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Critical Care > Neuro > Flashcards

Neuro Flashcards

1
Q

Cerebral Perfusion Pressure Formula

A

MAP-ICP

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2
Q

MAP Formula

A

((2 x DBP)+SBP)/3

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3
Q

Normal MAP range

A

80-100

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4
Q

Normal cerebral perfusion pressure

A

70-90

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5
Q

Normal ICP

A

0-10

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6
Q

What is Brudzinski’s Sign

A

Severe Neck stiffness causing the patinet’s hips and knees to flex when neck is flexed
Positive in meningitis and subarrachnoid bleed

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7
Q

What is “battle signs”

A

Bruising over the mastoid process as a result of extravation of blood along the path of the posterior auricular artery and indicates basilear skull fracture

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8
Q

Dolls Eye Relfex is

A

Also known as the oculocephalic reflex
reflex movement during the head movement by producing and eye movement in the direction opposite to the head movement
Absence of dolls eyes reflex (eyes remain in midposition when head is moved from side to side) can indicate injury to the midbrain or pons, cranial nerve III and VI.

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9
Q

What pupilary reaction occurs in Brain Herniation

A

Ipsilateral

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10
Q

What occurs in neurogenic shock (ie, CI, SVR, HR)

A

Low values in all due to a lack of sympathetic tone.

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11
Q

Pupillary dilation in response to the oculomotor nerve insult occurring in herniation is a result of

A

Loss of parasympathetic stimulation,
the uncus can compress the III crainal nerve, which afects the parasympathathetic input to the eye on the side of the affect nerve causing the pupil to dilate and fail to constrict

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12
Q

What vessel is usually responsible for Epidural bleeds

A

Middle meningeal artery

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13
Q

What is a skull fracture that appears to have a central focal point with multiple outward fractures on xray

A

Linear stellate

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14
Q

Skull fracture usual seen in infants and children, fracture line transverses one or more sutures of the skull causing a widening of the suture

A

Distatic

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15
Q

what kind of skull fracture usually occurs from blunt force trauma

A

compressed/depressed fracture

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16
Q

Fracture to the base of the skull, and presents with blood in the sinuses, CSF leading from nose or ears, racoons eyes, battles signs

A

Basilar

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17
Q

List cushings triad

A

Widening pulse pressures, bradycardia and irregular respirations

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18
Q

Classic Neurogenic Shock symptoms

A

Loss of sympathetic tone below the level of the injury results in loss of autoregulation, a decrease of vascular tone, and an inablility of the heart to increase its intrinisic rate

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19
Q

Hypertension, headaches, profuse sweating, facial erythema, flushing of the skin above the level of the injury, goosebumps, nasal stuffiness, bradycardia, anxiety and a feeling of doom are all signs of what and how is it treated

A

Autonomic Dysreflexia
Catherterization of the bladder or relief of a blocked urinary catheter tube may resolve the problem.

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20
Q

Which type of cord syndrome is characterizied by complete motor paralysis below the level of the lesion, loss of pain and temp sensation at and below the the level, and most offten occurs in hyperflexion injury

A

Anterior cord

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21
Q

Which type of cord syndrome is characterized by motor loss and numbness to touch and vibration on the same side of the spinal injury and loss of pain and temp on the opposite side. Most often occurs from penatrating injury that damaged one side of the cord

A

Brown-Sequard

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22
Q

Which type of cord syndrome is characterized by disproportionately greater motor impairment in the upper compared to the lower extremities and variable degree of sensory loss below the injury and most often occurs after hyperextension injury

A

Central Cord

23
Q

Which electrolytes must be maintained which in normal limits when managing a head injured patient

A

Glucose and Sodium
Hyponatremia can lead to extracellular volume depletion and cerebral edema.
Sodium levels should be maintained at 145-155 and a serum os of 320.

24
Q

What condition is characterized by excessive thirst and excretion of large amounts of diluted urine, with reduced fluid intake.
Deficiency of ADH.

