Essentials of Human Diseases and Conditions

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1 Essentials of Human Diseases and Conditions 6 th edition Margaret Schell Frazier Jeanette Wist Drzymkowski Copyright 2010 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright 2016, Elsevier Inc. All Rights Reserved. 1

3 Learning Objectives Lesson 13.1: Vascular Disorders, Head Trauma, and Spinal Cord Injuries 1. Name the main components of the nervous system. 2. Describe how data are collected during a neurologic assessment. 3. Name the common symptoms and signs of a cerebrovascular accident (CVA). 4. Name the three vascular disorders that may cause a CVA. 5. Define a transient ischemic attack (TIA). Copyright 2016, Elsevier Inc. All Rights Reserved. 3

4 Learning Objectives Lesson 13.1: Vascular Disorders, Head Trauma, and Spinal Cord Injuries (Cont.) 6. List some of the problems to which the nervous system is susceptible. 7. Distinguish between (a) epidural and subdural hematomas and (b) cerebral concussion and cerebral contusion. 8. Describe three mechanisms of spinal injuries. 9. Name the goals of treatment of spinal cord injuries. Copyright 2016, Elsevier Inc. All Rights Reserved. 4

5 Orderly Function of the Nervous System A complex network composed of: Ø Neurons (nerve cells that make up the brain) Ø Spinal cord Ø Nerves Composed of two divisions Ø Central nervous system (brain and spinal cord) Ø Peripheral nervous system Copyright 2016, Elsevier Inc. All Rights Reserved. 5

8 Central Nervous System (CNS) Processes and stores sensory and motor information, governs state of consciousness Ø Frontal lobe of the cerebrum controls intellectual functions of thinking, willing, remembering, deciding, and personality Ø Coordination, equilibrium, and posture coordinated in the cerebellum of the brain Ø Hypothalamus regulates secretion of hormones from pituitary gland Ø Medulla oblongata has vital centers that regulate heart rate, blood pressure, and respiration Copyright 2016, Elsevier Inc. All Rights Reserved. 8

Functional Areas of the Brain From Gould BE, Dyer RM: Pathophysiology for the health

10 Neurologic Assessment Methods to evaluate neurologic status Ø Take thorough medical history Ø Test speech, language, and writing skills Ø Test cranial nerve function Ø Test muscle strength and tone Ø Test coordination and balance Ø Test sensory function (diminished or abnormal sensation) Copyright 2016, Elsevier Inc. All Rights Reserved. 10

11 Peripheral Nervous System (PNS) Peripheral nerves connect with the spinal cord;; the information they carry travels to and from brain and spinal cord Ø Sensory (afferent) nerves transmit impulses from parts of the body to the spinal cord and brain Ø Motor (efferent) nerves transmit impulses away from the CNS and produce responses in muscles and glands The PNS contains 12 pairs of cranial nerves Copyright 2016, Elsevier Inc. All Rights Reserved. 11

14 Nervous System Four major blood vessels supply the brain with essential oxygen and nutrients Ø The carotid arteries (two internal and two external) are located in the anterior portion of the neck Ø Two vertebral arteries join with the two anterior and posterior cerebral arteries and the two anterior and posterior communicating arteries Circle of Willis is formed by these arteries Copyright 2016, Elsevier Inc. All Rights Reserved. 14

19 Cerebrovascular Accident (Stroke) Common stroke symptoms include: Ø Sudden severe headache, aphasia, dysphasia Ø Sudden weakness, numbness, paralysis Ø Sudden confusion or loss of vision, blurred vision Ø Sudden dizziness, loss of balance or coordination CVAs result from occlusion of an artery caused by an atheroma, sudden obstruction by an embolus, or a cerebral bleed Copyright 2016, Elsevier Inc. All Rights Reserved. 19

