NU-545 Unit 2 Quiz|Study Questions and Answers|100% Accurate: University of
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Definition
An inborn error in the metabolism of amino acids, phenylalanine
hydroxylase deficiency results in inability of the body to convert
essential amino acid phenylalanine to tyrosine. Autosomal recessive
disorder- mutations of phenylalanine hydroxylase (PAH) gene.
PKU causes accumulation of phenylalanine in the serum. elevated
serum result in developmental abnormalities of the cerebral cortical
layers, defective myelination, and cystic degeneration of the gray and
,white matter. bran damage occurs before the metabolites can be
detected in the urine and damage continues as long as phenylalanine
levels remains high.
Screening is used to detect PKU in the USA and more than 30 other
countries.
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Pku p.628 Pku p.619
PKU p.629 Pku p.624
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How Coup and Contrecoup injuries occur p. 552
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ICU begins to approach arterial pressure. Hypoxia and hypercapnia of brain tissues,
patients condition rapidly deteriorates.
Manifestations: decreasing levels of arousal or central neurogenic hyperventilation,
widening pulse pressure, bradycardia, pupils small and sluggish.
, The severity of the contusion varies with the amount of energy transmitted by
the skull to underlying brain tissue. The smaller the area of impact the more
severe the injury because of of the concentration force. Figure 18.3 p. 553
Dramatic sustained rises in ICP are not seen until all compensatory mechanisms
have been exhausted. Dramatic rises in ICP occur over a very short period.
Autoregulation, the compensatory alteration in the diameter of the intracranial
blood vessel designed to maintain a const blood flow during changes in cerebral
perfusion pressure, is lost with progressively increased ICP. Accumulating CO2 may
still cause vasodilation locally, but without auto regulation this vasodilation causes
the hydrostatic BP in the vessels to drop and blood volume to increase. The
increases pressure may obstruct venous outflow. The brain volume is thus further
enhanced, and ICP continues to rise., and the pressure takes much longer to return
to baseline As the ICP approaches systematic blood pressure, cerebral perfusion
pressure falls and cerebral perfusion slows dramatically. The brain tissues
experiences severe hypoxia, hypercapnia, and acidosis all of which cause
cerebrovascular dilation.
Astrocytomas are a type of glioma and the most common primary CNS tumor (75%
of all brain and spinal cord tumors). Astrocytomas develop from astrocytes and
grow by expansion and infiltration into the normal surrounding brain tissues. Tumor
cells are believed to have lost normal growth restraint, and thus they proliferate
uncontrollably. These slow-growing but infiltrative gliomas tend to form cavities
(pseudocysts).Although these tumors may occur anywhere in the brain or spinal
cord, they are located most commonly in the cerebrum, hypothalamus, and pons.
Low grade astrocytomas tend to be located laterally or supratentorially in adults
and in the posterior fossa in children.Headache and subtle neurobehavioral
changes may be an early sign with other neurologic symptoms evolving slowly and
IICP occuring late in the tumor's course. Onset of a focal seizure disorder between
the second and sixth decade of life suggests an Astrocytoma.There are four grades:
I, II, III, IV. Diagnosis of high-grade astrocytomas most commonly takes 3-6 mos.
From onset on the first clinical manifestation because the person does not
recognize the need to consult a healthcare provider. Grades III and IV are found
predominantly in the frontal lobes and cerebral hemispheres although they may
occur in the brainstem, cerebellum and spinal cord.Grade IV glioblastoma multiform
(GBM) is the most lethal and common type of primary brain tumor. GBM is higher
vascular and extensively irregular and infiltrative, making them difficult to remove
, surgically. 50 percent of glioblastomas are bilateral or at least occupy more than
one lobe at the time of death. Typical clinical presentation is that of diffuse, non
specific clinical signs, such as HA, irritability, and personality changes that progress
to more lear cut manifestations of IICP, including HA on position change,
papilledema, vomiting, seizure activity,. Symptoms may progress to include more
definite focal signs such as hemiparesis, dysphasia, dyspraxia, cranial nerve palsies,
and visual deficits.
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Located in the inferior frontal lobe is an important center for speech
and language processing?
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Occipital lobe p. 442 Grey matter p. 441
Broca area p. 442 Temporal lobe p. 443
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