Medical Emergencies Flashcards
1
Q
Occiptial
A
vision and storage of visual memories
2
Q
Parietal
A
Sense of touch and texture and storage of tactile memories
3
Q
Temporal
A
Hearing
Smell
Language
Storage of sound and odor memories
4
Q
Frontal
A
Motor cortex: voluntary muscle control and storage of spatial memories
Prefrontal cortex: Judgment and prediction of consequences of a person’s actions, abstract intellectual functions
5
Q
Limbic System
A
Basic emotions
Basic reflexes, such as chewing and swallowing
6
Q
Diencephalon (Thalmus)
A
Relay center that prioritizes signs to hone in on important messages
7
Q
Diencephalon (Hypothalamus)
A
Emotions
Temperature control
Interface with the endocrine system
8
Q
Midbrain
A
LOC
Location of the reticular activating system (RAS) which controls; arousal and consciousness
Muscle tone and posture
9
Q
Pons
A
Brain Stem
Respiratory pattern and depth
10
Q
Medulla oblongata
A
Pulse rate, blood pressure, RR
11
Q
Neuron cell body
A
The portion of the never where the nucleus resides, the site of protein synthesis
12
Q
Neuron axon
A
projection from the cell body that reaches out to connect with other neurons or target organs
signals are sent away from the cell body
some axons are covered with insulation called myelin
myelin increases the speed of nerve conduction
13
Q
Neuron dendrite
A
Projection from the cell body that receives signals from axons of other neurons
most neurons have multiple dendrites
14
Q
Neuron synapse
A
The gap between an axon and a dendrite
15
Q
Neuron neurotransmitter
A
A chemical released into a synapse that helps make the connection between one neuron and another (eg, serotonin, dopamine, and epinephrine)
16
Q
DeCORticate Posturing
A
Patient contract their arms and curl toward them
Points toes
Indicates damage to the area directly below the cerebral hemispheres
17
Q
Decerebrate Posturing
A
Extend their arms outward and rotate the lower arms in a palm down manner
Points toes
A more severe finding than decorticate.
Damage within or near the brain stem
18
Q
Trismus
A
Clenched teeth
Can indicate a seizure, severe head injury, or cerebral hypoxia
Patient may need to be sedated/paralyzed to relax facial muscles causing the clenched teeth
19
Q
Eupnea
A
Regular rate and pattern
Inspiration and expiration are equal
20
Q
Tachyplea
A
Increased RR
Regular pattern
Caused by: Stimulants, exercise, excitement
21
Q
Bradypnea
A
Decreased RR
Regular pattern
22
Q
Apnea
A
Absence of breathing
Causes: severe hypoxia, depressants
23
Q
Hyperpnea
A
Rapid, regluar, deep respirations
Causes: stimulants, overdose, exercise
24
Q
Cheyne-Stokes respirations
A
Gradual increases and decreases in respirations with periods of apnea
25
Biot/ataxic respirations
Irregular respirations with periods of apnea
Causes: brainstem injury
26
Kussmaul respirations
Extreme tachypnea and hyperpnea
Causes: Acidosis, diabetic ketiacidosis
27
Apneustic respirations
Prolonged inspiratory phase with shortened expiratory phase and bradypnea
Causes: Brainstem injury
28
Delusions
Thoughts, ideas, or perceived abilities that are not based in a common reality.
Examples include patent who think they can fly or that everyone is out to get them.
29
Psychosis
As delusions and hallucinations increase the patient moves further and further from reality. Eventually they can no longer determine what is real and what is inside their mind. This becomes psychosis
30
BGL hypoglycemia
below 60 mg/dL
31
BGL Hyperglycemia
Above 300 mg/dL
32
hemiparesis
weakness on one side of the body
33
hemiplegia
paralysis on one side of the body
Hemi-plegia
Plegia, paralyzed
Para-plegia
34
Ataxia
Alteration of a persons ability to perform coordinated movements such as walking
35
Rest tremor
Occurs when the patient is at rest and not moving
36
Intention tremor
Occurs when the patient is asked to reach out and grab an object. It is common for this tremor to increase as the patient gets closer to the object to be grabbed
37
Postural tremor
Occurs when a body part is placed in a particular position and required to maintain that position for a long period.
38
Tonic activity
A ridged, contracted body posture. The legs, arms, neck, and back can contract to tightly that the body part shakes from the intensity of the contraction
39
Clonic activity
is characterized by rhythmic contraction and relaxation of muscle groups. Clonic activity can be described as the bizarre, nonpurposeful movement of any body part. Arms and legs may flail, teeth may clench, the head may bob, and the torso may convulse wildly.