20 Treatment of Cerebrovascular Accident (Stroke) Immediate medical intervention within 3 hours may limit brain damage Includes: Ø Immediately chewing an aspirin Ø Surgery to improve circulation and remove clots Ø Surgery to repair broken or bleeding blood vessels and drugs to prevent or reverse brain swelling Copyright 2016, Elsevier Inc. All Rights Reserved. 20

21 Arteriovenous Malformations Formed during fetal development, arteriovenous malformations are abnormal structures of the blood vessels Although usually found in the brain, AVMs may be located in any vascular structure Ø Arterial blood moves directly into the veins, giving the blood vessels the appearance of a tangled mass Diagnosis made by assessment of the clinical signs and imaging studies Copyright 2016, Elsevier Inc. All Rights Reserved. 21

22 Cerebral Aneurysms Abnormal localized weakening, thinning, or dilation of the wall of a cerebral artery or vein resulting in a ballooning of the blood vessel Cerebral aneurysms often cause no symptoms and go unnoticed until rupture or leakage occurs Etiology may be a congenital defect, atherosclerosis, hypertension, infection, cancer, drugs, or trauma to the head Copyright 2016, Elsevier Inc. All Rights Reserved. 22

23 Transient Ischemic Attack Often are referred to as little strokes Ø Individual may report sudden weakness and numbness down one side of the body, dizziness, dysphagia, confusion, difficulty seeing with one eye, and/or loss of balance Most common cause of TIA is a piece of plaque, which breaks away from the wall of an artery and travels to the brain Treatment depends on the location of the TIA and the underlying cause Copyright 2016, Elsevier Inc. All Rights Reserved. 23

25 Transient Ischemic Attack (Cont.) Anticoagulant therapy may include heparin, enoxaparin, warfarin, aspirin, ticlopidine, and dipyridamole Prognosis varies according to extent and duration of the ischemia Prevention includes positive lifestyle changes to reduce controllable risk factors Instructions should be given concerning possible symptoms of an impending stroke Copyright 2016, Elsevier Inc. All Rights Reserved. 25

26 Epidural and Subdural Hematomas Epidural hematoma: Mass of blood that forms between the skull and the dura mater Subdural hematoma: A similar mass, but it forms beneath the dura mater Symptoms of an epidural hematoma typically appear within a few hours of head trauma Ø Sudden headache, dilated pupils, nausea and often vomiting, increased drowsiness Copyright 2016, Elsevier Inc. All Rights Reserved. 26

28 Epidural and Subdural Hematomas (Cont.) Result when blood from ruptured vessels seeps into and around the meningeal layers If the person loses consciousness, rapid medical attention is needed Ø A craniotomy may be necessary A patient not losing consciousness but displaying symptoms should be seen ASAP Provide postsurgical instructions for care of incision Copyright 2016, Elsevier Inc. All Rights Reserved. 28

29 Cerebral Concussion Patients may experience a loss of consciousness;; respirations become shallow, pulse rate is depressed, and muscle tone is flaccid A cerebral concussion is an injury resulting from impact with a blunt object, either by receiving a blow to the head or by falling Treatment is bed rest and observation for signs of behavioral changes Prognosis is unpredictable, depends on the extent Copyright 2016, Elsevier Inc. All Rights Reserved. 29

31 Cerebral Contusion Symptoms and signs of a contusion vary according to the site and extent of the injury Ø When conscious, the person may report a severe headache and hemiparesis;; may appear drowsy and lethargic or hostile and combative Caused by a blow to the head or impacting against a hard surface Patients need to be hospitalized so that their vital signs can be monitored and rapid medical intervention can be available Copyright 2016, Elsevier Inc. All Rights Reserved. 31

Closed Head Injuries From Stevens A, et al: Core pathology, ed 3, London,

33 Depressed Skull Fracture Symptoms depend on the site of the fracture Ø A bone fragment pressing on the motor area of the brain may cause hemiplegia Ø Signs include bleeding from the wound, ears, nose, or around the eyes;; changes in pupils;; clear or bloody drainage from ears or nose Direct impact on the skull with a blunt object is the most common cause Treatment: Craniotomy and bone elevation;; head protection is worn until healed Copyright 2016, Elsevier Inc. All Rights Reserved. 33

