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Sinclair Paramedic 2150 > 9- Neurology > Flashcards

9- Neurology Flashcards

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1
Q

Add types of

A

Seizures

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2
Q

CNS

A 
Central nervous system, responsible for:
Thought
Perception
Feeling
Autonomic body functions
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3
Q

PNS

A

Peripheral nervous system, responsible for:

Transmitting commands from brain to body and receiving feedback from the body

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4
Q

What are the parts of the brain (7)

“Oh please to find like that helps”

A 
Occipital lobe
Parietal lobe
Temporal lobe
Frontal lobe
Limbic system
Thalamus (Diencephalon)
Hypothalamus (Diencephalon)
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5
Q

What are the parts of the Brain Stem

A

Mid brain
Pons
Medulla Oblongata

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6
Q

What are the parts of the PNS

A

Cranial nerves

Peripheral nerves

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7
Q

Parts of a neuron (5)

A 
Cell body
Axon
Dendrite
Synapse
Neurotransmitter
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8
Q

Occipital lobe role

A

-Vision and storage of visual memories

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9
Q

Parietal lobe role

A
  • Touch and texture

- Storage of tactile memories

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10
Q

Temporal lobe role

A
  • Hearing and smell
  • Language
  • Storage fo sound and odor memories
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11
Q

Frontal lobe role

A
  • Motor cortex- Voluntary muscle control, storage fo spatial memories
  • Prefrontal cortex- Judgement and prediction of consequences, abstract intellectual functions
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12
Q

Limbic System role

A
  • Basic emotion

- Basic reflexes (chewing, swallowing)

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13
Q

Thalamus (Diencephalon) role

A

-Prioritize signals to hone in on important messages

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14
Q

Hypothalamus (Diencephalon) role

A
  • Emotions
  • Temperature control
  • Interface with endocrine system
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15
Q

Midbrain role

A
  • LOC
  • Home of reticular activating system (RAS), which controls arousal and consciousness
  • Muscle tone and posture
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16
Q

Pons role

A

-Respiratory pattern and depth

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17
Q

Medulla oblongata role

A
  • Pulse rate and BP

- Respiratory rate

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18
Q

Spinal cord role

A
  • Reflexes

- Relay info to and from body

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19
Q

Cranial nerves role

A

-Special peripheral nerves that connect directly from brain to body parts, send information to the brain

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20
Q

Peripheral nerves role

A

-Receive stimulus to body, send commands to body

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21
Q

Neuron cell body role

A

Home to nucleus and site of protein synthesis

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22
Q

Axon role

A

Projection from cell body to other neurons or organs and sends messages

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23
Q

Dendrite role

A

Projection from cell body that receives signals from axons

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24
Q

Synapse

A

Gap between an axon and dendrite

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25
Q

Neurotransmitter role

A

Chemical released by synapse that helps make the connection between one neuron and another

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26
Q

Decorticating posturing

Effected part

A

Abnormal flexion, armors contracted towards chest

-Maybe damage to area directly below cerebral hemispheres

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27
Q

Decerebrate posturing

Effected part

A

Abnormal extension, arms extended outward, palms probated, wrists flexed

Damage is near the brainstem

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28
Q

What cranial nerves are responsible for airway control

A

Trigeminal
Glossopharyngeal
Vagus
Hypoglossal

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29
Q

What is trismus

A

Tightly clenched teeth

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30
Q

Myelin is what color; white or grey?

A

WHITE

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31
Q

What do unmyelinated axons control

A

Gross motor function

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32
Q

What do myelinated axons control and another name for them

A

Fine motor skills

Schwann cells

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33
Q

Nodes of Ranvier

A

Allow impulse to jump from node to node for more rapid conduction

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34
Q

What is the pre synaptic neuron

A

The end of one neuron

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35
Q

What is the post synaptic neuron

A

The beginning of a neuron

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36
Q

Reflex process

A
  • Initiate in PNS
  • Synapse with Interneurons in CNS
  • Interneurons synapse with motor neurons
  • Motor neurons send out axons
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37
Q

What provides blood to the brain

A

2 carotid arteries, 80% of blood to brain

2 vertebral arteries, for basilar artery

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38
Q

Circle of Willis

A

Encircles pituitary

-A back up if carotids are blocked

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39
Q

Cerebrum and its role

A

Largest portion of brain, has left and right hemispheres

Thought, personality, mood, memory, intelligence

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40
Q

Cerebellum and its role

A

In posterior fossa of cranium, closely related to brain stem and higher brain centers

Spatial coordination, fine motor movement, muscle tone

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41
Q

How to measure CPP

A

CPP = MAP - ICP

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42
Q

Normal CPP range

A

50-160 mmHg

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43
Q

Critical CPP range

A

Below 40

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44
Q

Unconscious patient means what

A

Provide an airway

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45
Q

What does Cushings triad identify and the signs of it

A

Early stages of increased ICP

Increased systolic pressure
Widening pulse pressure
BradyC
Abnormal respirations

46
Q

Hyperpnea and causes

A

Rapid, regular, deep respirations

Causes- Stimulants, OD, exercise

47
Q

Cheyne-Stokes and causes

A

Crescendo, decrescendo with apnea

Causes- Brain stem injury, pre death pattern

48
Q

Biots/Ataxic and causes

A

Irregular with periods of apnea

Causes- Brain stem injury

49
Q

What are hallmark signs of ICP

A 
Cushing reflex
Posturing
Biots
Apneustic
Cheyne-Stokes
Unresponsive with dilated pupils or anisocoria
50
Q

Unreactive dilated pupils indicate what

A

Brain stem injury

51
Q

What should be considered if pupils are constricted

A

Narcotic overdose

52
Q

What does anisocoria indicate

A

Increased ICP

53
Q

What is a conjugate gaze

A

Deviation of both eyes in the same directions

54
Q

What is dysconjugate gaze

A

Deviation of eyes to opposite directions, brain stem conduction problem

55
Q

What are the causes of Coma (AEIOUTIPS)

A 
Alcohol/acidosis
Epilepsy
Infection
Overdose
Uremia
Trauma
Insulin
Psychosis
Stroke
56
Q

What is a structural coma

-Causes

A

Focal (asymmetrical) signs
Rapid onset
Unresponsive pupils

  • Trauma
  • Intracranial bleed
  • Tumor
57
Q

Toxic metabolic coma

-Causes

A

Symmetrical signs, slow onset, present pupil response

Causes- Hypo/Hyperglycemia, Kidney/Liver failure, Postictal, anoxia

58
Q

Coma management

A

ABC’s
No gag reflex = Intubate
BGL
Narcan

59
Q

Ischemic stroke

A

From atherosclerosis or tumor, block blood flow to the brain

Develops slowly

60
Q

Hemorrhagic stroke

A

From aneurysm, HTN, bleeding within the brain

Develops quickly and will get worse

61
Q

Transient Ischemic Attack (TIA)

A

Last minutes to hours
Mini strokes
Same S/S as ischemic strokes, may improve though

62
Q

Stroke S/S

A
  • Unilateral weakness/paralysis of face, opposite side extremity
  • Abnormal speech
  • Headache
  • Drooling
  • Numbness of face

Can cause seizures

63
Q

Cincinnati Stroke scale components

A

Facial droop
Arm drift
Speech

64
Q

Stroke management

A
  • ABC’s
  • Head elevated 15 degrees
  • BGL and vitals
  • Fluid only if hypotensive
65
Q

Seizure triggers

A
  • Specific time of day
  • Sleep deprivation
  • Fever or illness
  • Flashing lights
  • Drugs/Alcohol
  • Stress
  • Menstrual cycle
  • HypoGlycemia
  • Specific foods
66
Q

Focal seizure

A

Begins on one side of brain

67
Q

Generalized seizure

A

Both sides of the brain

68
Q

Motor seizure

A

Change in muscle activity

  • Clonic = Jerking
  • Tonic = Stiffness
  • Loss of muscle tone = Atonic
  • Automatism = Repetitive movement
69
Q

Non-motor seizure

A
  • Vitals change
  • Behavior change
  • Cognitive change
  • Emotional change
  • Sensory change
70
Q

Focal onset seizure

Awareness vs Impaired awareness

A

Awareness- Most common, usually <2min
-At risk for head injury, brain infection, stroke, brain tumor

Impaired awareness- Pt unaware, aura before, includes automatisms, usually 1-2 minutes
-Same risks as awareness

71
Q

Focal to Bilat Tonic Clonic

A
  • Starts in one area on one side, then both sides
  • Sometimes dont remember beginning of seizure
  • Focal <1 min
  • Tonic-clonic 2 to 3 min, but rare
72
Q

Myoclonic seizure

A

Shock like jerking

73
Q

Gelastic seizure

A

Imitates laughter

74
Q

Dacrrtystic seizure

A

Imitates crying

75
Q

Refractory seizure

A

Frequency and severity interrupts quality of life

  • Different seizure types throughout the day
  • Chronic problem
76
Q

Tonic-Clonic seizures (Grand Mal) steps

A
  1. Loss of consciousness
  2. Tonic phase: Rigid
  3. Hypertonic: Ached back, rigid
  4. Clonic phase: Vfib in the brain
  5. Post seizure, muscles relax, nystagmus
  6. Postictal
77
Q

Signs of Postictal phase

A
  • Initially aphasic (unable to speak)
  • Confused
  • Emotional
  • Tired
  • Headache
  • Gradual return to normal
78
Q

Psuedoseizures

-Explain

A

The same as Tonic Clonic seizures however the root is psychogenic, most cases it is unintentional
-Usually display with “organized” movement

79
Q

Absence seizures (Petit mal seizures)

A

Stops all activity and freezes up, last no more than several seconds, no postictal period, typically in children

80
Q

Partial seizure

A
  • Effect limited portion of the brain, can effect one part then spread
  • Considered simple partial or complex partial
81
Q

What is Jacksonian march

A

Seizure begins in one area (hand) and moves to the next (arm) then next (shoulder) and continues

82
Q

Seizure management steps

A
  1. Determine concern for trauma, inline stabilization if suspect
  2. History
  3. Do not restrain or prevent movement, dont place anything in patients mouth
  4. Provide ventilation for >30 sec apnea
  5. Place padding on cot to prevent injury
83
Q

Status epilepticus

-The goal

A

Seizure lasting more than 4-5 min or consecutive seizures without regaining consciousness in between

  • It IS life threatening
  • Can damage or kill neurons

-Stop the seizure and ensure ABC’s

84
Q

Status epilepticus Treatment

A

Benzos
Airway
Sedate and paralyze for airway ONLY if needed

85
Q

Seizures Physical exam (9)

A
  • Head/neck/tongue trauma
  • Swelling of gums (Chronic Dilantin therapy)
  • Amnesia
  • Pupils and cranial nerves intact
  • Motor/Sensory coordination
  • HypoT or Hypoxia
  • Incontinence
  • Automatisms
  • Dysrhythmias
86
Q

Syncope

S/S

A

Sudden/temporary loss of consciousness with accompanying loss of postural tone, possibly from life threatening dysrhythmia, stroke
-Typically a result of loss of blood flow to the brain

S/S- Warning of lightheaded, brief LOC, short focal Clonic phase, BradyC

87
Q

ALS seizure management

A
  • ABC’s
  • Meds
    • Diazepam (Valium) 5-10 mg
    • Midazolam (Versed) 1-2.5 mg
    • Lorazepam (Ativan) .5-2 mg
  • BGL
  • Constant reevaluation
88
Q

Common home seizure meds

A 
Phenytoin
Valproic acid
Clonazepam
Gabapentin
Phenobarbital
89
Q

What is the Brachial plexus

A

A network of nerves located in the posterior neck

90
Q

What parts make up the diencephalon

A

Thalamus, Hypothalamus, limbic system

91
Q

Types of headaches (4)

A

Tension
Migraine
Cluster
Sinus

92
Q

Tension Headache

  • Cause
  • S/S
  • Treatment
A

From muscle contractions of face, neck and/or scalp
-Stress, noise, eye strain, poor posture

S/S- Dull, persistent, non-throbbing

Treatment- ASA, Acetaminophen, Ibuprofen

93
Q

Migraine headache

  • Cause
  • S/S
  • Treatment
A

Causes by dilation and constriction of blood vessels in brain from hormone imbalance, caffeine, altitude changes, various foods

S/S- Intense throbbing on 1 side, nausea, vomiting, visual disturbance, photophobia

Treatment- Phenergan (Promethazine)
    -Class: Antihistamine
    -Dose: 12.5-25 mg IV/IM
    -SFx: Fluctuations in BP and HR
   -Note: Solid IV line needed to avoid arterial occlusion
                    Ondansetron (Zofran)
   -Class: Antihistamine
   -Dose: 4 mg
94
Q

Cluster headache

  • Causes
  • S/S
  • Treatment
A

Burst headaches that are severe and usually accompanied by severe pain around one eye, 30 min to 2 hrs

Causes- Histamine release

S/S- Uniorbital pain, tearing, nasal congestion

Treatment- Antihistamines, Corticos, Ca channel blockers

95
Q

Sinus headaches

  • Causes
  • Treatment
A

Pressure behind face with pain in forehead, nose and eyes

Causes- Infections of sinuses

Treatment- Analgesics, antihistamines, antibiotics

96
Q

“Thunder clap” Headache

A

Sudden intracerebral hemorrhage; CVA. Report worst headache of life followed by rapid deterioration

97
Q

Brain Tumor (Neoplasm)

A

Mass in the cranial vault and can cause compression of the brain

Treatment- Analgesics for pain and benzos for seizures

98
Q

Brain abscess

-S/S

A

Accumulation of puss in the brain from bacterial infection

S/S- Headache, fever, nausea/vomiting, seizures, ALOC

99
Q

11 degenerative diseases

A
  • Muscular dystrophy
  • Multiple sclerosis
  • Dystonia
  • Parkinson’s disease
  • Central Pain syndrome
  • Bell’s palsy
  • Amyotrophic Lateral sclerosis (ALS)
  • Peripheral neuropathy
  • Myoclonus
  • Spina Bifida
  • Polio
100
Q

Muscular Dystrophy
S/S
Treatment

A

Inherited muscular disorder where muscle of the body degenerate

S/S- Waddle gait, bulky calves, progressive weakness, unable to eventually walk, usually dead before 20

Treatment- Supportive

101
Q

Multiple Sclerosis

A

Autonomic condition where myelin of of brain and spinal cord are destroyed by the body, not fatal

S/S- Numbness, weakness, paralysis, slurred speech, visual changes, unstable gait, vertigo

Treatment- Mainly supportive

102
Q

Dystonia
S/S
Treatment

A

Localized alterations in muscle tone creating spasms, fixed postures and strange movement. Can result from stroke, Parkinson’s, schizophrenia

S/S- Listed above

Treatment- Mainly supportive, Benadryl 25mg IV can help with spasms

103
Q

Parkinson’s disease
S/S
Treatment

A

Decrease in dopamine, which helps muscles move smooth, from damage to ganglia nerve cells
-Progressive disease

S/S- (Postural instability, Tremor, Rigidity, Bradykinesia) Numbness, weakness, paralysis, visual changes, unstable gait, tremors, vertigo, rigid walking

Treatment- Mainly supportive

104
Q

Central pain syndronme
S/S
Treatment

A

Infection or damage to Trigeminal nerve (V)

S/S- Severe pain (electrical shocks) and painful twitch to face, lips, cheek, gums on one side

Treatment- Mainly supportive

105
Q

Bells Palsy
S/S
Treatment

A

Paralysis of face due to inflammation of the facial nerve (VII)

S/S- Eyelid, corner of mouth droop, possible numbness. S/S only in face

Treatment- Supportive

106
Q

Amyotrophic Lateral Sclerosis (ALS)
S/S
Treatment

A

Very fatal degenerative disease of voluntary muscle neurons

S/S-Progressive weakness arms and legs, eventually swallowing and respiratory problems, peripheral to medial

Treatment- Supportive

107
Q

Peripheral Neuropathy
S/S
Treatment

A

Group of conditions damaging peripheral nerves of the body

  • Mononeuropathy, Single nerve damage-Trauma, infection
  • Polyneuropathy, Multiple nerves damaged-Diabetes, GBS

S/S-Sensory/Motor impairment, numbness, burning, pain, muscle weakness

Treatment- Supportive

108
Q

Spina Bifida
S/S
Treatment

A

Congenital defect where one part of vertebra does not form, allowing spinal cord to be exposed

S/S- Can develop small pouch on the back, S/S vary

Treatment- Supportive

109
Q

Polio
S/S
Treatment

A

Infection that attacks the bodies nervous system, through feces

S/S-Mild infection to respiratory arrest, weakness, pain, muscle spasms, paralysis, inability to swallow

Treatment-Ensure patent airway

110
Q

Myasthenia Gravis

S/S

A

Autoimmune disease, resulting in chronic muscle weakness and neurotransmitters dont work

S/S-Look like death, double vision, facial muscle problems

111
Q

Guillain-Barré syndrome
S/S
Treatment

A

Immune system attacks portions of the nervous system resulting in nerve inflammation with progressive weakness and paralysis moving towards core of body

S/S- Recent infection, rapid progression of paralysis/tingling/numbness, toe to head paralysis pattern

Treatment- Supportive, ventilation if needed

Sinclair Paramedic 2150 (16 decks)

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