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PARAMEDIC SCHOOL > CHP 19: NEURO EMERGENCIES > Flashcards

CHP 19: NEURO EMERGENCIES Flashcards

1
Q

two components of central nervous system

A

brain and spinal cord

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2
Q

two components of peripheral nervous system

A

spinal and peripheral nerves

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3
Q

two main areas where emotions come from in the brain

A

limbic system (anger) and hypothalamus (pleasure, thirst/hunger)

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4
Q

occipital lobe function

A

vision/visual memories

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5
Q

parietal lobe function

A

touch/texture

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6
Q

temporal lobe function

A

hearing and smell, language, sound and odor memories

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7
Q

frontal lobe 2 cortexes and functions

A

motor cortex: voluntary muscle control and spatial awareness

prefrontal cortex: judgement

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8
Q

limbic system function

A

basic emotions and reflexes

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9
Q

diencephalon (thalamus) function

A

relay center

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10
Q

diencephalon (hypothalamus)

A

emotions, temp control

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11
Q

midbrain function

A

LOC, RAS (consciousness), muscle tone

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12
Q

pons function

A

respiratory pattern and depth

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13
Q

medulla oblongata function

A

HR, BP, RR

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14
Q

cranial vs peripheral nerves

A

cranial: send info to brain
peripheral: send commands to body

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15
Q

part of cell body that sends signals

A

axon

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16
Q

part of cell body that receives signals

A

dendrite

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17
Q

what three things does the GCS test

A

eye opening, verbal response, motor response

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18
Q

what is posturing

A

abnormal body positioning that indicates damage to the brain

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19
Q

decorticate vs decerebrate posturing and their GCS scores

A

decorticate: abnormal flexing (curl towards their body) - GCS of 3

decerebrate: abnormal extension (extending away from body) - GCS of 2

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20
Q

in what patient do you hyperventilate

A

signs of ICP and impending herniation

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21
Q

eupnea and its causes

A

normal breathing

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22
Q

tachypnea and its causes

A

rapid and shallow

stimulants, exercise, lung issues

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23
Q

bradypnea and its causes

A

slow rate

opioids, sedatives, alcohol

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24
Q

apnea and its causes

A

absence of breathing

hypoxia, heart attack

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25
Q

hyperpnea and its causes

A

increased rate and depth of breathing

stimulants, OD, exercise

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26
Q

Cheyne-Stokes respirations and its causes

A

gradual increase in rate and depth followed by gradual decrease and periods of apnea “torsades of breathing”

pre-death pattern, brainstem injury, brain herniation

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27
Q

biot/ataxic and its causes

A

extremely irregular with periods of apnea

brainstem injury, ICP

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28
Q

Kussmaul and its causes

A

deep, gasping respirations

acidosis, diabetic ketoacidosis

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29
Q

apneustic and its causes

A

prolonged inspiratory phase and short expiratory phase with bradypnea

brainstem injury

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30
Q

4 signs of Cushings reflex and what it indicates

A

decreased HR, decreased/irregular RR, increased BP, widened pulse pressure (systolic hypertension)

ICP

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31
Q

4 things that happen during shock

A

increased HR and RR, decreased BP, narrowed pulse pressure

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32
Q

what is anisocoria

A

unequal pupils greater than 1mm difference

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33
Q

two popular seizure medications

A

phenytoin (Dilantin) and phenobarbital (Solfoton)

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34
Q

what is ptosis and what can it indicate (2)

A

drooping or sagging of the eyelids

Bell palsy or stroke

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35
Q

state in which a person does not respond to verbal or painful stimuli

A

coma

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36
Q

difference between hallucinations and delusions

A

hallucinations: sensory stimulation that others cannot verify

delusions: thoughts/ideas that are not based on common reality

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37
Q

what is psychosis

A

patient can no longer determine what is real and what is a product of the mind

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38
Q

3 patient protective reflexes

A

cough, gag, and corneal

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39
Q

stimulants cause pupillary _____ and depressants cause pupillary _____

A

dilation

constriction

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40
Q

cranial nerve 1 and its function

A

olfactory - smell

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41
Q

cranial nerve 2 and its function

A

optic - vision

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42
Q

cranial nerve 3 and its function

A

oculomotor - movement of eye, pupil, and eyelid

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43
Q

cranial nerve 4 and its function

A

trochlear - movement of eye

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44
Q

cranial nerve 5 and its function

A

trigeminal - chewing, pain, temp, feeling of mouth/face

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45
Q

cranial nerve 6 and its function

A

abducens - movement of eye

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46
Q

cranial nerve 7 and its function

A

facial - movement of face, tears, salivation and taste

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47
Q

cranial nerve 8 and its function

A

auditory - hearing and balance

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48
Q

cranial nerve 9 and its function

A

glossopharyngeal - swallowing, tase, sensations in mouth and pharynx

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49
Q

cranial nerve 10 and its function

A

vagus - sensation and movement of pharynx, larynx, thorax, and GI

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50
Q

cranial nerve 11 and its function

A

accessory - movement of head and shoulders

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51
Q

cranial nerve 12 and its function

A

hypoglossal - movement of tongue

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52
Q

3 primary forms of aphasia

A

unable to understand speech but able to speak, unable to speak but able to understand, combination of both

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53
Q

what is hemiparesis

A

weakness of one side of the body

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54
Q

what is hemiplegia

A

paralysis on one side of the body

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55
Q

what is ataxia

A

alteration of person’s ability to perform coordinated motions such as walking

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56
Q

what is myoclonus

A

rapid, jerky muscle contraction that occurs involuntarily

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57
Q

what is dystonia

A

part of body contracts and remains contracted

58
Q

what is a rest tremor

A

patient shakes while relaxed but disappears with voluntary movement

59
Q

what is an intention tremor

A

patient shaking when demonstrating movement towards a target (touching nose) and increases as they get closer to target

60
Q

what is postural tremor

A

occurs when a body part is placed in a position and required to maintain that position for extended period

61
Q

tonic vs clonic activity

A

tonic: rigid, contracted body posture

clonic: rhythmic contraction and relaxation

62
Q

what is paresthesia

A

sensation of numbness or tingling

63
Q

what is anesthesia

A

patient can feel nothing within a body part

64
Q

American Stroke Association recommends stroke alert be activated in onset time of symptoms is less than how many hours

65
Q

what is the backup drug if you cannot obtain IV access for dextrose

66
Q

what is the normal cerebral perfusion pressure (CPP) range

A

70-90 mmHg

67
Q

what is multifactorial

A

diseases or conditions caused by more than one factor

68
Q

sudden neurologic conditions are usually caused by what two things

A

emboli or aneurysms

69
Q

two basic types of strokes

A

ischemic (occlusive) and hemorrhagic

70
Q

which type of stroke is self-limiting and why

A

ischemic - only tissue distal to the block can be affected

71
Q

which type of stroke has the hallmark “worst headache of my life”

A

hemorrhagic

72
Q

normal ICP range in adults

A

10-15 mmHg

73
Q

what is herniation

A

movement of a structure from its normal location into another space

74
Q

what is the large opening at the inferior portion of the skull through which the spinal cord exits

A

foramen magnum

75
Q

the three large vessels for a large vessel occlusion

A

basilar, internal carotid terminus, middle cerebral artery

76
Q

what is agnosia

A

inability to identify people or objects

77
Q

what is apraxia

A

inability to perform purposeful actions

78
Q

what is the BE-FAST mnemonic

A

to assess for stroke

balance, eyesight, face, arms, speech, time

79
Q

fibrinolytics needs to be administered within how many hours of onset for ischemic strokes

A

3-4.5 hours

80
Q

what medication should be withheld from stroke patients

A

aspirin (can help ischemic but harm hemorrhagic, no way to tell difference in the field)

81
Q

what are TIAs

A

transient ischemic attacks - episodes of cerebral ischemia that do not inflict permanent damage, many resolve within 1 hour

82
Q

what three features are used to classify seizures

A

where it began in brain, patient’s level of consciousness during seizure, motor symptoms/features associated with seizure

83
Q

generalized vs focal seizures

A

generalized: involve both sides of brain and affect awareness

focal: begin on one side of brain and awareness may remain intact

84
Q

what is nystagmus

A

involuntary, rhythmic eye movement

85
Q

6 steps of seizures

A

LOC, tonic phase, hypertonic phase, clonic phase, post seizure, postictal phase

86
Q

what is a nonmotor seizure

A

“petit mal” brief changes in awareness and little/no movement, common in children

87
Q

stroke vs seizure prodromal signs and symptoms

A

stroke: headache
seizure: odd taste in mouth, seeing lights/hearing sounds, twitching

88
Q

stroke vs seizure activity during event

A

stroke: muscle weakness often on one side
seizure: generalized body movement that typically stops within 12 mins

89
Q

stroke vs seizure response after event

A

stroke: may completely resolve, may have no change, may worsen
seizure: slow return of orientation

90
Q

how is status epilepticus defined

A

seizure lasting longer than 4-5 minutes or consecutive seizures without return of consciousness

91
Q

what is the most common cause of syncope in younger adults

A

vasovagal syncope in response to fear, stress, or pain

92
Q

what are prodromes

A

signs or symptoms that precede a disease or condition

93
Q

causes of muscle tension headaches and how they’re characterized

A

stress, high cortisol levels, depression which cause tension in face and head

dull ache and stiffness

94
Q

causes of migraine headaches and how they’re characterized

A

minor instability in clusters of neurons and changes in size of blood vessels at base of brain

throbbing, nausea, photophobia

95
Q

cause of cluster headaches and how they’re characterized

A

serotonin and histamine levels accompanied by anxiety

pain around one eye lasting 30-45mins

96
Q

cause of sinus headaches and how they’re characterized

A

inflammation or infection of sinus cavities

worst on waking, increases when patient bends over, accompanied with sore throat/nasal discharge

