Neurology Flashcards
What are the two categories that make up the nervous system?
Central Nervous system and Peripheral nervous system
Name of the components of the CNS and PNS
CNS:
- cortex
- Cerebrum
- Spinal Cord
PNS:
- Cranial Nerves
- Spinal Nerves
what is the Function of the cerebrum + its two components?
Higher order functions such as planning, meaningful thoughts and speech.
Divided in to the cortex (Gray matter) and sub-cortex (white matter)
What is the function of the Thalamus?
It is the maximal relay centre to the cerebral cortex
What is the function of the hypothalamus?
Anterior pituitary control, controls balance of the autonomic nervous system, also secretes ADH.
What does the basal ganglia do?
Controls the fluidity of movements and is link to the thalamus at the base of the brain.
Name the lobes of the brain
Frontal
Parietal
Occipital
Temporal
List the functions of each lobe
Frontal
-key role in communicative abilities/personality, emotional expression, problem solving, memory, language, judgment and sexual function
Parietal
-Processes sensory information from the outside world (IE. Temp, touch, taste, proprioception)
Occipital
-visual processing
Temporal
-Processes sensory input into derived meanings for appropriate retention of visual memory, language, comprehension and emotional association.
Components of the brain stem
Thalamus (superior) Midbrain, pons, medulla, spinal cord
Function of the midbrain
Responsible for vision, hearing, motor control, sleep, wakefulness and temperature regulation
Function of the pons
Primarily deal with sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye movement, facial sensation and posture.
Function of the Medulla Oblongata
Responsible for autonomic functions ranging from vomiting to sneezing
Function of the cerebellum
Coordination of voluntary movements (motor skills, coordination).
What is the blood brain barrier (make-up and function)
The BBB is a highly selective semi-permeable border made up of endothelial cells that prevents solutes from the circulation to cross into the CNS ECF
What is CSF and how is it drained?
CSF is fluid that assists the brain in nourishment and waste removal
20-30ml/h produced
Created in the lateral ventricles and drained via superior sagittal sinus–> jugular veins.
How many cranial nerves are there in total, and where do the majority exist?
12 CN total.
11 Housed in the brain stem
Where is broca’s area located?
The frontal lobe
Where is wernickes area located
The temporal lobe
Describe the physiology of an embolic CVA
Defined as a blockage in an artery that supplies blood to the brain.
Accounts for 87% of strokes
What is a TIA?
Temporary blockage of blood flow to the brain that is self resolving.
Warning sign for more to come!!
Hemorrhagic Stroke
May occur in any vessel in cerebral circulation.
Accounts for 13% of strokes
What is a subarachnoid hemorrhage and where does in occur within the brain?
Hemorrhage within the space surrounding the brain.
-Usually occurs in the circle of willis.
85% are aneurysmal
15% are AVM’s and cocaine induced.
List three signs/symptoms of SAH?
Do you need all three??
headache, photophobia, nuchal rigidity.
Physical exam findings of SAH?
Focal deficits, GCS (specifically motor deficits), CN exam
Tx for SAH
- ABC like always!
- Avoid hypertension and fluid admin if needed–>SBP goal is less than 140mmg
- Promote CSF drainage (head 30 deg. Goodluck)
What is a seizure?
Sudden, uncontrolled electrical disturbance in the brain leading to disregulation of electrical conduction and activation of neurons.
Define Status, and refractory seizures
Status
-Last greater than 5min OR 2 consecutive seizures without a return to Neuro baseline
Refractory
-Any seizure that cannot be terminated by antiepileptic medication (Benzos…then what?)
List 4 major causes of Seizures
Drugs, infection, metabolic, structural pathology
How many vertabrae make up the spine?
33 individual vertebrae
What is the role of the spine?
Protect the spinal cord, and serve as anchor points for ligaments.
Name the 5 spinal regions
Cervical (7) Thoracic (12) Lumbar (5) Sacrum (5) Coccyx (4)
Describe CNS communication from the skin to muscle fibre
Skin–> afferent nerve–>spinal cord–>efferent nerve–>muscle
What is Cauda Equina?
it is a bundle of nerves and their roots which are typically found at L1-L5 that give motor and sensory innervation to the legs, bladder, anus, and perineum.
What is a dermatome?
An area of skin that is mainly supplied by afferent nerve fibres.
CPG Managment for seizures
-ABC
-Correct hypoglycaemia
-Midazolam
IV/IO-2-5mg
IM-5-10MG
Max dose is 30mg!
Resuscitation plan for TBI
ABC management–>Oxygenate, ventilate
Spo2- target 90%
SBP 110mmhg
Hemodynamic Targets
general pop, TBI, SCI
General
-MAP >60 or SBP >90
TBI
-SBP 110
SCI
-MAP >80