36 Paraplegia and Quadriplegia Paraplegia: Loss of nerve function below the waist, resulting in paralysis of the lower trunk and legs Quadriplegia: Loss of nerve function below the cervical region, resulting in paralysis of arms, hands, trunk, and legs When the spinal cord is injured, a part or parts of the body inferior to the point of injury may be affected Copyright 2016, Elsevier Inc. All Rights Reserved. 36

37 Paraplegia Symptoms of Paraplegia and Quadriplegia Ø Loss of motor and sensory control in lower extremities and trunk Ø Loss of bladder, bowel, and sexual function Quadriplegia Ø Loss of motor and sensory control in upper and lower body Ø Hypotension Ø Hyperthermia Ø Bradycardia Ø Respiratory problems Copyright 2016, Elsevier Inc. All Rights Reserved. 37

38 Paraplegia and Quadriplegia (Cont.) Spinal cord injuries that cause paraplegia and quadriplegia are the result of vertebral fractures or vertebral dislocation Ø Trauma to the thoracic and lumbar regions of the spine (T1 and below) usually results in paraplegia Ø Trauma to the cervical vertebrae (C5 or above) may result in quadriplegia Treatment: Restoration of normal alignment and stability of spine;; decompression of spinal cord;; early rehabilitation Copyright 2016, Elsevier Inc. All Rights Reserved. 38

41 Learning Objectives Lesson 13.2: Intervertebral Disk Disorders and Functional Disorders 10. Explain the neurologic consequences of the deterioration or rupture of an intervertebral disk. 11. Explain why cephalalgia sometimes is considered a symptom of underlying disease. 12. Describe the symptoms of a migraine. 13. Describe first aid for seizures. 14. Explain how the symptoms of Parkinson disease are controlled. Copyright 2016, Elsevier Inc. All Rights Reserved. 41

42 Learning Objectives Lesson 13.2: Intervertebral Disk Disorders and Functional Disorders (Cont.) 15. Describe the progression of amyotrophic lateral sclerosis (ALS). 16. Discuss restless legs syndrome (RLS). Copyright 2016, Elsevier Inc. All Rights Reserved. 42

43 Degenerative Disk Disease When pain occurs, it radiates down the nerve path, may be described as burning, and can become intractable Ø May be accompanied by loss of some motor functions in the legs As a person ages, the water in the disk decreases, causing degenerative disk disease The present treatment includes advising the patients to be as active as possible Copyright 2016, Elsevier Inc. All Rights Reserved. 43

44 Treatment of Degenerative Disk Disease Narcotic analgesics and NSAIDs Oral steroids Epidurals or selective nerve root blocks Physical therapy Surgical intervention might be necessary When surgical intervention is not an option, lidocaine topical (Lidoderm) patches may be prescribed Copyright 2016, Elsevier Inc. All Rights Reserved. 44

45 Transcutaneous Electrical Nerve Stimulation Small electronic units operate with 9-volt power to produce high frequency electrical impulses that are transmitted to the surface of the skin through electrodes TENS units and the nondrug therapy option permit many with chronic pain to return to a fairly normal lifestyle TENS units may be ordered for pain relief of chronic back pain, spinal stenosis, sciatica, arthritis, and postherpetic neuralgia Copyright 2016, Elsevier Inc. All Rights Reserved. 45

46 Herniated and Bulging Disk Each disk acts as a shock-absorbing cushion for the vertebrae and gives the back its flexibility The nucleus pulposus is contained within the annular wall in a bulging disk The rupture can cause severe back pain and even disability if it presses against or pinches the spinal nerves Most herniated disks occur in the lower back Copyright 2016, Elsevier Inc. All Rights Reserved. 46

