Seminar 10 Advanced neuro assessment

Question 1

What are the components of a pupil assessment

Answer 1

remember PERRLA
Pupils
Equal
Round
Reactive to Light
Accommodation

Question 2

what is pupil accommodation

Answer 2

do the pupils dilate when focusing on a distant object and constrict when focusing on an object up close

Question 3

what is unilateral pupil dilation

Answer 3

When the two pupils are unequal in size

Question 4

how many pairs of spinal nerves are there

Answer 4

31

Question 5

how many dermatomes are there

Answer 5

30

Question 6

how many cervical dermatomes are there

Answer 6

there are 7 cervical dermatomes

Question 7

how many thoracic dermatomes are there

Answer 7

there are 12 thoracic dermatomes

Question 8

how many lumbar dermatomes are there

Answer 8

there are 5 lumbar dermatomes

Question 9

how many sacral dermatomes are there

Answer 9

5 sacral dermatomes

Question 10

how many coccygeal dermatomes are there

Answer 10

1 coccygeal

Question 11

what is ataxia

Answer 11

means without coordination

Question 12

what kind of deficits would a person have if they had a right brain stroke

Answer 12

-impaired judgment with impulsive behaviour
-tends to deny or minimize problems
-spatial-perceptual deficits

Question 13

what kind of deficits would a person have if they had a left brain stroke

Answer 13

-aphasia
-slow performance of tasks and cautious

Question 14

what does FAST-VAN stand for

Answer 14

Face
Arms
Speech
Time
Vision (right or left gaze)
Aphasia
Neglect (do they ignore the left side of their body)

Question 15

What 3 key features are seizure classifications based on

Answer 15

1. where the seizure begins in the brain
2. The level of awareness during the seizure
3. anything else that the patient does during the seizure ie spasms/movements

Question 16

What is a focal seizure

Answer 16

onset is in one area on one side of the brain

Question 17

what is a generalized seizure

Answer 17

involves both sides of the brain at onset

Question 18

what is a focal to bilateral seizure

Answer 18

starts on one side of the brain and spreads to both sides

Question 19

what is the prodromal phase of a seizure

Answer 19

The preceding signs before a seizure (headache, confusion, behaviour changes)

Question 20

What is the early ictal/aural phase

Answer 20

sensory warning ie changes in vision, auditory sensations

Question 21

what is the ictal phase of a seizure

Answer 21

the time where the actual seizure is occurring so there may be loss of awareness repeated movements

Question 22

what is the postictal phase of a seizure

Answer 22

the seizure has stopped and the patient is recovering from the seizure

Question 23

what is status epilepticus

Answer 23

a state of constant seizure or when seizures occur is rapid succession

Question 24

what is the maximum amount of time you should apply suction for

Answer 24

10-15 seconds

Question 25

how long should you allow a patient to rest between suctionings

Answer 25

30 sec-1 min

Question 26

how does alcohol create CNS depression

Answer 26

alcohol inhibits the excitatory receptors and and enhances the inhibitory GABA receptors

Question 27

what does the acronym cage stand for and what is it used to determine

Answer 27

-Felt like you need to CUT down on alcohol
-have people ANNOYED you by criticizing you’re drinking
-Have you ever felt GUILTY about your drinking
-Have you ever had an EYE opener drink (drink in the morning)

Question 28

what does CIWA stand for

Answer 28

Clinical Institute Withdrawal Assessment of Alcohol Scale

Question 29

symptoms of alcohol withdrawal typically start how long after someones last drink

Answer 29

usually start 6-12 hrs after someone’s last drink

Question 30

when someone is in alcohol withdrawal when are they most likely to have a seizure

Answer 30

seizures usually occur 12-48 hrs after someone’s last drink

Question 31

what is delirium tremens

Answer 31

the most severe effect of alcohol withdrawal manifested by widespread confusion and activation of the sympathetic NS

Question 32

when does delirium tremens usually start in someone with alcohol withdrawal

Answer 32

usually starts 48-72 hours after last drink

Question 33

what is the major sign of delirium tremens

Answer 33

Global confusion and disorientation

Question 34

what is the kindling phenomenon

Answer 34

when someone has recurring episodes of alcohol withdrawal each episode will get more severe and the pt will become more likely to experience seizures and delirium tremens

Question 35

Why are alcoholics more likely to contract beriberi and why

Answer 35

sine drinking excessive amounts of alcohol can create malabsorption of Vit B1

Question 36

what system does dry Beriberi affect

Answer 36

affects the CNS

Question 37

what system does wet Beriberi affect

Answer 37

effects the heart and the circulatory system

Question 38

what are common labs and diagnostics to monitor for AWS

Answer 38

-Glucose (Alcohol use can cause hyperglycemia)
-ECG (chronic alcohol use can damage the heart)
-CBC/electrolytes (due to risk of dehydration and malnutrition)
-Liver tests
-Lipase (since this is secreted by the pancreas and alcohol can damage the pancreas)

Question 39

what is a tonic clonic seizure

Answer 39

a seizure that involves both tonic (stiffening) and clonic (twitching/jerking) phases of muscle activity

Question 40

can a tonic clonic seizure result from a focal or generalized seizure

Answer 40

can result from both types of seizures

Question 41

what is the function of thiamine in the body

Answer 41

enables the body to metabolize and use carbohydrates for energy

Question 42

what is nystagmus

Answer 42

when the PT’s eyes make repetitive uncontrolled movements

Question 43

since diazepam can cause severe sedation in older adults what should be administered instead

Answer 43

Lorazepam

Question 44

how long are alcohol withdrawal orders good for

Answer 44

5 days