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CAL-Jac Paramedic Program > Neurological Emergencies > Flashcards

Neurological Emergencies Flashcards

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1
Q

Which lobe scans through images?

A

Occipital lobe

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2
Q

Which lobe attaches a name to an image?

A

Temporal lobe

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3
Q

Which lobe controls voluntary motion?

A

Frontal lobe

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4
Q

Which lobe perceives touch and pain?

A

Parietal lobe

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5
Q

Which neurological cause is the 5th leading cause of death in the US in 2019?

A

Stroke

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6
Q

Which neurological cause is the 6th leading cause of death in the US in 2019?

A

Alzheimer Disease

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7
Q

What section of the nervous system do thoughts, perceptions, feelings and autonomic body functions fall under?

A

Central Nervous System

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8
Q

What section of the nervous system do transmitting commands between the brain and body and receiving feedback fall under?

A

Peripheral Nervous System

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9
Q

What part of the brain filters out unneeded information and conscious vs. unconscious management of information?

A

Diencephalon

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10
Q

What part of the brain regulates level of consciousness?

A

Midbrain

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11
Q

What part of the brain frees cerebral cortex for higher activities?

A

Brainstem

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12
Q

What does the hypothalamus control?

A

controls pleasure, thirst, hunger

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13
Q

What part of the brain mediates all emotions?

A

prefrontal cortex

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14
Q

What part of the brain generates rage and anger?

A

limbic system

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15
Q

What part of the brain manages complex motor activity and transfers learned behaviors from the frontal lobe?

A

Cerebellum

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16
Q

Which nerves are responsible for airway control?

A

Trigeminal, glossopharyngeal, vagus, hypoglossal (allow for swallowing, tongue control, hypopharynx)

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17
Q

What does trismus mean?

A

clenched teeth

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18
Q

What could trismus indicate?

A

seizure in progress, severe head injury, cerebral hypoxia

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19
Q

What are the three major parts of the brain?

A

cerebrum, cerebellum, brainstem

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20
Q

What is the most significant risk for hemorrhagic stroke?

A

hypertension

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21
Q

What patient with an altered mental status is thought to be?

A

Is not thinking clearly or is incapable of being aroused

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22
Q

What is a simple partial seizure?

A

a seizure that begins in one extremity

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23
Q

When caring for a pt with documented hypoglycemia, you should be most alert for?

A

a seizure

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24
Q

What is aphasia?

A

unable to produce or understand speech

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25
Q

What is a contraindication for thrombolytic (fibrinolytic) therapy?

A

brain bleed

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26
Q

Components of the Cincinnati Stroke Scale include?

A

arm drift, speech, facial droop

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27
Q

What type of seizures are benign but should still be evaluated?

A

febrile seizures

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28
Q

What are individuals with chronic alcoholism predisposed to?

A

Intracranial bleeding and hypoglycemia

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29
Q

muscle control and body coordination are controlled by?

A

cerebellum

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30
Q

What type of seizure is prolonged in nature without a return of consciousness?

A

status epilepticus

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31
Q

What part of the brain controls basic body functions like breathing, BP and swallowing?

A

brain stem

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32
Q

The spinal cord exits the cranium through the…

A

foramen magnum

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33
Q

What is the most suggestive sign of ruptured aneurysm?

A

sudden, severe headache

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34
Q

What is a characteristic of a focal-onset aware seizure?

A

normal level of conscious

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35
Q

What is a cause of an ischemic stroke?

A

blockage of a cerebral artery

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36
Q

What is one metabolic cause of a seizure?

A

poisoning

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37
Q

Which type of posturing has abnormal flexion, curls arms toward chest, point their toes and flex their wrists (indicative of damage to the area below the cerebral hemispheres)

A

Decorticate

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38
Q

What is one characteristic of focal onset aware seizure?

A

a seizure that causes the pt to stare blankly

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39
Q

In most people, speech is controlled by which hemisphere?

A

Left hemisphere

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40
Q

What disorder of the brain is caused by the disruption of blood flow resulting in brain cell death?

A

cerebral infarction

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41
Q

What is the largest part of the brain?

A

Cerebrum

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42
Q

What type of posturing is abnormal extension, points their toes, extends their arms outward and palms down(pronation) [indicative of damage near or in the brainstem]

A

decerebrate

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43
Q

What sign lets you suspect ischemic stroke vs. hypoglycemia?

A

If the pt attempts to communicate with you

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44
Q

When is hyperventilation indicated for neuro emergencies?

A

those with documented signs of intracranial pressure (ICP) and impending herniation

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45
Q

What is anisocoria?

A

unresponsive and dilated pupils

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46
Q

What happens to blood flow and systolic pressure when ICP rises?

A

Blood flow diminishes, medulla oblongata signals heart to increase force of contractions causing systolic to rise

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47
Q

What is cushing’s reflex for ICP?

A

BRadycardia, irregular breathing, hypertension and widened pulse pressure

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48
Q

What is ptosis?

A

Drooping or sagging of the eyelids

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49
Q

What can ptosis indicate?

A

Bell palsy

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50
Q

What happens with a breakthrough seizure?

A

the seizure occurs despite a therapeutic medication blood level

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51
Q

What are thoughts, ideas, perceived abilities that are not based in common reality?

A

delusions

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52
Q

What are sensory stimulations that cannot be verified by others?

A

hallucinations

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53
Q

What is a protective movement that results in blinking. moving the head posteriorly and pupil constriction called?

A

corneal reflex

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54
Q

If you tap between a patient’s eye and the pt does not blink or twitch it is safe to assume what?

A

The the pt does not have an intact cough or gag reflex

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55
Q

What type of pupil response does cocaine, methamphetamines and hallucinogens tend to cause?

A

pupil dilation

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56
Q

What do depressants tent to the do the pupils?

A

constrict the pupils

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57
Q

What are unequal pupils a sign of?

A

increased ICP

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58
Q

What is weakness of one side of the body called?

A

hemiparesis

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59
Q

Paralysis of one side of the body is called?

A

hemiplegia

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60
Q

Uncontrolled hypertension, sudden severe headache and rapidly deteriorating level of consciousness is most suggestive of?

A

ruptured cerebral artery

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61
Q

A degenerative cerebral disease is an example of a _______ cause of a seizure?

A

structural

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62
Q

A hemorrhagic stroke occurs as a result of?

A

a ruptured cerebral artery

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63
Q

What is status epilepticus?

A

prolonged generalized motor seizure

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64
Q

A transient ischemic attack occurs when?

A

body’s normal processes destroy a cerebral thrombus

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65
Q

What is an idiopathic seizure?

A

a seizure without an identifiable etiology

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66
Q

What does hypermetabolic state mean?

A

they are using large amounts of glucose and produce lactic acid

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67
Q

Following a head injury, a pt who is verbally abusive and combative most likely had an injury to what part of the brain?

A

frontal

68
Q

What controls muscle and body coordination?

A

cerebellum

69
Q

Pt with hemorrhagic strole experience rapidly declinging LOC because?

A

of increasing ICP

70
Q

Migraines are thought to be caused by

A

changes in blood vessel size within the base of the brain

71
Q

The clonic phase of a generalized motor seizure is characterized by?

A

muscle contraction and relaxations in rapid succession

72
Q

Which condition can mimic the signs and symptoms of an acute ischemic stroke?

A

low bgl

73
Q

Where is the 12th cranial nerve located?

A

arises from the brain and innervates the head and face

74
Q

What is the alteration of a person’s ability to perform coordinated motions such as walking?

A

ataxia

75
Q

A sensation of numbness or tingling is called?

A

parasthesia

76
Q

If a pt does not feel anything within that body part, it is called?

A

anesthesia

77
Q

What is the minimum systolic BP for a pt with ICP?

A

110 to 120 mm Hg

78
Q

Sensations commonly experienced before a seizure or migraine headache like visual changes and hallucinations

A

aura

79
Q

What is the onset time of glucagon?

A

20 minutes

80
Q

What can increase the morbidity of pts who have had a stroke?

A

hyperglycemia

81
Q

Pts with hyperglycemic are often _____ and require volume support.

A

dehydrated

82
Q

What is a normal range for CPP?

A

70 to 90 mm Hg

83
Q

What is the target systolic BP of a pt with ICP?

A

110 mmHg

84
Q

What interventions should you consider with someone who has signs of ICP?

A

IV access and NS or Lactated Ringer

85
Q

An aneurysm can happen due to the following:

A

-tear in the arterial wall
-blood entering one of more of the three layers of the artery
-pressure build up and initial tear increases

86
Q

What is another name for an ischemic stroke?

A

occlusive stroke (bc it’s caused by an occlusion- blockage)

87
Q

What is a hallmark symptom of a hemorrhagic stroke?

A

“worst headache of my life”

88
Q

How do you calculate CPP?

A

MAP -ICP

89
Q

What serious conditions include headache as a symptom?

A

brain tumor, meningitis, stroke

90
Q

What are the three substances in the skull?

A

brain, blood and CHF

91
Q

What is the normal ICP in adults?

A

less than 10-15mm Hg

92
Q

What is the normal ICP in young children?

A

less than 3-7mm Hg

93
Q

What does MAP signify?

A

The mean arterial pressure is the average pressure within the blood vessel at any given time

94
Q

What are the four signs of increase ICP?

A

-Shock
-posturing
-irregular respiratory
-unequal pupils

95
Q

True or False: Pt with strokes will also exhibit cardiac dysrhythmias.

A

True

96
Q

Unless cervical spine injury, what how should you position a pt with stroke?

A

supine and elevate the head 30 degrees

97
Q

What can cause vasodilation of the cerebral arteries which allows more blood into the skull?

A

high CO2 level

98
Q

What is the ETCO2 goal for pt’s with stroke

A

30-35mm HG

99
Q

For ischemic strokes, fibrinolytics needs to be administered with how many hours of onset?

A

3-4.5 hrs

100
Q

What are episodes of cerebral ischemia without permanent damage?

A

TIAs - transient ischemic attacks

101
Q

What are mini-strokes(TIAs) a sign of?

A

serious vascular conditions that require medical evaluation

102
Q

According to AHA/ASA, TIAs resolve within what time frame?

A

1 hour

103
Q

What is the #1 preventable cause of strokes and TIAs?

A

hypertension

104
Q

What happens if a seizure occurs for a long period of time?

A

-cerebral glucose
-oxygen is depleted
-hypoxia
-hypercarbia
-hyperthermia

105
Q

what is another name for tonic-clonic seizures?

A

grand mal seizures

106
Q

What happens during the tonic phase of a tonic-clonic seizure?

A

systemic rigidity

107
Q

What happens during the hypertonic phase of the tonic-clonic seizure?

A

arched back and rigidity

108
Q

what happens during the clonic phase of the tonic-clonic seizure?

A

intermittent contractions of major muscle groups - contractions are chaotic

109
Q

What are some signs of postseixures?

A

major muscles relax, nystagmus, eyes on back of the head

110
Q

What are some signs of the postictal phase?

A

aphasic (unable to speak), confused, emotional, tired, headache, gradual return of normal brain function

111
Q

What do you do if a pt is apneic for more than 30 seconds during a seizure?

A

begin ventilation assistance

112
Q

What type of seizure might happen with hyperventilation and flashing lights?

A

absence seizures

113
Q

What is another name for an absence seizure?

A

petit mal seizure

114
Q
A
115
Q

What type of seizure has little to no movement, typically experience by children,last a few seconds and have no postictal period?

A

absence (nonmotor) seizures

116
Q

Causes of hemorrhagic stroke

A

hypertension, ruptured aneurysm, arteriovenous malformations, bleeding disorders

117
Q

If a pt’s awareness is affected or impaired at any time during a focal seizure, it is called?

A

focal impaired-awareness seizure

118
Q

What type of seizure affects an area on one side of the brain?

A

focal seizure

119
Q

If a pt had a focal seizure in the temporal lobe, what type signs and symptoms might you see?

A

snapping fingers, repeating phrases, walking in circles

120
Q

A focal seizure in the frontal lobe might have signs and symptoms of?

A

gesturing, cycling, kicking movements, loud cry and scream

121
Q

What is another name for psychogenic nonepileptic seizures?

A

pseudoseizures

122
Q

What is the root cause for pseudoseizures?

A

psychiatric

123
Q

What type of medications can be given for seizures?

A

diazepam(Valium), Lorazepam (Ativan), Midazolam (versed)

124
Q

What type of seizure last longer than 4-5 minutes or consecutive seizures without a return to consciousness between seizures?

A

status epilepticus

125
Q

During a seizure, the neurons are in what state?

A

hypermetabolic state

126
Q

Why must be prepared to control the airway and ventilations when administering benzo because?

A

Benzos can cause respiratory depression or arrest

127
Q

Pregnant patients experiencing eclampsia can be managed with?

A

magnesium

128
Q

Syncope can be a sign of what?

A

life-threatening cardiac dysrhythmias, stroke

129
Q

Conditions that may mimic stroke

A

hypoglycemia, postictal state, subdural/epidural bleeding, bells palsy

130
Q

Common causes of syncope

A

vagal stimulation, lack of oxygen, hypoglycemia, seizure activity

131
Q

Pt with syncope usually experience , ______________, signs and symptoms that precede a disease; dizziness, weakness, SOB, chest pain, headache, black vision

A

prodrome

132
Q

What causes muscle tension headaches?

