Chapter 15
Nervous System and Behavioral
Health
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Objectives




Identify organs and structures of the nervous
system.
Define and spell the word parts related to the
nervous system
Define, pronounce and spell disease and
disorder terms related to the nervous system.
Define, pronounce and spell surgical terms
related to the nervous system.
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15-2
Function of the Nervous System


Cooperates with the endocrine system in
regulating and controlling the activities of the
other body systems
The nervous system may be divided into two
parts:

central nervous system (CNS): made up of the
brain and spinal cord
 peripheral nervous system (PNS): made up of
cranial and spinal nerves
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15-3
Nervous System
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15-4
Cranial Nerves
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15-5
Central Nervous System

brain: major portion of the central nervous
system

cerebrum: largest portion of the brain, divided into
right and left hemispheres; controls the skeletal
muscles, interprets general senses (temperature,
pain, and touch), and contains centers for sight
and hearing. Intellect, memory, and emotional
reactions also take place in the cerebrum.
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15-6
Central Nervous System (cont’d.)

brain (cont’d)


ventricles: spaces within the cerebrum that
contain a fluid called cerebrospinal fluid (CSF),
which flows through the subarachnoid space
around the brain and spinal cord
cerebral spinal fluid (CSF): clear, colorless fluid
to cushion the brain and spinal column from
shock; transports nutrients, and clears metabolic
waste
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15-7
Central Nervous System (cont’d.)

brain (cont’d)


cerebellum: often called the hindbrain, located
under the posterior portion of the cerebrum. Its
function is to assist in the coordination of skeletal
muscles and to maintain balance.
brainstem: stemlike portion of the brain; connects
with the spinal cord.
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15-8
Central Nervous System (cont’d.)

brain (cont’d)


pons: literally means “bridge.” It connects the
cerebrum with the cerebellum and brainstem.
medulla oblongata: located between pons and
spinal cord; contains centers that control
respiration, heart rate, and the muscles in the
blood vessel walls, which assist in determining
blood pressure.
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15-9
Central Nervous System (cont’d.)

spinal cord

passes through the vertebral canal extending from
the medulla oblongata to the level of the 2nd
lumbar vertebra; conducts nerve impulses to and
from the brain and initiates reflex action to sensory
information without input from the brain.
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15-10
Central Nervous System (cont’d.)

spinal cord

meninges: 3 layers of membrane that cover the
brain and spinal cord
• dura mater: tough outer layer
• arachnoid: delicate middle layer; the arachnoid
membrane is loosely attached to the pia mater by
weblike fibers, which allow for the subarachnoid space
• pia mater: thin inner layer of the meanings
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15-11
Brain and Spinal Cord
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15-12
Spinal Cord Showing
Layers of Meninges
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15-13
Peripheral Nervous System

nerve: cordlike structure that carries
impulses from one part of the body to another
12 pair of cranial nerves
31 pair of spinal nerves



ganglion: group of nerve cells located outside the
central nervous system
glia: cells that support and nourish nervous tissue
neuron: conduct nerve empulses
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15-14
Combining Forms of
the Nervous System
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
cerebell/o - cerebellum
cerebr/o – cerebrum, brain
dur/o – hard, dura mater
encephal/o - brain
gangli/o, ganglion/o ganglion
gli/o – glia, gluey
substance (neuroglia)
mening/i, meningi/o meninges
 myel/o – spinal cord
 neur/o - nerve
 radic/o, radicul/o, rhiz/o –
nerve root, proximal end
closest to the spinal cord

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15-15
Combining Forms Commonly Used
with the Nervous System
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
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

esthesi/o – sensation, sensitivity, feeling
ment/o, psych/o - mind
mon/o – one, single
phas/o - speech
poli/o – gray matter
quadr/I - four
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15-16
Suffixes
• -iatrist – specialist, physician (also –logist)
• -iatry – treatment, speciality
• -ictal – seizure, attack
• -paresis – slight paralysis (-plegia, meaning
paralysis)
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15-17
Helpful Information


The combining form myel/o is defined as
spinal cord in Chapter 15, although it also
means bone marrow, as presented in
Chapter 14.
The suffix “-paresis” means slight paralysis
while the suffix “-plegia” means paralysis.
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15-18
Clicker Question
Which of the following means slight paralysis
-paresis
b) -plegia
a)
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15-19
Disease and Disorder Terms
Built from Word Parts
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Cerebellitis – inflammation of the cerebellum
cerebral thrombosis – pertaining to the cerebrum, abnormal
condition of a clot (blood clot in the vessel of the brain)
Onset of symptoms may appear min. to days after clot
occurs ischemic stoke)
Duritis – inflammation of the dura matter
Encephalitis – inflammation of the brain
Encephalomalacia – softening of the brain
Encephalomyeloradiculitis – inflammation of the brain,
spinal cord and nerve roots.
Ganglitis – inflammation of a ganglion
Glioblastoma – tumor composed of developing glial tissue
(the most malignant and most common brain tumor)
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15-20
Disease and Disorder Terms
Built from Word Parts
glioma – tumor composed of the glial tissue (glioma is the
term now used to describe all primary neoplasms of the brain)
 meningitis – inflammation of the meninges
 meningioma – tumor of the meninges (benign and slow
growing)
 meningocele – protrusion of the meninges (through a
defect in the skull or vertebrae
 meningomyelocele – protrusion of the meninges and spinal
cord through the vertebral column (myelomeningocele)
 mononeuropathy – disease affecting a single nerve such
as carpal tunnel
 neuralgia – pain in the nerve
Neurasthenia – nerve weakness

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15-21
meningomyelocele
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15-22
Disease and Disorder Terms
Built from Word Parts (cont’d.)
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
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
Neuritis – inflammation of a nerve
Neuroarthropathy – disease of nerves and joints
Neuroma – tumor made up of nerve cells
Neuropathy – disease of the nerves (peripheral)
Poliomyelitis – inflammation of the gray matter of the spinal
cord (polio; 3 polio viruses)
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15-23
Disease and Disorder Terms
Built from Word Parts (cont’d.)

polyneuritis – inflammation of many nerves
polyneuropathy – disease of many nerves (most often occurs as a side

effect of diabetes mellitus, but may also occur as a result of drug therapy, critical illness such as sepsis, or
carcinoma; exhibiting symptoms of weakness, distal sensory loss, and burning.)
radiculitis – inflammation of the nerve roots
 radiculopathy – disease of the nerve roots
 rhizomeningomyelitis – inflammation of the nerve root,
meninges, and spinal cord
 subdural hematoma – pertaining to below the dura mater,
tumor of blood (hematoma, translated literally, means blood
tumor; however, a hematoma is a collection of blood
resulting from a broken blood vessel)

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15-24
Disease and Disorder Terms
Not Built from Word Parts

Alzheimer disease (AD) – disease characterized by early
senility, confusion, loss of recognition of persons or familiar
surroundings, restlessness, and impaired memory.

amyotrophic lateral sclerosis (ALS) – Progressive
muscle atrophy caused by hardening of nerve tissue on the lateral
columns of the spinal cord. (also called Lou Gehrig disease)

Bell palsy – paralysis of muscles on one side of the face, usually a
temporary condition. Symptoms include a sagging mouth on the
affected side and nonclosure of the eyelid.

cerebral aneurysm – aneurysm in the cerebrum
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15-25
Disease and Disorder Terms
Not Built from Word Parts

cerebral embolism – an embolus (usually a blood clot or a
piece of atherosclerotic plaque arising from a distant site

cerebral palsy (CP) – condition characterized by lack of
muscle control and partial paralysis, caused by a brain defect or lesion
present at birth or shortly after

Dementia – cognitive impairment characterized by a loss of
intellectual brain function. Patients have difficulty in various ways,
including difficulty in performing complex tasks, reasoning, learning,
and retaining new information, orientation, word finding, and behavior.
Dementia has several causes and is not considered part of normal
aging.

Epilepsy – disorder in which the main symptom is recurring
seizures.

Hydrocephalus – increased amount of cerebrospinal fluid in the
ventricles of the brain, which can cause enlargement of the cranium in
infants.
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15-26
Clicker Question
A blood clot or a piece of atherosclerotic
plaque that lodges on a cerebral artery is
called?
cerebral embolism
b) cerebral thrombosis
a)
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15-27
Bell Palsy
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15-28
Causes of Stroke
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15-29
Disease and Disorder Terms Not
Built from Word Parts (cont’d.)