49 Herniated and Bulging Disk (Cont.) Herniated and bulging intervertebral disks usually result from accumulated trauma Physical examination of the back is performed to rule out other possible causes of the patient s symptoms Conservative treatment consists of the use of hot or cold packs and the administration of muscle relaxants and analgesics Prognosis depends on the extent and duration Copyright 2016, Elsevier Inc. All Rights Reserved. 49

50 Sciatic Nerve Injury: Spinal Stenosis Rupture of one or more disks or their nuclei produces severe, sharp pain radiating from the sciatic nerve down the leg and to the foot Ø The pain may be continuous or intermittent Trauma to the sciatic nerve may result from a fall, poor body mechanics, or gunshot or stab wounds Copyright 2016, Elsevier Inc. All Rights Reserved. 50

51 Treatment of Sciatic Nerve Injury: Spinal Stenosis Strengthening core muscles (after inflammation subsides) Medications (analgesics, muscle relaxants, antiinflammatories, and, in some cases, narcotics) Physical therapy may help relieve pain Corticosteroid epidural injections may relieve pain and reduce inflammation Surgical intervention Copyright 2016, Elsevier Inc. All Rights Reserved. 51

52 Headache May be acute or chronic and located in the frontal, temporal, or occipital regions of the head The type of pain may vary from dull and aching to almost unbearable Brain tissues themselves never ache because they do not contain sensory nerves Is sometimes a symptom of an underlying disorder or disease Copyright 2016, Elsevier Inc. All Rights Reserved. 52

53 Headache (Cont.) Irritation factors The first cause is strain on facial, neck, and scalp muscles resulting from tension The second cause is edema within the blood vessels of the head The cause of the headache determines the type of treatment chosen Ø For no underlying cause: Use analgesics, muscle relaxants, minor tranquilizers, muscle massages, and relaxation Copyright 2016, Elsevier Inc. All Rights Reserved. 53

54 Migraine Warning signs include visual auras and photophobia Persons feel abnormally fatigued and irritable;; numbness or tingling in one arm or on one side of the body, dizziness, and temporary mental confusion It is not known why some people are subject to migraines or what triggers them Ø There is a strong suspicion of inherited or genetic aspects Copyright 2016, Elsevier Inc. All Rights Reserved. 54

55 Treatment of Migraines Bed rest in a quiet, dark room Analgesics Drug therapy (vasoconstrictors) to constrict blood vessels Antiemetics (to control vomiting) Triptans Relaxation therapy Biofeedback Copyright 2016, Elsevier Inc. All Rights Reserved. 55

56 Epilepsy: A Seizure Disorder Epilepsy takes many forms and has a variety of manifestations Ø Generalized seizures cause a diffuse electrical abnormality within the brain and include absence and tonic-clonic attacks Ø Tonic-clonic seizures may begin with a loud cry, followed by falling to the ground and loss of consciousness Ø Status epilepticus occurs when one seizure follows another with no recovery of consciousness between attacks Copyright 2016, Elsevier Inc. All Rights Reserved. 56

57 Epilepsy: A Seizure Disorder (Cont.) In idiopathic epilepsy, no apparent cause for the abnormal electrical discharge is found In symptomatic epilepsy, a known abnormality in the brain resulting from a pathologic process seems to trigger seizures Anticonvulsant medications are the treatment of choice for epilepsy Ø Close monitoring and adjustments of dosage to attain good therapeutic control are essential Copyright 2016, Elsevier Inc. All Rights Reserved. 57

First Aid for Seizures From Epilepsy Foundation, www.

59 Parkinson Disease Symptoms may be associated with aging until the recognizable paradigm of Parkinson disease emerges Ø A primary symptom is tremor or trembling in hands, arms, jaw, face, and legs Ø There is a rigidity or stiffness of limbs and trunk, causing the posture to be stooped What causes the degeneration of nerves in the motor system of the brainstem is not known Copyright 2016, Elsevier Inc. All Rights Reserved. 59

61 Parkinson Disease (Cont.) Diagnosis is based on the characteristic history and careful neurologic examination Treatment is individualized to the patient Parkinson disease cannot be cured Medical management consists of supportive measures and control of symptoms with the administration of drugs Physical therapy helps the patient maximize mobility within the limitations Copyright 2016, Elsevier Inc. All Rights Reserved. 61

62 Huntington Chorea Has an insidious onset, with the loss of musculoskeletal control exhibited by subtle, semipurposeful movements Ø The arms and face are the first areas to be involved, with movements ranging from mild fidgets to tongue smacking Disruption in personality and personality changes may occur Transmitted by an autosomal-dominant trait that can be inherited by either sex Copyright 2016, Elsevier Inc. All Rights Reserved. 62

63 Treatment of Huntington Chorea Treatment is supportive, symptomatic, and protective Haloperidol (Haldol) and fluphenazine (Prolixin) are prescribed in an attempt to control choreic movements and to reduce agitation At the present time, no cure for Huntington chorea is known Copyright 2016, Elsevier Inc. All Rights Reserved. 63

64 Amyotrophic Lateral Sclerosis (ALS) Fasciculations and accompanying atrophy and weakness are noted in the forearms and hands These patients progress to having difficulties in speech, chewing, swallowing, and breathing;; eventually, a ventilator is required Although the etiology of ALS is uncertain, some cases may be caused by autosomal inherited traits Copyright 2016, Elsevier Inc. All Rights Reserved. 64

65 Treatment of ALS Treatment involving a team of caregivers consists of supportive measures and therapy directed at controlling symptoms Drug therapy includes tizanidine and baclofen Other medications are used to reduce fatigue, spasticity, pain, sleep difficulties and excess saliva Copyright 2016, Elsevier Inc. All Rights Reserved. 65

66 Restless Legs Syndrome (RLS) There are feelings that often are described as itching, burning, jittery, creepy-crawly, pulling, tugging, and/or painful sensations in the legs The inability to sit for extended periods of time often interferes with normal activities The exact cause of RLS is unknown Blood tests may show low blood iron content Treatment involves identifying the underlying cause of the disorder and treating that Copyright 2016, Elsevier Inc. All Rights Reserved. 66

67 Learning Objectives Lesson 13.3: Peripheral Nerve Disorders, Infectious Disorders, and Intracranial Tumors 17. Discuss transient global amnesia. 18. Distinguish between trigeminal neuralgia and Bell palsy. 19. List the diagnostic tests used for meningitis, and explain how the causative organism is identified. 20. Name the common causes of encephalitis. 21. Explain the pathologic course of Guillain-Barré syndrome. 22. Explain what is meant by post-polio syndrome. Copyright 2016, Elsevier Inc. All Rights Reserved. 67

68 Transient Global Amnesia The learning process is completely blocked and memory disturbances are involved Ø Repetitive asking of questions such as Where are we going? Why are we going there? Where am I? and Why did we do that? is typical Usual tasks are performed without difficulty and neurologic signs are normal Etiology is unknown Treatment is supportive Copyright 2016, Elsevier Inc. All Rights Reserved. 68

69 Peripheral Neuritis/Neuropathy Unless the precipitating factors are severe infection or chronic alcohol intoxication, the onset is insidious Ø Clumsiness and loss of sensation in the hands and feet are followed by a flaccid paralysis and a wasting of muscles in these areas Ø Deep tendon reflexes become diminished, and tenderness is noted in the atrophied muscles There are several causative factors Copyright 2016, Elsevier Inc. All Rights Reserved. 69

70 Treatment of Peripheral Neuritis/Neuropathy Eliminate exposure to toxic substances Correct any nutritional deficiencies Control underlying diseases Patient must avoid all alcohol in any form Administration of anticonvulsants and tricyclic antidepressants Physical therapy Copyright 2016, Elsevier Inc. All Rights Reserved. 70

71 Trigeminal Neuralgia (Tic Douloureux) Transient, excruciating pain of trigeminal neuralgia radiates along the fifth cranial nerve distribution Ø When the ophthalmic branch is affected, pain is experienced in the eye and forehead Ø The maxillary branch involves the nose, upper lip, and cheek Ø The mandibular branch involves the lower lip, the outer portion of the tongue, and the area of the cheek close to the ear Copyright 2016, Elsevier Inc. All Rights Reserved. 71

73 Trigeminal Neuralgia (Tic Douloureux) (Cont.) Cause is uncertain, although some cases have been found to be related to compression of a nerve root by a tumor or vascular lesion Analgesics are prescribed for pain Recent drug therapy includes the use of anticonvulsant drugs The addition of muscle relaxants may be more effective Copyright 2016, Elsevier Inc. All Rights Reserved. 73

74 Bell Palsy The patient may be aware of pain or a drawing sensation behind the ear, followed by an inability to open or close the eye and drooping of the mouth and drooling of saliva The patient is unable to smile, whistle, or grimace, and the facial expression is distorted Taste perception may be diminished The cause of Bell palsy is not always certain Copyright 2016, Elsevier Inc. All Rights Reserved. 74

75 Bell Palsy (Cont.) From Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment and management of clinical problems, ed 6, St Louis, 2004, Mosby. Copyright 2016, Elsevier Inc. All Rights Reserved. 75

76 Treatment of Bell Palsy Warm, moist gentle heat and massage Facial exercises to stimulate muscle tone Prednisone to reduce edema of facial nerve Analgesics Artificial tears and an eye patch Electrotherapy to stimulate nerves and prevent atrophy of muscles Copyright 2016, Elsevier Inc. All Rights Reserved. 76

77 Bell Palsy (Cont.) Differences between Bell palsy and trigeminal neuralgia Ø Bell palsy Sudden paralysis Motor function impaired Prognosis is good if treated early Ø Trigeminal Extreme pain No motor function impairment Prognosis varies Copyright 2016, Elsevier Inc. All Rights Reserved. 77

78 Meningitis Early symptoms of meningitis include vomiting and a headache that increases in intensity with movement or shaking of the head Deep tendon reflexes increase, and the patient exhibits irritability, photophobia, and a hypersensitivity of the skin Meningitis can be either bacterial or viral Copyright 2016, Elsevier Inc. All Rights Reserved. 78

79 Bacterial Meningitis From Damjanov I: Pathology for the health-related professions, ed 4, St Louis, 2011, Saunders/Elsevier. Courtesy of Dr. John J. Kepes, Kansas City, KS. Copyright 2016, Elsevier Inc. All Rights Reserved. 79

80 Treatment of Meningitis Aggressive antibiotic therapy Anticonvulsive drugs to control seizure activity Glucocorticoids may be administered to reduce cerebral inflammation and edema Aspirin or acetaminophen for headache Dark and quiet environment Copyright 2016, Elsevier Inc. All Rights Reserved. 80

81 Encephalitis May have an insidious or sudden onset Primary symptoms include a headache and elevated temperature Ø The patient experiences a stiffness in the neck and back, muscular weakness, restlessness, visual disturbances, and lethargy It is caused by viruses or the toxins from chickenpox, measles, or mumps. Most cases are the result of a bite from an infected mosquito Copyright 2016, Elsevier Inc. All Rights Reserved. 81

82 Treatment of Encephalitis Antiviral agents effective against herpes simplex encephalitis Otherwise: Ø Mild analgesics for pain Ø Anticonvulsants Ø Antibiotics for any present infection Stress the use of mosquito repellant when in an outdoor environment Copyright 2016, Elsevier Inc. All Rights Reserved. 82

