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Neuro test Flashcards

1
Q

Dura mater

A

Outer later that forms dural sinuses that collect venous blood and CSF to return to circulation

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2
Q

Subdural space

A

Normally empty but can fill with blood after an injury

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3
Q

Arachnoid mater

A

Middle layer that’s a loose and web like covering

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4
Q

Subarachnoid space

A

Lies below the arachnoid and contains CSF, cerebral arteries and veins

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5
Q

Pia mater

A

Inner most layer of connective tissue that adheres closely to the convolutions on the brain

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6
Q

First cranial nerve

A

Olfactory- sensory, smell

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7
Q

Second cranial nerve

A

Optic- sensory, vision

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8
Q

Third cranial nerve

A

Oculomotor- motor, eye movements including eyelids

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9
Q

Fourth cranial nerve

A

Trochlear- motor, eye movements

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10
Q

Fifth cranial nerve

A

Trigeminal- sensory/motor, general sensory- eye, nose, face or oral cavity, teeth, speech muscles

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11
Q

Sixth cranial nerve

A

Abducens- motor, eye movement

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12
Q

Seventh cranial nerve

A

Facial- sensory/motor, taste, muscles of facial expression, scalp muscles

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13
Q

Eighth cranial nerve

A

Vestibulocochlear- sensory, hearing and balance

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14
Q

Ninth cranial nerve

A

Glossopharyngeal- sensory/motor, taste, gag reflux

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15
Q

Tenth cranial nerve

A

Vagus- sensory/motor, external ear, parts of taste, heart and lung smooth muscle, glands of GI system, diaphragm

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16
Q

Eleventh cranial nerve

A

Spinal accessory- motor, voluntary muscle of pharynx, head movements

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17
Q

Twelfth cranial nerve

A

Hypoglossal- motor, muscles of the tongue

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18
Q

CSF

A

Clear colorless liquid used for a cushion for brain and spinal cord that is formed in the ventricles in the brain and flows into the subarachnoid space

500mls a day

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19
Q

How does the blood brain barrier work

A

Cells are tightly joined together to form a barrier that limits the passage of damaging materials into the brain to control balance of electrolytes, glucose, and proteins

Lipid soluble substances can still pass through

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19
Q

What is the blood brain barrier

A

A protective mechanism provided by a relatively impermeable membrane capillaries in the brain

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20
Q

Hemispheres of the brain

A

Two hemispheres- left and right, each with 4 major lobes: frontal, parietal, temporal, occipital

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21
Q

Afferent pathways

A

Ascending tract that relays information from the skeletal muscles to the brain

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22
Q

How do neurons work

A

Impulses are transmitted from cell to cell by neurotransmitters involving presynaptic and postsynaptic synapses

Axon and receptor are separated by a synaptic cleft and for impulses to travel the chemical flows a crossed the cleft to the receiving receptor that are specific for each chemical type

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23
Q

Efferent pathways

A

Descending tract that sends signals from the brain to the muscles for movement

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24
Q

Neurons

A

Specialized cells that conduct impulses through CNS/PNS that requires glucose/O2 for metabolism

Parts:

Dendrite- receptor site that conducts impulses towards the cell body

Cell body- contains the nucleus

Axon- conducts impulses away from cell body towards effector site or connecting neuron

Myelin sheath- insulates the fiber and speeds up the rate of conduction

Nodes of ranvier- spaces between the myelin sheaths

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25
Q

Spinal cord makeup

A

Starts at the medulla and ends at L1 (after L1 spinal cord is called cauda equina “horse tail”) and is protected by vertebral column, meninges, and CSF

Consists of nerves that innervate the skeletal muscles with ascending/ descending tracts (afferent/efferent pathways)

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26
Q

Main areas of the spine

A

Cervical- C1-C7

Thoracic- T1-T12

Lumbar- L1-L5

Sacral- S1-S5

Coccyx- 4

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27
Q

CNS breakdown

A

Made up of the brain and spinal cord. The brain receives, processed, and responds to sensory information and sends it to the spinal cord to be sent to the PNS

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28
Q

PNS breakdown

A

Is made up of the autonomic nervous system and the somatic nervous system

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29
Q

Autonomic nervous system

A

Branch of the PNS that acts as the involuntary control and has two further branches: SNS (sympathetic nervous system) and PNS (parasympathetic nervous system)

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30
Q

Sympathetic nervous system

A

Increases level of activity like cardio, respiratory and neurological functions, flight/fight (Ach) and stress (epi/norepi)

Antagonistic effects that maintain homeostasis (opposite effects- one is dominating other is blocking ability of the other)

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31
Q

Parasympathetic nervous system

A

Dominates digestive system and aids in recovery after sympathetic stimulation

Responsible for slowing of RR, HR, constriction of pupils

Largely innervated by the vagus nerve

Active chemical neurotransmitter is Ach

Antagonistic effects that maintain homeostasis (opposite effects- one is dominating other is blocking ability of the other)

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32
Q

Somatic nervous system

A

Has sensory nerves and motor nerves

Stretches to every part in the body to deliver information from your senses to your brain to carry out commands from brain to muscles for movement

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33
Q

Acetylcholine

A

Neurotransmitter present at neuromuscular junctions and in the autonomic nervous system and peripheral nervous system

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34
Q

Norepinephrine/epinephrine

A

Neurotransmitter in the SNS that causes vasoconstriction and increase HR and stimulate alpha and beta receptors

35
Q

Dopamine

A

Neurotransmitter that regulates impulses for mood

36
Q

Serotonin

A

Neurotransmitter for mood, sexual desire/function, appetite, sleep, memory/learning, temperature regulation, and social behavior

37
Q

Inter cranial pressure (ICP)

A

5-15 mmHg

38
Q

Cerebral perfusion pressure (CPP)

A

70-80 mmHg with no less of 60mmHg

39
Q

Mean arterial pressure (MAP)

A

70-100 mmHg, <60mmHg can be deadly to organs

40
Q

Cushing’s reflex

A

Caused from cerebral ischemia, where to increase blood supply to the brain, the heart will increase systolic pressure to widen pulse pressure, decreasing pulse, and irregular respirations.

41
Q

Why does crushing’s reflexes happen

A

The widening pulse pressure and decreased pulse is from the heart trying to perfuse the brain so the heart must work harder to push past the increased IPC to bring blood to the brain

Irregular respirations are from the pressure being put on the medulla from the ICP which interferes with the respiratory and cardiac centers

42
Q

Epidural hematoma/ extradural hematoma

A

Bleeding between the dura and the skull from a tear in the middle meningeal artery in the temporal region from a linear fracture with a quick onset and a deadly outcome

S&s: head trauma w/ LOC, rapid death, Lucid interval then signs of increased ICP within min to hours

42
Q

Subdural hematoma

A

Bleeding between the dura and the arachnoid from injury to underlying brain tissues where blood accumulates slowly so diagnosed hours to days later

Tear in the arachnoid can cause loss of CSF in subdural space increased ICP

High risk: alcoholics, people on blood thinners

S&s: headaches, changes in LOC, slurred speech

43
Q

Sub arachnoid hemorrhage

A

Bleeding between arachnoid and Pia from traumatic bleeding from blood vessels at the base of the brain (aneurysms) that causes CSF to mix with blood and prevents a hematoma formation (blood clots)

44
Q

Signs and symptoms of a sub arachnoid hemorrhage

A

sudden severe headache, localized but then becomes diffuse from meningeal irritation, as bleeding continues ICP makes decreased LOC, pupil changes, posturing, vomiting, and seizures

45
Q

Intracerebral hemorrhage

A

Bleeding in the brain tissue from blunt or penetrating trauma most common in frontal/temporal lobes

S&s: alterations in LOC, similar patterns to CVA, high mortality rate

46
Q

Hematomas

A

Increased ICP as bleeding puts pressure on the tissues and when blood slowly accumulates blood cells undergo hemolysis (destruction of RBCs) and fluid in the area of accumulation exerts osmotic pressure and draws water to the area increasing size/pressure exerted by the mass

47
Q

Meningitis

A

Bacterial infection of the meninges of the brain from microbes via the blood that can result from head trauma/ surgery or secondary to other infections like sinusitis or an abscess where the infection can spread through the bone

S&s: headache, back pain. Nuchal rigidity, vomiting, irritability lethargy, fever, chills, rash

48
Q

Multiple sclerosis (MS)

A

Progressive autoimmune disease of the CNS that causes patches of the myelin in brain/spine to be destroyed causing issues in nerve conduction and message impulse

S&s: physical/mental problems, muscle weakness, sensation troubles, vision issues (double/ blindness)

No cure- meds slow progression

49
Q

Parkinsons disease

A

Degeneration/damage to nerve cells in basal ganglia (voluntary motor movements) from a lack of dopamine which effects the nerve pathways controlling muscle contraction

S&s: tense muscles, tremors, joint rigidity, slow movement

50
Q

Bell’s palsy

A

Temporary paralysis/weakness of the facial muscles on one side of the face from inflammation of the 7th cranial nerve

S&s: severe headache. Lower face paralysis (mouth, cheek, eye), upper face paralysis (eyebrow, forehead)

51
Q

Types of seizures

A

Generalized- no definable origin where the entire brain is involved

Partial- known focus

52
Q

Petit mal

A

Generalized

Absence seizures around kids 4-12 with a lapse of consciousness, no loss of posture or motor activity, isolated clonic activity for a short period then return to normal.

