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NREMT® Paramedic > EMT-P (4) Medical > Neurologic Emergencies > Flashcards

Neurologic Emergencies Flashcards

Explore the neurological system and the prehospital emergencies within

1
Q

What is the function of the central nervous system (CNS)?

A
  • thought
  • perception
  • feeling
  • autonomic body functions

Composed of the brain, brainstem and spinal cord.

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2
Q

What is the function of the peripheral nervous system (PNS)?

A

It transmits commands from the brain to the body and receives feedback from the body.

It is composed of the cranial nerves and peripheral nerves.

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3
Q

Define:

efferent nerves

A

These are nerves that transmit commands from the brain to the body.

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4
Q

Define:

afferent nerves

A

These are nerves that send signals to the brain.

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5
Q

Describe the function.

diencephalon

A

It filters unneeded information.

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6
Q

Describe the function.

midbrain

A

It regulates level of consciousness.

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7
Q

Describe the function.

brainstem

A

It controls pulse, blood pressure, respiratory rate and pattern.

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8
Q

Describe the function.

pons

A

It controls respiratory rate and depth.

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9
Q

Describe the function.

medulla oblongata

A

It controls pressure and pulse rate.

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10
Q

Describe the function.

limbic system

A

It generates rage and anger.

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11
Q

Describe the function.

hypothalamus

A

It controls pleasure, thirst and, hunger.

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12
Q

Describe the function.

pituitary glands

A

Receives information from the hypothalamus and releases chemicals to the adrenal glands to release norepinephrine and epinephrine.

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13
Q

Describe the function.

adrenal glands

A

It releases epinephrine and norepinephrine.

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14
Q

Describe the function.

cerebellum

A

It controls complex motor activity.

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15
Q

Describe the function.

synapse

A

It connects to cells by neurotransmitters.

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16
Q

Give examples of neurotransmitters.

A
  • dopamine
  • acetylcholine
  • epinephrine
  • serotonin
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17
Q

Fill in the blank.

The bridge that connects the synapse is called a(n) ______.

A

axon

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18
Q

What is myelin?

A

A sheath that surrounds the nerve cell.

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19
Q

Define:

Cushing’s triad

A
  • decreased HR
  • irregular RR
  • widened pulse pressure
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20
Q

Define:

trismus

A

Clenched teeth.

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21
Q

Describe:

decorticate posturing

A
  • Arms contracted to the chest
  • Toes pointed inward
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22
Q

Describe:

decerebrate posturing

A
  • Arms and wrists contracted outwards
  • Toes pointed inwards
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23
Q

Study and memorize the GCS chart.

This chart will be referenced multiple times throughout the NREMT.

A
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24
Q

What are delusions?

A

These are thoughts or perceived abilities that are not realistic.

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25
Q

Define:

psychosis

A

The patient cannot tell the difference between reality and what’s in their mind.

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26
Q

Fill in the blank.

Tapping between the eyes to check for a gag reflex is known as the _____ reflex.

A

corneal

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27
Q

Fill in the blank.

A patient’s pupillary response should be ______ when relaxed and _____ when excited.

A

constricted, dilated

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28
Q

Define:

agnosia

A

Inability to recognize or identify objects, people, sounds, shapes, or smells, despite having intact sensory function.

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29
Q

Define:

apraxia

A

Inability to perform learned movements or gestures, even though there is no paralysis or weakness.

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30
Q

Define:

receptive aphasia

A

Unable to understand speech.

Can speak clearly.

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31
Q

Define:

expressive aphasia

A

Unable to speak clearly.

Can understand speech.

32
Q

Define:

global aphasia

A

Unable to talk or understand.

33
Q

Define:

hemiparesis

A

Weakness on one side of the body.

34
Q

Define:

hemiplegia

A

Paralysis on one side of the body.

35
Q

What is gait?

A

It refers to the manner of walking or moving on foot.

Typically abnormal in individuals with Parkinson’s disease.

36
Q

Define:

ataxia

A

It refers to the inability to perform coordinated motions.

Eg. walking, scratching their face.

37
Q

What occurs during the myoclonus phase of a seizure?

A

Involuntary rapid muscle jerking.

38
Q

Define:

dystonia

A

A movement disorder where a body part contracts and remains contracted.

Treatment is diphenhydramine for a dystonic reaction.

39
Q

Describe the tonic phase of a seizure.

A

The body is rigid.

40
Q

Describe the hypertonic phase of a seizure.

A

The body is rigid with an arched back.

41
Q

Define:

paresthesia

A

An abnormal sensation, such as tingling, prickling, or numbness.

