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Neuro > Final quick hits > Flashcards

Final quick hits Flashcards

1
Q

Where does the anterior lateral system cross over?

A

Decussates at the dorsal horn

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2
Q

What does ipsilateral stand for?

A

Same side

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3
Q

What is the dorsal column responsible for?

A

Fine touch
Two touch
Vibration
Proprioception

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4
Q

What is the Antero-lateral system responsible for?

A

Pain
Temp
Crude touch
Pressure

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5
Q

Which cranial nerve is most likely to be compressed by a pituitary tumor?

A

Optic - CN 2

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6
Q

At a PaCO2 of 40 what is the CBF?

A

50mL/100g brain tissue

(10 points higher)

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7
Q

What does compression on the medulla cause?

A

Irregular respirations

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8
Q

What level of PaCO2 is recommended for hyperventilation?

A

30-35

<30 can cause cerebral ischemia

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9
Q

Most common symptom of SAH? (sub-arachnoid hemorrhage)

A

Headache

About 50% lose consciousness

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10
Q

What is the most significant source of morbidity and mortality in the patient with SAH?

A

Cerebral vasospasm - Delayed contraction of the cerebral arteries which may lead to infarction

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11
Q

How does free Hgb and the amount of blood observed on CT correlate to a cerebral vasospasm?

A

Increases the incidence

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12
Q

Incidence of a cerebral vasospasm?

A

About 25% of patients a week later

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13
Q

What is an additional treatment for a cerebral vasospasm outside of HHH therapy?

A

Nimodipine - doesn’t break spasm but increases collateral flow

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14
Q

Best treatment if the aneurysm ruptures during the procedure?

A

Reverse with protamine -1mg per 100 units of heparin

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15
Q

Two common ways of reducing ICP that should be avoided in TBI’s?

A

Hyperventilation

Steroids

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16
Q

What drugs are patients with Alzheimer’s disease on? How does this affect our anesthetic plan?

A

Cholinesterase inhibitors are given such as tacrine, donepezil, rivastigmine, and galantamine

These increase the duration of Succ

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17
Q

What is affected by Parkinson’s?

A

Dopaminergic neurons in the basal ganglia

This increases AcH (shaking from constant stimulation)

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18
Q

What drugs should be avoided in Parkinsons?

A

-Metoclopramide
-Butyrophenones (Haldol+Droperidol)
-Phenothiazines (promethazine)

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19
Q

How is ocular perfusion pressure calculated?

A

MAP - intraocular pressure

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20
Q

Where is the most common site of arterial bleed in the brain?

A

Arachnoid and pia matter

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21
Q

What are the three layers of the brain?

A

DAP

Dura
Arachnoid
Pia

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22
Q

Most common site for venous bleed in the brain?

A

Dura and arachnoid

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23
Q

What CN is responsible for pupil constriction ?

A

CN3

24
Q

Order the path for posterior circulation

A

Subclavian

Vertebral

Basilar

Posterior cerebral artery

25
Q

What part of the cerebellum maintains equilibrium?

A

Archicerebelleum

26
Q

What part of the cerebellum maintains muscle tone?

A

Paleocerebellum

27
Q

What part of the cerebellum coordinates voluntary muscle movement?

A

Neocerebellum

28
Q

What part of the brainstem controls auditory and visual tracts?

A

Midbrain

29
Q

What part of the brainstem controls autonomic integration?

A

Medulla and Pons

30
Q

What part of the brainstem controls consciousness and sleep?

A

RAS

31
Q

What part of the brain controls memory and learning?

A

Hippocampus

32
Q

What part of the brain controls emotion, appetite, pain, and stress

A

Amygdala

33
Q

What part of the brain controls cognition, movement, and sensation?

A

Cerebral cortex

34
Q

What part of the brain has fine control of movement?

A

Basal ganglia

35
Q

Cranial nerves photo

A
36
Q

Seizure photo

A
37
Q

Blood flow of brain photo

A
38
Q

What nerves carry parasympathetic output?

A

3,7,9,10

39
Q

What percent of all parasympathetic activity is the vagus nerve responsible for?

A

75%

40
Q

Anterior or Posterior; What is the sensory pathway?

A

Posterior

SSEPS

posterior 1/3 of spinal cord

41
Q

Anterior or Posterior; What is the motor pathway?

A

MEPs

anterior 2/3 of spinal cord

42
Q

Which channelopathy is associated with hypokalemic periodic paralysis?

A

Calcium

43
Q

What two drugs should be avoided in Guilian Barre?

A

Ephedrine Exageratted response)

Succ

44
Q

Two common signs of a cerebral spasm?

A

New neurologic deficit

Altered LOC

44
Q
A
45
Q

Gold standard for diagnosing cerebral vasospasm?

A

Cerebral angiography

46
Q

Treatment for TBI for patient on aspirin?

A

Hypertonic solution

Platelets to reverse aspirin

47
Q

For a TBI, what should CPP be maintained above?

A

70

48
Q

What three drugs are helpful in mapping seizures?

A

Etomidate

Methohexital

Alfentanil

49
Q

How do locals affect the seizure threshold?

A

They reduce it but properly executed block does not increase the risk

50
Q

Which anticonvulsant is excreted unchanged by the kidneys?

A

Gabapentin

51
Q

What two changes are seen in Parkinsons?

A

Decreased dopamine in the basal ganglia

Increased GABA in the thalamus

52
Q

Anterior Spinal Artery Syndrome - S&S?

A

Flaccid paralysis

Bowel and Bladder dysfunction

Low of temp and pain

53
Q

What is preserved during Beck’s syndrome? (Anterior Spinal Artery syndrome) Why?

A

Preserved touch and proprioception

The dorsal column is perfused by the posterior (not anterior) which is why

54
Q

What is supplied by the anterior artery?

A

Corticospinal tract (motor)

Autonomic function (Bowel and Bladder)

Spinothalamic tract - pain and temperature

Neuro (7 decks)

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