Neuro Flashcards
S/S of epidural hematoma? Venous or arterial?
Lucidity then sudden unconsciousness. Arterial.
S/S of subdural hematoma? Arterial or venous?
Slow development of neuro changes. Venous.
S/S of increased ICP
Unequal pupil sizes, decreased LOC that progresses with continued elevation of ICP, N/V, seizure, headache, Cheyne-stokes respirations, pupil nonreactivity, papilledema
Treatments to decrease ICP?
Elevate HOB, IV mannitol, hypertonic saline, transient hyperventilation, barbiturates
How to treat elevated ICP if it is refractory to non-invasive measures?
Sedation, intubation, mechanical ventilation, and neuromuscular paralysis
What is glutamate?
An excitatory neurotransmitter needed for post synaptic excitation of neural cells. Plays a big role in neural communication, memory formation, and learning
What is glutamate a precursor for?
GABA (an inhibitory neurotransmitter)
_____ is a glutamate receptor. ______, ____, and ______ are _____ receptor antagonists
NMDA. Ketamine, nitrous oxide, and methadone are NMDA antagonists
S/S of autonomic dysreflexia (or hyperreflexia)?
Marker hypertension and bradycardia. Headache, blurred vision, LV failure, pulmonary edema, dysrhythmias, strokes, and seizures
What is the most common cause of CVA?
Poorly controlled or uncontrolled HTN
What is the most common cerebral artery involved in CVA?
The middle cerebral artery (MCA) is most often occluded in a stroke
What cerebral arteries supply the brainstem?
The vertebral and basilar arteries (and their branches) supply the brainstem and cerebellum
Within how many hours since onset of symptoms of a stroke must TPA be administered?
Within 4.5 hours of onset of symptoms
Which disorder is characterized by progressive demyelination of the CNS?
Multiple Sclerosis
What medication is important to know about when giving anesthesia to a patient with multiple sclerosis?
Succinylcholine - you cannot give it to MS patients because it can cause life threatening hyperkalemia in this population
Which disorder is characterized by a decreased number of acetylcholine receptors?
Myasthenia Gravis
Which disorder is characterized by improved muscle strength with use?
Myasthenic Syndrome (aka LEMS)
Deficiency of which substance during pregnancy accounts for up to 70% of neural tube defects?
Folate/folic acid
Which neural tube disorder is characterized by a sac-like cyst of meninges, spinal cord and nerves present on an infant’s back?
Myelomeningocele
Which neural tube closure defect seen in infants also has accompanying vertebral defects and usually result in paralysis?
Spina bifida
What is hydrocephalus?
Excess CSF in cranial vault due to either 1) CSF drainage 2) CSF overproduction, or 3) decreased CSF reabsorption
What is craniosynostosis?
Premature closure of 1 or more of the cranial sutures during 1st 18-20 mo of life, leading to limitation of skull expansion that normally occurs to accommodate rapidly growing brain
What is cerebral palsy?
Neurologic disorder of movement, muscle tone, or posture that is caused by injury to or abnormal development of the child’s brain from before, during or after birth up to 1 year
Risk factors for cerebral palsy?
LBW, prenatal cerebral hypoxia, hemorrhage, infection, and genetic abnormalities
Definition of febrile seizures in a child
Seizures occurring with fevers in the absence of a central nervous system infection
Which are longer in duration - simple or complex febrile seizures?
Complex febrile seizures
Is the EEG abnormal or normal between seizure bursts in simple febrile seizures?
Normal between seizures
Are meds often given in febrile seizures in children?
No. Risk outweighs benefit
What is the most common cause of hemorrhagic cerebrovascular disease seen in children?
Congenital cerebral AV malformations
What number in the Glasgow Coma Scale indicates Coma?
Score of 3-8
Which disease involves a genetic error that renders the body unable to metabolize an essential amino acid?
Phenylketonuria (PKU)
3 functions of cerebrum?
Receives/processes conscious sensation, generates thought, controls conscious activity
What are the functions of the archicerebellum?
Maintain equilibrium
What are the functions of the paleocerebellum?
Regulates muscle tone
What are the functions of the neocerebellum?
Coordinates voluntary muscle movement
What are the 3 meninges?
Dura mater – outer, lines skull
Arachnoid – middle, contains blood vessels
Pia mater – inner, covers brain
5 conditions that can mimic a stroke?
Seizures, systemic infection, syncope, toxic metabolic disturbances, tumor
What neurotransmitter the symptoms and pathophysiology of Parkinson’s disease?
Too little dopamine
Normal ICP is _____ mmHg
5-15
Normal CPP is ____ mmHg
60-100
What is a dermatome?
Specific areas of skin innervated by spinal nerves at various spinal cord segments, where sensory signals arise
