Neuro test Flashcards
1
Q
Dura mater
A
Outer later that forms dural sinuses that collect venous blood and CSF to return to circulation
2
Q
Subdural space
A
Normally empty but can fill with blood after an injury
3
Q
Arachnoid mater
A
Middle layer that’s a loose and web like covering
4
Q
Subarachnoid space
A
Lies below the arachnoid and contains CSF, cerebral arteries and veins
5
Q
Pia mater
A
Inner most layer of connective tissue that adheres closely to the convolutions on the brain
6
Q
First cranial nerve
A
Olfactory- sensory, smell
7
Q
Second cranial nerve
A
Optic- sensory, vision
8
Q
Third cranial nerve
A
Oculomotor- motor, eye movements including eyelids
9
Q
Fourth cranial nerve
A
Trochlear- motor, eye movements
10
Q
Fifth cranial nerve
A
Trigeminal- sensory/motor, general sensory- eye, nose, face or oral cavity, teeth, speech muscles
11
Q
Sixth cranial nerve
A
Abducens- motor, eye movement
12
Q
Seventh cranial nerve
A
Facial- sensory/motor, taste, muscles of facial expression, scalp muscles
13
Q
Eighth cranial nerve
A
Vestibulocochlear- sensory, hearing and balance
14
Q
Ninth cranial nerve
A
Glossopharyngeal- sensory/motor, taste, gag reflux
15
Q
Tenth cranial nerve
A
Vagus- sensory/motor, external ear, parts of taste, heart and lung smooth muscle, glands of GI system, diaphragm
16
Q
Eleventh cranial nerve
A
Spinal accessory- motor, voluntary muscle of pharynx, head movements
17
Q
Twelfth cranial nerve
A
Hypoglossal- motor, muscles of the tongue
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
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
19
Q
What is the blood brain barrier
A
A protective mechanism provided by a relatively impermeable membrane capillaries in the brain
20
Q
Hemispheres of the brain
A
Two hemispheres- left and right, each with 4 major lobes: frontal, parietal, temporal, occipital
21
Q
Afferent pathways
A
Ascending tract that relays information from the skeletal muscles to the brain
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
23
Q
Efferent pathways
A
Descending tract that sends signals from the brain to the muscles for movement
24
Neurons
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
25
Spinal cord makeup
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)
26
Main areas of the spine
Cervical- C1-C7
Thoracic- T1-T12
Lumbar- L1-L5
Sacral- S1-S5
Coccyx- 4
27
CNS breakdown
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
28
PNS breakdown
Is made up of the autonomic nervous system and the somatic nervous system
29
Autonomic nervous system
Branch of the PNS that acts as the involuntary control and has two further branches: SNS (sympathetic nervous system) and PNS (parasympathetic nervous system)
30
Sympathetic nervous system
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)
31
Parasympathetic nervous system
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)
32
Somatic nervous system
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
33
Acetylcholine
Neurotransmitter present at neuromuscular junctions and in the autonomic nervous system and peripheral nervous system
34
Norepinephrine/epinephrine
Neurotransmitter in the SNS that causes vasoconstriction and increase HR and stimulate alpha and beta receptors
35
Dopamine
Neurotransmitter that regulates impulses for mood
36
Serotonin
Neurotransmitter for mood, sexual desire/function, appetite, sleep, memory/learning, temperature regulation, and social behavior
37
Inter cranial pressure (ICP)
5-15 mmHg
38
Cerebral perfusion pressure (CPP)
70-80 mmHg with no less of 60mmHg
39
Mean arterial pressure (MAP)
70-100 mmHg, <60mmHg can be deadly to organs
40
Cushing's reflex
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
Why does crushing's reflexes happen
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
Epidural hematoma/ extradural hematoma
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
Subdural hematoma
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
Sub arachnoid hemorrhage
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
Signs and symptoms of a sub arachnoid hemorrhage
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
Intracerebral hemorrhage
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
Hematomas
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
Meningitis
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
Multiple sclerosis (MS)
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
Parkinsons disease
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
Bell's palsy
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
Types of seizures
Generalized- no definable origin where the entire brain is involved
Partial- known focus
52
Petit mal
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
Grand mal
Preceded by an aura with a sudden onset with loss of organized muscle tone
Tonic phase, clonic phase, postictal phase, status epilepticus
54
Tonic phase
extensor muscle tone, apnea, tongue biting, incontinence, short duration
54
Clonic phase
rigidity, convulsions, ANS discharge, hyperventilation, salivation, tachycardia, 1-3 min
55
Postictal phase
drowsiness, unconsciousness, min to hours, confusion, fatigue, transient neurological deficits
56
Status epilepticus
prolonged seizure activity that is reoccuring seizures before regained consciousness
57
Simple partial seizures
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
Complex partial seizure
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
Basilar skull fracture
A fracture involving the base of the skull
60
Depressed skull fracture
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
Migraines
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
Simple skull fracture
Linear crack or cracks with no displacement
61
Cluster headaches
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
Tension headaches
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
Sinus headaches
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
Types of strokes (CVAs)
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
Ischemic strokes
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
Hemorrhagic stroke
Hemorrhage in cranial vault from aneurysms, malformations, hypertension, stress/ exertion, cocaine with a sudden onset accompanied by headache, nausea, vomiting, quick deterioration
67
TIA (transient ischemic attack)
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
Stroke test
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
How to manage airway
Airway: suctioning/ positioning
Breathing: IPPV, oxygenation (hyperventilation)
Circulation: monitor BP, ECG, IV
Positioning: supine with head elevated 15 degrees
69
Assessments for stroke
Facial droop (smile/raise eyebrows), arm/ leg weakness/ drift, slurred speech, inappropriate words, mute, pupils (assessed but not deciding factor of a stroke)
70
LAMS test
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
Broca's area
Motor/ expressive speech area that controls the output of words (verbal/written) to ensure they are coordinated/ appropriate
Base of the frontal lobe
72
Limbic system
Responsible for emotional reactions and feelings- linked to the hypothalamus responsible for autonomic response associated with emotions
72
Wernicke's area
Integration center that comprehends language receive (written/spoken) with connective fibers to visual/ auditory areas
Located in the posterior temporal lobe
73
Diencephalon
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
Brainstem
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
Cerebellum
Coordinates movement, maintain posture and equilibrium from taking impulses from visual pathways, vestibular pathways, and proprioceptors in joints and muscles
76
frontal lobe functions
conscious thought and voluntary motor action
77
temporal lobe function
hearing
78
parietal lobe function
body awareness
79
occipital lobe function
vision
