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CEN Neuro Flashcards

1
Q

How is BACTERIAL MENINGITIS spread? ________Need to be on ________Precautions. Urgent _______should be initiated

A

Respiratory DROPLETS; Droplet; Antibiotics

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2
Q

How is VIRAL MENINGITIS spread>

A

Not contagious

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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
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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

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5
Q

What does cerebral hypo perfusion leads to _____

A

Anoxic encephalopathy.

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6
Q

What does cerebral HYPER perfusion leads to ______

A

Brain edema

Hypertensive encephalopathy

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7
Q

What is required to monitor CPP________

A

An ICP catheter

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8
Q

What ARRYTHMIA is frequently seen in NEUROGENIC SHOCK? Because

A

BRADYCARDIA; there is massive vasodilation because of loss of sympathetic tone.

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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.

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10
Q

In neurogenic shock, is there hypo or Hypertension

A

HYPOTENSION

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11
Q

The COUGH REFLEX in a patient with SCI ABOVE C3 would be

A

ABSENT

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12
Q

Injuries between C3 and C5, the COUGH REFLEX is

A

Weak and ineffective

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13
Q

Injuries between C6 and T1, the COUGH REFLEX Is

A

weak

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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

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15
Q

What is the LEADING CAUSE of non traumatic subarachnoid hemorrhage?

A

CEREBRAL ANEURYSM

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16
Q

What percentage of all strokes is SUBARACHNOID____ carries a ______rate of mortality and disability

A

3% HIGH

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17
Q

When a patient has a lateral eye movement. Which cranial nerve has MOST likely been injured

A

Abducens (VI)

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18
Q

What is the cranial nerve that affects the downward and medial eye movement ?

A

TROCHLEAR

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19
Q

What is the cranial nerve that affects ones vision

A

OPTIC

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20
Q

ABDUCEN’s nerve affects

A

The muscles for facial expression
Eyelid closure
Lacrimal and salivary glands

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21
Q

CN X is the

A

Vagus

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22
Q

What is the seizure when an individual experiences an ABRUPT LOSS of MUSCLE tone and may or may NOT fall

A

ATONIC

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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

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24
Q

What is the seizure in which one individual experience SLOW MUSCLE CONTRACTIONS and RELAXATION

A

CLONIC

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25
Q

What is the seizure in which one individual experiences SHORT, QUICK, Symmetric or asymmetric MUSCLE CONTRACTION in TORSO, ARMS, LEGS

A

MYOCLONIC

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26
Q

A chronic neurological disorders leads to total paralysis s

A

Amyotrophic Lateral Sclerosis (ALS)

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27
Q

Demyelinating chronic AUTOMIMMUNE DISORDER that affects the CNS

A

Multiple Sclerosis

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28
Q

NEURODEGENERATIVE disease that leads to shortage of DOPAMINE which affects the regulation of body movement

A

PARKINSON’S DISEASE

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29
Q

Progressive PERIPHERAL NS disorder that affects the voluntary muscles

A

MYASTHENIA GRAVIS

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30
Q

What does ALS Affect?

A

affects the nerve cells in both the BRAIN and SPINAL CORD (CNS)

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31
Q

What is used for Weber test and a Rinne test

A

Tuning Fork

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32
Q

What does the weber test and rinne test determines

A

Whether hearing loss is SENSORINEURAL OR CONDUCTIVE

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33
Q

A Seizure in which patient may bite tongue and have an episode of incontinence________they are also characterized by _______ and ___________ ____tone. AKA.

A

TONIC-CLONIC seizure; Loss of consciousness, organized muscle tone; Grand-mal seizures

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34
Q

Skin flushing is seen in________

A

simple partial seizure

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35
Q

Lip smacking or blinking eyes happen in

A

ABSENT seizure.

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36
Q

Classifications of hemorrhagic stroke

A

Intraparenchymal or intracerebral
Subarachnoid
Epidural hemorrhage

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37
Q

which one is a type of intracranial hemorrhage is considered secondary to trauma and not technically a “stroke”

A

Subdural hemorrhage

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38
Q

For assessing a patient’s level of consciousness what is used ________Score ranges from ___ to _____

A

Glasgow Coma Scale; 3-15

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39
Q

GCS 13-15
GS 9-12
GSC below 8

A

Mildly altered
Moderatly altered
severely altered, comatose.

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40
Q

What are the three specific categories of the Glasgow coma scale: EVB

A

Eye opening
verbal response
Best motor response.

