Test 3: Neurological Flashcards
What percentage does each component of the head make up?
Brain: 80%
Blood: 10%
CSF: 10%
Name the 3 coverings of the brain.
Dura Mater
Arachnoid
Pia Mater
Where is the CSF found?
between the arachnoid and pia mater
What percentage does the brain make up in infancy? In adults?
Infants: 15%
Adults: 3%
Name the 7 primitive reflexes:
1) moro
2) walking
3) plantar
4) babinski
5) galant
6) rooting
7) tonic
What is the moro reflex?
startle
“Don’t startle me no moro”!
What is the walking reflex?
stepping
What is the plantar reflex?
stroke foot and toes curl
What is the Babinski reflex?
stroke side of feet and toes fan out
What is the galant reflex?
infant swings to the side that is stroked
What is the rooting reflex?
turning head to side looking for food
What is the tonic neck reflex?
fencing
When one component of the skull expands (brain, CSF, blood), what happens to the other ones?
The other areas must increase or the skull will start to expand to accommodate the pressure
Who handles increased ICP better - adults or infants?
Infants, b/c their skull can expand due to unfused sutures
Signs of ICP?
- Headache
- Vomiting
- Personality changes/irritability
- Fatigue
- Gait changes
- Double/blurred vision, pupils react more slowly, then dilate and become fixed
- Seizures
- Increased head circumference, bulging fontanels
- LOC (sleepy then to coma, decreased recognition of parents)
What are 4 LATE signs of ICP?
- Cushing’s Triad
- Bradycardia
- Increased BP
- Irregular breathing
What is Cushing’s Triad? What does it signify?
It is a LATE sign of ICP
- bradycardia
- high BP
- slow breathing
What are the 5 levels of consciousness?
1) lethargy
2) obtunded
3) stupor
4) coma
5) persistent vegetative state (PVS)
What is seen in lethargy?
falls asleep quickly
What is seen in the obtunded level?
arousable with stimulation
What is seen in stupor?
Deep sleep
Responds to vigorous, repeated stimulation
What is seen in coma?
no response or decerebrate posturing to pain
What is seen in PVC?
eyes open, limbs spastic, no words, some swallow
What is “posturing”?
elicited by painful stimuli or herniation
What is “decorticate” posturing?
turn in toward the spinal cord
cerebral cortex/above brainstem
What is “decerebrate” posturing?
limbs turn out
midbrain or brainstem
Which reflexes are normal for babies but abnormal for older children?
Moro
Tonic
Withdrawal
What methods are used to diagnose the severity of head injuries?
- Glucose, electrolytes, BUN
- Drug testing
- Lumbar puncture
- Blood cultures
- Lead levels
- EEG
- CT
- MRI
What meds are used to treat ICP?
Mannitol (decrease fluid)
Steroids (decrease inflammation)
Which is the last sense to be lost with coma?
hearing
