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poc 27 module 5 > Neurologic Emergencies > Flashcards

Neurologic Emergencies Flashcards

1
Q

Central Nervous System

A

Responsible for thought, perception, feeling and autonomic body functions
(Brain, brainstem, spinal cord)

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2
Q

Peripheral Nervous System

A

Responsible for transmitting commands from the brain to the body and receiving feedback from the body
(Cranial Nerves, peripheral Nerves)

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3
Q

Efferent Nerves

A

Leave the brain and convey commands to other parts of the body

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4
Q

Afferent Nerves

A

Send signals to the brain

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5
Q

Diencephalon

A

Filters unneeded information before reaching cerebral cortex

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6
Q

Midbrain

A

Responsible for regulating LOC, including patterns of sleep and wakefulness

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7
Q

Brainstem

A

Controls pulse, pressure, and respiratory rate and pattern

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8
Q

Pons

A

Controls respiratory rate and depth

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9
Q

Medulla Oblongata

A

Controls pressure and pulse rate

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10
Q

Limbic System

A

Where rage and anger are generated

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11
Q

Hypothalamus

A

Where pleasure, thirst and hunger are found

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12
Q

Pituitary Glands

A

Receives information from the hypothalamus and then sends chemical to the adrenal glands to release epi and norepi

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13
Q

Adrenal Glands

A

Release epinephrine and norepinephrine

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14
Q

Cerebellum

A

Manages complex motor activity unconsciously (tree of life)

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15
Q

Synapse

A

Connects to the cell by chemicals called neurotransmitters. Doesn’t physically touch the nerve cell

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16
Q

Neurotransmitter

A

Dopamine, acetylcholine, epinephrine, serotonin

These chemicals send signals from one nerve cell to the other

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17
Q

Axon

A

Bridge that connects the synapse to the nucleus

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18
Q

Myelin

A

A sheath that surrounds the nerve cell allowing the cell to transmit its signal consistently without “shorting out”

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19
Q

Vitals for Increased Intercranial Pressure

A

Decreased HR, Decreased RR, Increased BP

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20
Q

Trismus

A

Clenched teeth

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21
Q

Ptosis

A

Drooping, sagging, or prolapse of a part of the body

Bell palsy, stroke

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22
Q

Coma

A

State where patient does not respond to painful stimuli

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23
Q

Supra orbital Foramen

A

Notch near bridge of nose used to elicit pain

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24
Q

Decorticate Posturing

A

Contractions of arms towards their chest and point their toes
Indicative of damage directly below cerebral hemisphere

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25
Q

Decebearate Posturing

A

Contract arms and wrists outwards and point their toes

Indicative of damage near the brainstem

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26
Q

GCS

A 
Eyes Opening- 
4 Spontaneous
3 Voice
2 Pain
1 None
Verbal-
5 Oriented
4 Disoriented
3 Innapropiate Words
2 Incompetent
1 None
Motor-
6 Obeys
5 Localizes
4 Withdraws
3 Decorticate
2 Deceberate
1 None
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27
Q

Hallucinations

A

Hear voices, see snakes, feel insects, all that are within their mind

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28
Q

Delusions

A

Thoughts or perceived abilities that are not based on reality

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29
Q

Psychosis

A

Patient can not tell what is real or inside his mind

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30
Q

Corneal Reflex

A

Tap between the eyes to determine gag reflex

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31
Q

Pupillary Response

A 
Shine from 45 degree angle
Thickness of dime is about a millimeter
Dialated with adrenaline
Constricted when relaxed
<1mm is not abnormal
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32
Q

Agnosia

A

Unable to tell you names of an object

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33
Q

Apraxia

A

Unable to use a common object

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34
Q

Receptive Aphasia

A

Unable to understand speech, but able to speak clearly

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35
Q

Expressive Aphasia

A

Unable to speak clearly, but understand speech

36
Q

Global Aphasia

A

Unable to talk or understand

37
Q

Hemiparesis

A

Weakness of one side of the body

38
Q

Hemiplegia

A

Paralysis of one side of the body

39
Q

Gait

A

Walking pattern

Parkinson’s is abnormal

40
Q

Ataxia

A

Unable to perform coordinated motions such as walking

41
Q

Myoclonus

A

Rapid, jerky, muscle contraction that occurs involuntarily

42
Q

Dystonia

A

Part of body contracts and remains contracted

Use diphenhydramine for cure

43
Q

Tonic

A

Rigid, contracted body posture

44
Q

Hypertnic

A

Rigid, ARCHED back

45
Q

Clonic

A

Rhythmic contraction with tonic and hypertonic phases

46
Q

Paresthesia

A

Numbness or tingling

47
Q

Anesthesia

A

Complete block of feeling or sensation

48
Q

Strokes

A

Ischemic (75%) & Hemmorrhagic (25%)

49
Q

Ischemic Stroke

A

Occlusion or blockage within the brain
Thrombus or embolus
Tissue begins to die but the brain does not become worse, just that isolated area

50
Q

Hemorrhagic Stroke

A

Tend to get worse over time due to increased pressure and brain herniation
“Worse headache of my life”

51
Q

Assessment of Stroke

A

Language- slurred speech, Aphasia, ptosis, apraxia
Movement- Hemiparesis, hemiplegia, arm drift, facial droop, ataxia
Sensory- headache, blindness
Cognitive- LOC, seizures, coma
Cardiac- hypertension

52
Q

Management of Stroke

A
  • No atropine. The ICP is causing the bradycardia
  • maintain BP at least 110-120
  • slight hyperventilate at 16-20bpm
  • etCO2 high 20’s low 30’s
53
Q

Ischemic Stroke Fibrinolytic times

A

Less than 3 hours

54
Q

Transient Ischemic Attack

A

Episodes of cerebral ischemia without permanent damage

Symptoms relieved within 24 hours

55
Q

Coma

A 
Use mnemonic AEIOUTIPS
Alcohol, acidosis
Epilepsy.        Benzodiazepines
Insulin.           D50 or glucagon
Overdose.     Romazicon, narcan, glucagon
Uremia.         Temp, glucose, oxygen
Trauma.         Spine, pressure
Infection.       Pressure 
Psychosis.    Oxygen, glucose, temp
Stroke.          Oxygen, glucose, temp
56
Q

Seizures

A

Sudden, erratic firing of neurons

57
Q

Tonic/Clonic Seizures

A 
"Grand mal" 
Aura
LOC               Consider ventilation, airway   
Tonic              and IM benzo
Hypertonic
Clonic
Postictal
58
Q

Absence Seizures

A

“Petit mal”
Little or NO movement (eyelids, finger shaking, stop walking)
Last several seconds

59
Q

Pseudoseizures

A

Psychological “fake” seizure

60
Q

Jacksonian March

A

Spreading of localized seizure and spreading through the body

61
Q

Partial Seizure

A

Localized to one part of the body

62
Q

Status Epilepticus

A

A seizure that lasts longer than 4 to 5 minutes or consecutive seizures without return of consciousness between seizures

63
Q

Prodromal

A

Signs or symptoms following and event

Fall- dizziness, weakness

64
Q

Management of migraine headaches

A 
Toradol 30mg
Demrerol 25mg
Morphine 2-4mg
Fentanyl 25mcg
Zofran 4mg
Phenegran 12.5-25mg
65
Q

Demntia

A

Chronic deterioration of memory, personality, language skills, perception, reasoning, or judgement with no LOC
-check BGL,

66
Q

Wernicke encephalopathy dementia

A

Mostly reversible
Lack of vitamin B1 from malnourishment administer thiamine 100-200mg IVP
before any glucose
May have hypo or hyper deficiencies

67
Q

Neoplasms

A

Growths within the body

Benign or malignant

68
Q

Metastasis

A

Process by which cancerous cells move from their site of origin

69
Q

Assessment of Neoplasm

A

May have months of headaches and suddenly have a seizure

70
Q

MS (Multiple Sclerosis)

A

Autoimmune disorder in which the body attacks the myelin sheath of brain and spinal cord

71
Q

Assessment of MS

A

Nystagmus, involuntary movement of the eyes
Impairment of pain, touch and sensory
Lhermitte Sign- experiencing electrical sensation when head is flexed forward

72
Q

Management of MS

A

Administering anti-inflammatory can decrease length of attack

73
Q

Gillian-Barré Syndrome

A

Immune system attacks portions of the Nervous System

Begins in the feet and works up towards the head

74
Q

ALS (Lou Gehrig Disease)

A

Disease that strike voluntary motor neurons
Assessment- fatigues, general weakness, difficulty doing daily activities. Destruction of neurons eventually stop the patient from breathing

75
Q

Parkinson’s Disease

A

Past injuries to the brain have influence.

Assessment- tremors, postural instability, ridgidity, bradykinesia

76
Q

Bradykinesia

A

When patient takes small steps when turning with abnormal gait

77
Q

Dystonia

A

Severe muscle cramps that cause bizarre contortions or postures
Assessment- usually take antipsychotic medications
Management- diphenhydramine 25-50mg

78
Q

Trigeminal Neuroglia

A

Stabbing or shock pain in the face

Involves cranial Nerve V

79
Q

Ménière Disease

A

Increased fluid within the ear

Tinnitus, dizziness, hearing loss, can cause permanent deafness

80
Q

Encephalitis

A

Caused from herpes simplex virus

Stiff neck, fever, malaise, vomiting, confusion and seizure

81
Q

Meningitis

A

Inflammation of meninges
KernignSign- unable to straighten leg when hips flexed
BrudzinskiSign- flexed knees when neck flexed

82
Q

Poliomyelitis

A

Viral infections caused by fecal-oral route

Virus attacks motor neurons in brain

83
Q

Peripheral Neuropathy

A

Group of conditions in which Nerves leaving spinal cord are damaged
Assessment- as BGL rises, damages occurs to peripheral nerves

84
Q

Hydrocephalus

A

Hydro- means water
Cephalosporins- means head
Only 120ml of CSF is present in CNS
OUR BODIES PRODUCE .3ml/min
Hydrocephalus is the body’s ability to produce adequate amounts of CSF but does not ride body of it fast enough
Assessment- lethargy, irritiability, vomiting, sun-setting eyes
Management- a shunt is placed in ventricle in brain. Drains CSF from brain to the abdomen. Be prepared for seizures with complications of shunt.

85
Q

Spine Bifida

A

Part of spine remains outside of the body.

86
Q

Cerebral Palsy

A

Damage done to the brain (frontal lobe).

poc 27 module 5 (19 decks)

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