Test 3: Neurological

Question 1

What percentage does each component of the head make up?

Answer 1

Brain: 80%
Blood: 10%
CSF: 10%

Question 2

Name the 3 coverings of the brain.

Answer 2

Dura Mater
Arachnoid
Pia Mater

Question 3

Where is the CSF found?

Answer 3

between the arachnoid and pia mater

Question 4

What percentage does the brain make up in infancy? In adults?

Answer 4

Infants: 15%
Adults: 3%

Question 5

Name the 7 primitive reflexes:

Answer 5

1) moro
2) walking
3) plantar
4) babinski
5) galant
6) rooting
7) tonic

Question 6

What is the moro reflex?

Answer 6

startle

“Don’t startle me no moro”!

Question 7

What is the walking reflex?

Answer 7

stepping

Question 8

What is the plantar reflex?

Answer 8

stroke foot and toes curl

Question 9

What is the Babinski reflex?

Answer 9

stroke side of feet and toes fan out

Question 10

What is the galant reflex?

Answer 10

infant swings to the side that is stroked

Question 11

What is the rooting reflex?

Answer 11

turning head to side looking for food

Question 12

What is the tonic neck reflex?

Answer 12

fencing

Question 13

When one component of the skull expands (brain, CSF, blood), what happens to the other ones?

Answer 13

The other areas must increase or the skull will start to expand to accommodate the pressure

Question 14

Who handles increased ICP better - adults or infants?

Answer 14

Infants, b/c their skull can expand due to unfused sutures

Question 15

Signs of ICP?

Answer 15

• 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)

Question 16

What are 4 LATE signs of ICP?

Answer 16

• Cushing’s Triad
• Bradycardia
• Increased BP
• Irregular breathing

Question 17

What is Cushing’s Triad? What does it signify?

Answer 17

It is a LATE sign of ICP

• bradycardia
• high BP
• slow breathing

Question 18

What are the 5 levels of consciousness?

Answer 18

1) lethargy
2) obtunded
3) stupor
4) coma
5) persistent vegetative state (PVS)

Question 19

What is seen in lethargy?

Answer 19

falls asleep quickly

Question 20

What is seen in the obtunded level?

Answer 20

arousable with stimulation

Question 21

What is seen in stupor?

Answer 21

Deep sleep

Responds to vigorous, repeated stimulation

Question 22

What is seen in coma?

Answer 22

no response or decerebrate posturing to pain

Question 23

What is seen in PVC?

Answer 23

eyes open, limbs spastic, no words, some swallow

Question 24

What is “posturing”?

Answer 24

elicited by painful stimuli or herniation

Question 25

What is “decorticate” posturing?

Answer 25

turn in toward the spinal cord

cerebral cortex/above brainstem

Question 26

What is “decerebrate” posturing?

Answer 26

limbs turn out

midbrain or brainstem

Question 27

Which reflexes are normal for babies but abnormal for older children?

Answer 27

Moro
Tonic
Withdrawal

Question 28

What methods are used to diagnose the severity of head injuries?

Answer 28

• Glucose, electrolytes, BUN
• Drug testing
• Lumbar puncture
• Blood cultures
• Lead levels
• EEG
• CT
• MRI

Question 29

What meds are used to treat ICP?

Answer 29

Mannitol (decrease fluid)

Steroids (decrease inflammation)

Question 30

Which is the last sense to be lost with coma?

Answer 30

hearing