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
What are the signs and symptoms of an ischemic stroke?
-Headache -Auditory/visual abnormalities -Facial droop -Ptosis -Speech issues -Unilateral weakness and/or drift
26
What are the signs and symptoms of a hemorrhagic stroke?
The same as an ischemic stroke as well as: -Dizziness -NV -Seizure -Unconsciousness -Irreg resps. -Inc. ICP (Cushing's triad)
27
What is an epidural hematoma?
-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
What is a subdural hematoma?
-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
What is a intracerebral hematoma?
-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
What is a subarachnoid hematoma?
-Bleeding under the arachnoid meningeal layer from ruptured blood vessel (aneurysm). Will c/o: -Severe (thunderclap) headache -Syncope -Confusion -Stiff neck -NV -Seizures
31
What is decorticate posturing?
-flexor -arms are like Cs and are brough in towards the core -Problems with cervical spinal tract or cerebral hemisphere
32
What is decerebrate posturing?
-extensor -arms like es at side -problems with midbrain or pons
33
What are the different levels of GCS for eye response?
4. spontaneous 3. to speech 2. to pain 1. no response
34
What are the different levels of GCS for verbal response?
5. oriented 4. confused 3. inappropriate words 2. incomprehensible sounds 1. no response
35
What are the different levels of GCS for motor response?
6. Obeys commands 5. Moves to localized pain 4. Flex to withdraw from pain 3. Abnormal flexion (decorticate) 2. Abnormal extension (decerebrate) 1. No response
36
What are the 3 main symptoms that a patient must present with at least 1 of to qualify for stroke bypass protocol?
a. unilateral arm/leg weakness or drift b. slurred speech or inappropriate words c. unilateral face droop
37
What are the contraindications for the stroke bypass protocol?
1. CTAS level 1 and/or uncorrected ABC problem 2. Symptoms of stroke resolved prior to paramedic arrival/assessment 3.Blood sugar <3 mmoL 4. Seizure at onset of symptoms or observed by paramedics 5. Glascow coma scale <10 6. Terminally ill or palliative patient 7.Duration of out of hospital transport exceeds 2 hours
38
What is the LAMS used for?
-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
What is the LAMS?
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