CEN Neuro Flashcards
1
Q
How is BACTERIAL MENINGITIS spread? ________Need to be on ________Precautions. Urgent _______should be initiated
A
Respiratory DROPLETS; Droplet; Antibiotics
2
Q
How is VIRAL MENINGITIS spread>
A
Not contagious
3
Q
the ASIA (American Spinal Injury Association) scale is used for _________ and is from ____to _____
No minimal contraction or movement is_____
Minimal movement is ______
Active movement, but not against gravity______
Active movement against gravity ______
Active movement against resistance _____
Active movement against full resistance _____
A
Motor function ; 0-5 0 1 2 3 4 5
4
Q
If a patient’s cerebral perfusion pressure is greater than 150mmHg it could cause ________
If patient’s CPP is 50 mmHg it could cause______
A
Hyperperfusion
Hypoperfusion
5
Q
What does cerebral hypo perfusion leads to _____
A
Anoxic encephalopathy.
6
Q
What does cerebral HYPER perfusion leads to ______
A
Brain edema
Hypertensive encephalopathy
7
Q
What is required to monitor CPP________
A
An ICP catheter
8
Q
What ARRYTHMIA is frequently seen in NEUROGENIC SHOCK? Because
A
BRADYCARDIA; there is massive vasodilation because of loss of sympathetic tone.
9
Q
When there is loss of sympathetic response what happens?
A
It does not allow for compensatory mechanism in the setting of Decreased cardiac output.
10
Q
In neurogenic shock, is there hypo or Hypertension
A
HYPOTENSION
11
Q
The COUGH REFLEX in a patient with SCI ABOVE C3 would be
A
ABSENT
12
Q
Injuries between C3 and C5, the COUGH REFLEX is
A
Weak and ineffective
13
Q
Injuries between C6 and T1, the COUGH REFLEX Is
A
weak
14
Q
The key areas of assessment in the CINCINATTI prehospital Stroke Scale include ____,_____,____ it is the most commonly used. How soon should he be evaluated by MD _____
A
Facial droop
Arm drift
Abnormal Speech
10 seconds
15
Q
What is the LEADING CAUSE of non traumatic subarachnoid hemorrhage?
A
CEREBRAL ANEURYSM
16
Q
What percentage of all strokes is SUBARACHNOID____ carries a ______rate of mortality and disability
A
3% HIGH
17
Q
When a patient has a lateral eye movement. Which cranial nerve has MOST likely been injured
A
Abducens (VI)
18
Q
What is the cranial nerve that affects the downward and medial eye movement ?
A
TROCHLEAR
19
Q
What is the cranial nerve that affects ones vision
A
OPTIC
20
Q
ABDUCEN’s nerve affects
A
The muscles for facial expression
Eyelid closure
Lacrimal and salivary glands
21
Q
CN X is the
A
Vagus
22
Q
What is the seizure when an individual experiences an ABRUPT LOSS of MUSCLE tone and may or may NOT fall
A
ATONIC
23
Q
What is the seizure when an individual experiences an ABRUPT increase in MUSCLE TONE and which causes FLEXION of arms and EXTENSION of legs
A
Tonic
24
Q
What is the seizure in which one individual experience SLOW MUSCLE CONTRACTIONS and RELAXATION
A
CLONIC
25
What is the seizure in which one individual experiences SHORT, QUICK, Symmetric or asymmetric MUSCLE CONTRACTION in TORSO, ARMS, LEGS
MYOCLONIC
26
A chronic neurological disorders leads to total paralysis s
Amyotrophic Lateral Sclerosis (ALS)
27
Demyelinating chronic AUTOMIMMUNE DISORDER that affects the CNS
Multiple Sclerosis
28
NEURODEGENERATIVE disease that leads to shortage of DOPAMINE which affects the regulation of body movement
PARKINSON'S DISEASE
29
Progressive PERIPHERAL NS disorder that affects the voluntary muscles
MYASTHENIA GRAVIS
30
What does ALS Affect?
affects the nerve cells in both the BRAIN and SPINAL CORD (CNS)
31
What is used for Weber test and a Rinne test
Tuning Fork
32
What does the weber test and rinne test determines
Whether hearing loss is SENSORINEURAL OR CONDUCTIVE
33
A Seizure in which patient may bite tongue and have an episode of incontinence________they are also characterized by _______ and ___________ ____tone. AKA.
TONIC-CLONIC seizure; Loss of consciousness, organized muscle tone; Grand-mal seizures
34
Skin flushing is seen in________
simple partial seizure
35
Lip smacking or blinking eyes happen in
ABSENT seizure.