40
Paresthesia
Numbness or tingling
41
Anesthesia
No feeling in a body part
42
Aura
Visual changes such as flashing lights of bling spots in the flied of vision
43
Common anti-seizure meds
Phenytoin (Dilantin)
lorazepam (Ativan)
carbamazepine (Tegretol)
valproic acid (Depakene)
44
Types of generalized seizures
Tonic-clonic
absence
45
Pseudoseizures
Seizures that present like a tonic-clonic seizure by psychological in origin. Typically only occur in the presence of other people. Caused by emotional events, stress, lights, or pain
46
Absence Seizures
Little to no movement of body.
Typical in children.
Person will just freeze for a few seconds.
No postictal period and no confusion
47
Partial Seizures - simple
Seizure in one part of the brain. Can spread to other adjacent parts of the brain like a pebble dropped in a still pond, called JACKSONIAN MARCH. Example: Shaking of the left hand leads to arm shaking leads to upper body shaking leads to full body shaking
Involve either movement or sensation in one part of the body.
48
Partial complex
Patient change in LOC but do not become unresponsive.
49
Cushing Triad
Bradycardia (under 60)
Bradypnea or irregular respirations
Widening pulse pressure
50
Signs of increased ICP
```
Cushing Triad
Decorticate posturing
Decerebrate posturing
Anisocoria or dilated and unresponsive pupils
Biot respirations
Apneustic respirations
Cheyne Stokes respirations
```
51
Herniation
The movement of tissue from one space into another space
52
CPP (Cerebral Perfusion Pressure) range
70-90 mm Hg
53
CPP formula
CPP = MAP - ICP
54
aphasia
loss of ability to understand or express speech, caused by brain damage.
55
agnosia
inability to interpret sensations and hence to recognize things, typically as a result of brain damage.
56
Apraxia
Apraxia is a neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood and there is a willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act.
57
Hemiparesis
Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles. Mild or partial
58
hemiplegia
Hemiplegia is a severe or complete loss of strength or paralysis on one side of the body.
59
Ptosis
Ptosis is when the upper eyelid droops over the eye
60
AMS algorithm
AEIOU-TIPS
61
hypercapnia
excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration.
62
Encephalitis
swelling of the brain
63
Menigitis
Swelling of the meninges, the outer covering of the central nervous system
64
Kernig sign
Kernig's sign is one of the physically demonstrable symptoms of meningitis. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
65
Brudzinski sign
One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.
66
Fontanelles
Fontanelles are the soft spots on an infant's head where the bony plates that make up the skull have not yet come together. It is normal for infants to have these soft spots, which can be seen and felt on the top and back of the head. Fontanelles that are abnormally large may indicate a medical condition.
67
Peripheral Neuropathy
Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other areas and body functions including digestion, urination and circulation.
68
TIA
Transient ischemic attack
69
The stroke Penumbra
Normal - no tissue damage
Oligemia - little tissue damage
Penumbra - savable tissue
Infarct core - shits dead yo
70
How to calculate MAP
Diastolic BP + 1/3 pulse pressure (systolic - diastolic = pulse pressure)
120/60
MAP = 60 + 20 = 80
71
Right hemisphere stroke
Left body
trouble with object distances
left sided neglect
impulsivity / poor decision making / safety concerns
short attention span / slow learning new things
72
Left hemisphere = right body
Aphasia (difficulty communicating): receptive and/or expressive
Slow careful movement
loss of sight on right side
trouble remembering or learning new things
73
Cranial nerve 1
Olfactory: smell
74
Cranial nerve 2
Optic: Visual acuity
75
Cranial nerve 3
Oculomotor: Opening of eyelids, eye movement
76
Cranial nerve 4
Trochlear: eye movement (downward/medial)
77
Cranial nerve 5
Trigeminal: Facial sensation, chewing movements
78
Cranial nerve 6
Abducens: eye movement lateral
79
Cranial nerve 7
Facial: facial muscle movement (except for chewing) and eyelid closing
80
Cranial nerve 8
Auditory: hearing and balance
81
Cranial nerve 9
Glossopharyngeal: Taste on the posterior third of the tongue
82
Cranial nerve 10
Vegas: Uvula (palate muscles) and swallowing
83
Cranial nerve 11
Accessory: Shoulder shrug
84
Cranial nerve 12
Hypoglossal: Tongue movement
85
the corpus callosum
The corpus callosum is a large bundle of more than 200 million myelinated nerve fibers that connect the two brain hemispheres, permitting communication between the right and left sides of the brain.
86
medulla oblongata
The medulla oblongata plays a critical role in transmitting signals between the spinal cord and the higher parts of the brain and in controlling autonomic activities, such as heartbeat and respiration.
Also where the crossover from the right brain to the left body
87
The Basal Ganglia
The “basal ganglia” refers to a group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.
88
the thalamus
The thalamus is a small structure within the brain located just above the brain stem between the cerebral cortex and the midbrain and has extensive nerve connections to both. The primary function of the thalamus is to relay motor and sensory signals to the cerebral cortex.
89
The cerebellum
The cerebellum is important for making postural adjustments in order to maintain balance. Through its input from vestibular receptors and proprioceptors, it modulates commands to motor neurons to compensate for shifts in body position or changes in load upon muscles.
90
The limbic system
The limbic system is the part of the brain involved in our behavioural and emotional responses, especially when it comes to behaviours we need for survival: feeding, reproduction and caring for our young, and fight or flight responses.
91
The hypothalamus
The hypothalamus is a gland in your brain that controls your hormone system. It releases hormones to another part of your brain called the pituitary gland, which sends hormones out to your different organs. These include: Adrenals.
92
The hippocampus
The hippocampus is a small, curved formation in the brain that plays an important role in the limbic system. The hippocampus is involved in the formation of new memories and is also associated with learning and emotions.
93
The amygdala
The amygdala is a complex structure of cells nestled in the middle of the brain, adjacent to the hippocampus (which is associated with memory formation). The amygdala is primarily involved in the processing of emotions and memories associated with fear.
94
The pineal gland
The pineal gland is a small, pea-shaped gland in the brain. Its function isn't fully understood. Researchers do know that it produces and regulates some hormones, including melatonin. Melatonin is best known for the role it plays in regulating sleep patterns. Sleep patterns are also called circadian rhythms.
95
The meninges
```
Scalp
Skull
Periosteal dura mater
Meningeal dura mater
Arachnoid mater
Subarachnoid space
Pia mater
Cerebral cortex
```
```
Savages
Scalp
People
Messing
Around
Selling
Poison
Cookies
```
96
Subdural vs Epidural hematoma
Subdural is below the dura mater between the brain and the dura mater. The bleed is venous in nature.
Epidural is above the dura mater and is between the skull and the dura mater. The bleeding is arteria in nature.
97
GCS Scale
Eyes 1-4
Verbal 1-5
Motor 1-6
98
Dead, coma, paralyzed
99
Up=dystonic
Down=brain bleed/mass
100
Roaving metabolic
These occur when third nerve nuclei and connections are intact and often indicate a toxic, metabolic or alternatively bilateral hemisphere cause for coma. Irritative or epileptic foci cause contralateral conjugate eye deviation.
101
Affected cranial nerves
102
Conjugate Lateral
Looks toward brain bleed
Looks away from the seizure
103
Skew deviation
Brain lesion
104
Pneumonic to remember cranial nerves
Oh Oh Oh, To Touch and Feel A Virgin Girls Vagina and Hymen
105
Altered Mental Status: AEIOU-TIPS
A -alcohol, abuse
E- epilepsy, electrolytes, endocrine, encephalopathy
I - insulin, intoxication
O - overdose
U - uremia, underdosage
T - trauma, temperature, tumor
I - infection, meningitis, Reyes syndrome, sepsis
P - psychological, poisoning
S - Shock, stroke, sickle cell amemia, subarachnoid hemorrhage, space occupying lesions, shunt related probems
106
Etiology of Seizures
```
Hypoxia
Hypoglycemia
Cranial cavity bleeding
brain tumor, abscess
head truma
metabolic imbalances
body temperature rapid rise
alcohol withdrawal, certain medications, illegal drugs
```
107
Types of partial seizures
Simple
| Complex
108
Types of generalized seizures
Absence
Tonic-clonic
febrile
pseudoseizures
109
Seizure interventions
```
No not restrain
100% O2 NRB
Ventilation BVM
Nasal airway
Benzodiazepine
Pulse oximetry
ECG
Cardiac monitor
BGL
```
110
Status Epilepticus
A seizure lasting more than 10 minutes
2 or more seizures without an intervening period on consciousness
111
Seizure: Valium (Diazepam) dose
5-10 mg IV
112
Seizure: Ativan (lorazepam) does
2-4 mg IV/IM
113
Seizure: Versed (Midazolam) dose
2-6 mg IV/IO/IM
10 mg IN
114
Syncope: Differentials
```
Cardiac
Pulmonary
Vascular or volume causes
Endocrine causes
Neurologic causes
Toxicology causes
Implanted device causes
Ob/Gyno causes
Electrolyte causes
Infectious causes
```
115
Phases of a migraine headache
Prodrome
- yawning
- cravings
Aura
- weakness
- visual issues
- tingling sensation
- aphasia
Migraine Headache
- irritability
- throbbing pain
- nausea or vertigo
- sensitivity to light, sound, and smells
Postdrome
- hungover feeling
- fatigue
116
Thrombus vs embolism
Thrombus is a clot that forms in a vessel.
An embolism is a thrombus that has broken free into the blood vessel to cause to cause a clot elsewhere.
117
Lacunar Stroke
A lacunar stroke, also called a lacunar infarct, occurs when an artery that supplies blood to the deeper portions of the brain becomes blocked. Other types of strokes occur on the surface, or cortex, of the brain. Lacunar strokes represent anywhere from 15% to 25% of strokes.
- Ischemia from small deep vessels
- stroke occurs in deeper critical areas of the brain
- common causes: hypertension and atherosclerosis
- small infarctions with big consequences
118
Two types types of hemorrhagic strokes
Intracerebral hemmorhage
- blood vessel rupture
- after embolic strike
- AV malformation
Subarachnoid hemmorhage
- berry anerurysm
- AV malformaion
119
The Stroke Penumbra
120
CPP = MAP - ICP
CPP = Cerebral perfusion pressure
MAP = Mean arterial pressure. MAP= Diastolic BP + 1/3 pulse pressure
ICP intracranial pressure
121
FAST-ED
| F
122
FAST-ED
| A
123
FAST-ED
| S
124
FAST-ED
| T
Time of symptom onset
Time last seen normal
125
FAST-ED
| E
126
FAST-ED
| D
127
FAST-ED
A score of ____ is considered a positive LVOS (Large Vessel Occlusion Strokes) result
4 or less
128
How much time so ischemic stroke patient have to get treatment?
6 hours
129
Prehospital critical actions
Assess and support cardio-respiratory function
Assess blood glucose
Assess and support oxygenation and ventilation. Keep SpO2 between 94-99%
Assess neurological function
Determine precise time of symptom onset
Determine essential medical information
Provide rapid transport to stroke center
Notify ED of stroke alert
130
Alzheimer's
Progressive loss of brain matter beginning in the hippocampus
131
Parkinsons
Degenerative disorder
Dopamine deficiency in cerebellum
Redidity, tremors, shuffling gate, changes in speech, pin-rolling tremor often earliest sign
132
ALS, also called Lou Gehrig's Disease
Progressive loss of muscle control
affects cortical motor strip and motor pathways in brainstem
Leads to respiratory failure and death
133
Multiple Sclerosis
Autoimmune disease
CNS Myelin sheath is attacked/destroyed
Common symptoms:
- vision loss
- fine motor control loss
- extremity pain
- paralysis
- hearing loss
- vertigo
134
Guillian-Barre Syndrome
Autoimmune attack of myelin sheath in peripheral nerves
weakness and tingling in extremity are early symptoms
Many cases after 1976 Swine Flu vaccine
135
Huntington's Disease
Genetic
progressive loss of brain function
Mood and personality changes
movement disorders
psychosis develops as disease progresses
136
Autonomic Dysreflexia
Autonomic dysreflexia is a serious medical problem that can happen if you've injured your spinal cord in your upper back. It makes your blood pressure dangerously high and, coupled with very low heartbeats, can lead to a stroke, seizure, or cardiac arrest.
137
Spina Bifida
a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.
138
Hydrocephalus
Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain. Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column.
139
Muscular Dystrophy
Muscular dystrophy is a group of diseases that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle. There are many kinds of muscular dystrophy.
140
Dystonic reaction medication treatment
25-50 mg of Benadryl will reverse extrapyramidal symptoms
141
Dystonic Reaction
Dystonic reactions (ie, dyskinesias) are characterized by intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, extremities, and even the larynx.
142
Trigeminal Neuralgia
Trigeminal neuralgia is a condition that causes painful sensations similar to an electric shock on one side of the face. This chronic pain condition affects the trigeminal nerve, which carries sensation from your face to your brain.
143
Bells Palsy
Facial drooping due to inflammation/infection of the trigeminal nerve
They can not move their forehead, in strokes they can
