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ICU TRANSITION PROGRAM > NEURO > Flashcards

NEURO Flashcards

1
Q

Anatomic Divisions

A
  • Central (brain and spinal cord)

- Peripheral (cranial nerves and spinal nerves)

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2
Q

Divisions of Peripheral Nervous System

A
  • Somatic (fibers connect brain w/ muscle and skin)

- Autonomic (fibers connect brain w/ cardiac muscle, smooth muscle, organs, and glands)

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3
Q

Divisions of Autonomic Nervous System

A
  • Sympathetic (fight or flight)

- Parasympathetic (vegetative, homeostasis, restores energy sources)

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4
Q

Cranial Fossa

A
  • Depression or hollow area
  • Anterior (supports frontal lobe)
  • Middle (supports temporal, occipital, and parietal lobes)
  • Posterior (supports brainstem and cerebellum)
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5
Q

Meninges/Layers of Meninges

A
  • Series of connective tissue that protects brain and spinal cord
  • Dura mater
  • Arachnoid mater
  • Pia mater
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6
Q

Dura Mater

A
  • Outermost layer of meninges directly beneath skull (shiny and tough)
  • 2 layers: periosteal (adheres to skull), meningeal (covers brain)
  • Within double layer lie venous sinuses that collect blood from intracranial and meningeal veins for drainage into internal jugular
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7
Q

Extensions of Dura Mater

A
  • Falx cerebri (separates L/R hemispheres)
  • Tenorium cerebelli (separates occipital lobe from cerebellum)
  • Falx cerebelli (separates cerebellar hemispheres)
  • Diaphragma sellae (protects sella turcica - houses pituitary gland)
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8
Q

Arachnoid Mater

A
  • Spongy, cobweb-like structure containing fluid loosely surrounding brain
  • Trabeculae connects arachnoid mater to pia mater making a spongy, web-like structure (subarachnoid space)
  • CSF flows freely in subarachnoid space (contains brain’s large arteries)
  • Arachnoid villi absorb CSF
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9
Q

Pia Mater

A
  • Adheres directly to brain tissue

- Supplies large volume of arterial blood to CNS

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10
Q

Spaces in Meninges

A
  • Epidural space (in dura)
  • Subdural (in arachnoid)
  • Subarachnoid (in pia)
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11
Q

Cerebral Circulation

A
  • Only 2% of body weight but uses 20% of body’s total resting cardiac output
  • Extracts 45% of arterial oxygen supply to meet metabolic needs
  • Two pairs of arteries (internal carotid and vertebral arteries) supply blood to brain
  • Separated into anterior and posterior circulations to form Circle of Willis
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12
Q

Internal Carotid Arteries

A
  • Anterior cerebral artery

- Middle cerebral artery

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13
Q

Anterior Cerebral Artery

A
  • Perfuses midline area of front of brain

- Interruption of flow results in loss of strength and sensation of lower body contralaterally

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14
Q

Middle Cerebral Artery

A
  • Perfuses lateral aspect of front of brain

- Interruption of flow results in loss of strength and sensation of upper body contralaterally

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15
Q

Vertebral Arteries

A
  • Posterior inferior cerebellar
  • Anterior spinal artery
  • Posterior spinal artery
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16
Q

Posterior Inferior Cerebellar Arteries

A
  • Perfuse posterior parts of cerebellum and medulla
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17
Q

Anterior Spinal Artery

A
  • Perfuse anterior 2/3 of spinal cord
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18
Q

Posterior Spinal Artery

A
  • Supplies posterior third of spinal cord
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19
Q

Posterior Cerebral Artery

A
  • Perfuse posterior aspect of brain, brainstem, and cerebellum
20
Q

Venous Sinuses

A
  • Veins empty into superior sagittal sinus and inferior sagittal sinus and then empty into internal jugular vein
21
Q

Brainstem Anatomy

A
  • Medulla oblangata (respiratory center, sneeze/cough/swallow/salivation/vomiting, cranial nerves IX, X, XI, & XII))
  • Pons (regulates rhythm of respiration, cranial nerves VI & VII)
  • Midbrain (visual tracking, visual/auditory reflexes, cranial nerves III, IV & V
  • RAS (controls wakefulness)
22
Q

Cerebellum Anatomy

A
  • Located in posterior fossa
  • Tentorium cerebelli separates cerebellum from cerebrum
  • Subconscious activities, relays/refines movement, equilibrium, muscle tone, balance, posture
23
Q

Frontal Lobe Functions

A
  • Voluntary motor function
  • Cognitive function (orientation, memory, insight, judgement, arithmetic, abstraction)
  • Expressive language (verbal and written)
  • Long term memory
  • Bowel and bladder
24
Q

Parietal Lobe Functions

A
  • Processing of sensory input strip
  • Interpretation of touch, pressure, pain
  • Comprehension of written word
  • Speech
  • Recognition of object size, shape, texture
25
Q

Temporal Lobe Functions

A
  • Auditory
  • Vestibular
  • Associative
  • Short-term memory
  • Wernicke’s speech
26
Q

Occipital Lobe

A
  • Visual stimuli

- Peripheral visual fields

27
Q

CN I

A
  • Olfactory

- Sense of smell

28
Q

CN II

A
  • Optic
  • Vision
  • Visual fields
29
Q

CN III

A
  • Oculomotor
  • Moves eyes up and in/up and out/down and out
  • Constricts pupil
  • Elevates eyelid
30
Q

CN IV

A
  • Trochlear

- Moves eyes down and in

31
Q

CN V

A
  • Trigeminal
  • Muscles of mastication (motor)
  • Opthalmic, maxillary, mandibular (sensory)
  • Feels front of head
  • Corneal reflex
32
Q

CN VI

A
  • Abducens

- Moves eyes outward

33
Q

CN VII

A
  • Facial
  • Moves muscles of facial expression (motor)
  • Taste anterior 2/3 of the tongue (sensory)
  • Salivation
  • Lacrimal secretions
34
Q

CN VIII

A
  • Acoustic
  • Hearing
  • Equilibrium
35
Q

CN IX

A
  • Glossopharyngeal
  • Elevation of pharynx
  • Swallow
  • Taste on posterior 1/3 of tongue
  • Gag reflex
36
Q

CN X

A
  • Vagus
  • Cardiac depression
  • Bronchoconstriction
  • Gag
  • Phonation
  • GI peristalsis and secretions
37
Q

CN XI

A
  • Spinal accessory
  • Elevates head/shoulders
  • Moves head side to side
38
Q

CN XII

A
  • Hypoglossal
  • Moves tongue side to side
  • Moves tongue out
39
Q

Cranial Nerve Assessment in Comatose Patient

A
  • Doll’s eyes [oculocephalic reflex (positive when eyes move in opposite direction of forced head movement)]
  • Corneal reflex
  • Pupillary response
  • Gag
  • Facial symmetry
40
Q

Herniation

A
  • Displacement of a portion of the brain resulting in compression, distortion, necrosis and vascular compromise
41
Q

Cingulate Herniation

A
  • Midline shift on CT
42
Q

Central Herniation

A
  • Downward displacement of the hemispheres, basal ganglia, diencephalons and midbrain
  • Change in LOC, hyperventilation, loss of vertical gaze, babinski, fixed/dilated pupils, coma, posturing
43
Q

Uncal Herniation

A
  • Increased pressure from large lateral lesion of the middle fossa or temporal lobes forces the uncus through the tenorial notch
  • Ipsilateral pupil dilation, contralateral hemiplegia, EOM paralysis, coma, decerebration, loss of doll’s eyes, death
44
Q

Subtentorial Herniation

A
  • Upward herniation of mesencephalon and cerebellum

- Downward herniation of cerebellar tonsils into foramen magnum

45
Q

Emergency Herniation Treatment

A
  • Mannitol 20%, 25 g (125 mL) IV rapidly
  • Intubate and mildly hyperventilate
  • Lasix 20 mg IVP
  • Foley/NG
  • CT/OR

ICU TRANSITION PROGRAM (3 decks)

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