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PCM IV Exam II > neuro procedures (Told) > Flashcards

neuro procedures (Told) Flashcards

1
Q

CSF PRESSURE

A

LESS THAN 25-30 CM (250-300mm) Water(Spinal Fluid)

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2
Q

spinal fluid is comparable to

A

blood without RBCor WBC

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3
Q

DOING A SPINAL TAP

A

CT SCAN SHOULD PRECEED SPINAL TAP UNLESS MENINGITIS IS SUSPECTED.

Needle- SHORT BEVEL
ONLY

L4-L5 is first choice

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4
Q

causes of LOW PRESSURE

spinal fluid

A

BELOW 7 cm. (70mm)H2O
( Spinal Fluid)

Hypo-production

Distal to Occlusion

Spinal fluid leak

Spinal cord tumor

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5
Q

causes of high spinal fluid pressure

A

ABOVE 25-30 cm.
(250-300mm)H2O
(Spinal Fluid)

Hyper-production

Proximal to Occlusion

Malabsorption of spinal
fluid

Obesity. Pseudo tumor
cerebri

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6
Q

New bleeding from a
cerebral bleed will give
CSF the appearance of

A

Cherry Limeade

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7
Q

XANTHOCHROMIC

spinal fluid means

A

Old blood pigments

Remote bleeding

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8
Q

normal appearance of spinal fluid

A

CLEAR
Usually normal
1-3 monocytes &
lymphocytes

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9
Q

CLOUDY spinal fluid

A

If greater
than 200 WBC/cc or
400 RBC/cc
Infection/Inflammation

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10
Q

cell findings in spinal fluid

A

neutrophils- baccterial infection

lymphocytes viral infections (mumps,/ fungal/ TB)

Monocytes (macrophages)- chronic conditions (purple u shape)

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11
Q

gram stain

A

60-90% positive in bacterial infections

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12
Q

fungal stain looks like

A

big purple blobs, pink stretchiness in between

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13
Q

glucose, proteins in CSF

A

GLUCOSE- CSF GLUCOSE LAGS ONE HOUR BEHIND BLOOD GLUCOSE NEVER
LOWER THAN 80% OF BLOOD GLUCOSE

PROTEIN- LESS THAN 45 MG/DL (1 MG/DL RISE FOR EVERY 1000 RBC PRESENT.)

special tests- oligoclonal bands = MS

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14
Q

EPIDURAL SPACE

A

POTENTIAL SPACE THAT CONTAINS NO FLUID OR BLOOD ONLY ACCESS

TO THE NERVE ROOTS & DISC MATERIAL

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15
Q

WHAT IS AN EPIDURAL ?

A

SPACE OUTSIDE THE SPINAL
CANAL ACCESSABLE TO NERVE
ROOTS. MEDICATIONS CAN REMAIN
OUTSIDE THE SPINAL CANAL.

CATHETERS ARE INSERTED INTO
EPIDURAL SPACE TO INFUSE
ANASTHETICS OR NARCOTICS

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16
Q

EEG BRAIN MAPPING

A

DIGITAL SIGNALS CAN BE CONVERTED TO COLOR &
3D IMAGES IF DESIRED.

HELPS LOCATE FOCUSES OF FUNCTION OR DYSFUNCTION
17
Q

RADIOGRAPHIC IMAGING

A

PLAIN X-RAY IS USED LESS OFTEN FOR
NEUROLOGIC DIAGNOSIS EXCEPT AS A
SCREEN FOR FRACTURES.

18
Q

lateral x-ray should show

A

at least 7 vertebrae

ALL
7 CERVICAL VERTEBRAE
PLUS T-1

19
Q

CT scans- more cameras

A

mean more heat and radiation!!

FASTER AND MORE DETAIL COMES WITH RISKS!!

EQUAL TO MORE THAN ONE
HUNDRED CHEST X-RAYS

20
Q

When is CT valuable?

A

abcess, tumor (needs IV contrast)

kidney stones

spinal fractures

hemorrhages

21
Q

MEDICINE’ HOT SUGAR

A

Nuclear glucose (FDG)

Positron Emission Tomogram Scan

“cancer just can’t resist having a PET”

22
Q

HOW MEDICINE’S HOT SUGAR WORKS

A

FDG injected into patient

METOBOLISM OF FDG IN THE GLUCOSE PATHWAY GIVES OFF POSITRON + GAMMA RADIATION

CANCER CELLS USE MORE GLUCOSE THAN NORMAL CELLS
AND EMIT MORE
GAMMA RADIATION

Glioblastomas and lymphomas and stuff show up as black dots

23
Q

T-1 and T-2 images

A

PROTONS WOBBLE
BUT THEY DON’T FALL DOWN

T-1 RELAXATION
LONGITUDINAL TO
THE MAGNETIC FIELD

T-2 RELAXATION
TRANSVERSE
TO THE MAGNETIC
FIELD

IN T-2 WEIGHTED IMAGES CSF (WATER) IS
BRIGHT. In FLAIR is T-2 with spinal fluid brightness blocked out

IN T-1 WEIGHTED IMAGES CSF (WATER) IS
DARK

24
Q

How stuff looks on T-1

A

DARK:
•CSF

  • Increased Water – edema, tumor, infarct, inflammation, infection, hemorrhage (hyper acute or chronic)
  • Low proton density, calcification
  • Flow Void
                  BRIGHT:
Fat
Subacute hemorrhage
Melanin
Protein-rich Fluid
Slowly flowing blood
Gadolinium
Laminar necrosis of an infarct
25
Q

How stuff looks on T-2

A

Dark:
•Low Proton Density, calcification, fibrous tissue

  • Paramagnetic substances - deoxyhemoglobin, methemoglobin (intracellular), iron, hemosiderin, melanin
  • Protein-rich fluid
  • Flow Void

Bright:
•Increased Water – edema, tumor, infarct, inflammation, infection, subdural collection

•Methemoglobin (extracellular) in subacute hemorrhage

26
Q

FLUID-ATTENUATED INVERSION RECOVERY

FLAIR

A

EDEMA AND GLIOSIS

ARE HYPERINTENSE

27
Q

Using the MRI effectively

A

SCLEROTIC LESIONS
IN BRAIN TISSUE (M.S.)

tumor

when there is edema or excess fluid (meningitis)

angiography

soft tissue surrounded y bone

Not as good as CT for acute stroke

28
Q

CLINICAL PEARLS

A

SPINAL TAP BEST FOR MENINGITIS, DEGENERATIVE NEUROLOGIC CONDITIONS AND DISEASES SUSPECTED TO ALTER SPINAL FLUID PRESSURE OR CIRCULATION.

ALWAYS DO CT SCAN BEFORE SPINAL TAP UNLESS INFECTION (MENINGITIS WITH NEURO SIGNS) IS SUSPECTED.

29
Q

different imaging for different stuff

A

MRI IS BEST FOR MOST TUMORS, EVALUATING SOFT TISSUES INSIDE BONEY CAVITIES (DISK DISEASE), AND VASCULAR LESIONS.

PET SCANS LOOK FOR CANCER.

CT SCAN IS BEST FOR ACUTE CEREBRAL BLEEDING, ABCESSES AND ALL FRACTURES

30
Q

young girl, papilledema, normal CT scan, high pressure spinal tap, no bacteria or WBC in CSF. Dx?

A

PSEUDOTUMOR CEREBRI

31
Q

old lady falling down
CSF- high protein, no white cells
dx?

A

ALBUMINOCYTOLOGIC DISSOCIATION
OR
GUILLAIN-BARRE SYNDROME

Give Iv IG

PCM IV Exam II (8 decks)

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