Intracerebral hemorrhage - bleeding into the brain as a result
of a ruptured blood vessel within the brain. Symptoms vary depending
on the location of the hemorrhage; acute symptoms include dyspnea,
dysphagia, aphasia, diminished level of consciousness and
hemiparesis. The symptoms often develop suddenly. This is a form of
ischemic stroke and is frequently associated with high blood pressure.

multiple sclerosis (MS) - degenerative disease characterized
by sclerotic patches along the brain and spinal cord.

Parkinson disease (PD) - chronic degenerative disease of the
central nervous system. Symptoms include resting tremors or the
hands and feet, rigidity, expressionless face, and shuffling gait. It
usually occurs after the age of 50 years.
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15-30
Disease and Disorder Terms Not
Built from Word Parts (cont’d.)

Sciatica - inflammation of the sciatic nerve, causing pain that travels
from the thigh through the leg to the foot and toes; can be caused by
injury, infection, arthritis, herniated disk, or from prolonged pressure on
the nerve from sitting for long periods

Shingles - viral disease that affects the peripheral nerves and
causes blisters on the skin that follow the course of the affected nerves
(also called herpes zoster)

Stroke - occurs when there is an interruption of blood supply to a
region of the brain, depriving nerve cells in the affected area of oxygen
and nutrients. The cells cannot perform and may be damaged or die
within minutes. The parts of the body controlled by the involved cells
will experience dysfunction. Speech, movement, memory, and other
CNS functions may be affected in varying degrees. Ischemic stroke is
a result of blocked blood vessels. Hemorrhagic stroke is a result of
bleeding (also called cerebrovascular accident [CVA], or brain attack.
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15-31
Disease and Disorder Terms Not
Built from Word Parts (cont’d.)

Subarachnold hemorrhage - bleeding caused by a ruptured
blood vessel just outside the brain (usually a ruptured cerebral
aneurysm) that rapidly fills the space between the brain and skull
(subarachnoid space) with blood. The patient may experience an
intense, sudden headache accompanied by nausea, vomiting, and
neck pain (a type of hemorrhagic stroke).

transient ischemic attack (TIA) - sudden deficient supply of
blood to the brain lasting a short time. The symptoms may be similar to
hose of stroke, but with TIA the symptoms are temporary and the usual
outcome is complete recovery. TIA’s are often warning signs for
eventual occurrence of a stroke.
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15-32
Shingles
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15-33
Surgical Terms Built from Word Parts
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

Ganglionectomy – excision of a ganglion
(also called a gangliectomy)
Neurectomy – excision of a nerve
Neurolysis – separating a nerve (from adhesions)
Neuroplasty – surgical repair of a nerve
Neurorrhaphy – suture of a nerve
Neurotomy – incision into a nerve
radicotomy, rhizotomy – incision into a nerve
root
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15-34
rhizotomy or radicotomy
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15-35
Diagnostic Terms Built
from Word Parts

Diagnostic imaging


cerebral angiography – radiographic imaging of the
blood vessels in the brain(after an injection of
contrast medium)
CT myelography – process of recording (scan) the
spinal cord (after an injection of a contrast agent
into the subarachnoid space by lumbar puncture.
Size, shape, and position of the spinal cord and
nerve roots are demonstrated.
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15-36
Diagnostic Terms Built
from Word Parts

Neurodiagnostic procedures

electroencephalogram (EEG) - record of the electrical
impulses of the brain

Electroencephalograph – instrument used to record the
electrical impulses of the brain

Electroencephalography – process of recording the
electrical impulses of the brain
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15-37
Diagnostic Terms Not
Built from Word Parts

Diagnostic imaging

computed tomography of the brain (CT scan) –
process that includes the use of a computer to produce a series of
brain tissue images at any desired depth. The procedure is
noninvasive, painless, and particularly useful in diagnosing brain
tumors.

magnetic resonance imaging of the brain or spine
(MRI scan) - a noninvasive technique that produces sectional
images of soft tissues of the brain or spine through a strong
magnetic field. Unlike a CT scan, MRI produces images without
use of radiation. It is used to visualize tumors, edema, multiple
sclerosis, and herniated disks.

positron emission tomography of the brain (PET
scan)
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15-38
Diagnostic Terms Not
Built from Word Parts

Diagnostic imaging

positron emission tomography of the brain (PET
scan) - an imaging technique with a radioactive substance that
produces sectional imaging of the brain to examine blood flow and
metabolic activity. Images are projected on a viewing screen.

