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NUR 280 > Neurologic disorders > Flashcards

Neurologic disorders Flashcards

1
Q

what is the CNS

A

brain and spinal cord

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2
Q

what is the PNS

A

peripheral nerves

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3
Q

what are glial cells

A

support cells
structure for neurons

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4
Q

assessment of neuro system

A

cognitive fx- remember words, dates, draw
facial droop- ask pt to smile, open up mouth
extremities- tremors, rigidity, lack of strength
motor strength- bilateral grip and quadriceps strength against resistance
DTR- babinski- should be neg
sensation- pt eyes closed

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5
Q

what is generalized onset seizure

A

whole brain

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6
Q

what is focal onset seizure

A

1 side of brain

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7
Q

what is clonic

A

rhythmic muscle twitching

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8
Q

what is atonic

A

go limp

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9
Q

what is myoclonis

A

nonrhythmic muscle twitching

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10
Q

what are absence seizures

A

staring spell
gone from presence

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11
Q

what is aura

A

sensation b4 seizure
smell, feeling, etc

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12
Q

what is ictal period

A

time of seizure
do not touch pt

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13
Q

what is postictal

A

after seizure
exhausted
confused

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14
Q

what is interictal

A

period btwn multiple seizures

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15
Q

what is status epilipticus

A

seizure lasting >5 min
medical emergency: can lead to permanent brain damage

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16
Q

what causes seizures

A

head trauma
stroke
brain neoplasms
congenital malformation
degenerative brain disorder
environmental stimuli
genetic predisposition
infections
metabolic disturbances: electrolye imbalance
perinatal injury
withdraw from alc or sedative-hypnotic drugs

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17
Q

what is epilepsy

A

chronic neurological disorder with recurrent seizures
2 unprovoked seizures at least 24 hrs apart

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18
Q

characterisitcs of migraine headaches

A

1 sided
periodic, throbbing headaches
altered perceptions, nausea, and severe pain
lasting 4-72 hrs
aggravated by routine physical activity
sensitivity to light and or sound

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19
Q

risk factors for migraines

A

female
oral contraceptive use
excessive exercise
stress/worry
fatigue/lack of sleep
foods with nitrites, aspartate, tyranmine
hypoglygemia

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20
Q

how to treat migraines

A

NSAIDs
serotonin receptor agonists
dopamine receptor antagonists
preventative, prophylactic treatment
botox

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21
Q

characteristics of tension type headaches

A

most common
bilateral pain with mild to moderate pressure
does not worsen with physical activity
no nausea and vomiting
increased cervical and pericrainial muscle activity
lasting from 30 min-7 days
sensitivity to either light or sound

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22
Q

treatment for TTH

A

pain relievers
relaxation therapy
SSRIs

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23
Q

what is MS

A

chronic demyelinating disorder
affects brain, spinal cord, and optic nerves
remissions and exacerbations
sensory and motor

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24
Q

symptoms of MS

A

weakness
numbness
balance probs
blurred vision
dysphagia
hemiparesis
paraparesis
memory probs

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25
Q

what is guillain barre syndrome

A

t cell mediated d/t virus
postinfectious disease: epstein barr, covid
acute inflammatory demyelination

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26
Q

symptoms of guillain barre

A

weakness
complete paralysis- starts @ feet- ascending- breathing
peripheral neuropathy

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27
Q

treamtnet for GBS

A

supportive
neuromuscular respiraotry failure- vent
continuous hemodynamic monitoring- autonomic nerves involved
immunomodulating agents

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28
Q

what is myasthenia gravis

A

autoimmune
chronic
fights acetylcholine
muscle weakness and fatigue
extraocular muscles affected first
b and t cell mediated
thymus gland hyperplasia- overproduces t cells

29
Q

diagnostics tests for MG

A

edrophonium testing
serum ach receptor antibodies
EMG

30
Q

treatments for MG

A

physostigmine
iv immunogobulin
plasmapharesis
thymectomy

31
Q

what is myasthenic crisis

A

weakness severe enough to cause respiratory failure necessition vent
requires ICU monitoring of forced vital capacity and neg inspiratory force every 2-4 hrs

32
Q

what is obtunded

A

difficult to arouse

33
Q

what is normal ICP

A

5-15 mm/hg

34
Q

3 elements of ICP

A

brain tissue
blood volume/circulation
CSF

35
Q

how to decrease pressure

A

drain fluid
decrease bp
hypertonic
vasoconstrict
remove brain tissue
remove part of skull (decompressive crainiotomy)

36
Q

what oercentage is brain tissue

A

80

37
Q

what percentage is CSF

A

10

38
Q

what percentage is blood

A

10

39
Q

what can caused increased icp

A

mass
tumor
trauma
bleed
ischemic stroke
hydrocephalus
airway obstruction
hypoventilation
seizures

