Neuro Flashcards
What are strokes
1)Pathophysiology
2)Common symptoms
3) treatment
Two main types of strokes with an additional
Cerebral vascular accident
Transit steam attack
Brain bleed-subarachnoid hemorrhage
Embolonic, athletic sclerosis, brain bleed- all results in disruption of blood flow to the brain-. Causing ischemia
2) fast aVVV
FIVER WINDOW STROKE CENTRE
What are the main different types groups of epileptic seizure
1) examples of each group
1)Generalised seizures or 2) focal seizures
1) Tonic clonic MyoClonic Absence ect
2) simple focal or complex partial seizures
What is PNES (pyogenic non epileptic seizures)
1)Pathophysiology
2)Common symptoms
3) treatment
Lack of electricaln abnormalities rather a reaction to physiological of phycological stresses
Micceglss
Mouth closed - lack of tongue biting
Intense - fluctuating
Curveture - neck and spine
Cyanosis - lack of
Eyes - closed+ pupils pearl
GCS - higher ( hear or grip hand )
Tremors - rather than shock like movement
Intensity fluwuating
Reassurance and time and treat ABC
What is bells- palsy
1)Pathophysiology
2)Common symptoms
3) treatment
Unilateral paralysis of the face due to damage to the facial nerve normally due to virus
2) absence of nasolabial fold
Droop of mouth and eye
Dryness of eye and mouth of effected side
Loss of taste to 2/3 of anterior tongue
3) gets better by itself or with corizone steroids + give stroke nurse a call
What is meningitis
1)Pathophysiology
2)Common symptoms
3) treatment
Bacterial or viral infection that affects the meninges ( Dura pia arachnoid )
2) photophobia, neck stiffness ( bruvinski sign ) non blanchibg rash, mottled )
3) benzopencillin - prealert
What is a TIA
1)Pathophysiology
2)Common symptoms
3) treatment
TIA (transient ischemic attack) is a temporary blockage causing ischemia last less than 24 hours
2) same as stroke - fast
3) treat as stroke call stroke nurse combat to stroke center or to nearest A&E - why = as you can’t wait for 24 hours
Obstructive Stroke (CVA) have two different causes
What are they
Embolonic - plaque it clot from the body travel to the brain causing blockage
Thrombotic - clots or plaque forms in the brain causing blockage
What is are the main 2 risk factor for CVA & why
Atrial fibrillation - as it caused a circulation ot blood pool in the atrium causing clots that can move
- hypertension as it causes excess pressure on vessel - only so much till it explodes
Anticoagulant + head injury = clot or excess bleeding
What is the basic test for a stroke
- what is the time window for thrombosis
Fast
F - face ( droop )
A- arms ( strength - weakness)
Speech - ( slurred)
T- time ( onset) - 5 hour window
Within 5 hour alert to stroke centre 🚨🚨
What is a berry aneurysm
What is a tonic clonic seizure (gran mal)
- symptoms
Stiffness (tonic) followed by shaking (Clonic)
- incontinence
- tongue biting
- full body shaking
- cyanosis
What is temporal arthritis
What is a migraine
What is a tension headache
What is a sinus headache
What is a cluster headache
What is a subarachnoid hemorrhage
What is a space occupying legion
What is carotid dissection
What is a focal seizure
2) what’s the difference between complex and partial seizures
3)bonus points what may focal seizures become ….
A seizure tha affect one hemisphere of the brain
2) complex = reduced awareness, simple = awareness commonly as a aura
3) focal seizures may intricate to generalised seizures
What is guillain-barré syndrome
What is lewy body dementia
1) pathophysiology
2) sign and symptoms
What is cerebral palsy
What is a syncope
What are the characteristics associated with Syncopy ( general )
Syncope is when there is a temporary lack of blood supply to the brain resulting in a LOC ( loss of consciousness)
2) fast onset
Spontaneous recovery
Short duration
What are the three main overarching types of Syncopy
Reflex/ neural mediator syncope
Orthostatic hypotension syncope
Cardiac syncope
What is classified as an reflex/ neural mediator based syncope ( there are 2 - what are they )
1)Vasovagal Syncopy which there is 3 orthostatic vasovagal, emotional vasovagal, situational vasovagal
2) carotid sinus syndrome
What is vasovagal Syncopy - pathophysiology hint there are 3
Vasovagal Syncopy is LOC due to temporary loss of blood supply to the brain
1) orthostatic vasovagal due to position change ( commonly standing up)
2) emotional vasovagal due to pain or fear
3) situational vasovagal on specific actions ( swallowing deficacating coughing or microruation )
What is syncope due to orthostatic hypotension hint there’s 3
Bonus point what is vasovagal orthostatic hypotension
Vasovagal orthostatic hypotension due to position change
But
1)Volume depictions = hemmorage/ D&V
2) drug induced - diuretic or vasodilation
3) autonomic failure - primary is old age or Parkinson diseases or secondary due to spinal injurys or diabetes
What are the cardiac causes of syncope
Hint they are 3
1)Heart Structural defects
2)Arrhythmia
3)Great vessel defect
1) valvular problems ( stenosis ), hypotrophy or myocardial infarction
