Chapter 15 Neurologic Emergencies Flashcards
What is the third leading cause of death in the U.S?
STROKE coming in after heart disease and cancer
What the 3 major parts of the brain?
Brain Stem, Cerebellum, Cerebrum?
What does the brain stem control?
It controls basic functions, such as, breathing, blood pressure, swallowing, and pupil constriction
What does the cerebellum control?
It controls muscle and body coordination
What does the cerebrum control?
The cerebrum is divided into the right and left hemisphere, each responsible for the opposite side of the body
What part of the cerebrum controls emotion and thought?
Front part
What part of the cerebrum controls touch and movement?
Middle
What part of the cerebrum processes sight?
Back
How many cranial nerves run from the brain to various parts of the head?
There are 12 cranial nerves
What is the brain most sensitive to?
Changes in oxygen, glucose, and temperature levels
What is the most common type of headache and what are they caused by?
Tension headaches are the most common and are caused by muscle contractions in the head and neck and are attributed to stress
What kind of headache is caused by changes in the blood vessel size in the base of the brain?
Migraine headaches
What is the cause of sinus headaches?
Pressure as a result of fluid accumulation in the sinus cavities
What are serious conditions that include headache as a symptom?
HEMORRHAGIC STROKE, BRAIN TUMORS, MENINGITIS
What should you suspect in patients when then complain of severe headache, seizures and AMS?
STROKE
What are early signs of INCREASED INTRACRANIAL PRESSURE?
Headache, Vomiting, AMS, and Seizures
What are symptoms of BACTERIAL MENINGITIS?
Headaches, Stiff Neck, Fever, and Sensitivity to Light
What is CVA?
CEREBROVASCULAR ACCIDENT aka STROKE
What is ISCHEMIA?
A lack of oxygen that causes the cells not to function properly
What is an ISCHEMIC STROKE?
Due to the direct blockage of blood flow through the cerebral arteries
What is a HEMORRHAGIC STROKE?
A blood vessel ruptures, causing increased pressure in the brain and subsequent brain damage
What are the two possible causes of the blockage of blood flow which causes an Ischemic Stroke?
THROMBOSIS, where a clot forms at the site of blockage or EMBOLUS, where the clot forms in a remote area and travels to the site of blockage
What is the most common type of stroke?
ISCHEMIC STROKE and it accounts for more than 80% of all strokes combined
What is the name of the disorder in which calcium and cholesterol build up, forming plaque inside the walls of the blood vessels?
ATHEROSCLEROSIS
What kind of stroke accounts for 10-20% of all strokes?
HEMORRHAGIC STROKE
Who are at highest risk of having a hemorrhagic stroke?
Those with high blood pressure or long term elevated blood pressure that is not treated
Those born with weaknesses in the wall of the arteries have what?
ANEURYSM, the swelling or enlargement of part of an artery resulting from weakening of the arterial wall
What is a BERRY ANEURYSM?
This type of aneurysm resembles a berry that juts out from the artery and is the most common type of stroke when a healthy young person has a stroke.
What is the medical term for a ministroke?
TRANSIENT ISCHEMIC ATTACK
What is APHASIA?
Inability to produce or understand stpeech and occurs when the patient’s left cerebral hemisphere has been affected by a stroke
What happens when the right cerebral hemisphere of the brain is not getting enough blood?
Patients will have trouble moving the muscles on the left side of the body
What are three conditions that may mimic stroke?
HYPOGLYCEMIA, POSTICTAL STATE, SUBDURAL OR EPIDURAL BLEEDING
What happens when a patient is in a postictal state?
a period following a seizure that lasts between 5-30 minutes, characterized by labored respirations and some degree of AMS
What is a SEIZURE?
A convulsion, is a temporary alteration in consciousness and is the reason behind almost 30% of EMS calls
What kind of seizure begins in one part of the brain and is classified as simple or complex?
PARTIAL SEIZURE
What do patients complain about when they have a partial seizure?
Numbness, weakness, or dizziness
What is AMS?
Altered mental status
What happens during a TONIC CLONIC SEIZURE?
Patient may exhibit bilateral movement characterized by muscle rigidity and relaxation usually lasting 1-3 minutes
What is STATUS EPILEPTICUS?
Seizures that continue every few minutes without the person regaining consciousness or last longer than 30 minutes
What are FEBRILE SEIZURES?
These seizures result from sudden high fevers, usually in children and in these cases, the child needs to be taken to the hospital for further evaluations
What happens when a patient experiences INCONTINENCE?
Loss of control over bowel and bladder functions
What can resemble a stroke while in the postictal state?
HEMIPARESIS which is the weakness on one side of the body
What are the most common symptoms during the postictal state?
lethargy and confusion
Symptoms in hypoglycemia can mimic stroke or seizures BUT there is a principal difference. What is the difference?
Patients who have had a stroke may be alert and attempting to communicate whereas a patient with hypoglycemia almost always has an altered state of consciousness
What can reverse stroke symptoms and even stop the stroke if given within 2-3 hours of the onset of symptoms?
THROMBOLYTIC THERAPY which are clot dissolvers
What kind of patients cannot be given thrombolytic therapy?
Patients suffering from hemorrhagic strokes
What needs to be monitored in a patient suffering a seizure?
You should monitor their oxygen saturation level with a pulse oximeter, and apply high flow oxygen; oxygen is rapidly consumed during seizure activity
What is your responsibility to a patient who has AMS?
Determining the cause, spinal immobilization as indicated, airway and ventilation support, and transport to the appropriate facility
