks, individuals experience hyperreflexia and spasticity. Hyperreflexia refers to an exaggerated reflex response, where even a slight stimulus can trigger a strong reflex action. Spasticity, on the other hand, is an increase in muscle tone that leads to stiffness and involuntary muscle contractions. These symptoms occur as the body begins to recover from the initial period of areflexia/hyporeflexia and reflexes become overly responsive.

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  • 17. 

    What phrases of spinal shock shows strong reflexes usually produced with minimal stimulation. Motor neurons begin sprouting and attempting to re-establish synapses?

    • A.

      Phase 1 - 0 - 1 day: areflexia/Hyporeflexia

    • B.

      Phase 2 - 1 - 3 days: Initial reflex return

    • C.

      Phase 3 - 1 - 4 weeks: Hyperreflexia (initial)

    • D.

      Phase 4 - 1 - 12 weeks: Hyperreflexia, Spasticity

    Correct Answer(s)
    C. Phase 3 - 1 - 4 weeks: Hyperreflexia (initial)
    D. Phase 4 - 1 - 12 weeks: Hyperreflexia, Spasticity
    Explanation
    During Phase 3 of spinal shock, which occurs between 1-4 weeks, there is an initial return of reflexes. This means that the reflexes become stronger and more pronounced, even with minimal stimulation. Motor neurons also start sprouting and attempting to re-establish synapses, which contributes to the increased reflex activity. In Phase 4, which occurs between 1-12 weeks, hyperreflexia and spasticity continue to be present, further indicating the strong reflex responses seen during this phase.

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  • 18. 

    What does S.C.I. stand for as it relates to spinal shock?

    • A.

      Standard Control Instructions

    • B.

      Spinal Cord Injury

    • C.

      Spinal Cord Instructions

    • D.

      Spinal Control Instructions

    • E.

      Spinal Cord Innervation

    Correct Answer
    B. Spinal Cord Injury
    Explanation
    The correct answer is "Spinal Cord Injury." This is because S.C.I. stands for Spinal Cord Injury, which refers to damage or trauma to the spinal cord that can result in temporary or permanent changes in its normal function.

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  • 19. 

    What is the cause of Thomas Potter's respiratory rate at 24 (very shallow breathing)?

    • A.

      Injury to C3

    • B.

      Injury to C4

    • C.

      Injury to C5

    • D.

      Injury to T1

    • E.

      Injury to C4 and C5

    Correct Answer
    C. Injury to C5
    Explanation
    Injury to the C5 vertebrae can cause Thomas Potter to have a respiratory rate of 24, characterized by very shallow breathing. The C5 vertebra is located in the cervical spine and plays a crucial role in innervating the diaphragm, which is the main muscle involved in the breathing process. Damage to the C5 vertebra can disrupt the signals sent to the diaphragm, leading to shallow breathing and potentially respiratory distress.

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  • 20. 

    Which cervical vertebrae was damaged in the patient's rock climbing injury? Taking all of the physical examination findings suggest that there was incomplete, diffuse, bilateral damage to the spinal cord at about the ___ segment.

    • A.

      Injury to C3

    • B.

      Injury to C4

    • C.

      Injury to C5

    • D.

      Injury to T1

    • E.

      Injury to C4 and C5

    Correct Answer
    C. Injury to C5
    Explanation
    The physical examination findings suggest that there was incomplete, diffuse, bilateral damage to the spinal cord at about the C5 segment.

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  • 21. 

    Due to damage of the C5 vertebrae and the respiration rate of this patient. What condition is causing his Blood pH to 7.25?

    • A.

      Thomas is hypoventilating resulting in respiratory acidosis.

    • B.

      Thomas is hyperventilating resulting in respiratory acidosis.

    • C.

      Thomas is hyporeflexia resulting in respiratory acidosis.

    • D.

      Thomas is not breathing on his own resulting in respiratory acidosis.

    Correct Answer
    A. Thomas is hypoventilating resulting in respiratory acidosis.
    Explanation
    Thomas is hypoventilating, which means he is not breathing enough to adequately remove carbon dioxide from his body. This leads to an accumulation of carbon dioxide in the blood, causing respiratory acidosis. The increased carbon dioxide levels in the blood lead to a decrease in blood pH, which is why Thomas's blood pH is 7.25.

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  • 22. 

    At what blood pH would Thomas have died?

    • A.

      7.40

    • B.

      6.70

    • C.

      7.60

    • D.

      7.50

    • E.

      7.30

    Correct Answer
    B. 6.70
  • 23. 

    The micturition reflex may return as Mr Potter's spinal shock resolves, since this reflex arc involves non-damaged segments of the spinal cord (S2 to S4).

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The micturition reflex is a reflex arc that involves the coordination between the bladder and the spinal cord. During spinal shock, which is a temporary loss of spinal reflex activity, the micturition reflex may be absent. However, as the spinal shock resolves, the reflex may return because the segments of the spinal cord involved in this reflex arc (S2 to S4) are not damaged. Therefore, the statement that the micturition reflex may return as Mr Potter's spinal shock resolves is true.

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  • 24. 

    What is the halo traction brace called?

    • A.

      Halo Orthosis

    • B.

      Cervical Halo Brace

    • C.

      Thoracic Halo Brace

    • D.

      Lumbar Halo Orthosis

    • E.