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41
Q

Eye opening (0-4)

A

Spontaneous 4
To speech 3
To pain 2
None 0

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42
Q

Verbal Response (1-5)

A 
Oriented 5
Confused conversation 4
Inappropriate words 3
Incomprehensible sounds 2
None 1
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43
Q

Best Motor Response (1-6)

A 
Obeys commands 6
Localizes pain 5
Normal flexion (withdrawa) 4
Abnormal flexion (decorticate)3
Extension (decebrate) 2
None (flaccid) 1
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44
Q

When assessing pupils how long should you allow at least to allow consensual response to diminish

A

10 seconds

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45
Q

Bilateral FIXED PUPILS indicate

A

Severe BRAINSTEM injury

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46
Q

A dilated FIXED PUPILS (UNILATERAL) indicates early _______Cranial nerve involvment and possible ________ herniation

A

THIRD; transtentorial

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47
Q

A FIXED, PINPOINT PUPILS indicates ______ involvement or the use of _______

A

PONS; Opiates

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48
Q

If a patient had an epidural block or any _________ ______ they should be monitored for _________

A

Spinal anesthesia; neurogenic shock

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49
Q

What is the cause of neurogenic shock?

A

sympathetic nervous system being suppressed, leading to massive vasodilation.

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50
Q

Shock caused by an inadequate volume of blood or fluid

A

Hypovolemic

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51
Q

NEUROGENIC SHOCK triad is

A

Hypotension
Bradycardia
Massive vasodilation

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52
Q

Neurogenic shock and treatment

A

IV fluids

medications with increase PVR such as norepinephrine and dopamine

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53
Q

What is a secondary headache?

A

it is related to an organic cause such as tumor, aneurysm, CNS infection, TEMPORAL ARTERITIS

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54
Q

What is primary headache?

A

No organic cause

TENSION, low BS, and alcohol, hormonal fluctuations

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55
Q

what is Guillain Barre Syndrome

A

it is an acute paralytic disease that decreases MYELIN in both the NERVE ROOTS as well as the PERIPHERAL NERVES

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56
Q

What are the risk factors Guillain Barre Syndrome

A 
HIV
Cytomegalovirus
Hepatitis B
Pregnancy 
Hodgkin's lymphoma
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57
Q

The 3 divisions of the brain

A

Cerebellum
Cerebrum
brainstem

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58
Q

What are the brain’s cerebral CORTICAL areas are the

A

Frontal lobe
Temporal lobe
Parietal lobe
Occipital Lobe

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59
Q

what type of herniation becomes life threatening when BRAINSTEM COMPRESSION occurs

A

UNCAL HERNIATION

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60
Q

Is not life threatening : ________Herniation

A

Cingulate

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61
Q

Which herniation places the patient at risk for an infection?

A

TRANSCALVARIAL Herniation

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62
Q

________ ______ is a series of consecutive seizures OR one continuous seizure lasting more than _____minutes in duration.

A

Status epilepticus

5minutes

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63
Q

Sequelae of status epilepticus

A 
Acidosis
HYPOGLYCEMIA
HYPERCALCEMIA
muscle damage
Autonomic dysfunction
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64
Q

Status epilepticus requires infusion of _____ or _______ and ______monitoring

A

Phenytoin
Fosphenytoin
continous EEG

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65
Q

NSAIDS acronym is used to determine ________________

A

SPINAL IMMOBILIZATION

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66
Q 
N
S
A
I
D
S
A

Neurological Examination
Significant traumatic mechanisms of injury
Alertness
Intoxication
Distracting Injury (any other injury )
Spinal Examination (pain in neck or spine)

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67
Q

What are the five BASIC questions for STROKE-LIKE symptoms

A 
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
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68
Q

What is a cytotoxic edema?

A

Type of cerebral edema characterized by swelling of glial cells and neurons

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69
Q

Causes of CYTOTOXIC EDEMA

A

HYPO-OSMOLALITY
HYPOXIA
Cardiac arrest

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70
Q

Short term memory is function of which lobe

71
Q

motor speech, PERSONALITY, behavior, voluntary motor function, JUDGMENT are functions of which part of the brain

72
Q

OBJECT RECOGNITION is the function of the ________lobe

A

Parietal lobe

73
Q

LONG-TERM MEMORY is a function of the

74
Q

ABSTRACT thinking a function of the

75
Q

What are ventricular shunt use for

A

surgically places in order to decrease ICP

76
Q

How does the ventricular shunt work?

A

Diverting Cerebrospinal fluid from the lateral ventricles to the TORSO or PERITONEAL SPACE

77
Q

Ventricular shunt are usually used for?

A

Hydrocephalus.

