Ch.18 Neurologicemergencies Flashcards
The__ is the body’s computer. It controls breathing, speech, and all other body functions. All thoughts, memories, needs, and desires reside in the_. Different parts of the__ perform different functions. For example, some parts of the__ receive input from the senses, including sight, hearing, taste, smell, and touch; some control the muscles and movement; and some control the formation of speech.
brain
The brain is divided into three major parts: the_, __,__, which is the largest part. The brainstem controls the most basic functions of the body, such as breathing, blood pressure, swallowing, and pupil constriction. Located just behind the brainstem is the cerebellum, which controls muscle and body coordination.
The cerebellum is responsible for coordinating complex tasks that involve many muscles, such as standing on one foot without falling, walking, writing, picking up a coin, and playing the piano.
brainstem, the cerebellum, and the cerebrum
The area of the brain between the spinal cord and cerebrun, surrounded by the cerebellum; controls functions that are necessary for life, such as respiration
Brainstem
One of the three major subdivisions of the brain, sometimes called the little brains; coordinates the various activities of the brain particularly fine body movements
Cerebellum
The largest part of the three subdivisions of the brain, sometimes called the gray matter; made up of several loves that control movement, hearing, balance, speech, visual perception, emotions, and personality
Cerebrum
The cerebrum, located above the cerebellum, is divided down the middle into the right and left ____
Cerebral hemispheres
The ___ part of cerebrum controls emotion and thought
Front part
The __ part controls sensation and movement
Middle part
The __ part of the cerebrum processes sight
Back part
In most people, speech is controlled on the __ side of the brain, near the middle of the cerebrum
Left side
Messages sent to and from the brain travel through __
Nerves
Twelve pairs of cranial nerves run directly from the brain to various parts of the body, especially in the head, such as the eyes, ears, nose, and face. The remaining nerves join in the spinal cord and exit the brain through a larger opening in the base of the skull called the _
Foramen magnum
At each vertebra in the neck and back, two nerves, called _, branch out from the spinal cord, one on each side, and carry signals to and from the body
Spinal nerves
The ___ is the continuation of the brainstem. It exits the skull at the foramen magnum and extends down to the level of the second lumbar vertebra
Spinal cord
Many different disorders may cause brain dysfunction or other neurologic symptoms and may affect the patient’s level of consciousness, speech, and voluntary muscle control. The brain is most sensitive to changes in oxygen, glucose, and temperature levels. A significant change in any one of these three levels will result in a neurologic change. In general, if the problem is caused primarily by disorders in the heart and lungs, the entire brain will be affected. For example, when blood flow is stopped (cardiac arrest), the patient will go into a____, a state of profound unconsciousness, and permanent brain damage can result within minutes. However, if the primary problem is in the brain, such as a poor blood supply to one side of the brain, the patient may have signs and symptoms affecting only one side of the body. A low oxygen level in the bloodstream will affect the entire brain, often causing anxiety, restlessness, and confusion. Low blood glucose levels (hypoglycemia) can cause a wide spectrum of symptoms ranging from mild confusion to symptoms that mimic stroke.
coma
The brain and skull do not actually sense pain because neither contains pain receptors. The pain associated with a____ is felt from the surrounding areas of the face; scalp; meninges (membranes that cover the brain and spinal cord); larger blood vessels; and muscles of the head, neck, and face.
headache
Three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal cord
Meninges
The thick skin covering the cranium, which usually bears hair
Scalp
___headaches are caused by muscle contractions in the head and neck and are attributed to stress. Patients usually describe the pain as squeezing, dull, or an ache. This type of headache typically does not have any associated symptoms and usually does not require medical attention.
Tension headaches
____headaches are thought to be caused by changes in blood vessel size in the base of the brain. Both adults and children can experience___. Women are three times as likely as men to experience___. Frequently, the patient will have a history of migraines and will tell you that this episode is similar to one in the past. Pain from a_____ headache is usually described as pounding, throbbing, or pulsating._____ are often associated with nausea and vomiting and may be preceded by visual warning signs such as flashing lights or partial vision loss. These headaches can last for several hours to days.
Migraine headaches
____headaches are caused by pressure that is the result of fluid accumulation in the sinus cavities. Patients may also have coldlike signs and symptoms of nasal congestion, cough, and fever if they have a sinus infection. Patients may report increased pain when they bend over or when their heads are moved forward. This type of headache is usually self-limiting, and prehospital emergency care is not required.
Sinus headaches
______(bleeding in the brain), brain tumor, and meningitis are serious neurologic conditions that may include headache as a symptom. Be concerned if the patient reports a sudden-onset, severe headache or a sudden-onset headache that has associated symptoms. Headaches accompanied by fever, stiff neck, seizures, or altered mental status or following a head trauma are potentially life threatening and require a complete assessment and transport to the hospital (TABLE 18-1). A ___will often present with a complaint of headache that is described as “the worst headache of my life.” If a patient describes a headache this way, you should have a very high index of suspicion and transport expeditiously to the hospital. An incident with multiple patients reporting a headache may indicate carbon monoxide poisoning.
Hemorrhagic stroke
A sudden, severe headache, often described as the worst pain the patient has ever had, could be a sign of a hemorrhagic stroke. The blood from a ruptured blood vessel irritates the tissues of the brain and can cause increased___, resulting in severe headache pain. This type of pain may initially be localized and then become more diffuse as the irritation in the meninges spreads. You should suspect a hemorrhagic stroke in patients with a severe headache, seizures, and altered mental status. Early signs of increased__ include headache, vomiting, altered mental status, and seizures. Increasing___ may also be caused by a hemorrhagic stroke (a blood vessel swells and ruptures), a tumor, or head trauma that may have occurred hours or days before this event. During your patient assessment, ask if the patient has experienced any recent head trauma.
intracranial pressure (ICP)
____, an inflammation of the meninges caused by a bacterial infection, is a central nervous system infection in which the patient may complain of a headache, stiff neck, fever, and sensitivity to light. This is a serious condition requiring prompt medical attention and is highly contagious. Use standard precautions and provide supportive care of the XABCs. Provide a quiet, darkened environment when possible and avoid using lights and siren.
Bacterial meningitis