Edema begins in the area of injury and spreads with

edema begins in the area of injury and spreads with fluid accumulation in the white matter.
70.Explain posturing: decorticate, decerebrate, spastic. Pg. 509 Table 17.6; 532
Decorticate : upper extremity flexion, lower extremity extension. Flexion of the arm, wrist, and fingers
with abduction in the upper extremity and extension, internal rotation, and plantar flexion of the lower
extremity.
Decerebrate : upper and lower extremity extensor responses. Opisthotonos (hyperextension of the
vertebral column) with clenching of the teeth; extension, abduction, and hyperpronation of the arms;
and extension of the lower extremities. In acute brain injury, shivering and hyperpnea may accompany
unelicited recurrent decerebrate spasms.
Spastic : Hyperexcitability of the stretch reflexes and is associated with damage to the motor, premotor,
and supplementary motor areas, as well as lateral corticospinal tract damage. Accompanied by
increased deep tendon reflexes and the spread of reflexes (clonus).
71.Explain the process of spinal shock. Pg. 538 72. Who is at risk for development of delirium? Pg. 517-518; Table 17.12
Older individuals
73.What is a contrecoup injury? What is a coup injury? Pg. 552
Relating to contusions or brain bruising from blood leaking from an injured vessel. The injury may be
coup (injury at site of impact) or contrecoup (injury from the brain rebounding and hitting the opposite
side of skull) or both. The severity of contusion varies with the amount of energy transmitted by the skull
to underlying brain tissue.

74.When does autonomic hyperreflexia occur? Pg. 559
75.What are the risk factors for CVA? Pg. 565-566
-Poorly or uncontrolled arterial hypertension
-smoking, which increases the risk of stroke by 50%
-insulin resistance and diabetes mellitus
-polycythemia and thrombocythemia
-high total cholesterol or low high-density lipoprotein (HDL) cholesterol
-elevated lipoprotein-a
-congestive heart disease and peripheral vascular disease
-hyper-homocysteinemia
-atrial fibrillation
-physical inactivity
-family history and genetics
-sleep apnea
-chlamydia pneumoniae infection
-sickle cell disease
-postmenopausal hormone therapy
-obesity
-depression
-high sodium intake, >2300mg; low potassium intake, <4700mg.
76.Herniation of which disk will likely result in sensory and motor changes of the lateral lower legs and
77.Explain multiple sclerosis. Pg. 581