medsurg test 1 Flashcards
frontal lobe
higher cognition, speech, memory, motor control, thought and concentration
Parietal lobes
processing somatosensory, so your body in the environment, sensing temperature changes
Temporal and Occipital
ears and eyes respectively
Cerebellum
coordinated muscle movement
Meninges
duramater (outer), arachnoid layer, subarachnoid space (csf is here), pia mater (really thin, rests directly on the brain)
CN 1
olfactory. make the patient sniff a thing
CN 2
optic. can they see?
CN 3
Oculomotor. eye movements
CN 4
trochlear - eye movements
CN 5
trigeminal. facial sensation and chewing movements
CN 6
abducens. eye movements
CN 7
facial. make some faces
CN 8
auditory. hey lil mama lemme whisper in ya ear
CN 9
glossopharyngeal. taste and not usually tested
CN 10
vagus. check out the palate and gag reflex
CN 11
accessory. shoulder shrug
CN 12
hypoglossal. stick ya tongue out
PET scan need to know
avoid caffeine, alcohol and tobacco for 24 hours before an exam
Single photon emission computed tomography (SPECT) is used to
detect aneurism
Electroencephalography (EEG) prep
clean hair and stay up all night
Akinetic mutism
unresponsive to the environment. Does not move, might have eye movements
Persistent vegetable state
devoid of cognitive function, but has sleep/wake cycles
Locked-in syndrome
inability to move or respond except for eye movements due to lesion affecting the ponds
normal intracranial pressure
Under 15 mm Hg
normal cerebral perfusion pressure
Normal CCP is 70-100
SIADH signs
decreased urine output, decreased Na+. 3% normal saline may be given (very slow infusion). Patients may be given mannitol
DI s/s
increased urine output, increased Na+
post-operative care for brain surgery
vigorously regulate body temperature
drug of choice for a seizure happening right now
diazepam
biggest risk factor for strike
HTN
Basilar skull fracture s/s
Fractures to the base of the skull can present with bleeding from nose pharynx or ears, battle sign (ecchymosis behind the ear)
CSF leak: halo sign is a ring of fluid around the blood stain from the damage.
NO NG TUBES
Cushing’s Triad
bradycardia, irregular respirations, and a widened pulse pressure
Epidural hematoma
blood collection in the space between the skull and the dura. May have a brief LOC before returning to a lucid state, hematoma expects and leads to increased ICP. Emergency
Intracerebral hemorrhage and hematoma
Occurs in the substance of the brain. Can be traumatic or non traumatic. Treatment includes supportive care, control of ICP. Craniotomy or craniectomy may be needed to remove clot.
Cardinal signs of brain death
coma, absence of brainstem reflex, apnea
Spinal Shock
sudden depression of reflex activity below the level of spinal injury. You will see muscular flaccidity and lack of sensation and reflexes
Neurogenic Shock
caused by loss of function of the autonomic nervous system. BP, HR and cardiac output decrease, venous pooling occurs because of shit peripheral vasodilation, paralyzed portions of the body do not perspire.
Autonomic Dysreflexia
acute emergency - occurs after spinal shock has resolved and may occur years after the injury.
most common cause is distended bladder
Meningitis Signs
Kernig’s Sign - leg cant be extended after bending
Brudzunski’s Sign - can’t just flex one leg, the other goes with it
Multiple Sclerosis
MS is an autoimmune disorder that affects nerve cells in the brain and spinal cord.
periods of relapse
Multiple Sclerosis Nursing Care
exercise, but really avoid overheating and heat in general, encourage fluids to avoid UTI, eyepatch for diplopia
Myasthenia Gravis
Autoimmune disorder affecting the myoneural junction. Antibodies directed at acetylcholine at the myoneural junction impair transmission of impulses. This one has the crises
Myasthenia Gravis Nursing Care
Directed at improving function and reducing and removing circulating antibodies, therapeutic plasma exchange, thymectomy (removing the thymus gland).
Myasthenic Crisis
MG related. From an infection
Cholinergic Crisis
MG problem. From medications
Guillain–Barré
Autoimmune disorder with acute attack of peripheral nerve myelin. Rapid demyelination may produce respiratory failure and autonomic nervous system dysfunction with CV instability.
Trigeminal Neuralgia
5th cranial nerve, characterized by pain. More common in women and patients with MS. Patients can occur with any stimulation, even just air. Patients may avoid eating, neglect hygiene and even isolate to prevent attacks
Bell’s Palsy
facial paralysis caused by unilateral inflammation of the seventh cranial nerve. Manifestations include unilateral facial muscle weakness or paralysis with facial distortion, increased lacrimation, and painful sensations in the face, they may have difficulty with speech and eating. Usually recover within 3-5 weeks.
Mononeuropathy
limited to one limb. teach the patient to protect the limb.
Huntington’s Disease
A chronic progressive hereditary disease that results in choreiform movement and dementia
Pathology involves premature death of cells in the striatum of the basal ganglia (control of movement) and the cortex (thinking, memory, perception, judgment)
ALS - Amyotrophic Lateral Sclerosis
Loss of motor neurons in the anterior horn of the spinal cord and loss of motor nuclei of the lower brainstem
Manifestations include progressive weakness and atrophy of muscles cramps, twitching, and lack of coordination, spasticity, deep tendon reflex brisk and overactive, difficulty speaking, swallowing, breathing
