Neurology Flashcards
What losses occur in Brown-Sequard syndrome?
It is when there is a hemisection of the spinal cord, severing it on one side only.
Loss of associated ipsilateral weakness, loss of proprioception and contralateral loss of pain and temperature sensation.
What losses occur in anterior cord syndrome?
Loss of motor abilities and some sensations (temperature, pain, vibration) below injury.
What losses occur in posterior cord syndrome?
Some sensation is lost below injury.
What losses occur in complete cord injury?
Bilateral paralysis and lack of sensation below injury.
What is caput succedaneum?
It is edema of the scalp that can cross suture lines and usually resolves after 2 to 4 days.
Causes of macrocephaly.
Hydrocephalus
[inc]
What cranial nerves are we assessing when performing eye exams?
II: pupil size reactivity, acuity, visual fields, and fundus
– Expected: equal, round, reactive to light
III, IV, VI: eye movements
– Abnormal: nystagmus
What is the cranial volume made up of?
80% brain
10% CSF
10% blood
Change in volume of one must lead to change in another
If compensation not possible, it can lead to increased ICP
What are s/s of ICP in infants? Children?
INFANTS Tense, bulging fontanels Separated cranial sutures Irritability High-pitched cry Increased HC Poor feeding Sunset eyes CHILDREN Headache N/V Blurred vision Seizures Behavior changes
Head injury: causes, types, presentation
1 health risk for children and leading cause of death in infants
Causes: falls, MVA’a, bicycle injuries
Types:
– 1o occurs at time of impact (skull fractures, contusions, intracranial hematomas
– 2o (hypoxic brain injuries, increased ICP, infection, cerebral edema
– Acceleration, deceleration (blow to head > brain moves and strikes skull > bruising > swelling)
– Shearing stresses (diff rates of acceleration within brain ? small tear in arteries > subdural hemorrhages
Presentation: extent of injury is r/t force of impact
Concussion: presentation, nursing considerations
Most common head injury
Most are transient and reversible
Can occur with or without LOC/alteration in mental status (lasting minutes to hours)
Presentation: confusion, amnesia after trauma
– Retrograde amnesia: loss of memory before trauma
– Antegrade: after trauma
Nursing considerations: assess s/s, bed rest, impact test, PT/OT/ST, vestibular therapy, vision therapy, school accommodations
What nursing intervention take place during a head injury emergency rescue?
Assess ABC Stabilize neck/spine Clean abrasions NPO or clears until no emesis for +6 hrs Neuro assessments REST for at least 24 hours or until symptom-free or re-evaluted by outpatient provider
Bacterial meningitis: causes, presentation, complications, nursing considerations
Causes: neonate (B-hemolytic strep, e. coli, +2 m.o. (Hib, strep, meningococcus)
Presentation: neonate (poor feeding, such and cry; irritability, seizures, apnea, infants (fever, poor feeding, irritability, seizures, high-pitch cry), +1 y.o. (fever, H/A, vomiting, seizures, irritability, behavior changes, resists neck flexion, petechial/purpuric rashes, septic shock
Complications: obstructive hydrocephalus, blindness, deafness, weakness/paralysis, cognitive/behavioral changes
Nursing interventions: isolation for 24 hr post-abx initiation, hydration,ventilation, monitor ICP, control seizures, treat complications
What is the difference between simple partial and complex partial seizures?
Simple: no alteration in consciousness (may have motor/ sensory/ autonomic symptoms)
Complex: involves impairment of consciousness (may have same kinds of symptoms)
What are the types of movements in generalized seizures?
Absent: brief stare (petit mal) Clonic: twitching Tonic: increased tone Tonic-clonic: convulsion--increased tone followed by twitching (grand mal) Myoclonic: muscle jump Atonic: loss of tone