It is typically felt in the hands, feet, arms, or legs.

42
Q

What are the two types of strokes?

A
  • Ischemic (75%)
  • Hemmorrhagic (25%)
43
Q

What causes an ischemic stroke?

A

An occlusion or blockage within the brain (thrombus).

44
Q

What causes a hemorrhagic stroke?

A

A bleed within the intracranial cavity.

It is caused by traumatic injury or rupture.

45
Q

Assessment:

stroke

A
  • Language - slurred speech, aphasia, apraxia
  • Movement - hemiparesis, hemiplegia, arm drift, facial droop, ataxia
  • Sensory - headache, blurred vision
  • Cognitive - LOC, seizures, coma
  • Cardiac - hypertension
46
Q

Treatment:

stroke

A
  • Maintain BP at least 110-120
  • Slight hyperventilation at 16-20 bpm if signs of herniation
  • HOB 30°
  • Draw labs if available
  • Fluid bolus for hypotension
  • MAP maintained >65mmHg
47
Q

What is the goal of tPA times for a stroke?

Tissue Plasminogen Activator

A

< 3 hours

48
Q

Describe:

transient ischemic attack

A

Episodes of cerebral ischemia that self-resolve.

49
Q

Describe:

presentation of tonic/clonic seizures

A

Wide spread body movement/involvement.

50
Q

Describe:

presentation of absence seizures

A

Little to no movement that involves a select body part.

Petit Mal

Eyes, fingers, eyelids, toes, feet.

51
Q

What are pseudoseizures?

A

Psychological “fake” seizures.

52
Q

Define:

Jacksonian march

A

Localized seizure that spreads throughout the body.

53
Q

Describe:

presentation of a partial seizure

A

Localized to one part of the body.

54
Q

What is classified as status epilepticus?

A
  • A seizure that lasts longer than 4 to 5 minutes.
  • Consecutive seizures without relief.
55
Q

Treatment:

migraine headaches

A
  • Toradol 30mg
  • Demrerol 25mg
  • Morphine 2-4mg
  • Fentanyl 25mcg
  • Zofran 4mg
  • Phenegran 12.5-25mg
56
Q

Define:

dementia

A

Chronic deterioration of:

  • memory
  • personality
  • language skills
  • perception
  • reasoning
57
Q

What is the cause of Wernicke encephalopathy?

A

Lack of vitamin B1.

Typically seen in alcoholism.

58
Q

Define:

neoplasms

A

Abnormal growths within the body.

Benign or malignant.

59
Q

Define

metastasis

A

The process of cancer cells moving to different locations.

60
Q

Define:

multiple sclerosis

(MS)

A

An autoimmune disorder that attacks the myelin sheaths of the brain and spinal cord.

61
Q

Assessment

multiple sclerosis

A
  • Nystagmus
  • Impairment of pain, touch and sensory
  • Lhermitte sign - experiencing electrical sensation when head is flexed forward.
62
Q

Define:

Gillian-Barré syndrome

A

The immune system attacks the nervous system and paralysis begins in the feet and works up towards the head.

63
Q

Define:

Lou Gehrig disease

(ALS)

A

A disease that affects voluntary neurons.

64
Q

Define:

Parkinson’s disease

A

A progressive neurological disorder that affects movement. It is characterized by tremors, stiffness, slow movements, and balance problems.

Past injuries of the brain can cause disassociation of neurons.

65
Q

Define:

bradykinesia

A

Patient takes small steps when turning.

66
Q

Define:

dystonia

A

Severe muscle cramps that cause abnormal contractions or postures.

67
Q

Fill in the blank.

Trigeminal neuroglia is a stabbing/shocking pain in the face that involves cranial nerve ___.

A

V

68
Q

Define:

Ménière’s disease

A

An increase of fluid in the inner ear.

69
Q

What is the typical cause of encephalitis?

A

Herpes simplex virus

70
Q

What sign is present if a patient is unable to straighten their legs when the hips are flexed?

A

Kernig sign

71
Q

What is hydrocephalus?

A

The body produces enough CSF, but can not rid of it fast enough.

72
Q

What is Spina Bifida?

A

A part of the spine remains outside of the body.

73
Q

What causes Cerebral Palsy?

A

Damage done to frontal lobe of the brain.

74
Q

Treatment:

Wernicke encephalopathy

A

Thiamine 100-200mg IVP

75
Q

What sign is present when a patient has flexed knees when you flex their neck?

A

Brudzinski sign

EMT-P (4) Medical (8 decks)

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