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238 Neuro Flashcards

1
Q

What is a myelography?

A

Test to see the subaranchnoid space, spinal cord, and vertebrae after injection of dye by LP

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2
Q

What is a contraindication to LP?

A

Increased ICP

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3
Q

What is specific of “neurogenic” or “central” DI?

A

It is caused by a lesion in the brain; it is the most common type

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4
Q

What is specific about “primary” DI?

A

It’s also called “psychogenic”, because it is caused by excessive water intake. Could be caused by a structural lesion in the thirst center or psych issues

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5
Q

What is “nephrogenic” DI?

A

It is when there is enough ADH in circulation, but decreased kidney response

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6
Q

What is one of the most common causes of Nephrogenic DI?

A

Lithium

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7
Q

How is central DI treated?

A

Desmopressin acetate is drug of choice; some form of vasopressin is used to replace missing ADH

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8
Q

How is Nephrogenic DI treated?

A

Low sodium diet and thiazide diuretics

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9
Q

What would be the clinical presentation of a patient with SIADH?

A

Hypobatremia; muscle cramping, weakness, dyspnea on exertion. As it get more severe: vomiting, abdominal cramps, muscle twitching and seizures

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10
Q

What is the treatment for SIADH?

A

Fluid restriction, duiretics (Lasix) and hypertonic saline.

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11
Q

What is Declomycin given for?

A

Treatment of SIADH; blocks the effects of ADH on the renal tubules (allowing a more dilute urine)

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12
Q

What is Samsca and Vaprisol given for?

A

They are vasopressin receptor antagonists (lessen the effect of AHD on the kidneys)

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13
Q

What disease results from a decrease in Acetylcholine-secreting neurons?

A

Alzheimer’s

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14
Q

What disease results from a reduction in acetylcholine receptors?

A

Myasthenia Gravis

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15
Q

What disease is due to destruction of dopamine-secreting neurons?

A

Parkinson’s

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16
Q

What does dopamine control?

A

Emotions, moods and regulation of motor control

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17
Q

What does Serotonin control?

A

Moods, emotions and sleep

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18
Q

What is normal ICP?

A

5-15

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19
Q

What is the brain’s use of glucose and oxygen?

A

20% of oxygen and 25% of glucose

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20
Q

What is normal CPP (cerebral perfusion pressure)?

A

60-100

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21
Q

What CPP indicates cerebral ischemia?

A

<50

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22
Q

What GCS score indicates a coma?

A

<8

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23
Q

What CSF lab value indicates infection?

A

> 5

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24
Q

The myelin sheath of CNS nerve fibers are composed of what?

A

Oligodendrocytes

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25
Q

The extrapyramidal carries impulses concerned with what?

A

Voluntary movement

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26
Q

What is the earliest sign of increased ICP?

A

Altered LOC

27
Q

What is Cushing’s Triad?

A

Increasing systolic BP (with widening pulse pressure), bradycardia and irregular breathing

28
Q

What is normal ICP?

A

5-15

29
Q

What is normal CPP?

A

60-100

30
Q

What CPP indicates ischemia?

A

<50

31
Q

How is CPP calculated?

A

CPP= MAP - ICP

32
Q

How can MAP be calculated?

A

MAP = SBP + 2(DBP) divided by 3

33
Q

What is Trigeminal Neuralgia?

A

Recurrent episodes of sharp, stabbing pain that last seconds to 2-3 minutes

34
Q

What is the etiology of TN?

A

It is not fully understood

35
Q

What are risk factors for TN?

A

MS, HTN, herpesvirus, tooth/jaw infection and brainstem infarct

36
Q

What drugs are “1st line therapy” for TN?

A

Tegretol and Trileptal

37
Q

What is the “cardinal sign” of Bell’s Palsy?

A

An eye that will not blink

38
Q

What is meant by the “primary” spinal cord injury?

A

The initial injury to the spinal cory

39
Q

What is meant by the “secondary” spinal cord injury?

A

Ongoing progressive injury that occurs after the initial injury

40
Q

What is “spinal shock”?

A

Decreased reflexes, loss of sensation and flaccid paralysis below the level of spinal injury

41
Q

What is “neurogenic shock” (as contrasted with spinal shock)?

A

Loss of vasomotor tone – characterized by hypotension and bradycardia

42
Q

How are spinal cord injuries classified?

A

By:

  • Mechanism of injury
  • Level of injury
  • Degree of injury
43
Q

What is tetrapelgia?

A

Injury is T1 or above; all 4 extremities involved

44
Q

What is Paraplegia?

A

Injury is below T1; lower extremities affected

45
Q

Cervical injury above C4 means that what is required?

A

Mechanical ventilation

46
Q

Cervical injury below C4 results in what type of breathing?

A

Diaphragmatic with hypoventilation because of use of intercostals

47
Q

What difficulties will a patient with an injury below C4 have?

A

Ineffective or absent cough; artificial airway possibly leading to atelectasis and/or pneumonia (bronchial and oral hygiene is very important)

48
Q

Spinal cord injury above which level reduces the sympathetic nervous system and causes bradycardia?

A

T6

49
Q

What is the drug of choice to increase HR in a pt with injury above T6?

A

Atropine

50
Q

Pt may have paralytic ileus and gastric distention after a cord injury at what level?

A

Above T5

51
Q

Excessive HCL in the stomach puts a pt at risk for what?

A

Stress ulcers

52
Q

What meds would a pt be given to reduce risk of stress ulcers?

A

H2 receptor blockers (Zantac, Pepcid) and Proton Pump Inhibitors (Protonix, Prevacid and Prilosec)

53
Q

Neurogenic bowel occurs when spinal shock or injury is at what level?

A

T12 or below

54
Q

What is Pikilothermism?

A

Adjustment of body temperature to room temperature

55
Q

Tetanus causes what type of muscle response?

A

Spacicity

56
Q

What is trismus?

A

“lockjaw”; spasms and stiffness of jaw

57
Q

How often do adults need the Tetanus/diptheria toxoid booster?

A

Every 10 years

58
Q

If you have an injury, you will be reimmunized if you haven’t had a booster in how many years?

A

5

59
Q

NG suctioning may lead to what state?

A

Metabolic Alkalosis

60
Q

Decreased tissue perfusion may lead to what state?

A

Acidosis

61
Q

Autonomic dysreflexia only occurs with injuries above?

A

T6

62
Q

What triggers autonomic dysreflexia?

A

Irritation, or discomfort; most common cause is distended bladder or bowel

63
Q

What are manifestations of Autonomic Dysreflexia?

A

Hypertension, Blurred vision, throbbing headache, marked diaphoresis, flushing of skin above injury, nasal congestion, anxiety, nausea and hair standing on end

64
Q

What are nursing interventions for autonomic dysreflexia?

A

Elevate HOB, notify MD, assess cause, loosen tight clothing, monitor VS q15, assess for bladder distention and cath if distended

Neuro (7 decks)

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