If the patient's dorsal columns are not functioning, the nurse ...

[james0929]

If the patient's dorsal columns are not functioning, the nurse will observe which of the following responses during neurotesting,
 
  where the nurse asks the patient to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points?
  A)
  Grimacing when body touched with sharp points
  B)
  No response to two-point discrimination
  C)
  Heightened proprioceptive response
  D)
  Inability to identify which way his finger was moved during the test

Question 2

Which of the following diagnostic findings is likely to result in the most serious brain insult?
 
  A)
  Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
  B)
  Moderate decrease in brain tissue volume secondary to a brain tumor removal
  C)
  Increased ICP accompanied by hyperventilation
  D)
  High intracellular concentration of glutamate

[joanwhite]

Answer to Question 1

Ans:
B

Feedback:

When comparing the discriminative dorsal column-medial lemniscus pathway with anterolateral tactile pathways with testing (with eyes closed), gently brush the skin with cotton, touch an area with one or two sharp points, touch corresponding parts of the body on each side simultaneously or in random sequence, and passively bend the person's finger one way and then another. If dorsal columns are not functioning, the tactile threshold two-point discrimination and proprioception are missing, and the person has difficulty discriminating which side of the body received stimulation.

Answer to Question 2

Ans:
A

Feedback:

When the pressure in the cranial cavity approaches or exceeds the MAP, tissue perfusion becomes inadequate; cellular hypoxia results; and neuronal death may occur. Displacement of CSF and blood can partially compensate for decreased brain tissue volume. Hyperventilation partially mitigates, rather than exacerbates, increase in ICP. Glutamate is normally in far higher concentrations intracellularly than extracellularly.