78
Q

COMMON complications of ventricular shunt

A

Infection
Obstruction
Malposition

79
Q

If a patient has a CENTRAL CORD SYNDROME, what type of injury MOST LIKELY OCCUR (CHighEX)

A

HyperEXTENSION (WHIPLASH)

80
Q

If a patient has a BROWN-SEQUARD SYNDROME, what type of injury MOST LIKELY OCCUR

A

Penetrating injury

Tumor

81
Q

If a patient has a ANTERIOR CORD SYNDROME, what type of injury MOST LIKELY OCCUR (AnHighFlex)

A

HYPERFLEXION

82
Q

What is the MOST COMMON cause of TBI

2nd common cause of TBI

83
Q

Most common long life effects of TBI

A

Depressin
PTSD
Chronic traumatic ENCEPHALOPATHY
Personality changes.

84
Q

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

A

HYPERFLEXION

85
Q

A __________ SCI when an individual’s head is thrown backward

A

HYPEREXTENSION

86
Q

A __________injury when the spinal cord is rotated

87
Q

A ________compression occurs when an individuals fall, jumps or lands directly on her HEAD of FEET

88
Q

_________Is when there is a fracture at the BASE SKULL Of the FOSSA

A

BASAL SKULL FRACTURE.

89
Q

If a patient has a basal skull fracture it could cause a ______because of the

A

CRANIAL NERVE ; proximity of the base skull to the CNs.

90
Q

A LINEAR SKULL fracture could cause an

A

EPIDURAL HEMATOMA

91
Q

A DEPRESSED SKULL Fracture could cause a

A

BRAIN LACERATION and INTRACRANIAL Hematoma

92
Q

Is a migraine headache considered primary or secondary

93
Q

A patient with POSTERIOR CORD Syndrome will experience

A 
preserved perception of pain
motor function and temperature sensation
Lose deep touch
Proprioception
VIBRATION
94
Q

CAUDA AQUINA SYNDROME will most likely experience

A

Lower extremity sensory loss (varying amount)

95
Q

ANTERIOR CORD SYNDROME will most likely experience

A

Loss of PAIN BELOW THE LESION

96
Q

BROWN SEQUARD SYNDROME will most likely experience

A

ISPILATERAL loss of position.

97
Q

______________is potentially life-threatening condition which occurs in spinal cord injuries at or above T6 it is caused by massive _________ causing _________ and dangerously ___________ BP

A

Autonomic Dysreflexia
sympathetic response
Vasoconstriction
Elevated

98
Q

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

A

CONCUSSION

99
Q

The following lab values are considered exclusionary for the administration of rt-PA:

A

Platelet Count <100,000
INR > 1.7
PT > 15 seconds
GLUCOSE less than 50 mg/DL

100
Q

The VAGUS NERVE (X) has the ability to affect one’s

A

Swallowing

101
Q

The ______ _____ CN XI as the ability to affect’s one shoulder and neck movement.

A

SPINAL ACCESSORY

102
Q

The Facial CN #______ has to ability to affect one’s EYELID CLOSURE

103
Q

What is Axial loading injury

A

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
Q

3 organisms that causes BACTERIAL MENINGITIS

A

Streptococcus Pneumoniae
Haemophillus Influenze
Neisseria Meningitis

105
Q

When the bottom of the foot is stroked, the big toe flexes UPWARD and other toes fan out

A

BABINSKI reflex

106
Q

What is the babinski test used to test

A

UPPER Motor neuron dysfunction

107
Q

Newborn have a ______babinski test and which goes away around _____months of age

A

positive; 6

108
Q

Which vitamin supports the brain and the PNS

A

Vitamin B12

109
Q

Vitamin B12 deficiency leads to wha type of anemia

A

PERNICIOUS Anemia

110
Q

Which vitamin supports the krebs cycle

A

Thiamine (B1)

111
Q

Which vitamin supports the synthesis of coenzymes

112
Q

Which vitamin is active in many enzymatic reaction in the Central NS

A

Pyridoxine (B6)

113
Q

A __________ is a simple fracture with a single line

A

linear skull fracture

114
Q

A ________Fracture is when the skull’s bones are separate at the suture lines

115
Q

A________Fracture is when the skull’s bones are fragmented into pieces

A

Communited

116
Q

A _____ fracture one in which the skull’s bone fragments have an inward depression

117
Q

Rear-end vehicular accident what type of injury do you anticipate_____

118
Q

Head on collision are up-over pathway; anticipated injury _______

A

CERVICAL SPINE COMPRESSION

119
Q

Lateral or ejection collision: anticipated injury

A

Spleen and liver lacerations.

120
Q

Ejection collision: Anticipated injury

A

Traumatic brain injuries

121
Q

GBS paralysis :

A

Symmetrical paralysis usually beginning in lower extremities

122
Q

Symptoms of GBS

A 
Dminished deep tensions reflexes
Tingling sensation in the hands and feet
Urinary retention
Ileus
Respiratory insufficiency
123
Q

The ABCD tool is used to assessing patients risk for having a stroke following

124
Q

ABCDD tool mnemonic

A 
Age
Blood pressure
Clinical features of TIA
Duration of symptoms 
Diabetes history
125
Q

Type of lesion NOT cause a patient to experience motor loss

A

POSTERIOR CORD syndrome.

