Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Academy > The Nervous System and Altered Mental Status > Flashcards

The Nervous System and Altered Mental Status Flashcards

1
Q

4 Functions of the nervous system

A

Motor
Senstation
Regulation
Cognitive and intregative functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Functionality of the nervous system includes what two types of nervous system?

A

Somatic (voluntary)

Autonomic (involuntary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Voluntary Nervous system

A

Somatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Involuntary nervous system

A

Autonomic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The autonomic nervous system includes the ___ and ____ systems

A

Sympathetic and parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CSF is produced in the ____ of the brain

A

ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Large vessels run where?

A

Between the dura and the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CSF drains out through ducts to the _____

A

Subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The largest part of the brain. Made up of two hemispheres.

A

Cerebrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Flip flop of the signals from the hemispheres that occurs in the spinal cord

A

Contralaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ribbon like strip of tissue that runs on the underside of the cerebrum. Allows the hemispheres to “chat.” Neural pathways between the left and right hemispheres.

A

Corpus callosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Frontal lobe is responsible for:

A

Personality, behavior, higher thought, executive function, speech, certain motor functions, intellect, emotion, “what makes you, you.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The ____ is in the frontal lobe and takes more time to develop than the rest of the brain. Why teenagers may not make good decisions.

A

Pre-frontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The parietal lobe is responsible for:

A

Sensory response (except sight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The occipital lobe is responsible for:

A

Vision, language, coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The _____ allows information from the right eye to go to the left brain and visa vera. Allows for depth perception and shading. In the occupital lobe.

A

Optic and chiasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The temporal lobe is responsible for:

A

Hearing, smell, memory, language coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The cerebellum is responsible for:

A

Position, balance, coordination (proprioception)
Muscle memory
Pathways between hemispheres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Proprioception

A

Positioning. Comes from eyes, inner ears and sometimes joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where is the cerebellum?

A

Posterior, inferior aspect of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The diencephalon is where? And contains what?

A

On the top of the brainstem
Thalamus
Hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Information from the spinal cord goes through here. A type of spinal relay

A

Thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The hypothalmus is responsible for:

A

Homeostasis; hormones; emotions
Takes nerve impulses and starts interpreting them
Endocrine gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Connects the hemispheres (communicates via the corpus callosium)
Sensory processing
Reflexes
LOC

A

Midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Respiration, pathways to cord, coordinates with cerebrum

A

Pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Vital functions
Vasomotor center
Cardiac Center
DRG, VRG

A

Medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The Reticular activating system contains what two nerves? What are their functions?

A

Excitatory nerves-wakefulness,

Inhibitatory nerves-sleepiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

To have consciousness, need to have:

A

Intact RAS and one functioning hemisphere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The brain needs a constant supply of:

A

O2 and glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Blood vessels that bring nutrients and blood to the brain. Run on underside of right and left hemispheres

A

Circle of Willis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The circle of willis creates____

A

Redundancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What artery in the circle of willis is where “shit can go bad” if there is a blockage?

A

Basilar artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Arteries in the circle of willis

A 
2 internal carotid 
2 anterior cerebral
2 vertebral
1 basilar
2 posterior cerebral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Spinal nerve ends where?

A

Mid lumbar area

Around L2/L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Nerves that exit distal to the end of the spinal nerve (L2/L3) are the _____

A

Cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

C
T
L
S

A

C=7
T=12
L=5
S=5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When the spinal root exits the spinal cord it becomes:

A

Spinal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Point of attachment for the vertebrae?

A

Transverse process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Communication in the nerve roots occurs via

A

electrical and chemical changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Sensory nerves that send information to the CNS

A

Afferent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sends information from the CNS out

A

Efferent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Dermatomes

A

Each spinal layer corresponds to a particular level of motor and sensory function. This can give us an guessimtate about where you may be affected in your brain based upon what is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q 
Dermatomes corresponding to:
C7
T4
T10
L4-L5
S2-S3
A 
Index finger
Nipple line
Umbilicus
Medial and lateral lower leg
Genitals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cervical nerves innervate what?

A

Everything from the clavicles up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cervical nerve that is the major parasympathetic player in the body?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

The autonomic nervous system regulates:

A 
Heart rate
Breathing rate
Blood pressure
Body temperature
Organ functions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Mental status assumption

A

If someone is altered, assume that normally is alter and oriented unless someone tells us otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Altered mental status: subjective terms

A

Lethargy: Sleepy, sluggish, easily aroused
Stupor: Decreased responsiveness, noxious stimulus
Semi coma: Unresponsive, noxious stimulus
Coma: Unresponsive, unarousable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Glasgow Coma Scale: Eye opening

A

Alert
Verbal
Painful
Unresponsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Glasgow Coma Scale: Speech

A 
Oriented (who, what, where, when, why)
Confused 
Inappropiate
Incoherent
None
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Glasgow Coma Scale: Motor function

A 
Obedience
Purposeful
Withdrawel
Flexion (decorticate)
Extension (decerebrate)
None
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The Glasgow Coma Scale, unlike subjective terms is____. Why is used to evaluate altered mental status.

A

quantifable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Flexion (decorticate) and extension (decerebrate) indicate____

A

Brain injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Under what number is the glascow coma scale concerning?

A

8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Structural causes and indicators of an altered mental status

A

Usually rapid/sudden onset

Usually present asymmetrically or signs are focal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Metabolic causes and indicators of an altered mental status

A

Gradual onset

Signs are generalized and symmetric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Altered mental status causes

A 
Alcohol (M), acidosis (M)
Environmental (M) , epilepsy (S)
Infection (M)
Overdose (M)
Urema (M)
Trauma (S)
Insulin (M)
Psychogenic (M)
Stroke(S)
58
Q

Constriction of pupils may be a result of:

A

Cholinergics
Pontine bleed
Opoid overdose

59
Q

Types of strokes

A

Occulsive Event
Hemorrhagic event
Transient event

60
Q

____ of strokes are occulsive events

____ of strokes are hemorrhagic events

A

80-85%

15-20%

61
Q

Adjacent parts of the brain control ____ of the body

A

Adjacent

62
Q

Risk factors for a stroke

A 
Atrial fibrillation
Smoking
Hypertension
Stimulants
High cholesteral
Age-Arterioscelerosis 
Diabetes
Dialysis (b/c prone to hypertension, may throw clots)
Sickle Cell
63
Q

Of the occulsive events, ____ of those will be thrombic

and ___ of those will be the result of embolus

A

60%

40%

64
Q

Narrowing of the cerebral arteries

A

Thrombosis

65
Q

Thrombosis

A

Narrowing of the cerebral arteries

66
Q

Is there typically pain and seizure associated with thrombosis?

A

No, gradual narrowing

67
Q

Sudden occulusion of the cerebral artery from a clot

A

Embolus

68
Q

ELVIS

A

Emergent Large Vessle Ischemic Stroke

69
Q

Why is a first time seizure in an adult concerning?

A

The seizure may be due to a CVA-occulsive event resulting from an embolus

70
Q

Why do embolus result in seizures?

A

Because sudden occlusions result in an electrical activity issue

71
Q

Clots for CVA embolus result from

A

Carotid artery, heart (from left side)
Fat (maybe from a long bone fracture)
Tumor
Air (diver)

72
Q

Onset and signs of CVA-embolus

A

Rapid onset, seizures common

73
Q

Ischemic tissue that is not dead

A

Penumbra

74
Q

Clot busting drugs that dissolve clots

A

Thrombolytics

75
Q

Window for thrombolytics

A

5-6 hours

76
Q

Vessels that result from gradual narrowing of the cerebral vessels due to Thrombosis

A

Collateral vessels

77
Q

Cautious about giving O2 for CVA because of a potential:

A

re-perfusion injury

78
Q

Increasing ICP is associated with a ____ event not a ____ event

A

Hemorrhagic

Occulsive

79
Q

CVA, hemorrhagic event that results from a ruptured vessel

A

Aneurysm

80
Q

An aneurysm can evolve overtime as a consequence of ____. Aso can be a result of a congential issue called ____

A

Abteriovenous malformation

81
Q

Weakened wall of the artery. Like a balloon

A

Aneurysm

82
Q

Ruptured vessel in the Intracerebral space versus subararachnoid space

A

Intracerebral is within the brain tissue. Subarachnoid is in the subarachnoid space

83
Q

Which is worse, a ruptured vessel in the intracerebral space or subararachnoid space

A

Intracerebral space

84
Q

A hemorrhagic event signs:

A

Sudden onset
Evolving focal signs
Severe headache-“thunderclap”

85
Q

Signs of ICP:

A

Unequal pupils (ipsilateral pupil)
Posture-decorticate, decerebrate
Seizure
Cushing’s response (hypertension, bradycardia, cheynes stokes respirations)

86
Q

Unequal pupil

A

Ipsilateral pupil

87
Q

Signs and systems similar to a cerebral vascular accident, but resolves within 24 hours of onset. Warning sign of things to come.

A

Transient ischemic Attack

88
Q

Etiology of a TIA

A

Plaque, embolus, spasm

89
Q

RIND and what it is associated with

A

Reversible ischemic neurologic deficit

TIA

90
Q

Signs and symptoms of a CVA

A 
Aphasia (random words)
Dysarthria (slurred speech)
Facial droop
Dysphagia (difficulting swallowing)
Sensorium (changes are unilateral-visual changes, tactile changes, hearing in one ear)
Hemi or mono plegia or paresis involving the grip or gait
Neglect 
Balance (vertigo)
91
Q

Why may a stroke patient’s balance be affected?

A

The cerebellum is affected

92
Q

Random words

A

Aphasia

93
Q

Slurred speech

A

Dysarthria

94
Q

Difficulty swallowing

A

Dysphagia

95
Q

Inflammation of the facial nerves. Unable to raise eyebrow or furrow forehead

A

Bell’s Palsy

96
Q

What position do you want to put a stroke patient in if they cannot manage secretions?

A

Lateral recumbent

97
Q

FAST ED can help determine if there is a ____

A

Large Vessel Occulsive (LVO) stroke

98
Q

LVO can have what type of intervention?

A

Surgical

99
Q

Large Vessel Occulsions

A

Middle cerebral artery (MVA)
Anterior cerebral artery (ACA)
Posterior cerebral artery (PCA)
Basilar artery

100
Q

Middle cerebral artery (MCA) signs:

A 
Aphasia (left)
Neglect (right)
Hemiparesis
Deviated gase
Visual field deficit
101
Q

Anterior cerebral artery (ACA) signs:

A

Hemiparesis

102
Q

Posterior cerebral artery (PCA) signs:

A

Visual field deficit

103
Q

Basilar artery signs:

A

Vertigo (because blockage in the cerebral artery will result in blockage in the cerebellum)
Dysconjugate gaze
Coma
Respiratory changes (perfusion to pons going down as well due to blockage)

104
Q

FAST ED

A

Facial palsy: normal or minor droop=0, partial or complete droop=1
Arm weakness: Normal, no drift=0, drift/some effort=1, no effort against gravity=2
Speech deficit: normal=0, mild/moderate=1, severe asphsia=2
Time
Eye deviation: Normal/absent=0, partial=1, forced deviation=2
Denial/neglect: Normal/absent=0, extinction to bilateral stimulaneous stimulation in only 1 sensory modality=1, does not recognize own affected limb or orients only to one side=2

105
Q

Benign headaches

A

Tension headache
Migraine
Cluster headache

106
Q

Why is it important to ask about the onset of a migraine?

A

Most of the time a migraine’s onset will follow the individual’s predictable pattern. Goot to know because onset is similar to that of a stroke

107
Q

Serious headache signs/symptions

A

Fever and neckstiffness-Meningitis
Sudden onset/thunderclap
Change in mental status
Change in neurologic function/change in focal deficits
New headache, different headache
Underlying disease: HIV, cancer, pregnancy

108
Q

Why is a headache with HIV concerning?

A

Possible brain abscess due to bacterial infection

109
Q

Why is a headache with cancer concerning?

A

Space occupying lesions lead to increased pressure in the skull

110
Q

Why is a headache when pregnant concerning?

A

Hormonal changes, prone to emboli

111
Q

What is a seizure?

A

Chaotic discharge of electricity int he brain

112
Q

Presentation of a seizure:

A

Varies by where the chaotic activity in the brain is occuring-focal event

  • follows a predictable pattern for each person
  • if changes, indicates something is different and is a cause for concern
113
Q

Causes of seizures:

A 
Epilepsy-congenital 
Head injury (recent or remote)
Tumor
Hypoxia 
Hypoglyemia
Infection (abscess, meningitis)
Febrile
OD/poisons
EtOH withdrawl 
Electrolytes (hypernutremia) 
Pregnancy (eclampsya)
114
Q

Primary seizures tend to be ____. Example:

A

Idiopathetic

Epilepsy

115
Q

If an alcohalic, DT’s can start around ___ hours after your last drink

A

9

116
Q

Seizures due to a remote head injury

A

Have persistent seizures due to a head injury from the past. Scar tissue due to injury may not resolve

117
Q

Generalized seizures and sequence

A 
Involve both hemispheres of the brain, usually involve loss of posture and/or consciousness, involves the RAS
Sequence:
Aura
Loss of consciousness
Tonic-hypertonic
Convulsion
Post ictal
118
Q

Tonic seizure

A

Increased muscle tone, sudden onset, short duration (1/2 minute-minute), no LOC

119
Q

Clonic seizure

A

Alternating contraction and relaxation of muscles. LOC varies

120
Q

Myoclonic seizure

A

Sudden brief muscle spasm (when falling asleep or waking up)

121
Q

Atonic seizure

A

Sudden loss of muscle tone, “drop” seizure, no LOC

122
Q

What is the most common type of seizure?

A

Tonic and clonic or some combination

123
Q

What type of seizures generally involve the RAS?

A

Generalized, why you are unconsious

124
Q

Signs of generalized seizure

A

Loss of consciousness, oral trauma, trismus, incontinence

125
Q

Treatment of generalized seizure

A

OPA/NPA
Protect patient
High flow oxygen
Lateral recumbent (if no trauma)-left lateral is best

126
Q

Seizure where patient is “daydreaming”
Short duration
Altered mental status but no loss of posture

A

Absence, petit mal

127
Q

Absence, petit mal seizures are common in what population?

A

Children

128
Q

Simple partial, focal

A

Seizure where there is no loss of posture or consciousness. Isolated body part but seizure will begin to spread to adjacent body parts as adjacent areas in brain are affected. Jacksonian march.

129
Q

Jacksonian “march”

A

When focal event spreads to adjacent part of body. Can (rarely) jump to other hemisphere and become a generalized seizure

130
Q

Complex partial, psychomotor seizure

A

More of a behavioral component. Altered mental status. May be combative
Automatisms

131
Q

Automatisms

A

Repetitive behavior, stuck in loop

Lip smacking

132
Q

Pseudoseizure

A

Psychogenic non-epileptic seizure
Purposeful behavior
Responds to voice
Not a post ictal period, no incontinence, will not accept an OPA or hurt themselves

133
Q

Status epilepticus

A

Prolonged seizure activity (more than 5 minutes)

More than one seizure without a lucid period

134
Q

Consider what for status epilepticus

A

Aggressive airway management
Ventilation
ALS
Entry note

135
Q

Medications for seizures

A 
Dilatin (phenytoin)
Depakote
Phenobarbital
Keppra
Tegretol (Carbamazapine)
Topamax (Toperamate)
Neurontin
Lamictal (Lamotragine)
136
Q

Neuromuscular disorders

A 
Cerebral palsy
Multiple sclerosis
ALS
Muscular dystrophy
Parkinsons
137
Q

Cerebral palsy

A

Congenital-due to some abnormality of developing brain
Higher likelihood in pre-term births
Variable presentation
Variable cause; prematurity, low birth weight, intrauterine infection, placental pathology, hypoxia (during development)

138
Q

Multiple sclerosis

A 
Autoimmune demyelinating disease
Women, child bearing age, Northern European
Average 30 years old
Highly variable
Changes in symptoms in time and in place
Weakness, numbness, blindness
Progressive or intermittent
Myline sheath covers nerves, as it degenerates, ability to conduct electricity and have neuromuscular interfaces decreases
139
Q

Amyotrophic lateral sclerosis (ALS)

A 
Progressive, incurable
Weakness, muscle atrophies
Spascity, no change in sensaton
Most commonly present in 60-70s
M=W (men and women in equal proportion)
Respiratory failure, inability to swallow
Death 3-5 years after diagnosis
Muscular atropy because neuromascular junctions are not working very well
140
Q

Muscular Dystrophy

A 
Family of genetic/inherited disorders
Progressive muscle weakness
Most commonly present in childhood
M>F
Weakness (of muscle), cardiomyopathy
Death in early 20s and 30s
More prone to CHF and other cardiac events
141
Q

Parkinsons disease

A 
Some genetic genetic predispositions
Chronic progressive disease
Movement disorder 
Resting tremor
Rigidty
Slow movements
Gait distrurbance
Average age 70 year old
Neurotransmitters in brain, usually dopamine (decrease in dopamine)
Lose control of muscle group

Academy (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions