NIGHTINGALE COLLEGE PATHOPHYSIOLOGY
COMPREHENSIVE EXAM UPDATED QUESTIONS AND
ANSWERS SURE A+
✔✔Differentiate between decorticate and decerebrate posture/responses - ✔✔-
Decorticate
Posturing/rigidity: upper extremity flexion, lower extremity extension
Response: Slowly developing flexion of arm, wrist, and fingers with adduction in the
upper extremity and extension, internal rotation, and plantar flexion of lower extremity
- Decerebrate
Posturing/rigidity: upper and lower extremity extensor responses
Response: Opisthotonos (hyperextension of vertebral column) with clenching of teeth;
extension, abduction, and hyperpronation of arms; and extension of lower extremities.
In acute brain injury, shivering and hyperpnea may accompany unelicited recurrent
decerebrate spasms
✔✔Identify the major characteristics of disorders of expression - ✔✔- Hypermimesis:
commonly manifests as pathologic laughter or crying. Pathologic laughter is associated
with right hemisphere injury, and pathologic crying is associated with left hemisphere
injury.
, - Hypomimesis: manifests as aprosody—the loss of emotional language. Receptive
aprosody involves an inability to understand emotion in speech and facial expression.
Expressive aprosody involves the inability to express emotion in speech and facial
expression. Aprosody is associated with right hemisphere damage.
- Apraxia/dyspraxia: A disorder of learned skilled movements with difficulty planning and
executing coordinated motor movements. The term is often used interchangeably with
dyspraxia. It can be developmental, beginning at birth (developmental apraxia), or
associated with vascular disorders (common in stroke), trauma, tumors, degenerative
disorders, infections, or metabolic disorders.
✔✔Identify the clinical manifestations of spinal cord and vertebral injury - ✔✔...
✔✔Risk factors for cerebrovascular disease (CVD) - ✔✔• Poorly controlled or
uncontrolled arterial hypertension
• Smoking, which increases the risk of stroke by 2 to 4 times
• Insulin resistance and diabetes mellitus
• Atrial fibrillation
• Polycythemia (excess red blood cells) and thrombocythemia (excess platelets)
• High total cholesterol or low high-density lipoprotein (HDL) cholesterol, elevated
lipoprotein-a
• Congestive heart disease and peripheral vascular disease
• Hyperhomocysteinemia
• Sickle cell disease
• Postmenopausal hormone therapy
• High sodium intake >2300 mg; low potassium intake <4700 mg
• Obesity
• Sleep apnea
• Depression
• Chlamydia pneumoniae infection
• Physical inactivity
• Family history of ischemic stroke
✔✔Clinical manifestations of multiple sclerosis - ✔✔Paresthesias of the face, trunk, or
limbs; weakness; impaired gait; or urinary incontinence, indicating diffuse CNS
involvement. Visual impairment is associated with optic neuritis. Cerebellar and
corticospinal involvement presents as nystagmus, ataxia, and weakness, with all four
limbs involved. Intention tremor and slurred speech may also occur.
✔✔Clinical manifestations of subarachnoid hemorrhage (SAH) - ✔✔If the hemorrhage is
confined to the subarachnoid space, there may be no local signs. If bleeding spreads
into the brain tissue, hemiparesis/paralysis, dysphasia, or homonymous hemianopia
(visual field loss on the same side of both eyes) may be present.
✔✔Differentiate the clinical manifestations of the different types of headaches - ✔✔-
Migraine without Aura: Vomiting
COMPREHENSIVE EXAM UPDATED QUESTIONS AND
ANSWERS SURE A+
✔✔Differentiate between decorticate and decerebrate posture/responses - ✔✔-
Decorticate
Posturing/rigidity: upper extremity flexion, lower extremity extension
Response: Slowly developing flexion of arm, wrist, and fingers with adduction in the
upper extremity and extension, internal rotation, and plantar flexion of lower extremity
- Decerebrate
Posturing/rigidity: upper and lower extremity extensor responses
Response: Opisthotonos (hyperextension of vertebral column) with clenching of teeth;
extension, abduction, and hyperpronation of arms; and extension of lower extremities.
In acute brain injury, shivering and hyperpnea may accompany unelicited recurrent
decerebrate spasms
✔✔Identify the major characteristics of disorders of expression - ✔✔- Hypermimesis:
commonly manifests as pathologic laughter or crying. Pathologic laughter is associated
with right hemisphere injury, and pathologic crying is associated with left hemisphere
injury.
, - Hypomimesis: manifests as aprosody—the loss of emotional language. Receptive
aprosody involves an inability to understand emotion in speech and facial expression.
Expressive aprosody involves the inability to express emotion in speech and facial
expression. Aprosody is associated with right hemisphere damage.
- Apraxia/dyspraxia: A disorder of learned skilled movements with difficulty planning and
executing coordinated motor movements. The term is often used interchangeably with
dyspraxia. It can be developmental, beginning at birth (developmental apraxia), or
associated with vascular disorders (common in stroke), trauma, tumors, degenerative
disorders, infections, or metabolic disorders.
✔✔Identify the clinical manifestations of spinal cord and vertebral injury - ✔✔...
✔✔Risk factors for cerebrovascular disease (CVD) - ✔✔• Poorly controlled or
uncontrolled arterial hypertension
• Smoking, which increases the risk of stroke by 2 to 4 times
• Insulin resistance and diabetes mellitus
• Atrial fibrillation
• Polycythemia (excess red blood cells) and thrombocythemia (excess platelets)
• High total cholesterol or low high-density lipoprotein (HDL) cholesterol, elevated
lipoprotein-a
• Congestive heart disease and peripheral vascular disease
• Hyperhomocysteinemia
• Sickle cell disease
• Postmenopausal hormone therapy
• High sodium intake >2300 mg; low potassium intake <4700 mg
• Obesity
• Sleep apnea
• Depression
• Chlamydia pneumoniae infection
• Physical inactivity
• Family history of ischemic stroke
✔✔Clinical manifestations of multiple sclerosis - ✔✔Paresthesias of the face, trunk, or
limbs; weakness; impaired gait; or urinary incontinence, indicating diffuse CNS
involvement. Visual impairment is associated with optic neuritis. Cerebellar and
corticospinal involvement presents as nystagmus, ataxia, and weakness, with all four
limbs involved. Intention tremor and slurred speech may also occur.
✔✔Clinical manifestations of subarachnoid hemorrhage (SAH) - ✔✔If the hemorrhage is
confined to the subarachnoid space, there may be no local signs. If bleeding spreads
into the brain tissue, hemiparesis/paralysis, dysphasia, or homonymous hemianopia
(visual field loss on the same side of both eyes) may be present.
✔✔Differentiate the clinical manifestations of the different types of headaches - ✔✔-
Migraine without Aura: Vomiting
