Block 1 Unit 5 Neurological System

Question 1

What is the function of gray matter?

Answer 1

Receive, integrate, store and transmit information

Question 2

What is the outmost layer of cell bodies of neurons within the cerebral cortex?

Answer 2

Grey matter

Question 3

What is the inner most layer composed of myelinated nerve fibers calledaxons?

Answer 3

White matter

Question 4

What is the function of white matter?

Answer 4

The framework and support of the neurologic system which provides support, protection, and nourishment to the neurons

Question 5

What is the Blood Brain Barrier and it’s purpose?

Answer 5

A highly selective, semipermeable border of endothelial cells that maintain the delicate metabolic balance in the CNS.

It regulates the transport of nutrients, ions, water, and waste products through selective permeability

Question 6

What is the Vestibulo-Ocular reflex test?

Answer 6

A test that stimulates the acoustic nerve by delivering cold water into the ear canal

Question 7

What should happen during the Vestibulo-Ocular reflex test?

Answer 7

When cold water enters the ear and the inner ear hanged temperature, it should cause fast, side to side eye movement (nystagmus)

Question 8

What is the Vestibulo-Ocular reflex testing for?

Answer 8

To see if there’s damage to the acoustic nerve

Question 9

What is a abnormal Vestibulo-Ocular reflex test result?

Answer 9

No nystagmus, may point to acoustic nerve damage to the ears balance sensors and or brain damage

Question 10

What causes pinpoint/ nonreactive pupils in patients?

Answer 10

Pontine lesion, or medication such as opiates

Question 11

What causes midsize/ nonreactive pupils in patients?

Answer 11

Could be a midbrain lesion

Question 12

What causes unilateral large >6mm and or a blown pupil and is nonreactive in patients?

Answer 12

Pressure on the theoculomotor nerve on the same side as the eye

Question 13

What causes bilateral large/ nonreactive pupils in patients?

Answer 13

Brain stem lesion or herniation

Question 14

What causes oval shape pupils in patients?

Answer 14

Increased ICP (18-35mmhg)

Question 15

What causes irregular shaped pupils in patients?

Answer 15

Cataracts or trauma

Question 16

What is a intracranial pressure monitor fiber optic bolt?

Answer 16

A bolt with a Fiber optic wire is placed in the brain to measure ICP.

Question 17

Where can a intracranial pressure monitor fiber optic bolt be placed?

Answer 17

-subdural
-epidural
-intraparenchymal
-subarachnoid

Question 18

What are the disadvantages of a intracranial pressure monitor fiber optic bolt?

Answer 18

-only measures pressure
- not ttherapeutic, unable to drain CSF

Question 19

What are the advantages of a intracranial pressure monitor fiber optic bolt?

Answer 19

-no clotting or bubbles dampening waveform
-less infection risk
-only have to zero once
-less artifact

Question 20

What is CPP?

Answer 20

Central perfusion pressure, a calculation of the approximate pressure on the cerebral blood flow in the brain

Question 21

How is the CPP calculated?

Answer 21

MAP-ICP= CPP

Use to determine average pressure on the perfusion within the brain

Question 22

What is a normal ICP?

Answer 22

5-15

Question 23

What is associated with CPP < 50mmhg?

Answer 23

Impaired neuronal function

Question 24

What is associated with CPP > 150mmhg?

Answer 24

Brain edema and HTN encephalopathy

Question 25

What is it called when you have dripping of clear fluid from the nose with a patient with a basal skull fracture?

Answer 25

CSF rhinorrhea

Question 26

What is it called when you have dripping of clear fluid from the ears with a patient with a basal skull fracture?

Answer 26

Otorrhea

Question 27

What are the additional sx if specifically bacterial meningitis?

Answer 27

-Altered metal status -Fever and malaise

Question 28

Who’s most at risk for bacterial meningitis?

Answer 28

-Infants -people living in a group setting -lower immune response -travelers going into countries that have it spreading -individuals working with meningitis pathogens such as microbiologist

Question 29

You have a pt who came into the ED with a Cheif complaint of being lethargic, nausea, vomiting, photophobia, HA, and neck stiffness. What could possibly be the Dx?

Answer 29

Meningitis

Question 30

Who’s at great risk for fungal meningitis?

Answer 30

People with weakened immune systems

Question 31

Who’s at great risk for viral meningitis?

Answer 31

Children <5 and those with weakened immune systems

Question 32

What increase cerebral blood flow?

Answer 32

-Hypercapnia -Hypoxemia -Hyperthermia

Question 33

What decreases cerebral blood flow?

Answer 33

-Hypocapnia -Hyperoxemia -Increased blood viscosity Hypothermia -ICPHTN Vasopressors -Cerebral vasospasm

Question 34

What does AVPU stand for?

Answer 34

A-Alert V-Verbal response P-Pain response U-Unresponsive

Question 35

What does decorticate posturing indicates?

Answer 35

There is a lesion or brain injury in the cerebral cortex, thalamus, or midbrain

Question 36

Describe a patient that has positive decorticate posturing ?

Answer 36

The arms are turned inwards “towards the core”

Question 37

Describe a patient that has positive decerebrate posturing ?

Answer 37

The arms are rotated outward, “wings to heaven”

Question 38

What does it mean if you have a pt with a positive decerebrate posturing ?

Answer 38

Lesion of the brainstem

Question 39

What happens to the optic nerve sheath if you have increased ICP?

Answer 39

It expands

Question 40

An ONSD >5mm is suggestive of what?

Answer 40

Elevated ICP