40
Q

what is the monroe-kellie hypothesis

A

one of above volumes compensates for the other that rises
once the need for volume can not be compensated for, ICP rises

41
Q

assessment of TBI

A

head trauma
neuro exam
durations of unconsciousness
post-traumatic amnesia
consciousness vs unconsciousness
cranial nerve testing both sides- pupil reaction to light, extraocular movements, corneal reflex, hearing, uvula and tongue position
sensory testing- light touch, pain, positioning
motor testing
DTR
coordination and gait
mental status
glascow coma scale
coma and posturing

42
Q

what does the glascow coma scale assess

A

severity of brain injury
eye opening, verbal response, motor response
lowest: 3
highest: 15- conscious

43
Q

what is decoritacte

A

flexed arms, clenched fists, rigid legs
indicates corticospinal tract damage

44
Q

what is decerebate

A

arms held striaght outward with toes pointed downward
indicates upper brainstem damage

45
Q

what is post concussion syndrome

A

may persist for several months

46
Q

treatment of mild tbi

A

certain activities should be resitrcted
frequent rest
stop playing sport/activity immediately until assessment and cleared by clinician to return to activity

47
Q

treatment of modereate to severe tbi

A

intensive care unit

48
Q

what is diffuse axonal injury

A

common type of tbi
widespread damage to brain tissue
major cause of unconsciousness and persistent coma after head trauma
immediate loss of consciousness, most remain in coma

49
Q

treatment for DAI

A

neurovascular stabilization
IV mannitol, steroids

50
Q

what is a concussion

A

mild TBI
traumatic force causes disruption in brain fx

51
Q

what is a simple concussion

A

resolve without complication
may take up to 10 days

52
Q

what is a complex concussion

A

symtoms may persist for longer
longer loss of consciousness

53
Q

what may a pt state after a concussion

A

seeing stars
dazed
confused
headache
dizzy
retrograde and antegrade amnesia

54
Q

diagnosis for concussion

A

rule out cervical spine injury, epidural hematoma, subdural hematoma, subarachnoid hemorrhage
neuro exam
s&s may evolve over time so do repeat evals
ct scan normal in most cases

55
Q

what is post-concussion syndrome

A

persistence of symptoms for more than 3 weks

56
Q

what is a cerebral contusion

A

scattered areas of bleeding on brain surface
most commonly undersurface frontal and temporal lobes
cerebral edema around contusion within 48-72 hrs
medical emergency- decreased HR, decreased respirations, hypertension, can not be awakened

57
Q

treatment for cerebral contusion

A

crainectomy/crainotomy
evacuation of blood through crainiotomy

58
Q

what is intracranial bleeding

A

epidural and subdural hematoma
can cause excessive pressure on brain and cause neuro damage or death

59
Q

what is epidural hematoma

A

collection of arterial blood above dura mater that is caused by rupture of the middle meningeal artery
commonly associated with skull fracture

60
Q

what is a subdural hematoma

A

collection of venous blood that is beneath dura mater

61
Q

what is a spinal cord injury

A

compression, stretching, or laceration of spinal cord d/t trauma
can result in impaired blood flow
causes temp or permanent sensory, motor or autonomic fx that are seen immediately after injury
deficits can worsen over time r/t edema
quadriplegia is most common type: all 4 limbs
paraplegia is second most common type

62
Q

where is a complete SCI

A

c4 or above

63
Q

where is an incomplete SCI

A

t11 or below

64
Q

what is a primary sci

A

mechanical- stretching or shearing forces injure neurons and glial cells
hemorrhage, cell death, and necrotic enviornment

65
Q

what is a secondary sci

A

ischemia caused by primary forces causes secondary injury processes that worsen damage over hours to weeks
ischemia cause cytotoxic edema, inflammation, cascade of tissue damage and scarring which inhibits regeneration of neurons at side of injury

66
Q

assessment for sci

A

abc’s
log roll- treat all back injuries as if they have sci until confirmed they do not
pulmonary -injuries at c4 and above tend to have respiratory complications
look for signs of hemorrhage, hypotension and shock
sensory testing
motor strength testing
extent of injury

67
Q

treatment for sci

A

ABCs
stabilization
neuro exam
pain management
SCDs-immobile
wound care
urinary cath
warmed IVF
surgery
LMW heparin if no bleeding risk

68
Q

what is spinal shock

A

areflexia: absence of reflexes
results from primary injury
flaccid muscles, paralysis, lack of sensation below injury, bowel and bladder dysfunction
loss of anal reflex or bulbocavernosus reflex
autonomic fx also disrupted
cannot assess extent of injury until shock resolves, may take weeks to days
indicated by return of anal reflex

69
Q

what is neurogenic shock

A

acute
occurs in pt’s with injuries at t6 and above
autonomic probs
abnormal SNS signaling
bradycardia
hypotension
peripheral vasodilation
hemodynamic monitoring and stabilization required- fluids

NUR 280 (7 decks)

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