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Path 3 > Nervous system > Flashcards

Nervous system Flashcards

(48 cards)

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1
Q

Any head injury that maybe damaged the spine shoudl get?

A

Immobilization

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2
Q

Basilar skull fx ssx?

A

Periorbital ecchymosis (raccoon eyes)

Ecchymosis behind ear (battle’s sign)

Hemotympanum (bloody TM)

CSF rhinorrhea/otorrhea (halo sign on gauze)

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3
Q

Blood accumulating between skull/dura

Classically, middle meningeal artery torn by temporal fragment

Expanding hematoma SLOWLY separates dura from skull

A

epidural hematoma (minutes to hours before hematoma is large enough to cause ssx)

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4
Q

Clinical features of epidural hematoma

A

Initial LOC, followed by regained consciousness (lucid interval)

Hours later… cerebral compression -> HA, N/V, confusion, vision changes

Tx = surgery

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5
Q

Blood between dura and arachnoid

Typically, blunt trauma when skull hits fixed object (elderly falls/hits head; MVA)

A

Subdural hematoma

repeated small traumas may have same cumulative effect as single large trauma… boxing, football, blasts

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6
Q

Clin features of subdural hematoma?

A

Slow cerebral compression… hours, days, weeks after head injury

Nonspecific symptoms (e.g., worsening HA) to lateralizing signs such as unilateral dilated/blown pupil, unilateral weakness, decorticate/decerebrate posturing

Requires sx to tx

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7
Q

Bleeding b/w arachnoid membrane/pia mater

Can be from brain trauma

OR

Bleeding from cerebral aneurysm/AVM

A

Subarachnoid hemorrhage

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8
Q

small saccular aneurysm in Circle of Willis

Often rupture spontaneously (35% mortality)

A

berry aneurysm

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9
Q

abnormal connection bw arteries/veins

A

AVM (rare but increased risk of bleed0

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10
Q

Thunderclap HA = sudden bleed

Vomiting

Hemiparesis/hemiplegia

Rapidly advances/requires immediate tx to avoid death

A

subarachnoid hemorrhage

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11
Q

CT image

Blood ouside dura

Concave shape

A

epidural hematoma

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12
Q

CT image

Blood under dura

Crescent shape

A

subdural hematoma

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13
Q

CT image

Blood within brain

compresses ventricles

A

subarachnoid hemorrhage

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14
Q

Pupil dilation (anisocoria)0

Papilledema (swelling of optic nerve)

Posturing (abnormal flexion = decorticate, abnormal extension = decerebrate)

A

Clinicial features of ICP

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15
Q

Cushing’s triad?

A

Respiratoyr changes (Cheyne-Stokes, agonal)

Widening pulses pressure

Bradycardia

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16
Q

Most common CVA (stroke)

Thrombosis formation (slower ssx onset)
Embolism (rapid onset)
A

Ischemic stroke - blood flow to brain is decreased

stroke is 3rd most common cause of death in US

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17
Q

Less common CVA…. associated w/ HTN or ruptured aneurysm/AVM

A

Hemorrhagic

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18
Q

Weakness/paralysis (contralateral to affected side of brain)

Difficulty speaking (aphasia)

Tx?

A

Clincal features of stroke…

Tx = CT to r/o hemorrhage!

Then fibrinolytics/transport to stroke center

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19
Q

Mini stroke

Milder/rapidly resolving symptoms

HIGH RISK OF FULL STROKE W/IN MOS

A

TIA

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20
Q

WHAT TYPE OF STROKE DOESN’T GET FIBRINOLYTICS?

Study These Flashcards
A

HEMORRHAGIC DUH DON’T KILL PEOPLE

21
Q

MOst common form of meningitis?

Study These Flashcards
A

Viral

Adults = flu

Children = rubella, adenovirus, measles

22
Q

Common pathogens for bacterial meningitis?

Study These Flashcards
A

Adults = strep pneumo

Children/Young adults= Neisseria meningitides

Neonates = GBS

23
Q

Clinical features of meningitis?

Study These Flashcards
A

Fever/HA

Nuchal rigidity

Kernig’s/Brudzinski’s

24
Q

forced flexion of neck -> flexion of hips/knees

Study These Flashcards
A

Brudzinski’s sign = meningitis

25
supine pt flexes hip at 90, then attempt to full extend leg upward Leg extension = pain/spasm in hamstring muscles
kernig's
26
Meningitis... all CSF get sent...
for culture
27
Clear CSF, lymphocytes Normal to high protein NORMAL glucose
viral meningitis
28
Cloudy CSF neutrophils HIGH PROTEIN AND LOW GLUCOSE
bacterial meningitis | HIGH DOSE ABX STAT
29
Bite, or urine, blood from dogs, yote, raccoon, bats, foxes, skunks Can take months to reach CNS Flu like illness then eventual agitation/delirium (death w/in 1-3 weeks)
Rabies Fatal if not immediately given postexposure rabies shot (once ssx manifest, no effective tx available)
30
Demyelinating dz presumed to be auto-immune Onset 25-45 years (women 2x more than men)
MS
31
Episodes of exacerbation/remission Sensory ssx (loss of touch, blurred vision) Motor ssx (muscle weakness, unsteady gait) Urinary incontinence
MS
32
What is the diagnostic criteria for MS?
2-nerve related ssx in 2 or more episodes separated by at least one month No tx, but steroids to manage ssx
33
Atrophy of brain cortex w/ neuritic (senile) plaques and neurofibrillary tangles 90% w/ apolipoprotein E4 gene mutation
alzheimers
34
Dementia (loss of memory) Decreased judgment and personality changes Sundowning... pt becomes restless/irritbale towards end of day
Alzheimers No cure... ACEIs and memantine OTs for ADLs
35
Degeneration of extrapyramidal motor system Loss of pigmented (dopaminergic) neurons in substantia nigra
Parkinson's
36
Lewy's bodies?
Parkinson's eisonophilic inclusion wthin depigmentaed neural tracts
37
Parkinson's pyramidal vs extrapyramidal?
Pyramidal = fine motion/completion of movt Extrapyramidal = involuntary
38
CLin features of parkinson's?
Resting tremor of hands (pill rolling) Slow shuffling walk w/ stooped posture (slowing of voluntary movt = bradykinesia) Cogwheel rigidity/stuffness (UE on PROM) Mask-like face (gradual loss of expression/drooling)(
39
Tx for parkinson's?
No cure, but dopamine eases ssx
40
Atrophy of caudate nucleus and motor cortex of frontal lobe Onset usually by 40 Presents w/ motor disturbances
Huntingtons chorea | also progressive dementia/abnormal behavior
41
Involuntary, gyrating movt Choreiform
Huntington's chorea (on CT - wide sulci, large ventricles) No cure, meds may ease ssx
42
Rare dz w/ progressive muscle wasting DZ SPARES COGNITION/INTELLECT (UNIQUE FEATURE) Onset, middle-aged to older
Amyotrophic Lateral Sclerosis
43
Hand muscle fasciculations (involuntary twitching that doens;t move limb) Rapidly increasing paralysis (difficulty swallowing, speaking)
ALS (Lou Gehrig's) No tx (meds minimally slow progression)
44
Onset 25-40 Autoimmune Demyelinating (brain) Blurred vision sensory loss muscle weakness
MS
45
onset 70+ Amyloid plaques and neurofibril tangles Memory loss dementia
Alzheimers
46
60+ Decreased dopaminaergic neurons in substantia nigara extrapyramidal motor d/o Pill rolling cogwheeling mask-like face
Parkinson's
47
40+ Atrophy of caudate nucleus/cerebral cortex gyrating movt dementia/behavioral changes
Huntington
48
35+ Spinal cord (ant horn), medulla, cerebral cortex Fasciculations Muscle wasting INTELLECT SPARED
Lou Gehrig (ALS)

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