A

stress, cortisol levels, depression

133
Q

What type of headache had pain on both sides of the head, travel from back to front, dull ache, squeezing pain?

A

muscle tension headache

134
Q

What type of headache reports seeing an aura, unilateral and focuses, throbbing, pounding, pulsating, nausea, vomiting, lasts several days?

A

migraine headaches

135
Q

What type of headache is a rare vascular headache that begins in the face as a minor pain around the eye, lasts 30-45minutes, sharp and excruiating pain on one side of the face?

A

cluster headache

136
Q

What plays a role in cluster headaches?

A

erotonin, histamine and anxiety

137
Q

What type of headache is caused by inflammation or infection within the sinus cavity of the face, worse when waking, postnasal drip, sore throat?

A

sinus headache

138
Q

What is a chronic deterioration of memory, personality, language skills, reasoning, judgement?

A

Dementia

139
Q

What can present as dementia and is caused by vitamin B1 deficiency, typically found in pt who are malnourished ro alcoholic?

A

Wernicke encephalopathy

140
Q

What is the most common form of dementia?

A

Alzheimer disease

141
Q

What type of disease is a progressive, organic condition where neurons die?

A

Alzheimer disease

142
Q

What type of disease has a genetic aspect, damage in the neurons in the frontal and temporal lobes, occurs between 55-65yrs, socially inappropriate behavior.

A

Pick disease

143
Q

What type of disease is fatal, myoclonic jerking, ataxia (unstable gait), where prions (proteins) clump together with resultant death of neurons.

A

Creutzfeldt-Jakob diease

144
Q

What type of disease is an adult-onset genetic disorder marked by a severe loss of neurons, fidgetiness, abnormal eye movement, memory loss, irritability?

A

Huntington disease (Huntington chorea)

145
Q

What is a medical term for growths within the body that serve no useful purpose and are caused by errors during cellular reproduction - cancer of the brain or spinal cord?

A

neoplasm

146
Q

Primary CNS tumors are usually caused by errors in what?

A

mitosis

147
Q

The process by which cancerous cells move to sites distant from their site of origin

A

metastasis

148
Q

What common type of cancers metastasize to the CNS?

A

lung and breast cancer

149
Q

An autoimmune condition in which the body attacks the myelin of the brain and spinal cord, destruction of myelin, demyelination, resulting in areas of scarring?

A

multiple sclerosis

150
Q

What are some symptoms during the pattern of episodes with Multiple sclerosis?

A

double, blurred vision, nystagmus, muscle weakness, loss of pain or temperature, ataxia, euphoria, electric sensation down the spine

151
Q

What type of sign is a strange electric sensation down the spine or extremities when the head is flexed forward

A

Lhermitte sign

152
Q

What is a rare disease in which the immune system attack portions of the nervous system with minor respiratory or gastrointestinal infection?

A

Guillain-Barre Syndrome

153
Q

Around 1/3 of Guillain Barre patients will need what type of support?

A

respiratory

154
Q

How is Guillain Barre described?

A

weakness, tingling sensations in the legs, which moves up to the thorax and arms. weakness can lead to paralysis.

155
Q

What part of the brain is responsible for production of dopamine and if injured, can cause Parkinson?

A

substantia nigra

156
Q

What neurologic condition have environmental and genetic factors place pts at risk for damage to certain neurons

A

parkinson disease

157
Q

What is another name for Amyotrophic lateral sclerosis that strikes the voluntary motor neurons?

A

Lou Gehrig disease

158
Q

What condition is subtle and progresses without being noticed, have generalized weakness of muscle groups, fasciculations, difficulty speaking.

A

ALS- Lou Gehrig

159
Q

True or False: Someone with severe facial pain or sudden-onset facial paralysis is not necessarily having a stroke.

A

True

160
Q

If a pt has vertigo, look at the pt’s eyes and you should see?

A

nystagmus

161
Q

What medications may provide relief for vertigo?

A

Benzodiazepines

162
Q

What medication may be helpful for nausea and vomiting present with cranial nerve disorders?

A

Phenergan (promethazine) or ondansetron (Zofran)

163
Q

What are severe abnormal muscle spasms that cause bizarre contortions, repetitive motions or postures?

A

Dystonias

164
Q

Do dystonias impact a pt’s LOC?

A

no

165
Q

What is a common dystonia that causes neck muscles to contract?

A

spasmodic torticollis

166
Q

Patients who take what type of medication can have sudden onset of dystonias?

A

antipsychotic medications

167
Q
A

CAL-Jac Paramedic Program (8 decks)

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