53
Q

Grand mal

A

Preceded by an aura with a sudden onset with loss of organized muscle tone

Tonic phase, clonic phase, postictal phase, status epilepticus

54
Q

Tonic phase

A

extensor muscle tone, apnea, tongue biting, incontinence, short duration

54
Q

Clonic phase

A

rigidity, convulsions, ANS discharge, hyperventilation, salivation, tachycardia, 1-3 min

55
Q

Postictal phase

A

drowsiness, unconsciousness, min to hours, confusion, fatigue, transient neurological deficits

56
Q

Status epilepticus

A

prolonged seizure activity that is reoccuring seizures before regained consciousness

57
Q

Simple partial seizures

A

Motor seizures clonic activity to one specific body part and sensory seizures are tingling, numbness, visual, auditory, and taste symptoms

Jacksonian seizure: seizure activity involving a brief alteration in movement, sensation or nerve function

58
Q

Complex partial seizure

A

Arise from focal seizures in the temporal lobe (psychomotor) that manifest as changes in behavior and present as abnormal repetitive motor behavior and a period of amnesia with a brief duration

59
Q

Basilar skull fracture

A

A fracture involving the base of the skull

60
Q

Depressed skull fracture

A

Part of the skull is indented posing a high risk for infection, CSF leaks, profuse bleeding, damage to brain tissue

S&s: raccoon eyes, CSF from ears/nose, mastoid bruising

61
Q

Migraines

A

Severe headaches preceded by visual/ GI disturbances with onset of an intense throbbing pain unilaterally accompanied by nausea and vomiting, constriction and dilation of blood vessels, sensitivity to light, sound or smell

61
Q

Simple skull fracture

A

Linear crack or cracks with no displacement

61
Q

Cluster headaches

A

Occurs in short lasting bursts on repeat for days or months (half/two hours) often during sleep due to abnormalities in biological clock (hypothalamus) causing severe pain around one eye, tearing and nasal congestion

Treatment: antihistamines, corticosteroids, calcium channel blockers, analgesics

62
Q

Tension headaches

A

Muscle contractions of the face, neck, and scalp from stress, persistent noise, poor posture, and eye strain

Most common type of headache

Treatment: analgesics

63
Q

Sinus headaches

A

Pain in forehead, nasal area, eyes or pressure behind face due to buildup in sinuses from infection/ inflammation of membranes

Treatment: analgesics, antihistamines, antibiotics

64
Q

Types of strokes (CVAs)

A

Ischemic- 80-85%, rarely lethal in the first hour, conscious w/ alterations

Hemorrhagic- less common and rapidly fatal, unconscious w/ no ability to perform testing

65
Q

Ischemic strokes

A

Occlusions of an artery from plaque buildup or an embolus causing sudden obstruction

S&s: hemiparesis/hemiplegia, contralateral numbness/ facial drooping, aphasia, confusion/coma, convulsions, incontinence, diplopia, dysarthria, headache, dizziness

66
Q

Hemorrhagic stroke

A

Hemorrhage in cranial vault from aneurysms, malformations, hypertension, stress/ exertion, cocaine with a sudden onset accompanied by headache, nausea, vomiting, quick deterioration

67
Q

TIA (transient ischemic attack)

A

Focal cerebral dysfunction (temporary reduction in blood flow) that lasts minutes to hours then the patient returns to normal with no permanent damage

Indicate obstruction related to atherosclerosis, can be from spasm of arteries and loss of autoregulation

67
Q

Stroke test

A

B- balance: loss of balance, headache, or dizziness
E- eyes: blurred vision
F- face: one side of face is drooping
A- arms: arm or leg weakness
S- speech: speech difficulty
T- time: all for an ambulance immediately

68
Q

How to manage airway

A

Airway: suctioning/ positioning

Breathing: IPPV, oxygenation (hyperventilation)

Circulation: monitor BP, ECG, IV

Positioning: supine with head elevated 15 degrees

69
Q

Assessments for stroke

A

Facial droop (smile/raise eyebrows), arm/ leg weakness/ drift, slurred speech, inappropriate words, mute, pupils (assessed but not deciding factor of a stroke)

70
Q

LAMS test

A

Facial droop: 0- absent, 1- present

Arm drift: 0- absent, 1- drifts down, 2- falls rapidly

Grip strength: 0- normal, 1- weak grip, 2- no grip

Add score is >4 or equal to then having a stroke

71
Q

Broca’s area

A

Motor/ expressive speech area that controls the output of words (verbal/written) to ensure they are coordinated/ appropriate

Base of the frontal lobe

72
Q

Limbic system

A

Responsible for emotional reactions and feelings- linked to the hypothalamus responsible for autonomic response associated with emotions

72
Q

Wernicke’s area

A

Integration center that comprehends language receive (written/spoken) with connective fibers to visual/ auditory areas

Located in the posterior temporal lobe

73
Q

Diencephalon

A

Contains thalamus/ hypothalamus

Thalamus- nerve bodies serve to sort/relay incoming sensory impulses

Hypothalamus- maintains homeostasis- regulates temp, intake of food/fluids, regulates sleep cycle, regulates libido

74
Q

Brainstem

A

Pons: contains afferent (incoming) and efferent (outgoing) fibers

Medulla: vital control to regulate respiratory and cardiovascular function

RAS (reticular activating system): determines degree, arousal, awareness of cerebral cortex (decides what sensory impulses brain ignores/notices)

75
Q

Cerebellum

A

Coordinates movement, maintain posture and equilibrium from taking impulses from visual pathways, vestibular pathways, and proprioceptors in joints and muscles

76
Q

frontal lobe functions

A

conscious thought and voluntary motor action

77
Q

temporal lobe function

A

hearing

78
Q

parietal lobe function

A

body awareness

79
Q

occipital lobe function

A

vision

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