126
Q

MOST RUPTURED Aneurysm is associated with

A

HYPERTENSION

127
Q

Type of herniation is best described as brain tissue that is extruded through the cranium

A

TRANSCALVARIAL HERNIATION.

128
Q

Repeated Head Trauma is a predisposing factors for which of the following chronic neurological disorders

A

PARKINSON’S Disease

129
Q

Predisposing factors of MS

A

Childhood viral illness
Genetic Factors
Autoimmunity

130
Q

Predisposing factors of ALS

A

Trauma
viral infections
metabolic disorders

131
Q

Predisposing factors of Parkinson’s

A 
Trauma
neoplasm
infection
CO intoxication
ENCEPHALITIS
132
Q

Loss of vision in the same visual field of both eyes

A

Homonymous hemianopsia

133
Q

Fractured ribs, aortic tears and rib fractures what type of injury is suspected

134
Q

The spinal Cord’s central canal communicates with which ventricle

135
Q

What is the central canal ? Opening of the middle to the spinal cord that contains

A

Cerebrospinal fluid.

136
Q

A deficiency of Vit B1 may cause conditions such as

A

Wenicke’s encephalopathy

Korsakoff syndrome

137
Q

Deficiency of Bit B1 seen in

A

Alcoholism

Malabsorption syndrome

138
Q

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

A

Thiamine IV

139
Q

Onset of myasthenia gravis typically occurs around which age groups _______Frequently in _____Than _____

A

20-30 years

Females; males

140
Q

What is the hallmark of Myasthenia Gravis?

A

ocular, facial neck muscles of upper extremities.

141
Q

In acute stroke, the goal is to lower the BP by only __ to ___ in the first 24 hours

142
Q

What is the timeframe for initiating thrombolytic therapy in an ischemic stroke is?

A

3 hours from onset of symptoms.

143
Q

What is the following anticonvulsants drugs has the LONGEST duration? how many hours ____

A

Phenobarbital (Luminal); 48

144
Q

How long does lorazepam lasts

A

12-24 hours

145
Q

How long does diazepam last

A

30 minutes

146
Q

Phenytoin + Fosphenytoin sodium lasts

147
Q

A flapping terror is associated with

A

metabolic encephalopahty

148
Q

COLD mnemonic stands for

A

Character
Onset
Location
Duration

149
Q

There are 2 types of nerve cells

A

Glia : more

neurons: less

150
Q

What are myasthenic crisis traced with

A

IV immune globulin

151
Q

Respiratory rhythm less than 10

152
Q

The regulation of temperature and the regulation of food intake is done by

A

the DIENCEPHALON

153
Q

The __________is responsible for relaying message from the brain to the lower levels o f the nervous system

154
Q

The ________ connect the 2 cerebral hemisphere by the corpus callosum

A

TELENCEPHALON

155
Q

______controls balance and synchronizing muscle action

A

CEREBELLUM

156
Q

Normal ICP

157
Q

ICP monitoring include

A

Intraventricular
Intraparenchymal
Subarachnoid bolt
Epidural systems

158
Q

One of the key points in helping patients manage migraines

A

Identify triggers

159
Q

2 types of Diabetes inspidus

A

Neurogenic

Nephrogenic

160
Q

What is DI? Neurogenic

Treatment

A

insufficient Antidiuretic hormone

Desompressin (DDAVP) or Aqueous pitressin

161
Q

What is DI? Nephrogenic

treatment

A 
renal tubules unresponsive to ADH
Dietary sodium
protein restrictions
Thiazide diuretics
NSAIDS
162
Q

Part of the brain that divides the skull into 3 fossae

A

SPHENOID bone

163
Q

______Protects the brain

164
Q

Components of PNS

A

Spinal and cranial nerves and peripheral nerves

165
Q

Components of ANS

A

sympathetic

Parasympathetic

166
Q

Pain associated with cluster headaches can be treated with

A

100% oxygen

167
Q

Migraine headache can be controlled with

A

Dihydroergotamine

Sumatriptan

168
Q

Hyperesthesia means

A

increased sensation

169
Q

Diesthesia means

A

impaired sensation

170
Q

HYPESthesia

A

Decreased sensation

171
Q

Which cerebral aneurysm is generally a result of atherosclerosis

172
Q

A _______aneuryms generally has congenital defects

173
Q

A _________aneurysm is generally the result of necrotic vasculitis or septic emboli

CEN (9 decks)

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