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AEMCA + Service Hiring > Neurological + Defib Review > Flashcards

Neurological + Defib Review Flashcards

1
Q

What do central chemoreceptors respond to?

A

Changes in O2 and CO2 in arterial circulation and CSF

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2
Q

What will decreased CO2 levels cause?

A

Hypoventilation > cerebral vasoconstriction > cerebral ischemia (lack of blood supply)

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3
Q

What will increased CO2 levels cause?

A

Hyperventilation > vasodilation > edema (hypoxia)

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4
Q

Regular levels for ICP?

A

5-15 mmHg

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5
Q

What is Cerebral Perfusion Pressure (CPP)?

A

Pressure needed to maintain blood flow to the brain.

  • Regularly 70-80 mmHg
  • Less than 60 DOUBLES death
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6
Q

What is Mean Arterial Pressure?

A

Average pressure in a person’s arteries in one cardiac cycle

  • Regularly 70 - 100 mmHg
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7
Q

S&S of ICP?

A
  • Severe headache (stretching of dural layer)
  • Vomiting (projectile vomit due to pressure in emetic center of medulla)
  • Papilledema (swelling of optic disc due to ICP)
  • Seizures
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8
Q

Pathophysiology behind ICP?

A
  • CSF will shift to spinal cavity to compensate
  • This decreases cerebral blood flow
  • Hypoxia eventually ensues
  • Hypoxia will then trigger arterial vasodilation in the brain
  • Adding fluid volume in an attempt to improve blood supply increases ICP
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9
Q

What is Cerebral Herniation Syndrome?

A
  • Brain swelling which then forces tissues through the foramen magnum
  • Obstructs blood flow
  • Puts pressure on brain steam
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10
Q

S&S of Cerebral Herniation Syndrome?

A
  • Decreased LOC
  • Coma
  • Dilation of pupil on same side
  • Paralysis on opposite side of the body
  • Decerebrate posturing
  • Increased BP
  • Bradycardia
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11
Q

What do you do to treat Cerebral Herniation Syndrome?

A
  • Rapid transport
  • Hyperventilate to reduce swelling at 1:3
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12
Q

What type of injury is highly vascular, bleeds well, and has inhibition of vasospasms?

A

Scalp wounds

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13
Q

How do you treat scalp wounds?

A

Direct pressure if no skull injuries

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14
Q

What does the Olfactory Nerve (CN 1) do?

A

Enables sense of smell; shortest sensory nerve

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15
Q

What does the Optic Nerve (CN 2) do?

A

Relays messages from the eyes to the brain to create visual images

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16
Q

What does the Oculomotor Nerve (CN 3) do?

A

Enables eye movements, such as focusing on an object that’s in motion

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17
Q

What does the Trochlear Nerve (CN 4) do?

A

Enables movement in the eye’s superior oblique muscle. This makes it possible to look down.

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18
Q

What does the Trigeminal Nerve (CN 5) do?

A

Sends pain, touch, and temperature sensations from the face to the brain.

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19
Q

What does the Abducens Nerve (CN 6) do?

A

Innervates the ipsilateral lateral rectus muscle.
Also partially innervates the contralateral medial rectus muscle

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20
Q

What does the Facial Nerve (CN 7) do?

A

Controls facial movement and expression.
Also carries nerves that are involved in taste and producing tears

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21
Q

What does the Vestibulocochlear Nerve (CN 8) do?

A

The vestibular nerve handles balance and equilibrium
The cochlear nerve handles hearing

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22
Q

What does the Glossopharyngeal Nerve (CN 9) do?

A

Provides motor, parasympathetic, and sensory information to the mouth and throat.
Specifically innervates the stylopharyngeus muscle (responsible for elevating pharynx and larynx)

23
Q

What does the Vagus Nerve (CN 10) do?

A

Controls digestion, heart rate, and immune system.

24
Q

What does the Spinal Accessory Nerve (CN 11) do?

A

Controls the movement of certain neck muscles
Innervates trapezius and sternocleidomastoid

25
Q

What does the Hypoglossal Nerve (CN 12) do?

A

Enables tongue movement.
Innervates muscles that helps speak, swallow, and move substances in the mouth.

26
Q

What are Tonic-Clonic (Grand Mal) seizures?

A

Two stages: tonic phase and clonic phase

Preceded by an AURA

Tonic phase - “Stiffening”. Loss of consciousness, possible fall. Spasm/stiffening of muscles can impair breathing.

Clonic phase - “Jerking”. Intense and rapid movement of arms, legs, and face. Usually lasts 1-3 minutes.

27
Q

What are Petit Mal (Absence) seizures?

A
  • Type of epilepsy
  • Blanking out or staring into space for a few seconds
  • Most common in children
  • Lasts less than 15 seconds
28
Q

What is a Transient Ischemic Attack (TIA)?

A
  • Temporary symptoms similar to a stroke
  • Lasts only a few minutes and doesn’t cause permanent damage
  • Serves as a warning for future strokes

Focal Cerebral Dysfunction: Temporary reduction in blood flow
Can also be from spasm of arteries

29
Q

What is the underlying cause of TIA’s?

