CEN Neuro Flashcards
How is BACTERIAL MENINGITIS spread? ________Need to be on ________Precautions. Urgent _______should be initiated
Respiratory DROPLETS; Droplet; Antibiotics
How is VIRAL MENINGITIS spread>
Not contagious
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 _____
Motor function ; 0-5 0 1 2 3 4 5
If a patient’s cerebral perfusion pressure is greater than 150mmHg it could cause ________
If patient’s CPP is 50 mmHg it could cause______
Hyperperfusion
Hypoperfusion
What does cerebral hypo perfusion leads to _____
Anoxic encephalopathy.
What does cerebral HYPER perfusion leads to ______
Brain edema
Hypertensive encephalopathy
What is required to monitor CPP________
An ICP catheter
What ARRYTHMIA is frequently seen in NEUROGENIC SHOCK? Because
BRADYCARDIA; there is massive vasodilation because of loss of sympathetic tone.
When there is loss of sympathetic response what happens?
It does not allow for compensatory mechanism in the setting of Decreased cardiac output.
In neurogenic shock, is there hypo or Hypertension
HYPOTENSION
The COUGH REFLEX in a patient with SCI ABOVE C3 would be
ABSENT
Injuries between C3 and C5, the COUGH REFLEX is
Weak and ineffective
Injuries between C6 and T1, the COUGH REFLEX Is
weak
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 _____
Facial droop
Arm drift
Abnormal Speech
10 seconds
What is the LEADING CAUSE of non traumatic subarachnoid hemorrhage?
CEREBRAL ANEURYSM
What percentage of all strokes is SUBARACHNOID____ carries a ______rate of mortality and disability
3% HIGH
When a patient has a lateral eye movement. Which cranial nerve has MOST likely been injured
Abducens (VI)
What is the cranial nerve that affects the downward and medial eye movement ?
TROCHLEAR
What is the cranial nerve that affects ones vision
OPTIC
ABDUCEN’s nerve affects
The muscles for facial expression
Eyelid closure
Lacrimal and salivary glands
CN X is the
Vagus
What is the seizure when an individual experiences an ABRUPT LOSS of MUSCLE tone and may or may NOT fall
ATONIC
What is the seizure when an individual experiences an ABRUPT increase in MUSCLE TONE and which causes FLEXION of arms and EXTENSION of legs
Tonic
What is the seizure in which one individual experience SLOW MUSCLE CONTRACTIONS and RELAXATION
CLONIC
What is the seizure in which one individual experiences SHORT, QUICK, Symmetric or asymmetric MUSCLE CONTRACTION in TORSO, ARMS, LEGS
MYOCLONIC
A chronic neurological disorders leads to total paralysis s
Amyotrophic Lateral Sclerosis (ALS)
Demyelinating chronic AUTOMIMMUNE DISORDER that affects the CNS
Multiple Sclerosis
NEURODEGENERATIVE disease that leads to shortage of DOPAMINE which affects the regulation of body movement
PARKINSON’S DISEASE
Progressive PERIPHERAL NS disorder that affects the voluntary muscles
MYASTHENIA GRAVIS
What does ALS Affect?
affects the nerve cells in both the BRAIN and SPINAL CORD (CNS)
What is used for Weber test and a Rinne test
Tuning Fork
What does the weber test and rinne test determines
Whether hearing loss is SENSORINEURAL OR CONDUCTIVE
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
Skin flushing is seen in________
simple partial seizure
Lip smacking or blinking eyes happen in
ABSENT seizure.
Classifications of hemorrhagic stroke
Intraparenchymal or intracerebral
Subarachnoid
Epidural hemorrhage
which one is a type of intracranial hemorrhage is considered secondary to trauma and not technically a “stroke”
Subdural hemorrhage
For assessing a patient’s level of consciousness what is used ________Score ranges from ___ to _____
Glasgow Coma Scale; 3-15
GCS 13-15
GS 9-12
GSC below 8
Mildly altered
Moderatly altered
severely altered, comatose.
What are the three specific categories of the Glasgow coma scale: EVB
Eye opening
verbal response
Best motor response.
Eye opening (0-4)
Spontaneous 4
To speech 3
To pain 2
None 0
Verbal Response (1-5)
Oriented 5 Confused conversation 4 Inappropriate words 3 Incomprehensible sounds 2 None 1
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
When assessing pupils how long should you allow at least to allow consensual response to diminish
10 seconds
Bilateral FIXED PUPILS indicate
Severe BRAINSTEM injury
A dilated FIXED PUPILS (UNILATERAL) indicates early _______Cranial nerve involvment and possible ________ herniation
THIRD; transtentorial
A FIXED, PINPOINT PUPILS indicates ______ involvement or the use of _______
PONS; Opiates
If a patient had an epidural block or any _________ ______ they should be monitored for _________
Spinal anesthesia; neurogenic shock
What is the cause of neurogenic shock?
sympathetic nervous system being suppressed, leading to massive vasodilation.
Shock caused by an inadequate volume of blood or fluid
Hypovolemic
NEUROGENIC SHOCK triad is
Hypotension
Bradycardia
Massive vasodilation
Neurogenic shock and treatment
IV fluids
medications with increase PVR such as norepinephrine and dopamine
What is a secondary headache?
it is related to an organic cause such as tumor, aneurysm, CNS infection, TEMPORAL ARTERITIS
What is primary headache?
No organic cause
TENSION, low BS, and alcohol, hormonal fluctuations
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
What are the risk factors Guillain Barre Syndrome
HIV Cytomegalovirus Hepatitis B Pregnancy Hodgkin's lymphoma
The 3 divisions of the brain
Cerebellum
Cerebrum
brainstem
What are the brain’s cerebral CORTICAL areas are the
Frontal lobe
Temporal lobe
Parietal lobe
Occipital Lobe
what type of herniation becomes life threatening when BRAINSTEM COMPRESSION occurs
UNCAL HERNIATION
Is not life threatening : ________Herniation
Cingulate
Which herniation places the patient at risk for an infection?
TRANSCALVARIAL Herniation
________ ______ is a series of consecutive seizures OR one continuous seizure lasting more than _____minutes in duration.
Status epilepticus
5minutes
Sequelae of status epilepticus
Acidosis HYPOGLYCEMIA HYPERCALCEMIA muscle damage Autonomic dysfunction
Status epilepticus requires infusion of _____ or _______ and ______monitoring
Phenytoin
Fosphenytoin
continous EEG
NSAIDS acronym is used to determine ________________
SPINAL IMMOBILIZATION
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)
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
What is a cytotoxic edema?
Type of cerebral edema characterized by swelling of glial cells and neurons
Causes of CYTOTOXIC EDEMA
HYPO-OSMOLALITY
HYPOXIA
Cardiac arrest