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First Aid > Neuro > Flashcards

Neuro Flashcards

1
Q

***First Aid for Seizures: what are the steps?

A
  1. cushion head
  2. loosen clothing
  3. turn on side (so no aspiration of vomit)
  4. time seizure (if > 4 min, then mb status epilepticus)
  5. don’t put anything in mouth
  6. look for ID
  7. don’t hold down
    offer help
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2
Q

Why time the seizure?

A

If > 5 min OR 2nd seizure wo regaining consciousness in between, then “Status Epilepticus”

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3
Q

***If pt is in their 50’s/60’s and has a seizure for their first time, you must R/O?

A

space occupying lesion

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4
Q

if younger pt w seizure, think…

A

febrile seizure

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5
Q

if 10-30 yo w seizure, think…

A

vascular malformations

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6
Q

if a pt is experiencing SYNCOPE, make sure to ask…

A

fever?

hx of trauma?

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7
Q

***3 types of Cerebrovascular Dz (stroke) … most prevalent neuro disorders that lead to morbidity and mortality

A
  1. thrombotic
  2. embolic
  3. hemorrhagic
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8
Q

If pt presents w acute neuro deficit or w altered level of consciousness, what should be in the DDx?

A

STROKE

- time of onset is important

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9
Q

Focal cerebral ischemia is usu dt…

A
  • embolus or thrombus in large vessel OR

- vasculitis

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10
Q

Global cerebral ischemia is usu dt…

A
  • cardiac arrest
  • shock
  • severe hypotension
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11
Q

Focal cerebral ischemia causes a _________ area of necrosis.

A

well circumscribed

- looks pie-shaped

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12
Q

Global cerebral ischemia causes ______ necrosis.

A

laminar necrosis

- and border zone infarcts

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13
Q

Ischemic vs Hemorrhagic Stroke:

  • which is MC?
  • which is more deadly?
A
  • MC is ischemic

- more deadly is hemorrhagic

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14
Q
  • **TIA (transient ischemic attacks)
  • Sxs
  • how long does it last?
  • defining characteristics
A
  • milder sxs than stroke
  • aphasia, think very well, mb LOC, weakness of limb(s)
  • lasts seconds to min
  • back to normal after 24 hrs
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15
Q

***CVA (cerebrovascular accident) or Stroke defining characteristic (vs TIA)

A

neuro deficits for 48-72 hrs it’s considered a stroke

- (remember contralateral sxs to artery affected)

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16
Q

*MC cause of Ischemic Stroke dt THROMBOTIC OCCLUSION

A

atherosclerosis

- occurs mc at carotid bifurcation or in vertebrobasilar system

17
Q
  • Posterior stroke sx

- Cerebellar, Brain Stem stroke sxs

A
  • dysphagia
  • dysphagia, coordination, eventually breathing affect bc close to medulla
  • usu dt VERTEBRAL or BASILAR ARTERIES
18
Q

what is uncal herniation?

A
  • edema can cause the brain to herniate downwards into foramen magnum
19
Q

bleeding in the CNS can be caused by?

A
  • berry aneurysm (it can leak too!)

- AV malformations (lots of little bleeding sites, see white clouds on CT)

20
Q

Vessel w greatest degree of compromise in an ischemic stroke

A

Middle Cerebral A.

- usu dt thrombotic occlusion

21
Q

Hemorrhagic stroke usu dt

A
  • *HTN….

- *intracerebral hemorrhage, subarachnoid hemorrhage, subdural hemorrhage, or epidural hemorrhage

22
Q

MC cause of Subarachnoid Hemorrhage

A

Berry Aneurysm

- other causes: AV malform., disorders of BV in spinal cord, tumor, cocaine, sickle cell anemia, trauma

23
Q

***BASAL SKULL FRACTURE is a

A
  • *linear fracture through petrus portion of temporal bone that leaks spinal fluid from an ear
  • base of the skull, typically involving the temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone
  • assoc sxs: hearing loss, instability of gait, vertigo
24
Q

***What is Battle’s Sign?

A

mastoid ecchymosis

- think BASILAR SKULL FRACTURE

25
Q

***What is Raccoon’s Eyes?

A

bilat. periorbital ecchymosis

- think BASILAR SKULL FRACTURE

26
Q

Linear vs Displaced skull fracture…

A
  • Linear bends inward making area around it buckle outward….
  • Displaced = bone is displaced into cranial cavity by distance greater than thickness of bone
27
Q

***Trauma to temporal region can result in laceration to ______ and cause an ______ hematoma.

A
  • MIDDLE MENINGEAL ARTERY
  • EPIDURAL HEMATOMA (blood bet dura and skull)
  • can also be caused by laceration to dural venous sinus
  • *ARTERIAL BLEED
28
Q

Epidural Hematomas do not cross….

A

cranial sutures

- so most unilat. and above tentorium

29
Q

***Trauma to fronto-parietal region can result in laceration to ______ and cause an _______ hematoma.

A
  • BRIDGING VEINS bet. brain and superior sagittal sinus
  • SUBDURAL HEMATOMA accum. of blood bet dura and arachnoid
  • *VENOUS BLEED
  • slower in develop. vs epidural hematoma
30
Q

Meningitis pertinent negatives:

A
  • it is a medical emergency and does not usu present classically
  • MC sxs: HA!!, F, nuchal rigidity… altered mental status
  • other sxs: photophobia, sensitivity to sound, N/V
31
Q

If see petechial rash, think what type of meningitis?

A

Neisseria Meningitidis

32
Q

**Other causes of Meningitis other than bacteria and viruses.

A
  • carcinomatous, drugs, hemochromatosis, wilson’s dz
33
Q

Bacterial Meningitis MC in:

  • premature babies, newborns
  • after 3/4 yo
  • older
  • recent skull trauma (from nasal cavity)
A
  • group B strep, e. coli, listeria monocytogenes
  • neisseria meningitidis
  • strep penumoniae, mb h flu
  • staph, pseudomonas, other gram (-)
34
Q

*CT scans are done immediately to see what in strokes?

A

blood… esp if on anticoags. cerebral edema will take 10-12 hrs to see.

First Aid (7 decks)

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