A

Atherosclerosis (buildup of plaque) in an artery or one of its branches that supplies oxygen and nutrients to the brain.

30
Q

Risk factors for TIA?

A
  • Family history
  • Age (after age 55, risk increases)
  • Sex (Men have a slightly higher risk of TIA)
  • Prior TIA’s
  • Sickle cell disease
31
Q

What is an Ischemic Stroke?

A

Occurs in two ways.

1) Blocked artery. Occurs when a blood clot blocks the blood flow in an artery within the brain.

2) Ruptured artery. Can lead to hemorrhagic strokes when a blood vessel bursts within the brain.

32
Q

What is an Aneurysm?

A

Occurs when a part of an artery wall weakens, allowing it to abnormally balloon out or widen.

  • If it bursts, it can lead to internal bleeding and often leading to death.
  • High BP overtime can weaken vessels
33
Q

S&S of Brain Aneurysm?

A
  • Severe headache (worst headache of life)
  • Stiff neck
  • Nausea and vomiting
  • Sensitivity to light
34
Q

What is Diffuse Axonal Injury?

A
  • Severe blunt head trauma
  • Brain moves back and forth, resulting in STRETCHING, SHEARING, TEARING of nerve fibers
  • Subarachnoid bleeding with irritation to surrounding tissues
  • Often results in permanent vegetative state
35
Q

What S&S would make you think someone has a Basilar Fracture?

A
  • Leaking of CSF from nose and ears
  • Periorbital ecchymosis
  • Battle Signs (Mastoid Bruising - behind the ears)
36
Q

What is an Anoxic Brain Injury?

A
  • Lack of oxygen to the cells (from circumstances such as cardiac arrest, airway obstruction, drowning)
  • Spasm of cerebral arteries affects perfusion
  • After 4-6 minutes of anoxia? Irreversible damage
  • Restoring blood pressure and oxygen will NOT restore perfusion
37
Q

What is a Contrecoup Injury?

A

Rebounding on the skull, causing brain to impact the opposite side of the skull

  • Closed Head Injury (skull is not fractured in the injury)
  • Brain tissue is injured from force exerting it against the skull
  • Blood vessels may rupture due to the force
38
Q

Neurogenic Shock S&S?

A
  • Bradycardic response to BP
  • Skin is warm and dry
  • No significant blood loss
  • Paralysis and loss of spinal reflexes
39
Q

Six General Causes of Coma?

A

Metabolic
Respiratory System
Drugs
Infection
Cardiovascular System
Structural

40
Q

What is Kernig’s Sign?

A

Resistance to leg extension when hip is flexed 90 degrees

41
Q

What is Brudzinski’s Sign?

A

Passive flexion of neck causes flexion of both legs/thighs

42
Q

Regarding the Head Injury BLS Standard, what are your hyperventilation values for an Adult, Child, and Infant?

A

Adult - 20 breaths per min
Child - 25 breaths per min
Infant (<1 yr old) - 30 breaths per min

43
Q

Thrombus vs Embolus?

A

Thrombus - Blood Clot

Embolus - Obstruction of blood flow due to mass of undissolved matter (i.e air embolus)

44
Q

Where is Broca’s Area located?

A

Frontal Lobe

45
Q

Where is Wernicke’s Area located?

A

Temporal/Parietal Lobe

46
Q

What is the Blood Brain Barrier?

A

Tight seal of endothelial cells that lines the blood vessels in the brain.

  • Semi-permeable (allows some materials such as O2, CO2, water, and general anesthetics to pass through
  • Blocks toxins and bacteria
47
Q

What is the Corpus Callosum?

A

White matter tracts that connect the left and right cerebral hemispheres.

48
Q

What is the Frontal Lobe responsible for?

A
  • Motor function
  • Emotions
  • Problem solving

Damage to Frontal Lobe results to loss of concentration, lack of judgment, decreased intellectual ability

49
Q

What is the Parietal Lobe responsible for?

A
  • Perception and sensory information
  • Space navigation
  • Language processing
50
Q

What is the Temporal Lobe responsible for?

A
  • Auditory processing
  • Memory storage
51
Q

What is the Occipital Lobe responsible for?

A
  • Visual perception (i.e colour and motion)

Damage to the Occipital Lobe can cause vision impairments such as blindness, visual distortions

52
Q
  • Autoimmune disease
  • Destruction of myelin in the brain and spinal cord
  • Progressive disease of CNS
  • Nerve and fibre damage

Upon hearing this, what disease do you think of?

A

Multiple Sclerosis

53
Q

What is Dystonia?

A

A disorder where involuntary muscle contractions cause slow repetitive moments or abnormal postures.

  • Associated with Parkinson’s and strokes
54
Q

What is Parkinson’s Disease?

A
  • Degeneration or damage to nerve cells in basal ganglia (voluntary motor movements)
  • Lack of dopamine (affects nerve pathways that control muscle contraction)
  • Tense muscles, tremors, joint rigidity

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