36
Classifications of hemorrhagic stroke
Intraparenchymal or intracerebral
Subarachnoid
Epidural hemorrhage
37
which one is a type of intracranial hemorrhage is considered secondary to trauma and not technically a "stroke"
Subdural hemorrhage
38
For assessing a patient's level of consciousness what is used ________Score ranges from ___ to _____
Glasgow Coma Scale; 3-15
39
GCS 13-15
GS 9-12
GSC below 8
Mildly altered
Moderatly altered
severely altered, comatose.
40
What are the three specific categories of the Glasgow coma scale: EVB
Eye opening
verbal response
Best motor response.
41
Eye opening (0-4)
Spontaneous 4
To speech 3
To pain 2
None 0
42
Verbal Response (1-5)
```
Oriented 5
Confused conversation 4
Inappropriate words 3
Incomprehensible sounds 2
None 1
```
43
Best Motor Response (1-6)
```
Obeys commands 6
Localizes pain 5
Normal flexion (withdrawa) 4
Abnormal flexion (decorticate)3
Extension (decebrate) 2
None (flaccid) 1
```
44
When assessing pupils how long should you allow at least to allow consensual response to diminish
10 seconds
45
Bilateral FIXED PUPILS indicate
Severe BRAINSTEM injury
46
A dilated FIXED PUPILS (UNILATERAL) indicates early _______Cranial nerve involvment and possible ________ herniation
THIRD; transtentorial
47
A FIXED, PINPOINT PUPILS indicates ______ involvement or the use of _______
PONS; Opiates
48
If a patient had an epidural block or any _________ ______ they should be monitored for _________
Spinal anesthesia; neurogenic shock
49
What is the cause of neurogenic shock?
sympathetic nervous system being suppressed, leading to massive vasodilation.
50
Shock caused by an inadequate volume of blood or fluid
Hypovolemic
51
NEUROGENIC SHOCK triad is
Hypotension
Bradycardia
Massive vasodilation
52
Neurogenic shock and treatment
IV fluids
| medications with increase PVR such as norepinephrine and dopamine
53
What is a secondary headache?
it is related to an organic cause such as tumor, aneurysm, CNS infection, TEMPORAL ARTERITIS
54
What is primary headache?
No organic cause
| TENSION, low BS, and alcohol, hormonal fluctuations
55
what is Guillain Barre Syndrome
it is an acute paralytic disease that decreases MYELIN in both the NERVE ROOTS as well as the PERIPHERAL NERVES
56
What are the risk factors Guillain Barre Syndrome
```
HIV
Cytomegalovirus
Hepatitis B
Pregnancy
Hodgkin's lymphoma
```
57
The 3 divisions of the brain
Cerebellum
Cerebrum
brainstem
58
What are the brain's cerebral CORTICAL areas are the
Frontal lobe
Temporal lobe
Parietal lobe
Occipital Lobe
59
what type of herniation becomes life threatening when BRAINSTEM COMPRESSION occurs
UNCAL HERNIATION
60
Is not life threatening : ________Herniation
Cingulate
61
Which herniation places the patient at risk for an infection?
TRANSCALVARIAL Herniation
62
________ ______ is a series of consecutive seizures OR one continuous seizure lasting more than _____minutes in duration.
Status epilepticus
| 5minutes
63
Sequelae of status epilepticus
```
Acidosis
HYPOGLYCEMIA
HYPERCALCEMIA
muscle damage
Autonomic dysfunction
```
64
Status epilepticus requires infusion of _____ or _______ and ______monitoring
Phenytoin
Fosphenytoin
continous EEG
65
NSAIDS acronym is used to determine ________________
SPINAL IMMOBILIZATION
66
```
N
S
A
I
D
S
```
Neurological Examination
Significant traumatic mechanisms of injury
Alertness
Intoxication
Distracting Injury (any other injury )
Spinal Examination (pain in neck or spine)
67
What are the five BASIC questions for STROKE-LIKE symptoms
```
Is this a stroke?
When did the symptoms begin?
are ABC adequate?
Are focal deficits present?
what immediate diagnostic procedures are recommended?
Hx of stroke within the last 3 months
```
68
What is a cytotoxic edema?
Type of cerebral edema characterized by swelling of glial cells and neurons
69
Causes of CYTOTOXIC EDEMA
HYPO-OSMOLALITY
HYPOXIA
Cardiac arrest
70
Short term memory is function of which lobe
Frontal
71
motor speech, PERSONALITY, behavior, voluntary motor function, JUDGMENT are functions of which part of the brain
Frontal
72
OBJECT RECOGNITION is the function of the ________lobe
Parietal lobe
73
LONG-TERM MEMORY is a function of the
Temporal
74
ABSTRACT thinking a function of the
Frontal
75
What are ventricular shunt use for
surgically places in order to decrease ICP
76
How does the ventricular shunt work?
Diverting Cerebrospinal fluid from the lateral ventricles to the TORSO or PERITONEAL SPACE
77
Ventricular shunt are usually used for?
Hydrocephalus.
78
COMMON complications of ventricular shunt
Infection
Obstruction
Malposition
79
If a patient has a CENTRAL CORD SYNDROME, what type of injury MOST LIKELY OCCUR (CHighEX)
HyperEXTENSION (WHIPLASH)
80
If a patient has a BROWN-SEQUARD SYNDROME, what type of injury MOST LIKELY OCCUR
Penetrating injury
| Tumor
81
If a patient has a ANTERIOR CORD SYNDROME, what type of injury MOST LIKELY OCCUR (AnHighFlex)
HYPERFLEXION
82
What is the MOST COMMON cause of TBI
| 2nd common cause of TBI
Fall
| MVC
83
Most common long life effects of TBI
Depressin
PTSD
Chronic traumatic ENCEPHALOPATHY
Personality changes.
84
An injury of _________is one where there is a forceful flexion in a forward direction of the cervical spine, such as chin is forced to patient's chest
HYPERFLEXION
85
A __________ SCI when an individual's head is thrown backward
HYPEREXTENSION
86
A __________injury when the spinal cord is rotated
Rotation
87
A ________compression occurs when an individuals fall, jumps or lands directly on her HEAD of FEET
VERTICAL
88
_________Is when there is a fracture at the BASE SKULL Of the FOSSA
BASAL SKULL FRACTURE.
89
If a patient has a basal skull fracture it could cause a ______because of the
CRANIAL NERVE ; proximity of the base skull to the CNs.
90
A LINEAR SKULL fracture could cause an
EPIDURAL HEMATOMA
91
A DEPRESSED SKULL Fracture could cause a
BRAIN LACERATION and INTRACRANIAL Hematoma
92
Is a migraine headache considered primary or secondary
Primary
93
A patient with POSTERIOR CORD Syndrome will experience
```
preserved perception of pain
motor function and temperature sensation
Lose deep touch
Proprioception
VIBRATION
```
94
CAUDA AQUINA SYNDROME will most likely experience
Lower extremity sensory loss (varying amount)
95
ANTERIOR CORD SYNDROME will most likely experience
Loss of PAIN BELOW THE LESION
96
BROWN SEQUARD SYNDROME will most likely experience
ISPILATERAL loss of position.
97
______________is potentially life-threatening condition which occurs in spinal cord injuries at or above T6 it is caused by massive _________ causing _________ and dangerously ___________ BP
Autonomic Dysreflexia
sympathetic response
Vasoconstriction
Elevated
98
A traumatic brain injury that occurs when the brain moves WITHIN the cranial vault and causes a brief alteration in one's level of consciousness
CONCUSSION
99
The following lab values are considered exclusionary for the administration of rt-PA:
Platelet Count <100,000
INR > 1.7
PT > 15 seconds
GLUCOSE less than 50 mg/DL
100
The VAGUS NERVE (X) has the ability to affect one's
Swallowing
101
The ______ _____ CN XI as the ability to affect's one shoulder and neck movement.
SPINAL ACCESSORY
102
The Facial CN #______ has to ability to affect one's EYELID CLOSURE
VII
103
What is Axial loading injury
the results of a direct force that is transmitted along the entire length of the vertebral column. Diver strikes , their head on the bottom a pool
104
3 organisms that causes BACTERIAL MENINGITIS
Streptococcus Pneumoniae
Haemophillus Influenze
Neisseria Meningitis
105
When the bottom of the foot is stroked, the big toe flexes UPWARD and other toes fan out
BABINSKI reflex
106
What is the babinski test used to test
UPPER Motor neuron dysfunction
107
Newborn have a ______babinski test and which goes away around _____months of age
positive; 6
108
Which vitamin supports the brain and the PNS
Vitamin B12
109
Vitamin B12 deficiency leads to wha type of anemia
PERNICIOUS Anemia
110
Which vitamin supports the krebs cycle
Thiamine (B1)
111
Which vitamin supports the synthesis of coenzymes
NIACIN
112
Which vitamin is active in many enzymatic reaction in the Central NS
Pyridoxine (B6)
113
A __________ is a simple fracture with a single line
linear skull fracture
114
A ________Fracture is when the skull's bones are separate at the suture lines
DIASTATIC
115
A________Fracture is when the skull's bones are fragmented into pieces
Communited
116
A _____ fracture one in which the skull's bone fragments have an inward depression
Depressed
117
Rear-end vehicular accident what type of injury do you anticipate_____
WHIPLASH
118
Head on collision are up-over pathway; anticipated injury _______
CERVICAL SPINE COMPRESSION
119
Lateral or ejection collision: anticipated injury
Spleen and liver lacerations.
