Nevrologi (AKUTTMEDISIN)

Question 1

hvorfor er skade på nervesystemet

Answer 1

vil kunne stoppe viktige kroppslige reflekser

Question 2

hva består cns av

Answer 2

hjernen og ryggmarg

Question 3

hva er trimus

Answer 3

Om luftveiene er knyttet sammen kaller man det trismus. In the unresponsive patient, trismus can indicate a seizure in progress, severe head injury, and/or cerebral hypoxia. In the case of trismus, the patient may need to be sedated/paralyzed to relax the facial muscles causing the clenched teeth, allowing you to better control the airway.

Question 4

hvordan er det med ventilering av pasienter med nevrologiske symptomer

Answer 4

Remember that routine hyperventilation of neurologic patients can be harmful. Provide hyperventilation only to those patients with documented signs of increased intracranial pressure (ICP)

Question 5

hvilke områder kontrollerer pusten?

Answer 5

Recall that the functions of breathing are controlled by the pons and the medulla oblongata

brainsteminjury kan påvirke raspirasjonsmønsteret

Question 6

hva betyr Eupnea

Answer 6

er definisjonen på normal pusting

Question 7

hva er cushing reflex

Answer 7

bt stiger, bradykardi og lav rf ved forhøyet ICP

The Cushing reflex (vasopressor response, Cushing reaction, Cushing effect, and Cushing phenomenon) is a physiological nervous system response to acute elevations of intracranial pressure (ICP), resulting in Cushing’s triad of widened pulse pressure (increasing systolic, decreasing diastolic), bradycardia, and irregular respirations.

Cushing reflex is the opposite of what typically occurs in shock, when blood pressure falls and the pulse rate and respiratory rate climb.

Question 8

hvilke to tegne kan man se ved økt ICP hos infants?

Answer 8

When you assess ICP in infants, consider the quality of the baby’s cry. As ICP increases, the pitch of the cry rises as well, until it resembles a shriek similar to that of a cat. At the same time, the shape of the pupils can change from round to more oval. These two findings are the basis of the mnemonic related to infants and ICP: “Cat’s eyes and cat’s cries.

Question 9

hvilke tre reflekser beskytter oss

Answer 9

hoste, blinke og breknignesrefleksen

SKjekke; If you tap lightly between the eyes and the patient does not blink or twitch, then assume that the patient does not have an intact cough or gag reflex and will not be able to protect the airway.

Question 10

hvordan opptrer pupillen ved adrenalin, stress og rusmidler

Answer 10

Generally speaking, stimulants cause pupillary dilation. Remember the flight-or-fight sympathetic response caused by epinephrine. If someone is trying to attack you, then you will need to see as much of your environment as possible to either defend yourself effectively or retreat. Your eyes, therefore, need as much light as possible.

Cocaine, methamphetamines, and hallucinogens also tend to cause pupil dilation. Conversely, depressants tend to constrict the pupils.

Question 11

hva kan det tyde på om pupillene er ulike?

Answer 11

økt ICP

Question 12

hva betyr anisocoria

Answer 12

at man har pupiller av ulik størrelse

Question 13

hva skjer om man har et anfall om man ber pasienten holde armene foran seg med lukkede øyne

Answer 13

Have the patient close his or her eyes and hold out the arms in front of the body at the same level. With the eyes closed, the patient’s only way to tell where his or her arms are located is from the sensations being processed by the cerebellum. If the patient has had a stroke, then one of the arms may drift away from the other

Question 14

hvilke tre faktorer er hjernen avhengig av for å fungere

Answer 14

Remember, the brain needs oxygen, glucose, and normal temperature to function.

Question 15

hva er hernering

Answer 15

Herniation is the movement of a structure from its normal location into another space. P

Question 16

hvilke reflekser kan øke icp

Answer 16

Ensure the airway is clear, but do not vigorously suction because stimulating the cough and gag reflexes will increase ICP

Question 17

hvordan er forholdet mellom ICP og puls

Answer 17

The patient may have bradycardia.

However, atropine and transcutaneous pacing are not indicated because of the systolic hypertension that accompanies the bradycardia. The ICP is causing the bradycardia, not the other way around.

Question 18

hva skjer med ICP om man reduserer CO2

Answer 18

Alternatively, a diminished(redusert) level of CO2 lowers ICP by causing vasoconstriction, decreasing blood supply to the brain. Increasing ventilation, then, decreases ICP (good) by decreasing blood supply (bad).

Question 19

hvorfor kan det være skadelig å gi 02 til pasienter med celleødleggelse

Answer 19

Oxygen is needed for cellular activity, but for patients in whom cells are being damaged and destroyed, more oxygen is not always better. After the cell membrane fails, cellular materials that were contained within that cell are able to move into the interstitial space. Some of these materials are chemicals (free radicals) that can cause damage to neighboring cells. In an oxygen-rich environment, these free radicals can increase their reactivity and “burn” hotter, causing damage or death to more neighboring cells.

Question 20

hva er en viktig årsak og risikofaktor bak slag som man kan behandle?

Answer 20

Hypertension is the number one preventable cause of strokes and TIAs.

Question 21

hva er vanlig ved absens epilepsi

Answer 21

Absenser er kortvarig bevissthetstap og kan være en form for epileptisk anfall. present with little or no movement. The typical patient with absence seizures is a child. Classically, the child will simply stop

Question 22

hvilke tre typer generaliserte anafall har man

Answer 22

GTK
absens
pnes

Question 23

hvilke to typer partiale anafall har man

Answer 23

simple

complex

Question 24

hva er forskjellen på synkope hos unge voksne og eldre voksne

Answer 24

In younger adults, the pattern is usually one of vasovagal syncope. In older adults, the more typical cause of syncope is a cardiac dysrhythmia.

Question 25

hva skjer om man mangler B1 i hjernen

Answer 25

Wernicke encephalopathy bears special mention. In this condition, the confusion and dementia are partially reversible. Remember that the brain needs vitamin B1 to metabolize sugars, so in patients suspected of being malnourished, you should administer thiamine, 100 to 200 mg IVP, before any glucose is given. In patients with a vitamin B1 deficit, giving glucose can actually cause confusion or worsen the patient’s presentation if thiamine is not present.

Question 26

hva er neoplasm?

Answer 26

Neoplasm is the medical term for growths within the body that serve no useful purpose and are caused by errors that occur during cellular reproduction.

Question 27

hvordan utvikler Guillain-Barré syndrome seg?

Answer 27

ødelegger myelinet

This rare condition is frightening for most patients. It begins as weakness and tingling sensations in the legs. This weakness moves up the legs and begins to affect the thorax and arms. The weakness can become severe and may lead to paralysis. This transition from being able to walk and speak to needing a ventilator to breathe can take as little as several hours.

Question 28

hvilken type nevron påvirker ALS

Answer 28

Because this condition impacts the motor neuron only, the patient is completely aware of his or her surroundings and the inability to move.

Question 29

hva er forskjell krystallsyken og svimmelhet:

Answer 29

forskjell krystallsyken og svimmelhet: Vertigo, which involves the cranial nerves, is the sensation that you are moving when you are not, like the feeling you had as a child rolling down a hill. It is typically caused by inner ear disease. Vertigo is not the same as dizziness. Dizziness is a sensation of lightheadedness typically related to low blood pressure in the brain.

Question 30

når kan man innen en 5d periode oppleve dystoni

Answer 30

Dystonias tend to occur within 5 days of either starting a new psychotropic medication or changing dosage.

Question 31

første symptomer meningitt

Answer 31

First signs and symptoms are upper respiratory infection (runny nose, cough, malaise).

Question 32

første symptomer encefalitt

Answer 32

First signs and symptoms are fever, headache, nausea/vomiting, and general malaise.

Question 33

hvorfor får man en abscess

Answer 33

Abscesses are caused by an infectious agent within the brain or spinal cord. When an infectious agent attacks brain or spinal cord cells and destroys tissue, the immune system responds by attempting to kill the pathogen. If it cannot, then the body’s second line of defense is to erect a “wall” to prevent the pathogen from spreading. This capsule envelops the infectious agent, as well as dead or dying brain or spinal cord cells, dead white blood cells, and white blood cells that are still fighting the infection. Over time, with continued tissue destruction and immune system response, swelling can occur. The result is an absces

Question 34

hva er den vanligste årsaken til polynevropati

Answer 34

diabetes

As the blood glucose level rises, damage can occur to the peripheral nerves. The result is misfiring and shorting of signals. Patients may have sensory or motor impairment. Loss of sensation, numbness, burning, pain, paresthesia, and muscle weakness are common. Patients may eventually have a loss of the ability to feel their feet or other areas. The condition is progressive and is accelerated by high blood glucose levels.

Question 35

når er det typisk å ta mr ved slag

Answer 35

om ma har hatt et wake up stroke, altså at man hade symptomene når man våknet, eller hvis man har slag med afasi for da klarer man ikke formidle om man har hatt symptomer i mindre enn 24t

Question 36

hva er anisokori

Answer 36

ulike størrelse på pupillene

ofte pga økt icp, har et trykk på 3. hjernenerve som har parasympatikusfibre som gjør at pupillen trekker seg sammen

Question 37

hva kan miotiske (små) øyne skyldes

Answer 37

opioider

kan og komme av sykdom på hjernestammen, da det er her kontrollen sitter

Question 38

årsak Myadrias

Answer 38

sentralstimulerende drugs, adrenalin, lite sirkulasjon i hjernen