Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PCM 4 FINAL TEST EVER > Neurologic procedures > Flashcards

Neurologic procedures Flashcards

1
Q

What spinal level do you perform a lumbar puncture?

A

L4-L5

Below L2 which is the end of the spinal cord

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

What should the CSF pressure normally be?

A

Less than 25-30 cm

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

What should you do before performing a spinal tap?

A

CT scan… unless meningitis is suspected

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

What needle do you use for lumbar puncture?

A

short bevel

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

What is considered low spinal pressure and what are some causes?

A

Below 7 cm

  • Hypoproduction
  • Distal to occlusion
  • Spinal fluid leak
  • Spinal cord tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is considered high spinal pressure and what are some causes?

A

Above 25-30

  • Hyperproduction
  • Proximal to occlusion
  • Malabsorption of spinal fluid
  • Obesity- pseudo tumor cerebri
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Xanthochromic

A

The color of CSF due to old blood pigments… subarachnoid hemorrhage

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

At what point will CSF become cloudy?

A

If greater than 200 WBC or 400 RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Elevated neutrophils means?

A

Bacterial infection

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

Elevated lymphocytes means?

A

Viral infection

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

Elevated monocytes/macrophages means?

A

Chronic condition

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

Things measured in spinal fluid analysis?

A

Glucose- CSF lags one hour behind blood glucose, never lower than 80% of blood glucose)
Protein
Culture and sensitivity
Special tests (oligoclonal bands)

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

What is the epidural space?

A

A potential space that contains no fluid or blood- only access to the nerve roots and disc material

It is accessible to nerve roots- medications can remain outside the spinal canal

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

How does EEG brain maping work?

A

Helps locate focuses of function or dysfunction by converting digitial signals to color and 3D images

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

When are x-rays most useful?

A

To screen for fracture

- Want to see all 7 cervical vertebrae plus T1… follow lines all the way down

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

How does a CT scan work?

A

Gives a 3D view of the body- rotates an x-ray beam around the pt, imaging the body in a series of slices

Adding cameras adds more slices, heat, and radiation

More radiation is = to more than 100 chest xrays

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

When do you use a CT?

A

To view

  • Hemorrhages
  • Spinal fractures
  • Kidney stones

Needs IV contrast

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

How does a PET scan work

A

Inject FDG into patient –> metabolism of FDG in the glucose pathway gives off positron + gamma radiation

Cancer cells use more glucose than normal cells and emit more gamma radiation

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

What shows up the most on MRI?

A

Things with a lot of water

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

How does an MRI work?

A

Protons wobble in alignment with magnetic fields of varying intensity, frequency of wobble is proportionate to strength of individual magnetic field

A brief radio signal whose soundwaves frequency equals the frequency of wobble of certain protons, knocks those protons out of alignment

When radio signal ceases, protons snap back into alignment with magnetic field, emitting a radio signal of their own that announces the presence of a specific tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do T2 weighted images appear?

A

CSF is bright

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do T1 weighted images appear?

A

CSF is dark

23
Q

Fluid-Attenuated Inversion Recovery

A

T2-weighted image with spinal fluid blanked out

- Shows edema and gliosis to be hyperintense

24
Q

When is an MRI useful?

