FINAL: Neurology Flashcards
what are the four clinical signs of increased intra-cranial pressure
projectile vomiting, uneven pupil size, pupil not reactive to light, declining level of consciousness
what are the three clinical signs of cushings syndrome
hypertension, brachycardia, abnormal resupiration (also indicitave of increased intra-cranial pressure)
when completing neurological testing, if it appears that the patient has one normally-responsing side of the body and one weak side, what is this an indication of?
decreased lateralization of neurological signs and it would indicate increased intra-cranial pressure
what are the four clinical signs of meningitis
photophobia, neck stiffness, positive brudinsky &/or kernigs test
under what circumstances would a spinal tap be a contraindication for someone we suspect has meningitis
if there are more prevalent increased intracranial pressure signs than meningeal signs, then we cannot do a spinal tap. due to the pressure inside the skull, a spinal tap would cause the brain to fall down and herniate into the formen magnum, killing the patient.
what are the three possible types of hemorrhages one can have in the brain
epidural hematoma, subdural hematoma, subarachnoid hematoma
what is the cause for an epidural hemorrhage
trauma that causes a tear in the middle meningeal artery
what are the clinical signs of an epidural hemorrhage
initial brief loss of consciousness, lucid interval after re-gianing consciousness, and death shortly after if left undiagnosed.
what is the cause for a subdural hemorrhage
trauma with tearing the bridging veins
what are the clinical signs of a subdural hemorrhage
stubborn headache increasing in intensity over time, and often in a fixed location
what is the source of a subarachnoid hemorrhage
ruptured aneurysm
what are the clinical signs of a subarachnoid hemorrhage
perceived as “the worse headache ever;” comes on suddenly followed by loss of consciousness minutes after
PERLA
acronymn for: pupils are equal, and reactive to light, and accomodation - if these tests are not positive, then we can suspect an injury in the midbrain
hydrocephalus
accumulation of excess cerebrospinal fluid
cause of hydrocephalus
lack of absorption of CSF into the dural sinuses as a result of atrophy of arachnoid granulations, which normally deliver CSF (communicating hydrcephalus)
also could be due to an obstruction of flow of CSF (non-communicating hydrocephalus)
what population is communicating hydrocephalus mostly found in
geriatric population
what is the cause of non-communicating hydrocephalus
may be a result of a congenital defect or a complication of meningitis (ie: adhesions after a surgery)
eitiology of ALS
loss of anterior horn cells
ALS presentation
patient presents with progressive weakness that proceeds to paralysis fromneurogenic muscular atrophy
degeneration of MOTOR neurons only!!
pathomechanism of ALS
because of the loss of anterior horn cells, the anterior (ventral) spinal motor nerve roots demonstrate atrophy. Upper motor neurons within the brain and the brain stem (pyramidial or corticospinal) may degernate as well.
clinical presentations of upper motor neuron injury
spinal reflexes are exaggerated; positive babinski
clinical presentations of lower motor neuron injury
disconnect to muscle-muscle becomes weak, reflexes become diminished and muscle atrophies; flacidity
which kind of meningitis is usually the most severe form
bacterial meningitis
which form of meningitis can be described as the following:
1. highly contageous
2. edema of the brain
3. disseminated intravascular coagulation
bacterial meningitis