CCP 214 - Neurological Emergencies Flashcards
What is the primary function of the thalami?
Transmission of impulses to and from the cerebrum.
What is the role of the basal ganglia?
Controls fluidity of movement. Injury to the basal ganglia (such as in Parkinson’s) results in rigid movement.
The frontal lobe is responsible for:
Behaviour and executive function.
The occipital lobe is responsible for:
Vision.
The temporal lobe is responsible for:
Memory.
The parietal lobe is responsible for:
Sensation, movement, and speech.
The brainstem houses ___ of the 12 cranial nerves.
10.
CN III is located in the ___.
Midbrain.
CN III is assessed by performing:
Pupil assessment.
CN V & VII are located in the ___.
Pons.
CN V & VII are assessed by performing:
Corneal reflex.
Pons injury can result in:
Abnormal pupil function, and abnormal pupil shape.
CN IX and X are located in ___.
The medulla.
Medullary function is assessed by assessing:
CN IX and X; which includes gag and cough.
How does TBI affect cerebral auto regulation?
TBI narrows the zone of auto regulation.
The RAS is located in ___.
The midbrain.
The respiratory centre is located in ___.
The medulla.
Brain stem exam contains these four components:
1) CN III (Midbrain)
2) CN V and VII (Pons)
3) CN IX and X (Medulla)
4) Respiratory centre (low medulla)
Respiratory centre assessment is performed by:
Assessing patients ability to breath independently (ie. breath over the vent setting).
The cerebral peduncles can be described as:
Structures at the front of the pons that contain large ascending and descending nerve tracts that from the cerebrum to the pons.
Uncal herniation produces:
Ipsilateral pupil dilation, but contralateral hemiparesis.
Uncal herniation can also be called:
Transtentorial herniation.
T or F:
Uncal herniation is often unilateral.
False.
What is the tentorium?
A fibrous layer separating the superior and inferior brain.
Cerebellar stroke shouldn’t be sedated unless necessary, why?
Constant assessment of motor ability and respiratory function needs to occur. Cerebellar herniation produces apnea before midbrain injury occurs (because of the caudal movement of cerebellar herniation).
Describe the three variations of muscle tone:
1) Flaccid
2) Rigid (ie. arm won’t straighten)
3) Spasticity (ie. arm initially tenses, but eventually straightens and relaxes)
Plantar reflex indicates:
Unspecific neurological issue.
Describe the approach to a neurological assessment:
1) Brainstem
2) Motor
3) Other (reflex/tone)
M5 motor score indicates:
Only some dysfunction of the cerebral cortex.
M4 motor score indicates:
Severe dysfunction of the cerebral cortex.
M3 motor score indicates:
Severe damage above the brainstem (ie. thalamus).
M2 motor score indicates:
Dysfunction below the thalamus.
M1 motor score indicates:
Severe dysfunction of cerebral cortex with or without dysfunction of the brainstem.
Present the cerebral oxygen delivery equation:
CBrO2 = CBF x CaO2
CBF = CPP/CVR
Summarize the approach to ICP management:
1) Parenchymal - Sedation, temperature, Sz prophylaxis, osmotherapy
2) CSF - EVD
3) Blood - Venous return, PaCO2
4) Other - Decompressive craniectomy/otomy, transfusion.
Astrocytes are responsible for:
Autoregulation of blood flow in the brain.
TBI with a period of lucency is often associated with what type of injury:
Epidural.
Almost everybody is __ dominant.
Left.
Left-sided MCA stroke produces:
Speech issues from damage to Broca’s and Wernicke’s area.
Broca’s area is responsible for:
Expressive speech.
Wernicke’s area is responsible for:
Receptive speech.
Right-sided MCA stroke produces:
Visual and neglect component.
Bell’s Palsy occurs from:
Inflammation of the facial nerve, which affects the frontal muscle.
ACA stroke presents:
Contralateral lower extremity paralysis.
MCA stroke presents as:
Contralateral arm, as well as speech and L face paralysis (sparing the frontal muscle).
Posterior circulation includes which three arteries?
Basilar, vertebral, and posterior cerebral artery.
MAP goal of SCI is:
> 85
What is the goal of adequate MAP in SCI?
Perfusion of the penumbra of spinal tissue.
T or F:
Adequate MAP in SCI can drastically improve ASIA score.
True.
Cardioembolic strokes often affect the __.
Right MCA (due to anatomy of the vasculature).
Basilar CVA presents as:
Drop attack, due to insult to the RAS.
Vertebral CVA presents as:
Respiratory issues, cough/gag absence.
PCA CVA presents as:
Contralateral hemianopsia.