A
  • Tumor
  • Soft tissue surrounded by bone
  • Sclerotic lesions in brain tissue (M.S.)
  • Vascular lesions
  • When there is edema or excess fluid (meningitis)
25
When is a spinal tap useful?
- Meningitis - Degenerative neurologic conditions (MS, ALS) - Diseases suspected to alter spinal fluid pressure or circulation
26
Where is the lesions if presenting with bitemporal hemianopia?
Around the pituitary gland
27
Causes for when a pupil doesn't react to light
- Blindness - Optic neuritis (sometimes due to MS) - Optic nerve tumor
28
Causes for when a pupil remains dilated
Adie's pupil A u/l dilated pupil may be a CN III due to - herniation of the ipsilateral cerebral hemisphere - strokes, diabetes, migraine If due to ischemia inside the brain- pupil is spared If due to lesions outside the brain (tumor, herniation)- pupil is not spared
29
Ptosis is injury to what muscle?
Levator palpebrae superioris
30
Horner's Syndrome
Due to damage of the sympathetic nervous system. Ptosis- weakness in Mueller's muscle Miosis Anhydrosis
31
How do you test CN IV?
Have patient look down and in | Serves the c/l superior oblique muscle
32
CN VI serves which muscle?
ipsilateral lateral rectus muscle
33
What does CN VII supply
Motor- muscles of facial expression - Taste of anterior tongue - Lacrimation and salivation
34
Central vs peripheral CN VII palsy
Peripheral- hits the facial nerve after it has left the pons - BOTH the upper and lower facial muscles on that side are impaired - -> Bell's Palsy Central- lesion is in the pons or upper brain stem - ONLY the lower facial muscles are impaired - May be bc the lower facial muscles receive innervation from BOTH SIDES of the motor strip in the frontal lobes MUST KNOW
35
Double cross of the cerebellum
Cerebellum coordinates movements of the SAME SIDE because the "double cross" of cerebellar efferents- cross over in the brainstem (traveling to c/l thalamus and motor cortex) and then cross again in the medulla MUST KNOW Therefore, L cerebellum problems effects your L leg
36
Why do strokes or hemorrhages that extend to one cerebral hemisphere cause rapid death?
Brain stem is damage and blocks the fourth ventricles CSF flow
37
What does Romberg test?
Posterior columns and cerebellum
38
What 3 functions does upright posture require?
1. Vision 2. Cerebellum 3. Posterior columns
39
Grading of strength
``` Severe weakness 0/5- absolutely no movement in a group 1/5- minimal, or "flicker" of movement 2/5- minimal horizontal movement, but no movement against gravity 3/5- some movement against gravity ``` Moderate weakness 4/5- moderate strength against gravity and some resistance 5/5- normal contraction
40
Quadriplegia
Disease of the upper or mid cervical spine, or both of the corticospinal tracts of the brain stem
41
Hemiplegia
Disease of one cerebral hemisphere or one side of the brainstem along the corticospinal tract
42
Paraplegia
Disease of the spinal cord in the thoracic or high lumbar regions
43
Causes of weakness of one arm
Cervical spine disease or the brachial plexus, or some strokes
44
Causes of weakness of one leg
Lumbar spine disease or the lumbar sacral plexus | - Rarely a stroke- anterior cerebral artery infarct
45
Grading of DTRs
``` 0- no reflex 1- diminished reflex 2- average reflex 3- increased reflex, but only one beat 4- increased reflex with clonus- 2 or more beats ``` A reflex of 0 is usually pathologic, but a reflex of 4 is always pathologic
46
Normal and abnormal plantar reflex
Normal- Flexion of the big toe | Abnormal- extensions of the big toe --> Babinski sign
47
Upper motor neuron signs
Problem in brain or spinal cord | - Increased reflexes, spasticity, only delyated atrophy of muscles, Babinski signs
48
Lower motor neuron signs
Problem in motor neuron, NMJ, muscle iteself | - Decreased reflexes, atrophy within weeks, sometimes fasciculations, no Babinski signs
49
Decreased DTRs can be caused by?
``` Diabetes mellitus Hypothyroidism vitamin B12 deficiency Exposure to heavy metals or some organic chemicals Auto immune disease ```
50
Increased DTRs can be caused by?
Lesions of the corticospinal tracts, especially in the spinal cord or brain stem
51
Hemiplegic gait
With circumduction- inability to bring the leg all the way in
52
Spastic gait
Limited ability to bend at the hips and knees
53
Fenistating gait
Slow with the first steps,t then faster and faster, and out of control- in Parkinson's disease

PCM 4 FINAL TEST EVER (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions