Neuro 2 Flashcards
what does the cerebellum do
Controls voluntary movement, equilibrium, distance, skilled movement
what is one of the first good indicators of increased ICP
- LOOK at the EYES
- optic nerve runs through middle of brain good first indicator of Increased ICP
- may see dilated/pinpoint, nystagmus, double vision
broca’s area is associated with what
producing language/speech
wernicke’s area is associated with what
comprehension of speech/language
language development
what is the purpose of the meninges
3 layers of PROTECTION
Arachnoid villus
layer in the brain that have a lot of blood flow
what is the hypothalamus in charge of
appetite, sleep-wake cycles (RAS) pituitary hormones, emotions and survival drive
what can pass the BBB
Can pass is oxygen, alcohol, CO2, anesthetics, glucose, water
what cannot pass the BBB
Blood (but can develop from inside), albumin and many antibiotics can not pass up into the brain
why are brain infections, viruses, and cancers of the brain so difficult to treat
cannot easily pass through the BBB with antibiotics or chemo
injury to C4 or higher will…
WILL NOT be able to BREATHE AT ALL
injury to C7-C4
may have resp difficulties and may only be able to move shoulders and upper arms (breathe somewhat but not well)
what are the ascending tracts of the brain
(spinal cord to brain)
1) spinothalamic
2) Spinocerebellar
3) Fasciculus
describe spinothalamic
*Spinal cord to thalamus
pain, temperature, touch and pressure
describe spinocerebellar
- Spinal cord to cerebellum
- Posterior tracts-proprioception
- Anterior tracts-sensory
- Balance, hand eye coordination
describe fasciculus
*Posterior white columns to thalamus
sensation from muscles, joints, tendons, vibration, touch and two point discrimination
what are the descending tracts of the brain
- descend into lower motor neurons
1) Brain to the spinal cord
2) Lateral corticospinal or pyramidal tract
3) Extrapyramidal
as the neurons exit the brain
As they exit the brain… cords from brain will cross (tumor on R side of brain will have L side deficits)
this is often the first sign of alzheimer’s
loss of smell
what # on the GCS do you intubate
<8
best/normal GCS and worst GCS
normal: 15
worst: 3
what are the sections of the GCS
1) Eye movement (not PERRLA, eye OPENING*** when come in or touch pt)
2) Verbal response (alert and thinking, make sense when they talk, follow commands??)
3) Motor response (posturing, pull away from you?)
testing these takes care of multiple cranial nerves
Accommodation and eye movement
describe storing
- attribution theory: things we learn are attributed to certain “boxes in brain”
- writing and auditory will help remember it better (more ways we can store it, the better you can remember)
questions of the mental status exam
What is your name? What is your mother’s name? What year is it? Where are you now? How old are you? Where were you born? What did you have for breakfast? Who is the President of the United States? Can you count backward from 100 to 1
when is the organ procurement team called on the GCS
required to call at 8 or less than
comatose on the GCS if…
8
what does no pupil dilation indicate
no oxygenation
what do fixed pupils or nonreactive tend to indicate
hemorrhage
*Midbrain involvement by edema hemorrhage
pinpoint pupils can indicate what
drug induced?
one eye dilated
Herniation, brain stem damage, increased ICP, bleed
bilateral dilation
Cardiac arrest, anticholinergic poisioning
brain is a box comprised of 3 sections…
1) Blood maintained by the vessels
2) CSF
3) Brain parenchyma
monro kellie doctrine states what
the volume of the intracranium is = to the volume of the intravascular blood (3-10%) + CSF (8-12%) + volume of brain tissue (80% water).
As long as the ________ is constant, the ICP is constant
intracranial volume
