Medical Emergencies Flashcards
Occiptial
vision and storage of visual memories
Parietal
Sense of touch and texture and storage of tactile memories
Temporal
Hearing
Smell
Language
Storage of sound and odor memories
Frontal
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
Limbic System
Basic emotions
Basic reflexes, such as chewing and swallowing
Diencephalon (Thalmus)
Relay center that prioritizes signs to hone in on important messages
Diencephalon (Hypothalamus)
Emotions
Temperature control
Interface with the endocrine system
Midbrain
LOC
Location of the reticular activating system (RAS) which controls; arousal and consciousness
Muscle tone and posture
Pons
Brain Stem
Respiratory pattern and depth
Medulla oblongata
Pulse rate, blood pressure, RR
Neuron cell body
The portion of the never where the nucleus resides, the site of protein synthesis
Neuron axon
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
Neuron dendrite
Projection from the cell body that receives signals from axons of other neurons
most neurons have multiple dendrites
Neuron synapse
The gap between an axon and a dendrite
Neuron neurotransmitter
A chemical released into a synapse that helps make the connection between one neuron and another (eg, serotonin, dopamine, and epinephrine)
DeCORticate Posturing
Patient contract their arms and curl toward them
Points toes
Indicates damage to the area directly below the cerebral hemispheres
Decerebrate Posturing
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
Trismus
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
Eupnea
Regular rate and pattern
Inspiration and expiration are equal
Tachyplea
Increased RR
Regular pattern
Caused by: Stimulants, exercise, excitement
Bradypnea
Decreased RR
Regular pattern
Apnea
Absence of breathing
Causes: severe hypoxia, depressants
Hyperpnea
Rapid, regluar, deep respirations
Causes: stimulants, overdose, exercise
Cheyne-Stokes respirations
Gradual increases and decreases in respirations with periods of apnea
Biot/ataxic respirations
Irregular respirations with periods of apnea
Causes: brainstem injury
Kussmaul respirations
Extreme tachypnea and hyperpnea
Causes: Acidosis, diabetic ketiacidosis
Apneustic respirations
Prolonged inspiratory phase with shortened expiratory phase and bradypnea
Causes: Brainstem injury
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.
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
BGL hypoglycemia
below 60 mg/dL
BGL Hyperglycemia
Above 300 mg/dL
hemiparesis
weakness on one side of the body
hemiplegia
paralysis on one side of the body
Hemi-plegia
Plegia, paralyzed
Para-plegia
Ataxia
Alteration of a persons ability to perform coordinated movements such as walking
Rest tremor
Occurs when the patient is at rest and not moving
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
Postural tremor
Occurs when a body part is placed in a particular position and required to maintain that position for a long period.
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
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.
Paresthesia
Numbness or tingling
Anesthesia
No feeling in a body part
Aura
Visual changes such as flashing lights of bling spots in the flied of vision
Common anti-seizure meds
Phenytoin (Dilantin)
lorazepam (Ativan)
carbamazepine (Tegretol)
valproic acid (Depakene)
Types of generalized seizures
Tonic-clonic
absence
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
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
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.
Partial complex
Patient change in LOC but do not become unresponsive.
Cushing Triad
Bradycardia (under 60)
Bradypnea or irregular respirations
Widening pulse pressure
Signs of increased ICP
Cushing Triad Decorticate posturing Decerebrate posturing Anisocoria or dilated and unresponsive pupils Biot respirations Apneustic respirations Cheyne Stokes respirations
Herniation
The movement of tissue from one space into another space
CPP (Cerebral Perfusion Pressure) range
70-90 mm Hg
CPP formula
CPP = MAP - ICP
aphasia
loss of ability to understand or express speech, caused by brain damage.
agnosia
inability to interpret sensations and hence to recognize things, typically as a result of brain damage.
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.
Hemiparesis
Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles. Mild or partial
Ptosis
Ptosis is when the upper eyelid droops over the eye
AMS algorithm
AEIOU-TIPS
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.
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.
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.
The stroke Penumbra
Normal - no tissue damage
Oligemia - little tissue damage
Penumbra - savable tissue
Infarct core - shits dead yo
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
GCS Scale
Eyes 1-4
Verbal 1-5
Motor 1-6
Dead, coma, paralyzed
Up=dystonic
Down=brain bleed/mass
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.
Affected cranial nerves
Conjugate Lateral
Looks toward brain bleed
Looks away from the seizure
Skew deviation
Brain lesion
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
Two types types of hemorrhagic strokes
Intracerebral hemmorhage
- blood vessel rupture
- after embolic strike
- AV malformation
Subarachnoid hemmorhage
- berry anerurysm
- AV malformaion
The Stroke Penumbra
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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.
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.
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.
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.
