Neuro Flashcards
During a stroke there is treatment if you
act FAST
FAST mnemonic
Face= face looks uneven Arm= one arm hanging down? Speech= slurred speech? Time= call 911 NOW!
change of LOC (level of consciousness) may be the earliest indicator of what?
central nervous system (CNS) pathology
cerebral ischemia
increased intracranial pressure (ICP)
6 Levels of consciousness
Alert wakefulness - AAOx3;responds quickly to stimuli. awake, alert, and oriented to time, person or place
Confusion - awake/alert, but disoriented to time, place or person; or shortened attention or poor memory
Lethargy - “drowsy”, slowed response to stimuli; may still be AAOx3
Obtunded - ”very drowsy”, less than full mental capacity, arousable with stimulation, minimal verbal response (12
words),follow simple commands
Stupor - unresponsive except to vigorous and repeated stimulation;may respond with eye opening or incomprehensible sounds
Coma - unresponsive;sleep-like state with eyes closed, no verbal response
Glasgow coma scale range
3 (worst) to 15 (best)
Glasgow coma scale measures (3 things)
Eye, Verbal, and Motor Responses
GCS less than 8
intubate
Eyes response (range)
4-1
Verbal response (range)
5-1
Motor response (range)
6-1
what is decortication s/s
abnormal flexion
Problems with Cervical Spinal Tract or Cerebral Hemisphere
what is decerebration s/s
abnormal extension - arms like “e’s”
Problems with Midbrain or Pons
If you come in and you find cranial nerve IX and X are diminished, what would you not want to do?
Feed the patient - they can’t protect their airway
If you have damage to your brain-stem, do you decorticate or decerebrate?
decerebrate
CN IX & X
Gag, Cough, Swallow (protective reflexes)
12 Cranial Nerves mnemonic
Oh Oh Oh To Touch And Feel A Girl’s Very Soft Hands
Oh Oh Oh To Touch And Feel A Girl’s Very Soft Hands
Olfactory= smell
Optic= visual field, snellen chart
Oculomotor = eye opening
Trochlear
Trigeminal= sensory areas of the face
Abducens
Facial = smile, close eyes tightly, facial symmetry etc..
Acoustic/Vestibulocochlear = hearing
Glossopharyngeal = sensory/taste, motor/gag & swallow
Vagus = have pt say ahh watch palate and uvula, both should rise
Spinal Accessory= Shoulder shrug, head and neck movement
Hypoglossal =Tongue movement
Motor/Sensory/Both mnemonic
Some Say Marry Money, But My Brother Says Big Brains Matter More
Pronator Drift (aka “drift test”)
Pt asked to hold out arms with palms up (hold your hands up like you’re holding a pizza box”), then close eyes and keep arms stationary for 10 secs
Test can be used to assess motor strength and control/coordination
positive pronator drift test
Drifting (usually downward) of the arm and/or pronation of palm
Positive pronator test indicates
Decrease in motor strength, or presence of spasticity, or decrease in proprioception
Documentation for pronator drift
patient has a left drift
what is graphesthesia
ability to feel writing on skin
what is stereognosis
ability to perceive size and shape of easily recognized objects: coins, keys, etc….
