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med surg 2 > neuro > Flashcards

neuro Flashcards

1
Q

ischemic stroke

A

disruption of the blood supply caused by an obstruction, usually a thrombus or embolism that causes an infarction of brain tissue
types: large artery thrombosis, small penetrating artery thrombosis, cardiogenic embolism, cryptogenic

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2
Q

ischemic stroke s&s

A

depend on the location and size of the area
numbness or weakness of face, arm, leg unilateral
confusion or change in mental status
trouble speaking or understanding speech
difficulty in walking, dizziness, or loss of balance or coordination
sudden severe headache
perceptual disturbances

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3
Q

ischemic stroke treatment

A

prevention: control of HTN
diagnosis: CT scan, cerebral angiography, lumbar puncture if CT is negative and ICP is not elevated to confirm subarachnoid hemorrhage
care is primarily supportive
bed rest with sedation
O2
treatment of vasospasm, increased ICP, HTN, potential seizures, and prevention of further bleeding
health maintenance measures including a healthy lifestyle, not
smoking, exercise, healthy diet, and weight
carotid endarterectomy for caratoid stenosis anticoagulant therapy for afib
antiplatelet therapy
statins
antihypertensive medication

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4
Q

ischemic stroke rehabilitation strategies

A

carotid endarterectomy (removal of plaque from carotid artery)

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5
Q

hemorrhagic stroke

A

spontaneous rupture of small vessels related to hypertension
ruptured aneurysm
intracerebral hemorrhage related to amyloid angiopathy
arterial vein malformations
intracranial aneurysms
anticoag meds
ICP increases caused by blood in the subarachnoid space

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6
Q

hemorrhagic stroke S&S

A

similar to ischemic stroke
severe headache
early and sudden changes in LOC
vomiting
bleeding

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7
Q

hemorrhagic stroke treatments

A

drugs that counteract blood thinning drugs
surgery
surgical clipping
coiling
surgical arterial venous malformation removal
stereotactic radiosurgery

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8
Q

right sided stroke symptoms

A

muscle weakness on the left side of the body
vision problems including seeing from the left side of each eye
hearing problems
sensory changes on the left side of the body
problems with depth perception or directions
problems with balance
a feeling of spinning when a person is still
memory problems

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9
Q

left sided stroke symptoms

A

right sided weakness or paralysis and sensory impairment
problems with speech and understanding language (aphasia)
visual problems, including ability to do math or organize reason and analyze items

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10
Q

decerebrate

A

Plantar flexed (feet point OUTWARD)
Arms adducted (toward midline), extended, pronated, and hands flexed outward feet pointed downwards

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11
Q

flaccid

A

rag doll appearance (risk for foot drop)

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12
Q

decorticate

A

Plantar flexed
Legs internally rotated
Arms flexed and adducted (towards midline)
Hands flexed
Toes pointed away from the body and turned slightly inward

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13
Q

Glasgow coma scale

A

numerical rating of eye opening, verbal response, and motor response
9-15 mild to moderate injury
3-8 severe injury
Eye opening
4. Spontaneous
3. Loud voice
2. Pain
1. None
Verbal response
5. Normal conversation
4. Disoriented conversation
3. Non coherent
2. No words, only sounds
1. None
Motor response
6. Normal
5. Localized to pain
4. Withdraws to pain
3. Flexion
2. Extension
1. None

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14
Q

cranial nerve 1

A

olfactory, sensory, identification of common scents

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15
Q

cranial nerve 2

A

optic, sensory, snellen chart, color blind test

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16
Q

cranial nerve 3

A

oculomotor, motor, PERLA (moves eyes up and down), pupil response

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17
Q

cranial nerve 4

A

trochlear, motor, moves eyes side to side PERLA

18
Q

cranial nerve 5

A

trigeminal, both, facial sensation and chewing (sharp or dull, assess chewing)

19
Q

cranial nerve 6

A

abducens, motor, eye movement diagonally PERLA

20
Q

cranial nerve 7

A

facial, both, facial expression and taste
identifiable tastes, smile puff cheeks out

21
Q

cranial nerve 8

A

auditory/vestibulocochlear, sensory, whisper test webber rinne

22
Q

cranial nerve 9

A

glossopharyngeal, both, phonation and gag reflex
make them talk watch swallowing

23
Q

cranial nerve 10

A

vagus, both, taste and gag reflex, aids in digestion and gag reflex

24
Q

cranial nerve 11

A

spinal accessory, motor, shrug shoulders with resistance

25
Q

cranial nerve 12

A

hypoglossal, motor, stick tongue out and move it

26
Q

The first clue of a deteriorating condition

A

changes in LOC

27
Q

full conciousness

A

alert, attentive, follows commands

28
Q

Lethargic

A

drowsy, awakens to stimulation

29
Q

obtunded

A

difficult to arouse, needs constant stimulation to follow a simple command

30
Q

stupor

A

arouses to vigorous, continuous stimulation

31
Q

coma

A

does not respond to continuous or painful stimulation

32
Q

akinetic mutism

A

unresponsive to enviornment, makes no movement or sound, sometimes opens eyes

33
Q

persistent vegetative state

A

devoid of cognitive function but has sleep wake cycles

34
Q

locked in syndrome

A

inability to move or respond except for eye movements due to lesion affecting the pons

35
Q

increased ICP S&S

A

Normal ICP 1-15
CUSHING’S TRIAD
Increased SBP w widening pulse pressure
Bradycardia
Bradypnea
Present in herniation syndrome

36
Q

early increased ICP symptoms

A

change in LOC
any change in condition
restlessness, confusion, increasing drowsiness, increased resp effort, purposeless movements
pupillary changes and impaired ocular movements
weakness in one extremity or one side
headache: constant, increasing in intensity, or aggravated by movement or straining

37
Q

late increased ICP symptoms

A

respiratory and vasomotor changes
major vital sign changes (cushings triad: bradypnea, htn with wide pulse pressure, bradycardia )
projectile vomiting
further deterioration of LOC
stupor to coma
hemiplegia, decortication, decerebration, flaccify
cheyne stokes breathing
loss of brainstem reflexes (pupil, gag, corneal, swallowing)

38
Q

brain tumors S&S

A

depend based on size and location
localized or generalized neurologic symptoms
symptoms of increased ICP
headache
vomiting
visual disturbances
seizures
hormonal effects with pituitary adenoma
loss of hearing, tinnitus, vertigo with acoustic neuroma

39
Q

brain tumor diagnostic

A

neuro exam
ct scan
mri
pet
eeg
cytologic study of csf
biopsy

40
Q

medical management of brain tumor

A

dependent on size and location
surgery: remove as much tumor as possible without messing with neurologic symptoms, craniotomy, transsphenoidal surgery, stereotactic procedures
radiation therapy: cornerstone treatment, chemo, pharmacologic therapy

med surg 2 (11 decks)

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