120
Ejection collision: Anticipated injury
Traumatic brain injuries
121
GBS paralysis :
Symmetrical paralysis usually beginning in lower extremities
122
Symptoms of GBS
```
Dminished deep tensions reflexes
Tingling sensation in the hands and feet
Urinary retention
Ileus
Respiratory insufficiency
```
123
The ABCD tool is used to assessing patients risk for having a stroke following
A TIA
124
ABCDD tool mnemonic
```
Age
Blood pressure
Clinical features of TIA
Duration of symptoms
Diabetes history
```
125
Type of lesion NOT cause a patient to experience motor loss
POSTERIOR CORD syndrome.
126
MOST RUPTURED Aneurysm is associated with
HYPERTENSION
127
Type of herniation is best described as brain tissue that is extruded through the cranium
TRANSCALVARIAL HERNIATION.
128
Repeated Head Trauma is a predisposing factors for which of the following chronic neurological disorders
PARKINSON'S Disease
129
Predisposing factors of MS
Childhood viral illness
Genetic Factors
Autoimmunity
130
Predisposing factors of ALS
Trauma
viral infections
metabolic disorders
131
Predisposing factors of Parkinson's
```
Trauma
neoplasm
infection
CO intoxication
ENCEPHALITIS
```
132
Loss of vision in the same visual field of both eyes
Homonymous hemianopsia
133
Fractured ribs, aortic tears and rib fractures what type of injury is suspected
EJECTION
134
The spinal Cord's central canal communicates with which ventricle
FOURTH
135
What is the central canal ? Opening of the middle to the spinal cord that contains
Cerebrospinal fluid.
136
A deficiency of Vit B1 may cause conditions such as
Wenicke's encephalopathy
| Korsakoff syndrome
137
Deficiency of Bit B1 seen in
Alcoholism
| Malabsorption syndrome
138
In the ED , if a patient is unconscious and you suspect alcoholism it is important to administer_______ prior to D50 to prevent the development of Wernicke-Korsakoff syndrom
Thiamine IV
139
Onset of myasthenia gravis typically occurs around which age groups _______Frequently in _____Than _____
20-30 years
| Females; males
140
What is the hallmark of Myasthenia Gravis?
ocular, facial neck muscles of upper extremities.
141
In acute stroke, the goal is to lower the BP by only __ to ___ in the first 24 hours
15-25%
142
What is the timeframe for initiating thrombolytic therapy in an ischemic stroke is?
3 hours from onset of symptoms.
143
What is the following anticonvulsants drugs has the LONGEST duration? how many hours ____
Phenobarbital (Luminal); 48
144
How long does lorazepam lasts
12-24 hours
145
How long does diazepam last
30 minutes
146
Phenytoin + Fosphenytoin sodium lasts
24 hours
147
A flapping terror is associated with
metabolic encephalopahty
148
COLD mnemonic stands for
Character
Onset
Location
Duration
149
There are 2 types of nerve cells
Glia : more
| neurons: less
150
What are myasthenic crisis traced with
IV immune globulin
151
Respiratory rhythm less than 10
Bradypnea
152
The regulation of temperature and the regulation of food intake is done by
the DIENCEPHALON
153
The __________is responsible for relaying message from the brain to the lower levels o f the nervous system
Brainstem
154
The ________ connect the 2 cerebral hemisphere by the corpus callosum
TELENCEPHALON
155
______controls balance and synchronizing muscle action
CEREBELLUM
156
Normal ICP
0-20mmHg
157
ICP monitoring include
Intraventricular
Intraparenchymal
Subarachnoid bolt
Epidural systems
158
One of the key points in helping patients manage migraines
Identify triggers
159
2 types of Diabetes inspidus
Neurogenic
| Nephrogenic
160
What is DI? Neurogenic
| Treatment
insufficient Antidiuretic hormone
| Desompressin (DDAVP) or Aqueous pitressin
161
What is DI? Nephrogenic
| treatment
```
renal tubules unresponsive to ADH
Dietary sodium
protein restrictions
Thiazide diuretics
NSAIDS
```
162
Part of the brain that divides the skull into 3 fossae
SPHENOID bone
163
______Protects the brain
Cranium
164
Components of PNS
Spinal and cranial nerves and peripheral nerves
165
Components of ANS
sympathetic
| Parasympathetic
166
Pain associated with cluster headaches can be treated with
100% oxygen
167
Migraine headache can be controlled with
Dihydroergotamine
| Sumatriptan
168
Hyperesthesia means
increased sensation
169
Diesthesia means
impaired sensation
170
HYPESthesia
Decreased sensation
171
Which cerebral aneurysm is generally a result of atherosclerosis
FUSIFORM
172
A _______aneuryms generally has congenital defects
Saccular
173
A _________aneurysm is generally the result of necrotic vasculitis or septic emboli
MYCOTIC