2) tachycardia eg PVT/ SVT or Bradycardia
3) AAA, PE, Aortic dissection
What can you check in your history or assessment which will aid in the impression of vasovagal Syncopy
History - spefic trigger of pain, emotions, or swallowing pooing
Clinical signs of pallor, nausea,PT recognises they’re going to faint = try to hold something
What can you check in your history or assessment which will aid in the impression of orthostatic hypotension based Syncopy
History = dizziness on standing
Reduced fluid intake or history of D&V
Any drug ingestion
2) assessment of postural drop of 20 systolic or 10 diastolic from sitting to standing
What can you check in your history or assessment which will aid in the impression of cardiac syncope
History - chest pain, ACS pain, history of random DROP won’t try to catch themselves
2) ECG, feel for apex beat, auscultation of heart sounds
What is Parkinson’s disease
1) pathophysiology
2) signs and symptoms
3) treatment
1) an irreversible condition whereby there’s a degeneration of neurons within the substantia Niagara ( par compactor) whom responsible for send signalsl to strium thus the release of dopamine this stimulates Cortex thus movement
Tremor - resting due to imbalance ( no weakness tho)
Cogwheel Rigidity - like a robot stop start
What is Wernicke encephalopathy
1) pathophysiology
2) command symptoms ❄️❄️❄️
3) treatment plan
1) reduction in thyamine (destroyed liver = no storage, destroyed intestines = no absorption, no activation of thymine = reduction of glucose to brain
2) stride ( wide short paced gate = ataxia ), nystagmus ( cn6) , oblivious ( delirium, disorientated)
3) combat for IV thamine to prevent Wernicke Korsakoff syndrome
Wernicke Korsakoff syndrome
1) pathophysiology
2) command symptoms
3) treatment plan
1) chronic Wernicke encephalopathy due to reduced thyamine = neurons degeneration.
2) psychosis, amnesia ( old or new memory’s ) causing **confabulation ( making up story to fill gaps )
3) convay for thyamine
What is alcohol withdrawal
1) pathophysiology
2) command symptoms
3) treatment plan
1) alcohol enhances gaba ( depressing) = prolonged usage = body overstimulates to antipate alcohol = no alcohol result withdrawal
2) agitation, deletium, tremors, clamminess, seizures, reduced GCS
3) convey
What are the warning signs for severe alcohol withdrawal
- Seizures
- Tachtile disturbance( crawling )
- visual ( hallucinations)
- tremors
- severe agitation
Any alcohol + head injury
Any patient who is drunk - what should you do and what must you consider and check
- Consider any risk for head injury causing symptoms or exaccibating
- can PT maintain airway
If sure there’s no head injury and you have checked then discharge in care of responsible adult or convey
How can you diagnose incomplicated vasovagal Syncopy
3 p’s
- posture ( prolong standing or feeling of fainting
- provoking factors ( eating vomiting, pain, fear, medical procedure)
- prodromal( sweating or hot before loc)
What are the 3 assessments you must conduct for patient with an LOC
-H2t
-12 lead ECG
- BP ( INDCUDING POSTRAL DROP)
- mobility test
What is the difference between a generalised and focal seizures
1) generalised = affect both hemisphere
2) focal seizures = one hemisphere
What are the different types of focal seizures
Simple
Complex partial focal seizures = lack of awareness
What is an absent seizure
2) what types of seizures is it
3) signs and symptoms
4) command duration
Fixed body state
- eyes open ( staring blankely )
- unconscious
What is a tonic seizure
2) what types of seizures is it
3) signs and symptoms
4) common duration
1)Tonic - stiffening of the muscles
2) generlised epileptic
3)muscle stiffening, back arching, cyanosis, ictal cry - cry just before (air leaves by lungs), ? Fall backwards
4) less than 1 minute
What is a myotonic seizure
2) what types of seizures is it
3) signs and symptoms
1) muscular spasms
2) generalised epileptic
3) rapid full body shaking - lasting few seconds - PT maybe awake
What is a complex partial focal seizure
2) what types of seizures is it
3) signs and symptoms
conscious/non - maybe aware
-Lips smacking
- picking up and dropping stuff
- chewing
- plucking at clothes
- rapid blinking
- muscle jerking
What is a simple focal seizure
2) what types of seizures is it
3) signs and symptoms
Focal epileptic seizure = one sided
**patient will be awake + symptoms= aura **
- pins and needles
- strange smell / taste
- localised muscle jerking ( may turn to jacksonial march
What is encephalitis
What is Cushing traid
- why is Cushing traid important/show
Bradycardia + irregular resps + hypertension
Major trauma to the brain = signs of increased ICP
Absence seizures
1) command symptoms
2) seizure type
1) eyes staring, eyelids fluttering, fixed eyes
2) generalized epileptic
What are the basic questions need for an loc
Prior - general circumstances (sitting, activity) + any symptoms ( fear, fever , sweating, colour, palandrome)
During - seizure activity, fall how, duration of loc
Post - recovery period quick, confusion, any prior loc