Neurodiagnostic procedures

evoked potential studies (EP studies) - a group of
diagnostic tests that measure changes and response in brain
waves elicited by visual, auditory, or somatosensory stimuli. Visual
evoked response (VER) is a response to visual stimuli. Auditory
evoked response (AER) is a response to auditory stimuli.
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15-39
Clicker Question
Correct labeling of the diagram is:
a) CT myelography
b) CT mylography
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15-40
Diagnostic Terms Not
Built from Word Parts (cont’d.)

Other

lumbar puncture (LP) – insertion of a needle into
the subarachnoid space usually between the third
and fourth lumbar vertebrae. It is performed for
many reasons, including the removal of
cerebrospinal fluid for diagnostic purposes (also
called a spinal tap).
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15-41
Lumbar Puncture with Needle in Place
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15-42
Complementary Terms
Built from Word Parts







Anesthesia – without (or loss of) feeling or sensation
Aphasia – condition of without speaking (loss or
impairment of the ability to speak
Cephalalgia – pain in the head (headache) also called
cephalgia
Cerebral – pertaining to the cerebrum
Craniocerebral – pertaining to the cranium and
cerebrum
Dysphasia – condition of difficulty speaking
Encephalosclerosis – hardening of the brain
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15-43
Complementary Terms
Built from Word Parts
gliocyte – glial cell
 hemiparesis – slight paralysis of half (right or left side of the
body)
 hemiplegia - paralysis of half (right or left side of the body);
stroke is the most common cause
 hyperesthesia – excessive sensitivity to stimuli
 interictal – (occurring) between seizures or attacks.
 intracerebral – pertaining to within the cerebrum

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15-44
Complementary Terms
Built from Word Parts (con’t)







Monoparesis – slight paralysis of one limb
Monoplegia – paralysis of one limb
Myelomalacia – softening of the spinal cord
Neuroid – resembling an nerve
Neurologist – physician who studies and treats
diseases of the nerves
Neurology – study of nerves (branch of medicine
dealing with diseases of the nervous system)
Paresthesia – abnormal sensation (such as burning,
pricking, or tingling sensation, often in the
extremities; may be caused by nerve damage or
peripheral neuropathy)
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15-45
Complementary Terms
Built from Word Parts (con’t)




Panplegia – total paralysis (also spelled pamplegia)
Postictal – (occurring) after a seizure or attack
Quadriplegia – paralysis of four (limbs)
Subdural – pertaining to below the dura mater
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15-46
Complementary Terms
Not Built from Word Parts









Afferent – conveying toward a center (nerves carrying impulses to the
central nervous system
Ataxia – lack of muscle coordination
Cognitive – pertaining to the mental process of comprehension,
judgment, memory, and reason
Coma – state of profound unconsciousness
Concussion – jarring or shaking that results in an injury. Caused by
slight or severe head injury. Symptoms include vertigo, headache, and
loss of consciousness.
Conscious – awake, alert, aware of one’s surroundings
Convulsion – sudden, involuntary contraction of a group of muscles.
(synonymous with seizure)
Disorientation – a state of mental confusion as to time, place or identity
Dysarthria – the inability to use speech that is distinct and connected
because of a loss of muscle control after damage to the peripheral or
central nervous system.
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15-47
Complementary Terms
Not Built from Word Parts
efferent – conveying away from the center (carrying information
away from the central nervous system)
 gait – a manner or style of walking
 incoherent – unable to express one’s thoughts or ideas in an
orderly, intelligible manner
 paraplegia – paralysis from the waist down caused by damage to
the lower level of the spinal cord
 seizure – sudden attack with an involuntary series of contractions
(synonymous with convulsion)
 shunt – tube implanted in the body to redirect the flow of a fluid
 syncope – fainting or sudden loss of consciousness caused by
lack of blood supply to the cerebrum
 unconsciousness – state of being unaware of surrounding and
incapable of responding to stimuli as a result of injury, shock or
illness

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15-48
1. Hemiplegia.
2. Paraplegia.
3. Quadriplegia.
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15-49
Behavioral Health Terms
Built from Word Parts








