Neurological Emergencies Flashcards
Afferent
Sensory nerves
Efferent
Motor nerves
Cerebral blood supply
From vertebral arteries (20%) and internal carotids (80%)
Circle of Willis
Complete circle around brain and pituitary gland
Safeguard if blockage in 1 artery
2 Cerebral blood supply factoids
20% of body’s blood to brain
25% of body’s glucose to brain
Meninges
Dura mater
Arachnoid mater
Pia mater
Cerebellum
Balance, coordination and vision
Cerebrum
Language and memory, learning analysis
Cerebrum lobe
Frontal- personality
Parietal
Temporal- Speach
Occipital- Vision
RAS
Reticular activating system
Dorsal nerve root
Afferent
Ventral nerve root
Efferent
Broca
(expressive) Aphasia
speech is difficult to initiate, non-fluent, labored, and halting
Wernicke
(receptive) Aphasia
Speech is preserved, but language content is incorrect.
Paralysis
Loss of function, or voluntary movement, typically one side of the body or another
Paresthesia
Abnormal sensation felt in body, usually in extremities, often referred to as numbness or tingling
Hemiplegia
Paralysis of one lateral half of the body
Hemiparesis
Muscular weakness or partial paralysis to one side of the body
Aphasia
Unable to speak
Aphagia
Unable to swallow
AEIOUTIPS
A Alcohol, Anoxia E Epilepsy – Seizure disorder I Insulin (hypoglycemia/ hyperglycemia) O overdose U uremia (renal failure) T trauma (head injury and/or hypovolemia) I infection (CNS, septicemia, septic shock) P psych (psych meds can alter) S Stroke, CVA
ALOC differential diagnosis in the field
Medical
Trauma
Psychiatric
Structural coma
lesions CA, CVA, trauma
unilateral dysfunction, pupil changes
Metabolic states
Toxic states, drugs, diabetes, hypoxia
bilateral dysfunction, pupils may be equal
Medulla increased ICP
respiration Altered , pulse decrease, B/P widening PP (kushings triad)
TIA
resolves w/in 24 hours
spasm or blockage leading to cell ischemia
Stroke
3 hour IV TPA time limit
4 hour from onset of symptoms
CVA
Thrombus or Embolus
7 “D’s”
DETECTION DISPATCH DELIVERY DOOR (ER) data decision drug, IV tpa
LASS
age >45 no Hx seizure onset of symptoms in last 24hrs Pt was ambulatory at baseline Blood glucose 60-400 Unilateral asymmetry in 1 -Facial droop -Grip weakness or absence -arm drift(pronation)
Focal seizure
specific motor, sensory or psychomotor phenomena
Jacksonian
clonic convulsive movements or abnormal sensations begining in one hand or foot and “marching” to major muscle group.
Psychomotor
Complex partial
Temporal lobe seizures
Seizures characterized by 1-2 minute loss of contact with surroundings (transient ALOC)
Patient staggers or performs complex automatic behaviors, for example; climbing stairs.
May present a sudden unexplained fits of rage
Patient does not understand what is happening and may refuse aid due to confusion for 1 to 2 minutes after seizure
Can be triggered by loud noises or rapid light movement
Often preceded by specific auras (smell, taste or sound)
Petite Mal
Absence Seizure- 10-30seconds
Status epilepticus
2+ seizures
Dystonia
Involuntary muscle contraction and distorted posture
ptosis
eye droop
Headaches are
Vascular
Parkinson’s Disease
50K new cases annually
GCS =
EVM/eyes, verbal, motor
4,5,6
GCS Score
15
Infarct, injury, ischemic part of the brain
Penumbra
