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Neuro Part 2 > Week 6.1 > Flashcards

Week 6.1 Flashcards

1
Q

Why is ammonia used to test CN I?

A

because it is a chemical irritant, doesn’t rely on olfaction to be noxious, and therefore serves as an excellent control

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2
Q

What are the afferent and efferent innervations for the corneal reflex?

A
  • afferent: CN V

- efferent: CN VII

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3
Q

If both corneal reflexes are slow, it indicates what?

A
  • ipsilateral CN V damage

- or bilateral CN VII damage

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4
Q

What is the Weber test and which is the Rinne yes?

A
  • Weber: fork is held at the vertex of the head

- Rinne: fork is held on the mastoid process

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5
Q

The gag reflex is a test of which cranial nerve?

A

CN IX

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6
Q

How can you test the vagus nerve?

A
  • listen for hoarseness

- test swallow

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7
Q

Tongue deviation is a sign of damage to what cranial nerve?

A

hypoglossal

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8
Q

If there is damage to the hypoglossal nerve, the tongue will deviate to which side?

A

the ipsilateral

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9
Q

What is the key difference between a penetrating head injury caused by a knife or bullet?

A

the bullet has a higher velocity and doubling velocity quadruples tissue damage

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10
Q

What are the five kinds of primary brain injury?

A
  • concussion
  • diffuse axonal injury
  • cranial nerve injury
  • contusion
  • laceration
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11
Q

What parts of the brain are most affected by the shearing stresses of angular acceleration?

A
  • high brainstem

- grey-white junction

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12
Q

What causes a person to lose consciousness when they experience head trauma?

A

fibers form the RAS are disrupted by the shearing stress of angular acceleration

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13
Q

Angular acceleration is a key feature of which kinds of primary brain injury?

A

concussion and diffuse axonal injury

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14
Q

What is the difference between a concussion and diffuse axonal injury?

A
  • both involve angular acceleration and shearing stress
  • if the axons are stretched but don’t tear, that’s a concussion
  • if the axons tear, that’s a diffuse axonal injury
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15
Q

How do we define concussion?

A

as a reversible traumatic paralysis of nervous function induced by biomechanics forces and defined by any change in neurologic functioning

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16
Q

What are the two most common changes in neurologic functioning associated with concussion?

A

retrograde or anterograde amnesia

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17
Q

The severity of head injury and likelihood of long-term sequelae following concussion are correlated with what?

A
  • duration of LOC

- presence of amnesia

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18
Q

What symptoms are likely to persist longest after a concussion?

A
  • headache

- difficulty concentrating

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19
Q

What are some physiologic changes that often occur at the time of a concussion?

A
  • LOC
  • loss of body tone
  • transient arrest of respiration
  • bradycardia and hypotension
  • concussive convulsion
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20
Q

Diffuse axonal injury primarily affects which brain regions?

A
  • midbrain
  • diencephalon
  • corona radiata
  • gray-white junction
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21
Q

Which cranial nerves are most susceptible to injury?

A

CN I, VII, VIII

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22
Q

Cranial nerve injury is most often associated with what sort of trauma/injury?

A

basilar skull fractures

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23
Q

CN VII injury is most strongly associated with what sort of basilar fracture?

A

one involving the transverse petrous

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24
Q

CN VII injury is most strongly associated with what sort of basilar fracture?

A

one involving the petrous pyramid

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25
Q

CN XII injury is most strongly associated with what sort of basilar fracture?

A

one involving the hypoglossal canal

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26
Q

Which ocular motor nerve is most susceptible to cranial nerve injury?

A

CN IV because it is thin and has a long course

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27
Q

The most severe sort of brain trauma is what?

A

contusion

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28
Q

Which parts of the brain are most commonly affected by contusion?

A

those that contact the rough anterior fossa and petrous pyramid

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29
Q

What are six possible secondary brain injuries?

A
  • edema
  • CSF disturbances
  • bleeding
  • herniation
  • seizures
  • infection
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30
Q

What is the Monroe-Kellie Doctrine?

A

the idea that there are three compartments in the cranium and the sum of these volumes is constant

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31
Q

What is considered normal intracranial pressure?

A

15 cm H2O

32
Q

How do we calculate cerebral perfusion pressure?

A

CPP = MAP - ICP

33
Q

What is the elastance of the cranium?

A

the idea that the cranium has lots of reserve volume and initial increases in volume are met by only small changes in pressure

34
Q

What is considered normal cerebral blood flow?

A

50 cc/100g/min

35
Q

How is cerebral blood flow auto-regulated?

A
  • changes in BP elicit changes in arteriolar diameter

- changes in pCO2 elicit changes in arteriolar diameter

36
Q

Cerebral arterioles auto-dilate in response to what two things?

A
  • diminishing BP

- increasing pCO2

37
Q

How can we decrease ICP in a patient using just blood gas?

A

hyperventilate the patient to reduce pCO2 and constrict arterioles

38
Q

TBI is usually followed by what type of edema?

A

cytotoxic

39
Q

Edema is typically seen in what time period following TBI?

A

24-72 hours

40
Q

Which kind of intracranial bleed is best tolerated?

A

epidural

41
Q

Subdural hematomas have a mortality rate of what?

A

30-90 percent

42
Q

Subdural hematomas are the result of damage to which vessels?

A

bridging veins

43
Q

Epidural hematomas are most commonly the result of damage to which vessels?

A

the middle meningeal artery following a pterion fracture

44
Q

In which populations are the incidence of epidural hematomas very low?

A

infants and the elderly

45
Q

What are the signs and symptoms of chronic subdural hematoma?

A
  • headache
  • progressive alteration in mental status
  • focal neurologic signs
46
Q

Subarachnoid hemorrhage is due to rupture of which vessels?

A

pial vessels

47
Q

Traumatic subarachnoid hemorrhages are usually located where?

A

in the basilar cisterns

48
Q

Traumatic subarachnoid hemorrhage has what time course?

A

a rapid one, minutes to hours

49
Q

How can you tell central herniation syndrome from lateral herniation syndrome?

A
  • central: bilaterally mid-size, non-reactive pupils

- lateral: unilaterally dilated, non-reactive pupil

50
Q

What is the difference between communicating and non-communicating hydrocephalus?

A

communicating involves a disruption of CSF flow somewhere outside the brain or ventricular system

51
Q

What is the primary symptom of CSF leak?

A

headache

52
Q

The primary complication of CSF leak is what?

A

infection

53
Q

What is a tension pneumocephalus?

A

a complication of CSF leak in which air is trapped in the cranium

54
Q

How are post-traumatic seizures treated?

A

with acute prophylactic anti-seizure medications for no longer than one week

55
Q

What is a subdural empyema?

A

a collection of pus in the subdural space

56
Q

What three abilities are assessed by the Glasgow coma scale?

A
  • best eye response
  • best verbal response
  • best motor response
57
Q

We begin monitoring someone’s ICP directly when what is true about their Glasgow coma score?

A

it falls below eight

58
Q

Treatment of TBI relies on what three goals?

A
  • prevent infection
  • treat seizures
  • control ICP
59
Q

How can we pharmacologically reduce ICP in a patient?

A

osmotic diuresis with mannitol

60
Q

What is external ventricular drainage?

A

an intraventricular catheter that drains CSF and monitors ICP

61
Q

What is mannitol?

A

a hyper osmotic saline solution

62
Q

What is the ecological perspective on learning?

A

the consideration of how behavior and learning function for survival

63
Q

What is behaviorism?

A

the attempt to understand behavior in terms of relationships between observable stimuli and observable responses

64
Q

What is the only example of one-trial learning?

A

food aversion

65
Q

What is operant condition?

A

a process whereby the consequences of a response increase or decrease the likelihood that the response will occur again

66
Q

What is Thorndike’s Law of Effect?

A

responses that produce a satisfying effect become more likely to occur in that same situation while responses that produce a discomforting effect become less likely

67
Q

What is the difference between positive and negative reinforcement?

A

positive means to add some reinforcement while negative means to remove something as reinforcement

68
Q

What is the difference between reinforcement an punishment?

A

reinforcement is used to increase the response while punishment is used to decrease the response

69
Q

What is the most effective reinforcement schedule?

A

variable interval

70
Q

What is a fixed ratio reinforcement schedule?

A

reinforcement every nth response

71
Q

What is the partial reinforcement effect?

A

the idea that resistance to extinction is greater following acquisition where some, but not all, response are reinforced

72
Q

What kind of reinforcement schedule is most effective in the first stages of training?

A

continuous

73
Q

What is “shaping” in the context of learning?

A

the reinforcement of successive steps toward an end goal behavior

74
Q

The opposite of generalization in conditioning is what?

A

discrimination

75
Q

What is an “extinction burst”?

A

the phenomenon whereby a behavior will increase just before it tapers off

76
Q

What is a good real life example of operant conditioning?

A

avoidance of trauma-related cues by PTSD patients

77
Q

Avoidance of trauma-related cues by PTSD patients is an example of (positive/negative) (reinforcement/punishment).

A

negative reinforcement (diminished anxiety)

Neuro Part 2 (18 decks)

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