Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CERT STUDY > Neurologic Dysfunction > Flashcards

Neurologic Dysfunction Flashcards

1
Q

Potential signs of neurologic complications

A

Development of handedness before 1 year, absence/persistence/asymmetry of reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Spinal cord in neonates ends at ____

A

L13

L1-L12 in adults, affects lumbar puncture placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Children have ____ of CSF

A

60-140ml

Adults have 90-150ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Increased ICP

A

Excessive pressure in the rigid cranial vault that disrupts neurologic function
Caused by tumors, accumulation of CSF in the ventricular system, intracranial bleeding, edema of cerebral tissues, craniocerebral trauma, hydrocephalus, meningitis, encephalitis, Guillain-Barre syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Increased ICP signs - infants and young children

A

Tense, bulging anterior fontanel, high-pitched cry, increased head circumference, “setting sun” sign (eyes), Macewen’s sign (cracked pot sign), irritability, restlessness, changes in feeding habits, crying with cuddling and rocking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Increased ICP signs - older children

A

Headache, vomiting, cognitive/personality/behavior changes, diplopia, blurred vision, anorexia, nausea, weight loss, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Late manifestations of increased ICP

A

Decreased LOC (lethargy, coma), abnormal pupil size and reactivity, abnormal sensation, decerebrate and decorticate posturing, papilledema, abnormal breathing, Cheyne-Stokes respirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Increased ICP treatment

A 
Medications - diuretics, steroids
Keep head and neck neutral
No suctioning, percussion, fast movements, flexion or extension of neck 
Strict I/Os
Laxatives to prevent straining
Prevent weight loss
Monitor for DI and SIADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Generalized seizure

A

Involves both hemispheres of the brain, are bilateral and symmetrical
Includes tonic, clonic, tonic-clonic, absence, atonic, myoclonic, and febrile seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tonic seizure

A

Rigidity, extension and stiffening of extremities, fixed jaw, respiratory cessation, dilated pupils, loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clonic seizure

A

Rhythmic jerking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Absence seizure

A

Staring spell, may not remember what happened during seizure, usually returns to normal state of awareness immediately afterward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Atonic seizure

A

Sudden loss of muscle tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Myoclonic seizure

A

Short muscle contractions - body “jolts”
Infantile spasms - occurs in first few months of life - sudden jerk then stiffening that lasts 1-2 seconds, can occur in clusters, most often just after waking up or falling asleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Partial seizure

A

Occurs in a limited area of the cerebral cortex - symptoms vary depending on what area it affects - one-sided contractions, abnormal head and eye movements, lip smacking, sensory issues, inappropriate behavior
Includes simple and complex partial seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Simple partial seizure

A

Maintains consciousness, no memory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Complex partial seizure

A

Progress to unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Neural tube defects

A

Group of related defects of the CNS involving the cranium or spinal cord that vary from mild to severely disabling
Cystic or non-cystic
Include anencephaly, encephalocele, spina bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

50% of neural tube defect cases are due to ____

A

Deficiency of folic acid in diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anencephaly

A

Absence of entire brain or cerebral hemispheres - incompatible with life

21
Q

Encephalocele

A

Meningeal and cerebral tissue protrudes in a sac through a defect in the skill
In mild forms, there is little to no residual neurologic impairment

22
Q

Spina bifida

A

Defective closure of the vertebral column, most common defect in the CNS
Types - occulta, meningocele, myelomeningocele

23
Q

Spina bifida occulta

A

Does not usually affect the spinal cord - dimpling of the skin, nevi, or tufts of hair over a dural sinus

24
Q

Meningocele

A

Characterized by a sac which contains meninges and CSF protruding outside of the vertebrae, but the spinal cord is not affected

25
Q

Myelomeningocele

A

Spinal cord and accompanying nerve roots are involved - most severe type of spina bifida - causes sensorimotor deficits, urinary and bowel problems, joint deformities