97
Q

Alzheimer disease cause and presentation

A

cause: neuronal death from plaque buildup in brain

presentation: chronic memory loss, decrease in judgement

98
Q

Pick disease cause and presentation

A

cause: damage to neurons in frontal/temporal lobes

presentation: socially inappropriate behavior, rest tremors

99
Q

Huntington disease cause and presentation

A

cause: genetic disorder marked by severe loss of neurons

presentation: tics, irritability, memory loss, difficulty standing

100
Q

Creutzfeldt-Jakob disease cause and presentation

A

cause: proteins clump together with resultant death of neurons

presentation: myoclonic jerking, cognitive deterioration, unstable gait

101
Q

Wernicke encephalopathy cause and presentation

A

cause: thiamine deficiency from malnutrition or chronic alcoholism

presentation: ataxia, confusion, agitation, weakness, peripheral neuopathy

102
Q

AIDS dementia cause and presentation

A

cause: HIV and destruction of nervous system cells

presentation: impaired memory loss, progresses to paralysis, mutism, vegetative state

103
Q

what is neoplasm

A

growths within body serving no useful purpose from cellular reproduction errors

104
Q

what is metastasis

A

process which cancerous cells move to sites distant from their origin site

105
Q

common symptoms of spinal tumors

A

back pain, weakness, ataxia, loss of limb sensation, deformity along spine

106
Q

what are demyelinating disorders

A

occur after damage is done to myelin sheath and prevents smooth signal transmission from neuron to neuron

107
Q

what are degenerating disorders

A

progressive damage/death of neurons

108
Q

what are motor disorders

A

destruction of motor neurons

109
Q

what is MS

A

multiple sclerosis - autoimmune condition in which body attacks myelin of the brain and spinal cord

110
Q

what is Lhermitte sign

A

electric sensation down the spine or extremities when head is flexed forward

111
Q

what is Guillain-Barre syndrome

A

tingling and weakness that starts in legs and moves up to eventual paralysis

112
Q

what causes Parkinson disease

A

damage to substantia nigra (area of brain responsive for production of dopamine)

113
Q

four characteristics of classic Parkinson presentation

A

tremors, postural instability, rigidity, bradykinesia

114
Q

what is bradykinesia

A

shuffle in straight line with feet close together, taking small steps to turn

115
Q

what is aphagia

A

difficulty swallowing

116
Q

what does ALS effect

A

voluntary motor neurons

117
Q

acoustic neuroma - nerve effected and presentation

A

VIII and VII - unilateral hearing loss, headache, facial numbness, balance issues

118
Q

bell palsy S/S

A

eyelid ptosis, facial droop, excessive salivation, loss of taste

119
Q

glossopharyngeal neuralgia - nerve effected and presentation

A

IX - severe, unilateral pain in the tongue, throat, and middle ear

120
Q

hemifacial spasm - nerve effected and presentation

A

VII - involuntary unilateral facial movements

121
Q

Meniere disease - nerve effected and presentation

A

VIII - spontaneous unilateral tinnitus, dizziness, hearing loss, fullness in the ear

122
Q

Trigeminal neuralgia - nerve effected and presentation

A

V - stabbing pain on one side of face

123
Q

what medication can provide relief from vertigo

124
Q

what type of medications can cause secondary dystonia

A

antipsychotics

125
Q

what is spasmodic torticollis

A

neck muscles contract, twisting head to one side and pulling it forward/backward

126
Q

what is oculogyric crisis

A

deviation of eyes in any direction

127
Q

what is oromandibular dystonia

A

contractions of face, tongue in and out of mouth

128
Q

what is blepharospasm

A

eyelid spasms/blinking

129
Q

what is athetosis

A

slow writhing in face and distal extremities

130
Q

what is upper limb dystonia

A

cramping of hands, elbows, arms

131
Q

what is choreiform movements

A

quick jerky irregular movements in face, arms, and hands

132
Q

what is spasmodic dysphonia

A

involuntary contraction of vocal cords

133
Q

what is encephalitis

A

inflammation of the brain

134
Q

what is meningitis

A

inflammation of the meninges

135
Q

presentation of encephalitis

A

fever, headache, nausea/vomiting - personality changes, stiff neck, confusion, photophobia, lethary, confusion, seizure

136
Q

presentation of bacterial meningitis

A

upper respiratory infection - headache, fever, chills, Kernig sign, Brudzinski sign, ICP
(peds - high-pitched cry and bulging fontanelles)

137
Q

key presentation difference in viral meningitis vs bacterial

A

viral meningitis does not have ICP

138
Q

how is poliomyelitis transmitted

A

viral infection through fecal-oral route

139
Q

what is peripheral neuropathy and most common form

A

nerves leaving spinal cord are damaged, causing distorted signals

diabetic neuropathy

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