83 Guillain-Barré Syndrome The individual experiences numbness and tingling of the feet and hands at the onset of the disease, followed by increasing muscle pain and tenderness Progressive muscle weakness and paralysis usually start in the lower extremities and move up the body The syndrome is thought to have an autoimmune basis Copyright 2016, Elsevier Inc. All Rights Reserved. 83

84 Treatment of Guillain-Barré Syndrome Hospitalization required for observation Plasmapheresis washes the plasma to remove antibodies, thereby shortening the time required for recovery Intravenous human immunoglobulin may be beneficial No method of prevention is known Copyright 2016, Elsevier Inc. All Rights Reserved. 84

85 Brain Abscess The primary symptom of a brain abscess is a headache Other symptoms and signs depend on the location and extent of the abscess CNS abscesses may be the result of a local infection or may be secondary to infections elsewhere in the body Copyright 2016, Elsevier Inc. All Rights Reserved. 85

Bacterial Infections of the CNS From Damjanov I: Pathology for the health-related professions,

88 Treatment of a Brain Abscess Intravenous antibiotics Mannitol or steroids to reduce cerebral edema Surgical drainage of abscess to relieve pressure Prognosis varies depending on the location, size, and causative agent of the abscess Copyright 2016, Elsevier Inc. All Rights Reserved. 88

89 Poliomyelitis and Postpolio Syndrome The patient with poliomyelitis has a low-grade fever, a profuse discharge from the nose, and malaise These symptoms are followed by a progressive muscle weakness, stiff neck, nausea and vomiting, and a flaccid paralysis of the muscles involved Poliovirus enters the body through the nose and throat, crosses into the gastrointestinal tract, and reproduces in the lymphoid tissue Copyright 2016, Elsevier Inc. All Rights Reserved. 89

90 Treatment of Poliomyelitis and Postpolio Syndrome Analgesics Moist heat Bed rest Physical therapy Leg braces Mechanical ventilation A monovalent Sabin vaccine also is available, which grants immunity to only one form Copyright 2016, Elsevier Inc. All Rights Reserved. 90

91 Intracranial Tumors (Brain Tumors) Primary tumors can arise from any cell within the CNS Regardless of the tumor cell type, symptoms and signs result from displacement and compression of normal brain tissue by the tumor Primary brain tumors are classified histologically according to the predominant cell type Copyright 2016, Elsevier Inc. All Rights Reserved. 91

Increased Intracranial Pressure From Gould BE, Dyer RM: Pathophysiology for the health

94 Intracranial Tumors (Brain Tumors) (Cont.) Evaluation of a patient with a suspected brain tumor includes a detailed history, a neurologic examination, and diagnostic neuroimaging studies Although brain tumors can be malignant or benign, the distinction is blurred in the brain Copyright 2016, Elsevier Inc. All Rights Reserved. 94

96 Intracranial Tumors (Brain Tumors) (Cont.) Treatment: Secondary tumors Ø Focuses on relief of neurologic symptoms and long-term tumor control Ø Patients with solitary brain lesions and no other sites of metastasis undergo: Surgery Whole brain radiation therapy No methods are known to prevent intracranial neoplasms Copyright 2016, Elsevier Inc. All Rights Reserved. 96

97 Prognosis Intracranial Tumors (Brain Tumors) (Cont.) Ø Five-year survival rate for all types of brain tumors combined is 32%, which is among the lowest for all types of cancer Copyright 2016, Elsevier Inc. All Rights Reserved. 97

Workbook Answers Chapter 13. Neurologic Diseases and Conditions

Workbook Answers Chapter 13. Neurologic Diseases and Conditions Workbook Answers Chapter 13 Neurologic Diseases and Conditions Short Answer 1. Afferent nerves transmit impulses from parts of the body to the spinal cord; efferent nerves transmit impulses away from the