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Acute and Critical Illness > Neurological assessment and management > Flashcards

Neurological assessment and management Flashcards

1
Q

What are the layers of the skull

A

Dura matter
Arachnoid matter
Pia Matter
Brain

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2
Q

What are some common stroke mimics?

A

Seizures
Migraines
Fainting
Infections
Functional Neurological Disorder (FND)

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3
Q

What is Functional Neurological Disorder?

A

“Functional Stroke” Caused by a disorder that effects the nervous system rather than the brain resulting in the signals between brain and body being interrupted.

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4
Q

What is a TIA

A

Transient Ischemic Attack

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5
Q

What is the timeframe for it to be classed as a TIA and not a full stroke?

A

24 hours

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6
Q

What can you use to assess risk if you suspect a patient has had a TIA?

A

ABCD2

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7
Q

What is ABCD2?

A

A scoring system used to assess the risk of TIA to occur in the next 2 days, 7 days, or 90 days.

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8
Q

What are seizures?

A

Seizures occur when there is a rapid and intense episode of electrical activity.

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9
Q

What are convulsions?

A

A convulsion is an involuntary contraction and relaxation of the muscles producing rigidity and violent shaking of the body and limbs. Often associated with altered / reduced consciousness

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10
Q

What are focal seizures?

A

When one localised area of the brain is initially involved - can spread to other areas.

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11
Q

What are generalised seizures?

A

Affects both sides of the brain

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12
Q

What is the tonic phase of a tonic clonic seizure?

A

LOC
Stiffness of muscles
Crying out (air pushing out of vocal cords)
May bite there tung

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13
Q

What is the clonic phase of a tonic clonic seizure?

A

Rhythmic jerking of limbs
Loss of control of bladder/bowels
Breathing affected - cyanosis may occur.

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14
Q

How long do tonic clonic seizures last?

A

1-3 mins - longer than 5 mins in status epilepticus.

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15
Q

What is the responsiveness level of focal aware seizures?

A

Fully aware of surroundings during the seizure but may not be able to move or respond.

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16
Q

What are focal impaired awareness seizures?

A

Where awareness is affected at some point during the seizure.

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17
Q

What are motor seizures?

A

Muscle activity localised jerking, loss of tone, or repeated movement.

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18
Q

What are non motor seizures?

A

No muscle activity btt may affect emotions, thinking and sensations.

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19
Q

What are typical absences seizures?

A

Usually last 10 secs but come in clusters.
Appear to be day dreaming, may be slight jerking.
Usually unnoticed
May not fall
Will not be aware of what is happening.

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20
Q

What are atypical absences seizures?

A

Usually last about 30 secs
Similar to typical but last longer and have a slower start and finish.
May be able to move around but appear clumsy as muscles become limp.
Can occur in any age group but often occurs in people with learning difficulties or brain conditions.

21
Q

What are myoclonic seizures?

A

Can be focal or generalised.
Mild twitches or can be more forceful.
Does not usually affect level of consciousness.
Usually last for less than a second but can be in clusters.

22
Q

What are tonic seizures?

A

Can be focal or generalised.
Muscle stiffness
May fall
Neck extension
Eyes open and roll upwards
Arms and legs stretch and contract
May cry out and stop breathing briefly
Usually last 3 secs - 2 mins

23
Q

What are atonic seizures?

A

Muscles become limp
Will fall to floor if standing
Usually lasts less than a couple of seconds.

24
Q

What is the treatment of seizures?

A

Protect against injury
Do not move patient unless for safety of patient.
Protect dignity
They usually self resolve.

25
Q

If BTCS (bilateral tonic clonic seizure) has not stopped after 5 mins to a series of seizures without recovery. Then it is classed as what?

A

Convulsive Status Epilepticus and give diazepam.

26
Q

What is recovery for Focal seizures?

A

Very quick with little to no after effects, may feel tired or headaches.

27
Q

What is recovery for tonic clonic seizures?

A

Headache, sore, tired, very unwell, may be confused and have memory issues. Can last hours to days.

28
Q

What is the recovery for absent seizures?

A

Usually recover quickly and may present as if nothing has happened although may feel unwell or tired.

29
Q

What is the recovery for myoclonic seizures?

A

Usually immediate recovery

30
Q

What is the recovery for tonic seizures?

A

Sleepy, tired and may be confused for some time afterwards.

31
Q

What is the recovery for atonic seizures?

A

Normally no after effects and muscle tone returns but may be injured from fall.

32
Q

What are Acute Symptomatic Seizures?

A

Non epileptic seizures

33
Q

What are acute symptomatic seizures caused by?

A

TBI
Brain Tumour
Stroke
TB
Neurocysticercosis
Alcohol withdrawal
Renal failure
Hepatic failure
Hypoglycaemia

34
Q

What does PNES stand for?

A

Psychogenic Non Epileptic Seizures

35
Q

When does PNES occur?

A

Usually when trauma occurs and the brain gets overwhelmed and causes seizure. NOT EPILEPTIC

36
Q

How is meningitis usually transmitted?

A

Coughing
Sneezing
Kissing

37
Q

How many cases of bacterial meningitis are fatal?

A

1 in 10 cases

38
Q

What is encephalitis?

A

Uncommon but very serious condition.
It is an inflammation of the brain.
Most common in very young and very old.

39
Q

What are the non serious symptoms of encephalitis?

A

Similar to flu

Fever
Headache
N&V
Aching muscles and joints

40
Q

What are the serious symptoms of encephalitis?

A

Confusion
Drowsiness
Seizures
Agitation
Difficulty speaking
Weakness or loss of movement
Hallucinations
Loss of feeling in certain parts of body
LOC

41
Q

What is the difference between vertigo and dizziness?

A

Dizziness everything is spinning around

Vertigo is spinning up and down ( on a boat )

Vertigo is a symptom of a condition

42
Q

What are the two types of vertigo?

A

Peripheral
Central

43
Q

Want is vertigo usually caused by?

A

The way that balance works in the inner ear, but can have other causes as well within the brain

44
Q

What is peripheral vertigo?

A

Benign Paroxysmal Positional Vertigo (BPPV)
Head injury
Labryinthitis

Caused by balance mechanisms in the inner ear.

45
Q

What is Gullain Barre syndrome?

A

Rare condition
Immune system attaks the peripheral nervous system
Can affect all ages – most common in adult males
Most recover fully
Symptoms develop usually over hours or days
Usually reaches most severe within 4 weeks
Early symptoms tend to be in feet and hands

46
Q

What is bells palsy?

A

Temporary weakness or lack of movement usually affecting one side of the face (other symptoms include, drooling, drooping eyelid, loss of taste, dry mouth and dry or watering eye)
Treated with steroids, eye drops to stop drying out, tape to close eye during sleep
Recovery usually around 6 months

47
Q

What is supra nuclear palsy (rare)

A

Neurological condition that can cause problems with balance, movement, vision, speech and swallowing caused by build up of protein (tau) damaging brain cells
Other symptoms include falls, changes in behaviour muscle stiffness, inability to control eye movement, memory problems
Increasing damage to brain cells over time
Approx 4000 people with PSP in UK (PSP Association figures)
Usually develop in people over the age of 60

48
Q

What is the most common cause of vertigo?

A

BPPV ( Benign Paroxysmal Positional Vertigo )

49
Q
A

Acute and Critical Illness (13 decks)

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