A

Diabetes Insipidus

25
Q

A positive Babinski’s Sign in an adult presents by

A

Plantar flexor reflex and indicates an upper motor neuron lesion

26
Q

What is the first line drug for seizures in the neuocritical patient

A

Dilantin

27
Q

What cranial nerve is associated with Bells palsy

A

The Facial Nerve VII

28
Q

A patient diagnosed with Guillen Barre would most likely present with

A

Ascending paralysis, dysphagia,dysesthesia
Guillain-ABarre is an acute inflammatory demyelinating polyneurophathy. Noted by paralysis that begins in the lower extremities and progresses upward, complete loss of deep tendon reflexes

29
Q

Motor function and sensory function loss below the nipple line is assossiated with which dermatome

A

T4

30
Q

What is the oculocephalic relfex also known as and what is it

A

Dolls eye
The presence of dolls eyes reflex is normal and the absence indicates injury to the midbrain, pons including cranial nerve III, and VI. caused by lesions to the cerebellum and brain stem

31
Q

What is the oculovestibular reflex is used to assess the

A

brainstem function
used to assess brain death can be preformed with the application of th eoculovestibular reflex, the cold-caloric exam.
With head on a bed at 30 degrees, instill 50 ml of iced water in to the ear canal. A normal response, the presence of the oculovestibular reflex, is tonic deviation of the eyes toward the irrigated ear.

32
Q

Define mydriasis

A

excess dilation of the pupils due to disease, trauma, or use of drugs.

33
Q

Battle’s Sign and racoons sign indicates

A

basilar skull fracture

34
Q

Define miosis

A

Pinpoint pupils

35
Q

Define Macewens Sign

A

Tapping the skull near the junction of the frontal temporal and parietal bones will priduce a stronger resonant sounds when hydrocephalus or brain abscess is present

36
Q

Define Brocas Aphasia

A

Expressive aphasia, loss of ability to produce language

37
Q

How is dysarhteria different from expressive aphasia

A

Inablity to move the muscles of the tongue to produce speech where as expressive asphasia is the inability to produce language written or spoken

38
Q

Wernicke Aphasia is defined as

A

a patient is able to speak long sentances but the words have no meaning, add unnecessary words and creat new words.
They also have difficulty in understanding speech or themselves and others.

39
Q

What presents with AMS, Fever, petechiae and/or brudzinski/kernig sign

A

Meningitis
brudzinski sign, reflexive flexion of the knees and hips following passive neck flexion
Kernig sign, flexing the thighs at the hip, and the knees, at 90 degree angles, and assessing whether subsequent extension of the knee is painful (leading to resistance), in which case it is deemed positive.

40
Q

Spinal cord injury dermatome C3-C5

A

phrenic nerve

41
Q

Spinal cord injury dermatome C6

A

Elbow flexion

42
Q

Spin cord injury dermatome C7

A

elbow extension

43
Q

Spinal cord injury dermatome associated T4

A

nipple line

44
Q

Spinal cord injury dermatome T10

A

umbilicus

45
Q

What cranial nerve is associated with visual acuity

A

II Optic nerve

46
Q

What cranial nerve is associated with pupillary dilation and eye movement

A

III oculomotor

47
Q

What cranial nerve is associated with mastication, face sensation and can cause trismus

A

V Trigeminal

48
Q

What cranial nerve is associated with cardiac inhibition, swallowing and sensation oropharynx

A

X Vagus

49
Q

What is fractured in the LeFort I

A

Maxilla

50
Q

What is fractured in the LeFort II

A

Fractured below the zygomatic arch

51
Q

What is fractured in the LeFort III

A

Fracutred above the zygomatic arch

52
Q

Mass transfusion protocol

A

1-1-1 ratio or FFP, Platelets and PRBC’s

53
Q

Blood products administration cause what shift on the oxy hemoglobin curve

A

Leftward

54
Q

What does persistant bubbling in the atrium chamber indicate in the chest tubed patient

A

air leak or tracheobronchial tear/injury

Critical Care (13 decks)

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