Chapter 17 Neurologic Emergencies Flashcards
The three major parts of the brain are the:
Cerebrum, cerebellum, and brainstem
What is a symptom that would lead the EMT to believe that a patients headache is caused by sinus congestion?
The pain is worse when bending over
The most significant risk factor for a hemorrhage stroke is:
Hypertension
The patient whose speech is slurred and difficult to understand is experiencing (the term):
Dysarthria
What is a condition that would likely mimic the signs and symptoms of a stroke?
Hypoglycemia
What can describe a simple partial seizure?
A seizure that begins in one extremity
What will the patient most likely experience during the postictal state that follows a seizure?
Confusion
Fatigue
Labored respirations
Altered mental status
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a two-year-old male. The child is conscious and crying. According to the mother, the child has been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:
Transport the child to the hospital and reassure the mother in route
A patient with an altered mental status is:
Not thinking clearly or is incapable of being aroused
When caring for a patient with documented hypoglycemia, you should most be alert for:
A seizure
During the primary assessment of a semi-conscious 70-year-old female: you should:
Ensure a patent airway and support ventilation as needed
You are caring for a 68-year-old man with sudden onset of left sided paralysis and slurred speech. Airway is patent, his respirations or 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include
Recovery position and transport
When you’re obtaining medical history from the family of a suspected stroke patient, it is most important to determine:
When patient last appeared normal
When assessing for arm drift of a patient with a suspected stroke, you should:
Ask the patient to close his or her eyes during the assessment
Your patient opens his eyes moans and pulls away from you when you pinch his check easiest muscle. You should assign a Glasgow Coma Scale (GCS) of
Eight
The patient who is possibly experiencing A stroke is not eligible for thrombolytic therapy if he or she
Has bleeding in the brain
A 30-year-old male experienced a generalized seizure, which stoped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. What would be the a compelling reason to disagree with his refusal of transport?
He is currently not prescribed any medications
The left cerebral hemisphere controls:
The right side of the body
What condition would most likely affect the entire brain?
Respiratory failure or cardiopulmonary arrest
When the blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel, the result is:
An ischemic stroke
Patients with a subarachnoid hemorrhage typically complain of a sudden severe:
Headache
The principal difference between a patient who has had a stroke and the patient with hypoglycemia almost always has to do with the:
Mental status
Headaches, vomiting, altered mental status, and seizures are all considered early signs of:
Increased intracranial pressure
You are called to a home and find a 56 your old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You asked the patient, “What day is today?” and her reply is, “Butterfly”. Which area of the brain is likely affected?
The left hemisphere
The _____ controls the most basic functions of the body, such as breathing, blood pressure, swelling, and pupil constriction.
Brainstem
At each vertebra in the neck and back, two nerves, called _____ nerves, branch out from the spinal cord and carry signals to and from the body.
Spinal
_____ is the a loss of bowel and bladder control and can be due to a generalized seizure.
Incontinence
_____ may reverse stroke symptoms and even stop the stroke if given within 3 to 6 hours of onset of symptoms.
Thrombolytics
A swelling or enlargement of part of an artery resulting from weakness of the arterial wall is called:
An aneurysm
An inability to produce or understand speech is called:
Aphasia
A sense of warning experienced prior to a seizure is called:
An aura
Weakness of one side of the body is called:
Hemiparesis
What does TIA stand for?
Transient ischemic stroke
Define a TIA
“Mini-stroke”
Brain cells stop functioning from lack of oxygen, causing stroke-like symptoms.
Completely resolves itself within 24 hours
Define stroke
Interruption of blood flow to the brain, resulting in loss of function
What are four causes of a stroke?
Thrombus
Embolism
Compression
Aneurism
What is a CVA?
Cerebrovascular accident (stroke)
What is the most common cause of a CVA?
A blood clot (thrombus)
List the three stages of a seizure
Aura
Tonic-clonic
Postictal
Define seizure
A surge of electrical activity in the brain
What are three types of seizures?
Petite mal (absence) Grand mal (tonic-clonic) Febrile (high fever)
What is status epilepticus?
A seizure that continues every few minutes without the person regaining consciousness or longer than 30 minutes
What do you do for a patient who is having a grand mal seizure?
Protect the head and let it pass
What is a tension headache caused by?
Muscle contractions in the head and neck attributed to stress
What is a migraine headache?
Thought to be caused by changes in blood vessel size in the brain
What symptoms might a patient with a migraine headache experience?
Nausea and vomiting
Light sensitivity
What is a sinus headache caused by?
Pressure that is a result of fluid accumulation in the sinus cavities
What is bacterial meningitis?
Inflammation of the meninges caused by a bacterial infection
What signs/symptoms would a patient with bacterial meningitis experience?
Headache
Fever
Stiff neck
Sensitivity to light
if a person is having a stroke on the left side of the brain what will they exhibit?
Aphasia (answers ‘butterfly’ when asked a question)
Right sided paralysis
if a person is having a stroke on the right side of the brain what will they exhibit?
Dysarthia (slurred speech)
Trouble moving muscles on the left side
May be completely oblivious to it
What is the GCS ratings for eye opening?
4 - Spontaneous
3 - Response to speech
2 - Response to pain
1 - None
What is the GCS ratings for verbal response?
5 - Oriented conversation 4 - Confused conversation 3 - Inappropriate words 2 - Incomprehensible sounds 1 - None
What is the GCS ratings for motor response?
6 - Obeys commands 5 - Localizes pain 4 - Withdraws from pain 3 - Abnormal flexion 2 - Abnormal extension 1 - None
The brain is most sensitive to _____, _____, and _____ levels.
Oxygen
Glucose
Temperature
A(n) _____ _____ seizure may cause twitching of the extremity muscles that may spread slowly to another body part.
Simple partial
What is the difference between a simple partial and a complex partial seizure?
Simple partial - no change in mental status, may experience sensory changes or muscle twitching that slowly spreads to another area
Complex partial - altered mental status, isolated convulsions (lip smacking, eye blinking)
What are three conditions that may simulate a stroke?
Hypoglycemia
Postictal state
Subdural/Epidural bleeding