26
Q

Thoracic myelomeningocele

A

Causes leg paralysis

27
Q

L3 myelomeningocele

A

Causes ankle and toe paralysis

28
Q

L4-5 myelomeningocele

A

Causes weak or absent ankle and toe flextion

29
Q

Sacral myelomeningocele

A

Causes mild ankle and toe weakness, may have bladder or bowel issues

30
Q

Neural tube defects pre-op care

A

Preventing infection
Sterile dressing to lesion, constantly moisten with saline, examine for leakage
Avoid placing diaper or other covering over lesion to prevent fecal contamination
Place in prone or side lying position to prevent contamination
Prevent hip subluxation by maintaining legs in abduction with pad between knees, keep feet in neutral position
Use protective devices, handle infant with care

31
Q

Hydrocephalus

A

Caused by imbalance in production and absorption of CSF in the ventricular system - production exceeds absorption, CSF accumulates and produces dilation of ventricles

32
Q

Communicating hydrocephalus

A

Caused by impaired absorption of CSF - meningitis, leukemia, lymphoma

33
Q

Non-communicating hydrocephalus

A

Caused by obstruction of flow of CSF - trauma, infection

34
Q

Hydrocephalus signs

A

abnormal rate of head growth, bulging fontanel, dilated scalp veins, Macewen’s sign (cracked pot sign), “sun setting” sign, sluggish pupils

35
Q

Hydrocephalus treatment

A

Placement of shunt

36
Q

Signs of shunt malfunction

A

Rapid onset of vomiting, severe headache, irritability, lethargy, fever, redness along shunt tract, fluid around shunt valve

37
Q

Reye’s syndrome

A

Acute, multi-system disorder that follows viral infection, usually flu A/B or varicella zoster - can lead to death within hours
Causes brain encephalopathy and fatty degeneration of liver, hyperammonia results from reduction in enzyme that converts ammonia to urea

38
Q

Causes of Reye’s syndrome

A

Salicylates (aspirin), toxins, antidiarrheals

39
Q

Reye’s syndrome stages

A

Stage 1 - vomiting, lethargy, confusion, slowing of EEG, liver dysfunction
Stage 2 - disoriented, combative, hallucinations
Stage 3 - coma, decorticate rigidity, hyperventilation, preservation of pupillary and ocular reflexes
Stage 4 - deep coma, decerebrate rigidity, large fixed pupils, brain stem dysfunction
Stage 5 - seizures, respiratory arrest, loss of deep tendon reflexes

40
Q

Reye’s syndrome treatment

A

Supportive care, ICU setting

41
Q

Comminuted fracture

A

Eggshell appearance

42
Q

Basal fracture

A

Linear fracture through base of skull - raccoon eyes, blood leakage into frontal sinuses, battle sign (bruising behind ears from blood leakage into mastoid sinus)
Can cause cranial nerve damage

43
Q

Diastatic fracture

A

Occurs along a suture line

44
Q

Cervical injury

A

Do not move child until possibility of injury is ruled out or managed
HOB 30 degrees if there is NO cervical injury

45
Q

Subdural hematoma

A

Bleeding between dura and arachnoid layers, occurs within 48 hours of head injury

46
Q

Lead toxicity

A

Results from ingesting or inhaling lead containing substances - common cause is household dust or contaminated yard soil
No safe blood lead level (BLL) in children - intervention is warranted for BLL ≥5

47
Q

Lead toxicity signs

A

Behavioral changes, distractibility, learning problems, cramping pain, vomiting, constipation, anorexia, anemia, glycosuria, proteinuria, ketonuria, hyperphosphaturia
High dose - encephalopathy, seizures, paralysis, blinding, coma, death

48
Q

Lead toxicity treatment

A

Chelation therapy, succimer - binds with lead and is eliminated through urine
BLL ≥70 - immediate hospitalization for inpatient lead chelation
BLL 45-69 - hospitalization if child is symptomatic

49
Q

Submersion injury

A

Survival for at least 24 hours after submersion (death within 24 hours = drowning)
Good prognosis if submersion was less than 5 mins and required resuscitation for less than 10 mins

CERT STUDY (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions