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NCLEX > Neurology > Flashcards

Neurology Flashcards

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1
Q

Function of neurotransmitter adrenaline

A

fight or flight

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2
Q

Function of neurotransmitter noradrenaline

A

concentration

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3
Q

Function of neurotransmitter dopamine

A

pleasure

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4
Q

Function of neurotransmitter GABA

A

calming

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5
Q

Function of neurotransmitter acetylcholine

A

learning

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6
Q

Function of neurotransmitter serotonin

A

calming and sleep

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7
Q

Function of neurotransmitter histamine

A

immunity

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8
Q

CNS is made up of the

A

brains and spinal cord

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9
Q

the peripheral nervous system is made up of the

A

cranial and spinal nerves

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10
Q

occipital lobe of the brain

A

vision

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11
Q

temporal lobe of the brain is

A

memory, understanding language

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12
Q

parietal lobe of the brain

A

perception, math, spelling, logic

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13
Q

frontal lobe of the brain

A

thinking, planning, organizing, problem solving, emotions, behavioural control, personality

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14
Q

cerebellum of the brain

A

balance

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15
Q

medulla of the brain is responsible for

A

HR, BP, reflexes (swallowing, vomiting)

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16
Q

Broca’s area is

A

expressive language

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17
Q

Wernicke’s area is

A

receptive language

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18
Q

meninges

A

cover and coat nervous system to protect it

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19
Q

CSF is found in

A

brain and spinal cord

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20
Q

Peripheral nervous system includes two type of neurons ______ and ________

A

sensory/afferent and motor/efferent

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21
Q

voluntary nerves are called and example

A

somatic; ex) skeletal muscle

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22
Q

involuntary nerves are called and example

A

autonomic; ex) cardiac and smooth muscle, glands

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23
Q

autonomic breaks into _______ and _______

A

parasympathetic and sympathetic

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24
Q

the sympathetic nervous system does

A

fight or flight; dilates pupils, inhibit salivation, increase HR, dilate bronchi, inhibit peristalsis, glucose release, adrenaline and noradrenaline, inhibit bladder

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25
Q

the parasympathetic nervous system does

A

rest and digest; constrict pupils, stimulate salivation, decrease HR, construct bronchi, stimulate peristalsis, bile release, stimulate intestines, constrict bladder

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26
Q

cranial nerves send information from

A

peripheral to central nervous system

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27
Q

cranial nerve I

A

olfactory

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28
Q

cranial nerve II

A

optic

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29
Q

cranial nerve III

A

oculomotor (pupil constriction)

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30
Q

cranial nerve IV

A

trochlear (downward movement of eyes)

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31
Q

cranial nerve V

A

Trigeminal (jaw movement, sensation of face and neck)

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32
Q

cranial nerve VI

A

abducens (lateral movement of eyes)

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33
Q

cranial nerve VII

A

facial (facial movement, taste)

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34
Q

cranial nerve VIII

A

vestibulocochlear (hearing and balance)

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35
Q

cranial nerve IX

A

glossopharyngeal (swallowing, taste)

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36
Q

cranial nerve X

A

vagus (swallowing, speaking)

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37
Q

cranial nerve XI

A

spinal/accessory (flexing and rotation of head)

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38
Q

cranial nerve XII

A

hypoglossal (tongue movements)

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39
Q

C1

A

head and neck

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40
Q

C2/C3

A

diaphragm

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41
Q

C4

A

deltoids, biceps

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42
Q

C5

A

wrist extenders

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43
Q

C6/C7

A

triceps

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44
Q

C8

A

hand

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45
Q

T7

A

chest muscles

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46
Q

T8

A

abdominal muscles

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47
Q

L3

A

leg muscles

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48
Q

S3

A

bowel, bladder

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49
Q

S4

A

sexual functions

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50
Q

cerebral perfusion is

A

the blood flow to the. rain

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51
Q

to maintain adequate cerebral perfusion

A

BP needs to be high enough to send blood to the brain; MAP >60

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52
Q

ICP

A

pressure inside the still

5-15 is normal

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53
Q

________ works against the BP and pushing blood away from the brain

A

ICP

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54
Q

monroe-kellie hypothesis

A

as pressure in skull goes up it can only get so high before something else has to give

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55
Q

causes of ICP

A

cerebral edema, hemorrhage, tumor growth, excess CSF

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56
Q

increased ICP S&S

A

headache, vomiting
change in LOC, GCS decreasing, posturing, pupillary changes, changes in speech, cushing’s triad

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57
Q

cushing’s triad

A

increased systolic BP
decreased HR
altered respirations

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58
Q

herniation

A

too much pressure and and brain protrudes through skull

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59
Q

Decorticate posturing

A

abnormal flexion; arms pulled in towards centre, clenched fists, rigid muscles, damage in mid brain

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60
Q

decerebrate posturing

A

abnormal extension; arms and legs straight out, toes downward, neck and head arched back, rigid muscles, damage to deep brain structures (pons), GCS 2

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61
Q

hydrocephalus

A

increased accumulation of CSF, increases ICP

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62
Q

extra ventricular drain and important nursing consideration

A

acute, temporary fix; drain must always be in like with tragus of ear, if standing must clamp drain temporarily

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63
Q

VP shunt

A

drains extra CSF from brain to abdomen where it can then be excreted as urine

64
Q

hemi means _______ of body

A

one side of body

65
Q

para means _______ of body

A

only legs

66
Q

quad means ______ of body

A

all four extremities

67
Q

hyperkinesia

A

tremors

68
Q

dyskinesias

A

spasms, involuntary movements

69
Q

hypokinesia

A

bradykinesia, akinesia (absence)

70
Q

ataxia

A

poor muscle control causes clumsy voluntary movements

71
Q

dyspraxia

A

partial inability to perform purposeful or skilled motor acts

72
Q

apraxia

A

complete inability to perform purposeful or skilled motor acts

73
Q

seizures are not a disease but a symptom of

A

an underlying disorder

74
Q

epilepsy

A

neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain

75
Q

epilepsy is diagnosed when

A

no other reason can be found for having seizures

76
Q

partial seizure

A

specific area of brain

77
Q

generalized seizure

A

entire brain

78
Q

simple seizure

A

no loss of consciousness

79
Q

complex seizure

A

impaired consciousness ranging from confusion to non responsive

80
Q

tonic/clonic

A

phases of tonic and clonic spasm

81
Q

myoclonic

A

sudden, brief contractions of a muscle or group of muscles

82
Q

atonic

A

muscles become limp, no tone

83
Q

absence seizure

A

loss of consciousness, staring off into space

84
Q

generalized seizures include

A

tonic clonic, myoclonic, atonic, absence

85
Q

partial (focal) seizures include

A

complex and simple

86
Q

general seizure treatment

A

fix the cause! anticonvulsant

87
Q

during a seizure you need to

A

stay with client, note time, duration, and characteristics, remove harmful objects in clients area, cushion clients head, loosen restrictive clothing, assist client to side lying position if possible

88
Q

seizure precautions at bedside

A

oxygen and suctioning equipment, side lying with pillow under head, padded rails, all four rails raised, bed in lowest position

89
Q

benzodiazepines are

A

CNS depressant, slow everything down “lam” and “pam”

90
Q

short acting benzodiazepines

A

midazolam

91
Q

intermediate acting

A

alprazolam, clonazepam, lorazepam

92
Q

long acting benzodiazepines

A

diazepam

93
Q

phenytoin

A

anticonvulsant; needs to be at therapeutic level; blocks sustained high frequency repetitive firing of action potentials

94
Q

TBI

A

alteration in brain function caused by an external source

95
Q

in an open skull fracture the dura is

A

torn

96
Q

in a closed skull fracture the dura is

A

intact

97
Q

Basilar skull fraction shows these findings

A

Battle’s sign and raccoon eyes and cerebrospinal rhinorrhea

98
Q

battle’s signs

A

bruising over mastoid process

99
Q

raccoon eyes

A

periodical bruising

100
Q

cerebrospinal rhinorrhea

A

test drainage for CSF, clear odor less fluid from nose. Two ways to identify: halo test and test for glucose (CSF will have glucose in it)

101
Q

never put a ______________ in a pt with a basilar skull fracture

A

NG tube

102
Q

epidural hematoma

A

above the dura; occurs because of arterial bleeds

103
Q

epidural hematoma S&S

A

loss of consciousness followed by awake period of confusion and bad headache, then neuro will begin to decline, no longer PERRLA, decrease LOC, decrease GCS, posturing and then pt will begin to decline quickly due to arterial bleeds bleeding quickly

104
Q

subdural hematoma

A

below the dura; low pressure, slow bleed, body will accommodate for these changes in increased ICP pressure (brain gradually gets pushed down), neuro status does not change dramatically

105
Q

subdural hematome S&S

A

fall or injury awhile ago, family/friends/self notices they begin to act not like themselves

106
Q

difference between epidural and subdural hematoma

A

epidural = arterial bleed = quick bleeding = quick neurological changes/decline

subdural = low pressure, slow bleed = symptoms slowly arise

107
Q

subdural hematomas are likely to occur in

A

elderly (risk of falls), geriatric pts, and those on blood thinners

108
Q

Spinal cord injury

A

damage to spinal cord causes permanent changes in strength, sensation, and other body functions below the site of injury

109
Q

for SCI at and above T6 we need to closely monitor for

A

autonomic dysreflexia

110
Q

fatal SCI include injury to cervical vertebrae

A

C1 and C2; b/c it affects diaphragm function -> resp distress -> resp failure and needing mechanical ventilation

111
Q

the higher the SCI the more ___________ that is lost

A

function

112
Q

autonomic dysreflexia is characterized by

A

sudden severe htn, bradycardia, headache, nasal stuffiness, flushing, sweating, blurred vision, anxiety

113
Q

autonomic dysreflexia happens because

A

communication between bottom half and top half is lost

114
Q

autonomic dysreflexia triggers

A

restrictive clothing, dehyrdration, pressure ulcers, anxiety, fecal impaction, full blader, broken bone, UTI, blister

115
Q

autonomic dysreflexia tx

A

sit client up to help lower bp, antihypertensives, find cause and treat it

116
Q

stroke / CVA

A

lack of oxygen to the brain that causes damage either due to a bleeding or a clot

117
Q

hemorrhagic stroke

A

vessel ruptures and bleeds into the brain, blood accumulates leading to increased pressure on brain and increased ICP

118
Q

ischemic stroke

A

blood flow to brain is blocked by a blood clot; either thrombotic or embolic; lack of blood -> lack of O2 to brain -> ischemia

119
Q

thrombotic stroke

A

blood clot in an artery going to the brain; onset happens in a “stepwise” fashion

120
Q

embolic stroke

A

clot that is formed elsewhere and travels the bloodstream, then clogs a blood vessel in or leading to the brain; sudden onset

121
Q

Stroke S&S

A

dizziness, headache, loss of balance, blurry vision, unilateral facial drooping, arm or leg weakness/drift, speech difficulty (aphagia, dysphagia)

122
Q

Ischemic stroke tx

A

ensure perfusion to brain (bring down bp), antithrombotics, percutaneous thrombectomy

123
Q

tPA

A

clot buster; breaks up clot and restores blood flow; must be done quickly, door to tPA = 60min

124
Q

hemorrhagic stroke tx

A

get bleeding under control, if caused by aneurysm coiling or clipping, craniotomy, EVD (drainage device)

125
Q

Meningitis

A

inflammation of the spinal cord or brain; usually caused by a virus or bacteria

126
Q

bacterial meningitis is _____________ compare to viral

A

more dangerous

127
Q

meningitis S&S

A

nuchal rigidity (neck stiffness), photophobia, Kernig’s sign, Brudzinski’s sign, fever, headache, vomiting, flushed, fatigue, seizure

128
Q

most concerning meningitis signs

A

nuchal rigidity and photophobia (pushing on cranial nerves)

129
Q

Kernig’s sign

A

when client place supine and hip flexed knee cannot be extended completely due to extreme pain

130
Q

Brudzinski’s sign

A

when pt supine passive flexion the neck causes involuntary flexion of knee and hips

131
Q

why do Kernig’s sign and Brudzinski’s sign happen

A

pain is due inflammation of meninges

132
Q

meningitis tx

A

steroids, analgesics, abx (only if bacterial), isolation precautions viral = standard bacterial = droplet

132
Q

meningitis prevention

A

Hib vaccine

132
Q

encephalitis and S&S

A

inflammation of brain tissue due to a viral infections, causes edema and necrosis, meninges are also inflamed

133
Q

encephalitis tx

A

steroids to address inflammation, analgesics to address pain, and treating cause of infection

134
Q

Multiple sclerosis

A

autoimmune disorder where body starts attacking myelin sheath causing CNS inflammation

135
Q

Multiple sclerosis S&S

A

tingling and numbness, weakness, optic neuritis, dysdiadochokinesia (inability to perform rapid, alternating movements), ataxia, nystagmus (involuntary, rapid, repetitive eye movement), intentional tremor, scanning speech, hypotonia, epilepsy/seizures, spasticity (muscles, bladder)

136
Q

MS treatment

A

no cure, corticosteroids (decreasing inflammation to slow progression), plasmapheresis

137
Q

plasmapheresis

A

removal of some plasma that contains destructive antibodies and putting back in “clean” plasma with no antibodies

138
Q

Guillain-Barre

A

antibody and cell mediated immunologic reaction precipitated by a viral or bacterial illness; immune system attacks nerves and de-myelinates peripheral nerves; causes ascending weakness and paralysis

139
Q

Guillain-Barre S&S

A

recent illness/infection, weakness or tingling in lower extremities, increases in severity and moves up symmetrically, paralysis, absent reflexes, loss of muscle tone, respiratory distress (as severity increases), peaks in about 2 weeks, slow recovery

140
Q

Guillain-Barre tx

A

gradually recover as antibodies clear, plasmapheresis, immunoglobulin therapy

141
Q

neuropathy

A

weakness, numbness, and pain from nerve damage; has been an injury to a peripheral nerve; “pins and needles”

142
Q

Botulism

A

botulinum toxin release by clostridium botulinum; found in soil and dust (can contaminate honey), inhibits acetylcholine release at junction between peripheral nerves and muscles causing life-threatening flaccid paralysis - paralysis is descending

143
Q

botulism tx

A

antitoxin

144
Q

botulism S&S

A

blurry vision, difficulty breathing, resp failure, symmetric descending flaccid paralysis

145
Q

myasthenia gravis

A

antibodies in peripheral nervous system, communication between nerves and muscles destroyed, blocks acetylcholine making muscles very weak

146
Q

Tensilon test

A

diagnose myasthenia gravis; boost of acetylcholine is given, will see improvement in S&S if it is myasthenia gravis and will see no change if it is not

147
Q

difference between multiple sclerosis and myasthenia gravis

A

MS = autoimmune disorder in CENTRAL nervous system

Myasthenia gravis = autoimmune disorder in PERIPHERAL nervous system

148
Q

myasthenia gravis S&S and tx

A

weak muscles, ptosis (drooping eyelid)
tx: cholinesterase inhibitors (improve communication between nerves and muscles), corticosteroids, immunosuppressants (stop body from making antibodies)

149
Q

Parkinson’s Disease

A

progressive nervous system disorder, caused by degeneration of dopamine neurons

150
Q

Parkinson’s S&S

A

tremors, rigidity, hypophonia, mask-like faces, akinesia, bradykinesia, dyskinesia, stooped posture, difficulty balancing, orthostatic hypotension

151
Q

Parkinson’s Tx/Interventions

A

reduce fall risk, no cure, therapies (PT, OT, SLP), carbidopa-levodopa

152
Q

carbidopa-levodopa action

A

increases dopamine in the brain to hopefully help tx symptoms of Parkinson’s - is NOT a cure but will help improve quality of life

153
Q
A

NCLEX (23 decks)

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