Psychiatrist – physician who studies and treats disease of the
mind
Psychiatry – specialty of the mind (treatment of mental disorders
Psychogenic – originating in the mind
Psychologist – specialist of the mind
Psychology – study of the mind (deals with the mind and mental
processes in relation to human behavior
Psychopathy – any disease of the mind
Psychosis – abnormal condition of the mind (major mental
disorder characterized by extreme derangement, often with
delusions and hallucinations
Psychosomatic – pertaining to the mind and body (interrelations
of)
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15-50
Behavioral Health Terms
Not Built from Word Parts




anorexia nervosa – an eating disorder characterized by a disturbed
perception of body image resulting in failure to maintain body
weight, intensive fear of gaining weight, pronounced desire for
thinness, and, in females, amenorrhea
anxiety disorder – an emotional disorder characterized by feelings
of apprehension, tension, or uneasiness arising typically from the
anticipation of unreal or imagined danger
attention deficit hyperactivity disorder (ADHD) – a disorder of
learning and behavioral problems characterized by marked
inattention, distractibility, impulsiveness, and hyperactivity.
Autism – a mental disorder, the features of which include onset
during infancy or childhood, preoccupation with subjective mental
activity, inability to interact socially, impaired communication, and
repetitive body movements.
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15-51
Behavioral Health Terms
Not Built from Word Parts




bipolar disorder – a major psychological disorder typified by a disturbance
in mood. The disorder is manifested by manic and depressive episodes
that may alternate or elements of both may occur simultaneously.
bulimia nervosa – an eating disorder characterized by uncontrolled binge
eating followed by purging (induced vomiting).
major depression – a mood disturbance characterized by feelings of
sadness, despair, discouragement, hopelessness, lack of joy, altered
sleep patterns, and difficulty with decision making and daily function.
Depression range from normal feelings of sadness (resulting from and
proportional to personal loss or tragedy), through dysthymia (chronic
depressive neurosis), to major depression (clinical depression, mood
disorder.)
obsessive-compulsive disorder (OCD) – a disorder characterized by
intrusive, unwanted thoughts that result in the tendency to perform
repetitive acts or rituals(compulsions), usually as a means of releasing
tension or anxiety.
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15-52
Behavioral Health Terms
Not Built from Word Parts
panic attack – an episode of sudden onset of acute anxiety,
occurring unpredictably, with feelings of acute apprehension,
dyspnea, dizziness, sweating, and/or chest pain,
depersonalization, paresthesia and fear of dying, loss of mind or
control.
 phobia – a marked and persistent fear that is excessive or
unreasonable cued by the presence or anticipation of a specific
situation or object.
 pica – compulsive eating of nonnutritive substance such as
clay or ice. This condition is often the result of an iron
deficiency. When iron deficiency is the cause if pica the
condition will disappear in 1 or 2 weeks when treated with iron
therapy.

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15-53
Behavioral Health Terms
Not Built from Word Parts
posttraumatic stress disorder – a disorder characterized by
an acute emotional response to a traumatic event perceived as
life threatening or severe emotional stress such as an airplane
crash, repeated physical or emotional trauma, or military
combat. Symptoms include anxiety, sleep disturbance,
nightmares, difficulty concentrating, and depression.
 schizophrenia – any one of a large group of psychotic
disorders characterized by gross distortions of reality,
disturbance of language and communication, withdrawal from
social interaction, and the disorganization and fragmentation of
thought, perception, and emotional reaction.
 somatoform disorders – disorders characterized by physical
symptoms for which no known physical cause exists.

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15-54
Abbreviations








AD – Alzheimer disease
ADHD – attention deficit
hyperactivity disorder
ALS – amyotrophic lateral
sclerosis
CP – cerebral palsy
CSF – cerebrospinal fluid
CVA – cerebrovascular
accident
EEG - electroencephalogram
EP studies – evoked
potential studies
LP – lumbar puncture
 MRI scan – magnetic
resonance imaging scan
 OCD – obsessive-compulsive
disorder
 PD – Parkinson disease
 PET scan – positron emission
tomography scan
 PNS – peripheral nervous
system
 PTSD – posttraumatic stress
disorder
 TIA – transient ischemic attack

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15-55
Clicker Question
PTSD is the abbreviation for
posttraumatic schizophrenia disease
b) posttraumatic stress disorder
a)
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A 78-year-old right-handed man presented to the
Emergency Department with a right hemiparesis,
expressive aphasia, and no apparent cognitive decline.
He has a history of hypertension and 2 years ago had a
transient ischemic attack. A computed tomography scan
of the brain was negative for an intracerebral
hemorrhage. A neurologist was consulted. She
confirmed the diagnosis of a ischemic stroke after
magnetic resonance imaging of the brain demonstrated
an ischemic area of the left cerebral cortex caused by a
cerebral embolism.
Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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