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Neuro Part 2 > Week 8.1 > Flashcards

Week 8.1 Flashcards

1
Q

Describe the appearance of a T1 weighted brain MRI.

A

white matter is hyperintense

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2
Q

Describe the appearance of a T2 weighted brain MRI.

A

white matter is hypo intense and CSF is hyperintense

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3
Q

Describe the appearance of a FLAIR MRI.

A

white matter and CSF is hypointense

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4
Q

What is the density of water on CT?

A

0 Hounsfield units

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5
Q

What are the major risks of angiopathy?

A
  • vascular injury
  • ischemic stroke
  • intracerebral hemorrhage
  • iodinated contrast complications
  • prolonged x-ray exposure
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6
Q

What is true of all enhancing lesions?

A

they have disrupted the BBB

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7
Q

Why are CT angiograms less risky than conventional catheter angiograms?

A

because they involve a venous rather than an arterial injection

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8
Q

What are the primary risks of CT?

A
  • ionizing radiation exposure

- iodinated contrast exposure

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9
Q

What are the potential complications of iodinated contrast exposure?

A
  • allergic reaction

- nephrotoxicity

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10
Q

What is a diffusion weighted MRI?

A

One in which areas of restricted fluid diffusion appear hyperintense

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11
Q

What are the primary risks of MRI?

A
  • claustrophobia
  • long scan time
  • ferromagnetic metals can’t go through
  • gadolinium-associated sclerosing dermopathy in those with renal failure
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12
Q

An fMRI measures what?

A

changes in oxygen delivery

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13
Q

What is SPECT imaging?

A
  • single photon emission CT
  • inject a radioactive compound into the blood
  • follow it, much like an fMRI
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14
Q

How can you identify the medulla on MRI?

A

it is at the level of the cerebellum and is smaller (compared to the pons)

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15
Q

How can you identify the third ventricle on MRI?

A

it is connected to the lateral ventricles and is superior compared to the more inferior fourth ventricle

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16
Q

Name the four phases of swallowing.

A
  • preparatory
  • oral
  • pharyngeal
  • esophageal
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17
Q

The preparatory phase of swallowing involves which cranial nerves?

A

V, VII, XII

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18
Q

What does the oral phase of swallowing involve?

A

elevating the tongue to the palate and propelling the bolus into the pharynx while also closing the soft palate

19
Q

The pharyngeal phase of swallowing is initiated by what?

A

the food bolus contacting the pharynx

20
Q

What happens during the pharyngeal phase of swallowing?

A
  • vocal folds close
  • larynx elevates
  • epiglottis shuts
  • peristaltic contraction of pharyngeal constrictors
  • relaxation of the cricopharyngeus muscle (UES)
21
Q

Which brainstem nuclei mediate swallowing?

A
  • hypoglossal
  • solitary
  • ambiguous
22
Q

The pharyngeal phase of swallowing involves primarily which CN?

A

the vagus

23
Q

What is the role of the reticular formation in swallowing?

A

coordinate activity of the involved brainstem nuclei

24
Q

What is the purpose of the ambiguous nucleus in swallowing?

A

innervate branchial-derive muscles

25
Q

What is the role of CN IX in swallowing?

A

visceral afferent to help control swallowing

26
Q

The solitary nucleus plays what role in swallowing?

A

obtains sensory input to modulate swallowing

27
Q

Describe the input of corticobulbar tracts on swallowing?

A

bilateral innervation of the RAS

28
Q

What two things can cause delayed initiation of swallow reflex?

A
  • weakness of tongue

- numbers of posterior palate and pharynx

29
Q

What two things can cause nasal reflux during swallow?

A
  • weakness of palatal elevators

- weakness of upper pharyngeal constrictors

30
Q

Problems with which cranial nerve contribute most to nasal reflux during swallowing?

A

the vagus which innervates the palatal elevators and superior pharyngeal constrictors

31
Q

What two problems can lead to aspiration during swallowing?

A
  • weakness of pharyngeal and laryngeal muscles

- pharyngeal numbness

32
Q

Name three complications of dysphagia.

A
  • airway obstruction
  • aspiration pneumonia
  • poor nutrition
33
Q

Four methods for identifying dysphagia?

A
  • patient self-reporting
  • CN exam
  • bedside swallow test
  • modified barium swallow
34
Q

Signs and symptoms of dysphagia.

A
  • difficulty swallowing
  • weight loss
  • failure to finish meals
  • coughing while eating
35
Q

Problems swallowing liquids suggest what compared to problems swallowing solids.

A
  • liquids: neurologic

- solids: mechanical problem (e.g. esophageal stricture)

36
Q

Bedside swallow test is abnormal if what occurs?

A
  • coughing during or within 1 minute

- wet/hoarse quality to the person’s voice after

37
Q

What are the five dietary textures?

A
  • liquid
  • thickened liquid
  • puree
  • mechanical soft
  • regular
38
Q

What texture of food is often best for stroke patients?

A

a middle texture like puree

39
Q

Why can’t stroke patients handle liquids or solids?

A
  • liquids pose an aspiration risk

- solids are unlikely to be cleared and therefore obstruct the airway

40
Q

Name five swallowing maneuvers that can help those with dysphagia.

A
  • sit fully upright
  • chin tuck/chin up
  • head turn
  • small bites
  • double swallow
41
Q

The chin up feeding maneuver is best for who?

A

those with a weak tongue and struggling with the oral phase

42
Q

The chin tuck feeding maneuver is best for who?

A

those with weak pharyngeal muscles because it narrows the pharyngeal space

43
Q

What are the cons go NG tubes?

A
  • uncomfortable and pulled out
  • increased gastric reflux
  • increased saliva
  • interferes with airway protection

Neuro Part 2 (18 decks)

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