NUR 611: Physical Examination and Health History
Parasympathetic nervous system - answers✔✔Which body system is responsible for conserving
energy and body resources
Sympathetic nervous system (SNS) - answers✔✔which system responds to stress by preparing
the body to defend itself
blood flow to the muscles is increased while blood flow to GI and integumentary is decreased -
answers✔✔how is blood flow redistributed by the sympathetic nervous system (SNS)
focal or diffuse (aka multifocal) - answers✔✔how are primary brain injuries classified
specific, grossly observable brain lesions that occur in a precise location
Epidural and subdural hemorrhages - answers✔✔focal brain injuries
include brain injury due to hypoxia, meningitis, encephalitis, and damage to blood vessels
The brain is confined in a limited space so increased pressure can cause collateral dysfunction:
Diabetes Insipidus (ADH not secreted thus polyuria) - answers✔✔diffuse brain injuries
affected at the t5-t6 level or above; characterized by paroxysmal HTN (up to 300 mmHg
systolic), a pounding headache, blurred vision, sweating above the level of the lesion with
flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and
bradycardia (30-40 beats/min) - answers✔✔autonomic hyperreflexia
individual most likely to be affected have lesions at the T5-T6 level or above -
answers✔✔location of lesions in cases of autonomic hyperreflexia
,bradycardia (30-40bpm) is a sx of hyperreflexia
Stimulation of the carotid sinus -->vagus nerve -->sinoatrial (SA) node. The intact ANS reflexively
responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral
vessels, the carotid sinus, and the aorta sense the HTN and stimulate the PNS. The heart rate
decreases, but the visceral and peripheral vessels do not dilate because efferent impulses
cannot pass through the cord - answers✔✔sequence of events that lead to hyperreflexia
induced bradycardia
leading cause of dementia and one of the most common causes of severe cognitive dysfunction
in older adults - answers✔✔Alzheimer's disease
age, family history - answers✔✔what are the greatest risk factors for Alzheimer's disease
low calorie diets, estrogen replacement at time of menopause, NSAIDs, physical activity,
antioxidants, the presence of apoE2 - answers✔✔what are the proposed protective factors for
Alzheimer's disease
PSEN 1 (presenilin) on chromosome 14, PSEN 2, and APP (amyloid precursor protein) on
chromosome 21 - answers✔✔what genetic susceptibility tests are used to screen for early-
onset AD
postmortem examination - answers✔✔When can a specific diagnosis of AD be given
hypertension (87% of occurrences) - answers✔✔what is the single greatest risk factor for stroke
arterial HTN, insulin resistance and DM, elevated cholesterol or low high density lipoprotein
(HDL), elevated lipoprotein- A level, hyperhomocysteinemia, congestive heart disease and PVD,
asymptomatic carotid stenosis, polycythemia and thrombocythemia, a-fib, postmenopausal
hormone therapy, high sodium intake above 2300mg, low potassium intake less than 4700mg,
, smoking, lack of physical activity, obesity, chronic sleep deprivation - answers✔✔what are
common risk factors for stroke
Guillain-Barre syndrome - answers✔✔which autoimmune disease typically presents 2-4 weeks
following a bacterial/viral infection such as respiratory or GI illness (ex: flu)
typical first manifestations are numbness, pain, paresthesias, or weakness in the limbs.
Paresis/paralysis may present in an ascending pattern - answers✔✔Describe the progression of
Guillain-Barre symptoms
weakness usually plateaus or improves by the 4th week in 90% of cases - answers✔✔when can
improvement be expected with Guillain-Barre
a chronic autoimmune disease that is mediated by Ach receptor antibodies that act at the
neuromuscular junction. The antibodies prevent normal reception for muscle contraction -
answers✔✔Myasthenia Gravis
-exertional fatigue and weakness that worsens with activity, improves with rest, and recurs with
resumption of activity
-a recent history of recurring upper resp tract infections
-diplopia, ptosis, and ocular palsies
-facial droop and an expressionless face; difficulty chewing and swallowing associated with
dietary changes and weight loss; drooling
-episodes of choking and aspiration - answers✔✔myasthenia gravis clinical manifestations
Graves disease is a result of autoantibodies binding to the TSH receptor sites. This leads to
hyperthyroidism - answers✔✔Graves disease
Parasympathetic nervous system - answers✔✔Which body system is responsible for conserving
energy and body resources
Sympathetic nervous system (SNS) - answers✔✔which system responds to stress by preparing
the body to defend itself
blood flow to the muscles is increased while blood flow to GI and integumentary is decreased -
answers✔✔how is blood flow redistributed by the sympathetic nervous system (SNS)
focal or diffuse (aka multifocal) - answers✔✔how are primary brain injuries classified
specific, grossly observable brain lesions that occur in a precise location
Epidural and subdural hemorrhages - answers✔✔focal brain injuries
include brain injury due to hypoxia, meningitis, encephalitis, and damage to blood vessels
The brain is confined in a limited space so increased pressure can cause collateral dysfunction:
Diabetes Insipidus (ADH not secreted thus polyuria) - answers✔✔diffuse brain injuries
affected at the t5-t6 level or above; characterized by paroxysmal HTN (up to 300 mmHg
systolic), a pounding headache, blurred vision, sweating above the level of the lesion with
flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and
bradycardia (30-40 beats/min) - answers✔✔autonomic hyperreflexia
individual most likely to be affected have lesions at the T5-T6 level or above -
answers✔✔location of lesions in cases of autonomic hyperreflexia
,bradycardia (30-40bpm) is a sx of hyperreflexia
Stimulation of the carotid sinus -->vagus nerve -->sinoatrial (SA) node. The intact ANS reflexively
responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral
vessels, the carotid sinus, and the aorta sense the HTN and stimulate the PNS. The heart rate
decreases, but the visceral and peripheral vessels do not dilate because efferent impulses
cannot pass through the cord - answers✔✔sequence of events that lead to hyperreflexia
induced bradycardia
leading cause of dementia and one of the most common causes of severe cognitive dysfunction
in older adults - answers✔✔Alzheimer's disease
age, family history - answers✔✔what are the greatest risk factors for Alzheimer's disease
low calorie diets, estrogen replacement at time of menopause, NSAIDs, physical activity,
antioxidants, the presence of apoE2 - answers✔✔what are the proposed protective factors for
Alzheimer's disease
PSEN 1 (presenilin) on chromosome 14, PSEN 2, and APP (amyloid precursor protein) on
chromosome 21 - answers✔✔what genetic susceptibility tests are used to screen for early-
onset AD
postmortem examination - answers✔✔When can a specific diagnosis of AD be given
hypertension (87% of occurrences) - answers✔✔what is the single greatest risk factor for stroke
arterial HTN, insulin resistance and DM, elevated cholesterol or low high density lipoprotein
(HDL), elevated lipoprotein- A level, hyperhomocysteinemia, congestive heart disease and PVD,
asymptomatic carotid stenosis, polycythemia and thrombocythemia, a-fib, postmenopausal
hormone therapy, high sodium intake above 2300mg, low potassium intake less than 4700mg,
, smoking, lack of physical activity, obesity, chronic sleep deprivation - answers✔✔what are
common risk factors for stroke
Guillain-Barre syndrome - answers✔✔which autoimmune disease typically presents 2-4 weeks
following a bacterial/viral infection such as respiratory or GI illness (ex: flu)
typical first manifestations are numbness, pain, paresthesias, or weakness in the limbs.
Paresis/paralysis may present in an ascending pattern - answers✔✔Describe the progression of
Guillain-Barre symptoms
weakness usually plateaus or improves by the 4th week in 90% of cases - answers✔✔when can
improvement be expected with Guillain-Barre
a chronic autoimmune disease that is mediated by Ach receptor antibodies that act at the
neuromuscular junction. The antibodies prevent normal reception for muscle contraction -
answers✔✔Myasthenia Gravis
-exertional fatigue and weakness that worsens with activity, improves with rest, and recurs with
resumption of activity
-a recent history of recurring upper resp tract infections
-diplopia, ptosis, and ocular palsies
-facial droop and an expressionless face; difficulty chewing and swallowing associated with
dietary changes and weight loss; drooling
-episodes of choking and aspiration - answers✔✔myasthenia gravis clinical manifestations
Graves disease is a result of autoantibodies binding to the TSH receptor sites. This leads to
hyperthyroidism - answers✔✔Graves disease