      Cervical Orthosis

    Correct Answer
    A. Halo Orthosis
    Explanation
    The correct answer is Halo Orthosis. Halo Orthosis is the traction brace used to immobilize and stabilize the cervical spine. It is a metal ring that is attached to the patient's skull using screws and is connected to a vest worn around the torso. The Halo Orthosis is used in cases of severe neck injuries or spinal fractures to prevent further damage and promote healing. It provides support and immobilization to the head and neck, allowing the patient to heal properly.

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  • 25. 

    Tommy Potter will wear his halo orthosis due to severe damage to the C5 vertebrae for ___ weeks. (Hint: please enter a number from 5 to 24.)

    Correct Answer
    12
    Explanation
    Tommy Potter will wear his halo orthosis for 12 weeks because he has severe damage to the C5 vertebrae. The halo orthosis is a device used to immobilize the head and neck, providing support and stability during the healing process. The duration of 12 weeks is likely determined by medical professionals based on the severity of the injury and the expected time needed for proper healing and recovery.

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  • 26. 

    How many rock climbing members are part of Thomas's team including himself?

    • A.

      4

    • B.

      6

    • C.

      9

    • D.

      12

    • E.

      15

    Correct Answer
    A. 4
    Explanation
    The correct answer is 4 because the question asks for the number of rock climbing members in Thomas's team, including himself. Since Thomas is part of the team, he counts as one member, and there are no additional members mentioned. Therefore, the total number of rock climbing members in Thomas's team, including himself, is 1.

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  • 27. 

    ___ / ___ is the medical term used when a person has a spinal cord injury above the first thoracic vertebra. Paralysis affects the cervical spinal nerves (C1-C8) resulting in paralysis in varying degrees in all four limbs.

    • A.

      Tetraplegia

    • B.

      Paraplegia

    • C.

      Quadriplegia

    • D.

      Cauda Equina Syndrome

    Correct Answer(s)
    A. Tetraplegia
    C. Quadriplegia
    Explanation
    Tetraplegia and quadriplegia both refer to the medical condition where a person has a spinal cord injury above the first thoracic vertebra, resulting in paralysis in all four limbs. Both terms are used interchangeably to describe the same condition. Therefore, either tetraplegia or quadriplegia can be considered the correct answer for this question. Cauda Equina Syndrome, on the other hand, refers to a different condition where there is compression of the nerve roots at the lower end of the spinal cord, causing symptoms such as lower back pain, numbness, and weakness in the legs.

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  • 28. 

    ___ / ___ is the medical term used when the level of spinal cord injury occurs below the first thoracic spinal nerve root (T1-S5). The degree at which the person is paralysed can vary from the impairment of leg movement, to complete paralysis of the legs and abdomen up to the nipple line. Paraplegics have full use of their arms and hands.

    • A.

      Tetraplegia

    • B.

      Paraplegia

    • C.

      Quadriplegia

    • D.

      Cauda Equina Syndrome

    Correct Answer
    B. Paraplegia
    Explanation
    Paraplegia is the correct answer because it is the medical term used to describe the level of spinal cord injury that occurs below the first thoracic spinal nerve root (T1-S5). Paraplegia results in varying degrees of paralysis, ranging from impairment of leg movement to complete paralysis of the legs and abdomen up to the nipple line. However, individuals with paraplegia still have full use of their arms and hands.

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  • 29. 

    ___ / ___  is the mass of nerves which fan out of the spinal cord at just below the first and second Lumbar region of the spinal cord, an area known as the conus medullaris. The spinal cord ends at L1 and L2 at which point a bundle of nerves travel downwards within the lumbar and sacral vertebrae.

    • A.

      Tetraplegia

    • B.

      Paraplegia

    • C.

      Quadriplegia

    • D.

      Cauda Equina Syndrome

    Correct Answer
    D. Cauda Equina Syndrome
    Explanation
    The correct answer is Cauda Equina Syndrome. Cauda Equina Syndrome refers to the compression or damage of the nerves that extend from the lower end of the spinal cord, known as the conus medullaris, causing a variety of symptoms such as lower back pain, leg weakness, numbness, and problems with bowel and bladder control. This condition occurs below the level of the spinal cord, specifically at the first and second Lumbar region, and is different from tetraplegia, paraplegia, and quadriplegia, which involve paralysis or loss of function in different parts of the body due to spinal cord injury.

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  • 30. 

    When Cauda Equina Syndrome,  Injury to these nerves will cause partial or complete loss of movement and sensation of ___, ___, ___, and ___.

    • A.

      Urinary Bladder

    • B.

      Bowels

    • C.

      Legs

    • D.

      Sexual Organs

    • E.

      Heart

    • F.

      Liver

    Correct Answer(s)
    A. Urinary Bladder
    B. Bowels
    C. Legs
    D. Sexual Organs
    Explanation
    Injury to the nerves of the cauda equina can result in a loss of movement and sensation in the urinary bladder, bowels, legs, and sexual organs. The cauda equina is a bundle of nerves located at the base of the spinal cord, and damage to these nerves can lead to a condition called cauda equina syndrome. This syndrome can cause various symptoms, including urinary and bowel dysfunction, weakness or paralysis in the legs, and sexual dysfunction. Therefore, the correct answer includes the organs and body parts that are commonly affected by cauda equina syndrome.

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