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Patient Care Theory II > Neurological Emergencies > Flashcards

Neurological Emergencies Flashcards

1
Q

What is Ptosis?

A

Drooping of the eye

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2
Q

What is dysphagia?

A

inability to swallow/eat/drink

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3
Q

What is dysarthria?

A

impairment or clumsiness in the uttering of words

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4
Q

What is nystagmus?

A

involuntary back and forth eye movements; horizontal, vertical or cyclical

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5
Q

What is paresthesia?

A

numbness or tingling; pins and needles

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6
Q

What is anesthesia?

A

complete loss of sensation

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7
Q

What is agnosia?

A

inability to ID simple objects

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8
Q

What is apraxia?

A

Unable to use common objects

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9
Q

What is hemiparesis?

A

One sided weakness

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10
Q

What is hemiplegia?

A

one sided paralysis

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11
Q

What does ipsilateral mean?

A

affecting the same side of the body

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12
Q

What does contralateral mean?

A

affecting the opposite side of the body

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13
Q

What are the meninges?

A

The layers that surround the CNS moving outward in - Dura, arachnoid and pia mater

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14
Q

What signs and symptoms indicate neurological compromise?

A

-Headache
-Visual/auditory abnormalities
-Paralysis
-Paresthesia
-Altered LOA
-Facial droop/ptosis
-Motor function compromise

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15
Q

What is Cushing’s Triad?

A

dec HR and RR, inc. BP w wide PP

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16
Q

What is multiple sclerosis?

A

-Autoimmune disorder where the body attacks the myelin sheath (insulator) in the brain and/or spinal cord resulting in disruption of signal.
-Can result in blindness, motor dysfunctions and/or speech dysfunction.
-Symptoms may persist or come and go (attacks)

17
Q

What is cerebral palsy?

A

-A group of permanent movement disorders that appear early in childhood generally caused by abnormal development or damage to parts of the brain in utero.
-Will present with poor coordination, muscle stiffness, weak muscles or tremors and can
lead to complications like seizures and intellectual disabilities.

18
Q

What is GBS?

A

-Sudden bilateral weakness within the PNS usually starting w hands or feet and moving upward.
-Can be fatal if moves into chest and muscles used in respiration.
-Autoimmune in nature where the body attacks the myelin sheath (like MS).
-Pt’s can improve and return to normal life with treatment usually involving IVIG.

19
Q

What are the signs and symptoms of meningitis?

A

-Fever
-Headache
-Nuccal rigidity
-Photophobia
-Altered LOA
-Sometimes a rash (petechiae)

20
Q

What is Parkinson’s?

A

-A long-term degenerative disorder of the CNS (cell death within the basil ganglia) mainly affecting motor function.
-S&S worsen over time may include: Tremors, unsteady gait or shuffling, rigidity and difficulty with speech

21
Q

What is Bells Palsy?

A

-Dysfunction of cranial nerve VII resulting in facial paralysis, twitching or weakness.
-It has a sudden onset and generally lasts around 2 weeks.
-Risk factors are: Diabetes, recent URI, pregnancy

22
Q

What is myasthenia gravis?

A

-Autoimmune disease that causes breakdown of receptors at the nerve/muscle junction.
-Most commonly affects muscles of the eyes, face and swallowing but can cause motor dysfunction.
S&S may include:
-Unsteady gait
-Ptosis
-Dysarthria
-Muscle weakness

23
Q

What is Wernicke-Korsakoff Encephalopathy?

A

-Chronic thiamine (vitamin B1) deficiency generally as a result of chronic alcohol abuse.
S&S may include:
-Visual disturbances
-Altered LOA (mood)
-Ataxia (unsteady gait)

24
Q

What are the signs and symptoms of increased ICP?

A

-Headache
-NV
-Photophobia
-Hemiparesis
-Hemiplegia
-Altered LOA
-Unconsciousness
-Seizure
-Blown pupil
-and/or Cushing’s triad.

25
Q

What are the signs and symptoms of an ischemic stroke?

A

-Headache
-Auditory/visual abnormalities
-Facial droop
-Ptosis
-Speech issues
-Unilateral weakness and/or drift

26
Q

What are the signs and symptoms of a hemorrhagic stroke?

A

The same as an ischemic stroke as well as:
-Dizziness
-NV
-Seizure
-Unconsciousness
-Irreg resps.
-Inc. ICP (Cushing’s triad)

27
Q

What is an epidural hematoma?

A

-Occur between the skull and dura mater and of a arterial or large vein origin.
-Develop headache immediately following or a few hours after injury which may disappear and then return even worse.
-Will have dec. LOA, sleepiness and coma.
-Will sometimes lose consciousness then regain mental function for a period of time and then become unconscious again.
-May develop unilateral and other CVA symptoms

28
Q

What is a subdural hematoma?

A

-Generally caused by bleeding from veins between outer and middle meninges and bc of slower bleed may take hours/days to onset.
-Trauma or medical causes.
Will c/o:
-Persistent headache
-Fluctuating drowsiness
-Confusion
-Memory loss
-Unilateral/CVA symptoms

29
Q

What is a intracerebral hematoma?

A

-Bleeding formed within the brain itself caused by head injury and sometimes from cerebral contusion.
May c/o:
-Drowsiness
-Confusion
-Unilateral plus other CVA symptoms.

30
Q

What is a subarachnoid hematoma?

A

-Bleeding under the arachnoid meningeal layer from ruptured blood vessel (aneurysm).
Will c/o:
-Severe (thunderclap) headache
-Syncope
-Confusion
-Stiff neck
-NV
-Seizures

31
Q

What is decorticate posturing?

A

-flexor
-arms are like Cs and are brough in towards the core
-Problems with cervical spinal tract or cerebral hemisphere

32
Q

What is decerebrate posturing?

A

-extensor
-arms like es at side
-problems with midbrain or pons

33
Q

What are the different levels of GCS for eye response?

A
  1. spontaneous
  2. to speech
  3. to pain
  4. no response
34
Q

What are the different levels of GCS for verbal response?

A
  1. oriented
  2. confused
  3. inappropriate words
  4. incomprehensible sounds
  5. no response
35
Q

What are the different levels of GCS for motor response?

A
  1. Obeys commands
  2. Moves to localized pain
  3. Flex to withdraw from pain
  4. Abnormal flexion (decorticate)
  5. Abnormal extension (decerebrate)
  6. No response
36
Q

What are the 3 main symptoms that a patient must present with at least 1 of to qualify for stroke bypass protocol?

A

a. unilateral arm/leg weakness or drift
b. slurred speech or inappropriate words
c. unilateral face droop

37
Q

What are the contraindications for the stroke bypass protocol?

A
  1. CTAS level 1 and/or uncorrected ABC problem
  2. Symptoms of stroke resolved prior to paramedic arrival/assessment
    3.Blood sugar <3 mmoL
  3. Seizure at onset of symptoms or observed by paramedics
  4. Glascow coma scale <10
  5. Terminally ill or palliative patient
    7.Duration of out of hospital transport exceeds 2 hours
38
Q

What is the LAMS used for?

A

-a tool used to predict the likelihood of a Large
Vessel Occlusion (LVO) in the stroke patient
-A Patient who has a LAMS >= 4 is a high probability of having an LVO

39
Q

What is the LAMS?

A

FACE
0-Both sides move normally
1- One side is weak or flaccid

ARMS
0- Both sides move normally
1- One side is weak
2- One side is flaccid/does not move

GRIP
0- Both sides move normally
1- One side is weak
2- One side is flaccid/does not move

Patient Care Theory II (8 decks)

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