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IDC Stuff > Neuro Review > Flashcards

Neuro Review Flashcards

1
Q

How many cranial nerves are there?

A

12

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2
Q

How many spinal nerves are there?

A

31

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3
Q

What are specialized cells that monitor changes in the internal and external enviroment?

A

Sensory Receptors

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4
Q

What is a small mass of nervous tissue consisting of neuronal cells bodies in the PNS?

A

Ganglia

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5
Q

What are the 3 basic functions of the nervous system?

A

Sensory (afferent)
Integrative (information process)
Motor (efferent)

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6
Q

What are the two types of cells that make up the nervous tissues? What do they provide?

A

Neurons- Unique functions

Neuroglia - support, nourishment and protection of neurons

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7
Q

What are the parts of the cell body?

A

Cell body
Dendrites
Axon
Axon Terminals

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8
Q

What are Structural Classes of Neurons?

A

Multipolar
Bipolar
Unipolar

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9
Q

What neuron class has several dendrites and one axon? Most common type in the brain and spinal cord.

A

Multipolar

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10
Q

What neuron class has one dendrite and one axon?

A

Bipolar

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11
Q

What neuron class has a fused dendrite and axon? Sensory neuron of spinal nerves

A

Unipolar

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12
Q

What neuron class is this?

A

Bipolar

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13
Q

What neuron class is this?

A

Unipolar

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14
Q

What neuron class is this?

A

Multipolar

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15
Q

What are sensory neuron functions?

A

Convey impulses into the CNS

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16
Q

What are motor neuron functions?

A

Convey impulses from CNS through PNS to muscles or glands

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17
Q

What are interneurons (integrative) neuron functions? Where are they located?

A

Transmit impulses between neurons (sensory and motor)

Located within CNS

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18
Q

What neuron cell is responsible for support, nourishment and protection. Critical for homeostasis of interstitial fluid around neurons?

A

Neuroglia

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19
Q

What are the types of neuroglia?

A 
Astrocytes
Oligodendrocytes
Microglia
Ependymal
Schwann
Satellite
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20
Q

What neuroglia types are found in the CNS?

A

Astrocytes
Oligodendrocytes
Microglia
Ependymal

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21
Q

What neuroglia are found in the PNS?

A

Schwann and Satellite

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22
Q

Which neuroglia form the blood brain barrier?

A

Astrocytes

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23
Q

Which neuroglia produce myelin in the CNS?

A

Oligodendrocytes

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24
Q

Which neuroglia protect CNS cells from disease?

A

Microglia

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25
Q

Which neuroglia form CSF in the ventricles?

A

Ependymal

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26
Q

Which neuroglia produces myelin in the PNS?

A

Schwann

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27
Q

Which neuroglia support cells in PNS ganglia?

A

Satellite

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28
Q

What are gaps in the myelin along the axon?

A

Nodes of Ranvier

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29
Q

What are the two types of collection of nervous tissues?

A

Ganglion

Nucleus

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30
Q

What collection of neuronal cell bodies are found in the PNS?

A

Ganglia

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31
Q

What collection of neuronal cell bodies are found in the CNS?

A

Nucleus

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32
Q

What are the type of axon bundles?

A

Nerve

Tract

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33
Q

What are a bundles of axons found in the PNS?

A

Nerve

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34
Q

What are a bundle of axons found in the CNS?

A

Tract

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35
Q

What are the two matters that make up the spinal cord and brain?

A

White and grey matter

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36
Q

Which matter contains primarily myelinated axons?

A

White matter

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37
Q

Which matter contains cell bodies, dendrites, unmyelinated axons, axon terminals and neuroglia?

A

Grey matter

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38
Q

Where is the white and grey matter located in the spinal cord?

A

White matter surrounds a centrally located grey matter (H or butterfly)

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39
Q

Where is the white and grey matter in the brain?

A

Grey matter in thin cortex that surrounds the white matter.

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40
Q

What is action potential?

A

Communication between neurons

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41
Q

What are required to enact action potential?

A

A resting membrane potential

Ion Channels

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42
Q

What is a charge difference across cell membrane (polarization)?

A

Resting membrane potential

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43
Q

What allows ions to move by diffusion from high to low concentration?

A

Ion Channels

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44
Q

What are the two types of ion channels?

A

Leakage

Gate

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45
Q

What is the process of the initial event or stimulus?

A
  1. Resting membrane triggered to become more permeable to Na+
  2. Na+ entering reaches threshold
  3. An action potential arises(all or nothing response)
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46
Q

What is the threshold required for action potential?

A

-55 mv

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47
Q

What are the 2 main phases of action potential?

A

Depolarizing and repolarizing

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48
Q

What action potential phase is when enough Na+ enters a cell and membrane potential rises and becomes positive?

A

Depolarizing

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49
Q

What action potential phase is when enough K+ leave a cell and the membrane potential is returned to a resting value?

A

Repolarization

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50
Q

What action potential phase is (-70 ~ 0 ~ +30 mv)

A

Depolarizing

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51
Q

What action potential phase is (+30 ~ 0 ~ -70 mv)

A

Repolarization

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52
Q

What are the two types of nerve impulse conductions?

A

Continuous

Saltatory

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53
Q

Which type of conduction is the slower form associated with unmyelinated axons.

A

Continuous

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54
Q

Which type of conduction is fast associated with myelinated axons, Nodes of Ranvier that allow impulses to leap?

A

Saltatory

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55
Q

What is synaptic transmission?

A

Communication from neurons to other neurons or effectors

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56
Q

What are the main components of synapse?

A

Presynaptic neuron
Synaptic cleft
Postsynaptic neuron

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57
Q

What component of synapse is the sending neuron and releases neurotransmitters?

A

Presynaptic neuron

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58
Q

what is the space between neurons in the synaptic transmission?

A

Synaptic cleft

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59
Q

What is the receiving neuron that has receptors that bind to the neurotransmitter?

A

Postsynaptic neuron

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60
Q

In the presynaptic neuron, increased Ca2+ concentration causes what to happen?

A

Exocytosis

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61
Q

What is released into the synaptic cleft after exocytosis?

A

Neurotransmitters

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62
Q

Neurotransmitters act as a chemical trigger open ion channels in what?

A

Postsynaptic neuron

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63
Q

Neurotransmitters are removed from the cleft how?

A

Diffusion
Destruction by enzymes
Reuptake into presynaptic cell

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64
Q

What are the types of neurotransmitters?

A 
Acetylcholine
Amino Acids
Modified amino acids
Neuropeptides
Nitric oxide
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65
Q

Neurotransmitters bind to what in the postsynaptic neuron

A

Ligand-gated channels

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66
Q

What are forms of acetylcholine neurotransmitters?

A

Stimulatory (skeletal)

Inhibitory (cardiac)

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67
Q

What are examples of amino acids?

A

Glutamate
Aspartate
gamma aminobutyric acid (GABA)
Glycine

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68
Q

What are examples of modified amino acids?

A

Norepinephrine
Dopamine
Serotonin

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69
Q

What are the two systems of the nervous tissue?

A

Central Nervous System

Peripheral Nervous System

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70
Q

What nervous system is responsible for thoughts, emotions and memories?

A

Central Nervous System

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71
Q

What are the subcategories of the Peripheral Nervous System?

A

Somatic
Autonomic
Enteric

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72
Q

Sensory neurons of the SNS do what?

A

Convey info to CNS from head, body wall, limbs and special senses

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73
Q

Motor neurons in the SNS do what?

A

Conduct impulses to the skeletal muscles (voluntary control)

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74
Q

Sensory neurons of the ANS do what?

A

Convey information from visceral organs to the CNS

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75
Q

Motor Neurons of the ANS do what?

A

Conduction impulses to smooth/cardiac muscles and glands (involuntary control)

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76
Q

Autonomic Nervous System motor neurons are divided into what two subcategories?

A

Sympathetic and Parasympathetic

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77
Q

What subcategory of the ANS motor neurons is for fight or flight?

A

Sympathetic

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78
Q

What subcategory of the ANS motor neurons is rest and digest?

A

Parasympathetic

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79
Q

The Enteric Nervous System is known as what?

A

Brain of the gut

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80
Q

Sensory neurons of the ENS do what?

A

Monitor chemical change in the GI tract and stretching of walls

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81
Q

Motor neurons of the ENS do what?

A

regulate contractions, acid secretion and endocrine cell secretions

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82
Q

Enteric Nervous System is an involuntary or voluntary control?

A

Involuntary

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83
Q

What are the structures that protect the spinal cord?

A

Vertebral Column
Vertebral Ligaments
Meninges
Cerebrospinal Fluid

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84
Q

What are the three layers of connective tissue that make up the meninges

A

Dura
Arachnoid
Pia

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85
Q

Which layer of the meninges is the outer layer and is a tough dense connective tissue?

A

Dura mater

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86
Q

What layer is the middle layer of the meninges, resembles a spider web and extends into the subarachnoid space?

A

Arachnoid mater

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87
Q

What layer of the meninges is thin and delicate that adheres to the spinal cord and the brain and contains blood vessels?

A

Pia mater

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88
Q

What is the space between the arachnoid and pia matter that is filled with CSF?

A

Subarachnoid space

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89
Q

What space is between the vertebra and (above) dura mater that is made up of fat and helps with cushioning and protection?

A

Epidural space

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90
Q

The spinal cord is on average what length?

A

16-18 inches

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91
Q

The spinal cord extends from the ___________ to the ____________.

A

Medulla oblongata

Second Lumbar vertebra (L2)

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92
Q

What are the two grooves in the spinal cord that divide it into hemispheres?

A

Anterior median fissure

Posterior median sulcus

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93
Q

The spinal cord has how many spinal nerves?

A

31 pairs

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94
Q

What are roots in the spinal cord? What are the different roots?

A

Two bundles of axons that connect each spinal nerve to to a segment of the cord.

Posterior and Anterior

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95
Q

Posterior spinal roots contain what?

A

Sensory axons which conduct nerve impulse from sensory receptors to into the CNS

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96
Q

Anterior spinal roots contain what?

A

Motor neurons (autonomic and somatic) which conduct nerve impulses from the CNS to effectors.

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97
Q

What are the plexuses that make up the spinal cord?

A

Cervical (C1-C5)
Brachial (C5-T1)
Lumbar (L1-L4)
Sacral (L4-S4)

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98
Q

What are the main functions of white matter in the spinal cord?

A

A tract that serves as highways for nerve impulses

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99
Q

What are the main functions of grey matter in the spinal cord?

A

Receives and integrates incoming and outgoing information and is a site for integration of reflexes.

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100
Q

Grey matter is subdivided into what?

A

Left and Right regions called horns that are relative to their location (anterior, lateral and posterior)

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101
Q

The posterior grey horn does what

A

contains cell bodies and axons of interneurons as well as axons of incoming sensory neurons.

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102
Q

The anterior grey horn contains

A

cell bodies of somatic motor neurons that provide impulses for contraction of muscles.

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103
Q

The lateral grey horn is only present where? And contains what?

A

Thoracic and upper lumbar segments

Contains cell bodies of the autonomic motor neuron that regulates cardiac/smooth muscle and glands.

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104
Q

White matter consists of two tracks, what are they?

A

Sensory and Motor

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105
Q

Sensory tracts direction is

A

ascending, spinothalamic tract

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106
Q

Motor tracts direction is

A

descending, corticospinal tract

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107
Q

Spinal nerves are a part of what nervous system?

A

Peripheral Nervous System

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108
Q

What is the breakdown of the spinal nerves?

A 
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccyx
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109
Q

What root does sensory information go through the spinal cord?

A

Dorsal root

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110
Q

What root does motor information go through in the spinal cord?

A

anterior root

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111
Q

What are the spinal nerve layers

A

Endoneurium (wraps axons)
Fascicles (bundle of axons)
Perineurium (wraps Fascicles)
Epineurium (wraps Perineuriums of multiple fascicles or the entire spinal nerve)

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112
Q

Cervical plexus supplies what areas

A

posterior head, neck, upper shoulder and diaphragm.

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113
Q

Brachial plexus supplies what?

A

Upper limbs, some neck and shoulder muscles

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114
Q

Lumbar plexus supplies what

A

abdominal wall, external genitals and parts of the lower limb

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115
Q

Sacral plexus supplies what

A

Buttocks, perineum and most of the lower limbs

116
Q

Brain protections is done by what parts?

A 
Cranium 
Meninges
- Dura
- Arachnoid
- Pia
117
Q

The brain is supplied with blood from what structure?

A

Circle of willis

118
Q

The circle of willis consists of what structures

A

Internal carotids
Vertebral artery
Anterior/posterior communicating arteries

119
Q

The brain consist of what percent of the body’s weight and requires how much of the body’s oxygen supply?

A

2% of weight

20% of oxygen

120
Q

Infarction happens when

A

the brain is deprived of oxygen for 4 or more minutes.

121
Q

What lipid soluble materials are able to pass into the blood brain barrier?

A

O2
CO2
Alcohol
Anesthesia

122
Q

What type of fluids cushions the brain

A

Cerebrospinal Fluid

123
Q

Where does CSF circulate

A

subarachnoid space, central canal and ventricles of the brain

124
Q

Where is CSF produced?

A

Choroid plexuses

125
Q

Where is CSF reabsorbed?

A

arachnoid villi

126
Q

What are the major parts of the brain?

A

Brain stem
Diencephalon
Cerebellum
Cerebrum

127
Q

What does the brain stem contain?

A

medulla oblongata
pons
midbrain

128
Q

Where does the medulla oblongata lie on the brain stem?

A

inferior aspect

129
Q

What does the diencephalon contain

A

thalamus
hypothalamus
pineal gland

130
Q

Where does the cerebellum lie and what are it’s functions?

A

posterior and inferior to the cerebrum

balance, equilibrium and coordination

131
Q

What is the largest, most superior part of the brain?

A

Cerebrum

132
Q

Medullary rhythmicity areas that regulate breathing are located in

A

medulla oblongata grey matter

133
Q

posterior medulla oblongata nuclei are associated with

A

touch
pressure
vibration
proprioception

134
Q

Medulla oblongata contains nuclei associated with which cranial nerves?

A

VIII-XII

135
Q

What is part of the brain stem is known as the bridge and connects the right and left sides of the brain?

A

Pons

136
Q

The pons contain nuclei associated with which cranial nerves?

A

V-VIII

137
Q

What part of the brain stem connects the pons to the diencephalon?

A

Midbrain

138
Q

The midbrain consists of what parts

A

Cerebral peduncles
Substantia nigra
red nuclei

139
Q

The midbrain contains nuclei associated with which cranial nerves?

A

III-IV

140
Q

What part of the diencephalon has major sensory relay center, contributes to motor functions and plays a role in consciousness?

A

Thalamus

141
Q

What part of the diencephalon is responsible for homeostasis?

A

Hypothalamus

142
Q

What part of the diencephalon is a part of the endocrine system and is responsible for the secretion of melatonin and sets the body’s biological clock?

A

Pineal gland

143
Q

The cerebellar cortex is what type of matter?

A

Grey matter

144
Q

What is the structure in the brain that has a tree like appearance of white and grey nuclei?

A

Cerebellum

145
Q

What part of the brain receives a wide range of sensory inputs and compares actual movements to intended ones?

A

Cerebellum

146
Q

What divides the cerebrum into right and left cerebral hemispheres?

A

longitudinal fissure

147
Q

What part of the cerebrum connects the right and left hemispheres?

A

Corpus Callosum

148
Q

What 3 areas comprise the basal ganglia?

A

Globus pallidus
putamen
Caudate nucleus

149
Q

What does the basal ganglia assist with

A

motor control, emotions, behavior, executive function

150
Q

The folds of the cerebrum are called

A

Gyri or gyrus

151
Q

The shallow grooves of the cerebrum are called

A

sulci or sulcus

152
Q

Each cerebrum hemisphere has how many lobes?

A

4

153
Q

The 4 lobes of each cerebrum hemisphere are

A

frontal
parietal
temporal
occipital

154
Q

The central sulcus separates the frontal and parietal lobes is the divide between what

A

precentral gyrus

postcentral gyrus

155
Q

The precentral gyrus is the primary area for what?

A

motor

156
Q

The postcentral gyrus is the primary area for

A

somatosensory area

157
Q

Posterior to the primary somatosensory area areas do what

A

store memories of past sensory experiences

158
Q

Premotor areas do what

A

generate nerve impulses causing a specific group of muscles to contract in specific sequence.

159
Q

What is a ring structure on the inner border of the cerebrum and floor of the diencephalon?

A

Limbic system

160
Q

The limbic system is referred to as the __________ as it plays a role in the pain, pleasure, anger, affection and behavior?

A

emotional brain

161
Q

IRT to the brain and body, lateralization means

A

one side of the brain controls the other side of the body

162
Q

All sensory and motor pathways cross where

A

CNS

163
Q

The left hemisphere of the brain is responsible for what type of skills?

A

language
numerical
scientific
reasoning

164
Q

the right hemisphere of the brain is responsible for what type of skills?

A

spatial and pattern recognition
emotional content of language
generating images of sight, sound, taste and smell

165
Q

Somatic Nervous System Pathways

A

Sensory and Motor

166
Q

What nervous system is voluntary, it’s motor pathway has one neuron from CNS to effector and releases ACH neurotransmitter?

A

Somatic Nervous System

167
Q

What are the three neurons in the somatic sensory pathway?

A

Cell body #1 in dorsal root ganglion
Cell body #2 in the spinal cord or brainstem
Cell body #3 in the thalamus to post central gyrus

168
Q

What are two examples of a somatic sensory pathway

A

Posterior column- medial lemniscus pathway
Spinothalamic Pathway
-Lateral spinothalamic tract
-Anterior

169
Q

The medial lemniscus pathway senses what

A

touch
pressure
vibration
conscious proprioception

170
Q

The anterior spinothalamic pathway senses

A

Light touch, deep pressure

171
Q

The lateral spinothalamic pathways senses

A

pain sensation and temperature sensation

172
Q

The Somatic Motor pathways signals come from

A

Upper motor neurons
basal ganglia
cerebellum
sensory neurons or interneurons via reflexes

173
Q

What corticospinal tract pathway neuron originates in the primary motor cortex and synapes with a lower motor neuron of appropriate spinal level?

A

Upper motor neuron

174
Q

What corticospinal tract pathway neuron exits the spinal ventral root to the muscle for movement

A

Lower Motor Neuron

175
Q

What nervous system is an unconscious/involuntary system with two divisions that controls viscera and releases norepinephrine and acetylcholine?

A

Autonomic Nervous System

176
Q

What are the two divisions of the autonomic nervous system?

A

Sympathetic and Parasympathetic

177
Q

What is the motor pathway of the ANS

A

Series of two neurons from CNS to the effector

178
Q

what is dual innervation?

A

Most viscera supplied with nerves of both symp and parasymp divisions

179
Q

Sympathetic and Parasympathetic have what effects in contrast to each other?

A

Antagonistic

180
Q

How does the sympathetic and parasympathetic effect Heart rate?

A

S- stimulates

P- inhibits

181
Q

How does the sympathetic and parasympathetic effect Digestive organs?

A

S- inhibits

P- Stimulates

182
Q

What two motor neurons does the ANS pathway have?

A

Preganglionic and postganglionic

183
Q

Preganglionic path is

A

neuron from CNS to neuron in autonomic ganglion

184
Q

Post ganglionic path is

A

from cell body in ganglion to effector

185
Q

Where do sympathetic preganglionic nerves reside?

A

cell bodies in the lateral grey horn of spinal cord segments T1-L2.

186
Q

What is often referred to as the thoracolumbar division?

A

Sympathetic preganglionic neurons in the T1-L2

187
Q

What is the path of the sympathetic preganglionic neurons

A

axons emerge from spinal cord via anterior root and pass through ventral roots of spinal nerves

188
Q

Where does most synapse occur with postganglionic neurons?

A

sympathetic trunk ganglion

189
Q

How many post ganglionic neuron cell bodies can synapse with a single preganglionic axon?

A

20 or more

190
Q

What are the abdominal arteries the prevertebral ganglia follow along?

A

celiac
superior mesenteric
inferior mesenteric

191
Q

Parasympathetic preganglionic neurons cell bodies are located where?

A

Brainstem - CN III, VII, IX, X

Spinal cord - S2-S4

192
Q

What nerves carry 80% of all parasympathetic nerve impulses?

A

Vagus

193
Q

Where do parasympathetic post ganglionic neurons reside?

A

terminal ganglia

194
Q

Parasympathetic nerves cause what kind of effects?

A

precise, localized

195
Q

What are the sympathetic effects on the autonomic nervous system?

A 
FIGHT OR FLIGHT
increase HR, contraction and BP
dilate pupils and airways
Dilate vessels to muscles, heart, liver and adipose tissue
Constrict vessels to nonessential organs
Mobilize nutrients for energy
196
Q

What is the parasympathetic effect on the autonomic nervous system?

A

SLUDD

Salivation
Lacrimation
Urination
Defecation
Digestion
197
Q

What are the types of Headaches

A 
Tension 
Cluster
Migraine
Post Traumatic HA
Medication Overuse
198
Q

What headache is bilateral, often daily, described as vice like and may present with hypertonicity of neck muscles

A

Tension

199
Q

What is the treatment of tension HAs?

A

NSAIDS

Tylenol

200
Q

What HAs usually affect middle aged men, present with unilateral pain around the temple/eye, occur in 15-3 hours episodes and horner’s syndrome?

A

Cluster

201
Q

What is horner’s syndrome?

A

ptosis
miosis
anhidrosis

202
Q

What is the treatment for cluster HAs?

A

Oxygen 100% 15 mins
SubQ sumatriptan 6mg, 12 mg in 24 hr period
Oral zolmitirptan 2.5mg, 10mg in 24 hr period

203
Q

What HAs have a gradual buildup of throbbing HA, last several hours, may have Aura, associated with nausea and vomiting and family history?

A

Migraine

204
Q

Treatment for migraine

A 
rest in dark area
Analgesic/NSAID
Sumatriptan
-oral, 25/50/100 mg 
-subQ, 6mg up to 12 in 24hrs
Zolmitriptan
-2.5mg up to 10 in 24 hrs
205
Q

What are some migraine prophylaxis? What indicates use?

A 
Needed when migraines occur 2-3 times per month
Antihypertensives
-Propanolol- 40mg - 160mg
Antidepressants
-Amitryptyline 10mg - 20-50mg
Anticonvulsants
-Topiramate 100-200mg/day
Symptomatic treatment
-Antiemetic-promethazine 12.5-25mg q4-6h
206
Q

What is the pathophysiology of a seizure?

A

An abnormal, excessive, hypersynchronous discharge from an aggregate of CNS neurons

207
Q

What type of seizure is identified by how much cortical involvement occurs?

A

Partial or focal seizure

208
Q

What type of focal seizures are there?

A

Focal w/ and w/o impaired awareness

209
Q

What is the difference between focal w/ and w/o impaired awareness?

A

Patient appears to be awake but not in contact with others, does not respond normally and has no recollection of what occurred during seizure with impaired awareness.

210
Q

What automatisms may a patient exhibit during a focal seizure?

A 
Facial grimacing
Gesturing
Lip smacking
Chewing
Repeating words or phrases
211
Q

Generalized Seizures involve how much of the brain?

A

Entire brain

212
Q

What is the most common type of generalized seizure?

A

tonic-clonic seizure (grand mal)

213
Q

What does tonic mean?

A

Muscle stiffening

214
Q

What does clonic mean?

A

Rhythmic jerking

215
Q

What are other types of generalized seizures?

A

absent
clonic
atonic (w/o tone)

216
Q

What is the phase after a seizure that the patient is somnolence, confused with HAs, no recollection and Todd’s paralysis?

A

Postictal Phase

217
Q

What is Todd’s paraylsis?

A

Weakness of the limbs

218
Q

What is the only definitive way to diagnosis a seizure?

A

Video EEG

219
Q

Treatment of Seizure

A

First aid

  • Clear area
  • maintain airway
  • Start IV
  • Blood work

Diazepam 5mg IV/IM Q5-10M, do not exceed 30mg

Medevac

220
Q

What is a condition that a single seizure last greater than 5 mins or 2 or more seizures during the postictal phase?

A

Status eplilepticus

221
Q

What is a condition that a single seizure last greater than 5 mins or 2 or more seizures during the postictal phase?

A

Status eplilepticus

222
Q

What is the treatment for status eplilepticus?

A

Diazepam 5mg IM/IV Q5-10m, do not exceed 30mg
Valproic acid 30mg/kg
Correct possible underlying issue
Intubate

223
Q

What are the two major branches of internal carotid arteries?

A

Anterior and middle cerebral artery

224
Q

Two verterbral arteries fuse to become _______ that create the __________.

A

Basilar Artery

Vertebral-basilar arteries

225
Q

What are the two types of strokes?

A

Hemorrhagic

Ischemic

226
Q

What are the two types of Ischemic Strokes?

A

Transient ischemic attack (TIA)

Cerebral Vascular Accident (CVA)

227
Q

What is an acute neurologic injury that occurs in the result of interrupted blood flow to the brain?

A

Stroke

228
Q

What type of stroke is caused by a ruptured blood vessel causing bleeding into the brain and lack of cerebral blood flow?

A

Hemorrhagic

229
Q

What type of stroke is from a blockage of a blood vessel causing lack of cerebral blood flow?

A

Ischemic

230
Q

What are the percentages of types of strokes?

A

80% ischemic, 20% hemorrhagic

231
Q

What are the subtypes of Ischemic Strokes?

A

Thrombotic
Embolic
Systemic hypoperfusion

232
Q

What stroke is caused by and obstruction of an artery due to a blockage that forms in the vessel? (atherosclerosis)

A

Thrombotic

233
Q

What type of stroke is caused by and obstruction of an artery due to a blockage from debris that has broken off from a distal area?

A

Embolic

234
Q

What type of stroke is caused by a lack of brain flow due to decreased systemic blood flow? (hypovolemia)

A

Systemic hypoperfusion

235
Q

What is defined as a transient episode of neurologic dysfunction caused by focal brain, spinal cord or retinal ischemia without acute infarction and may be reversible?

A

Transient Ischemic Attack (TIA)

236
Q

What is defined as a neurologic dysfunction caused by focal brain, spinal cord or retinal ischemia with infarction of central nervous system tissue?

A

Cerebral Vascular Accident

237
Q

What is the only way to determine TIA vs CVA?

A

MRI

238
Q

What is the FASTER mneumonic?

A

Face-drooping or numbness on one side
Arms- one limb being weaker or more numb
Stability- steadiness on feet
Talking- slurring, garbled, nonsensical words,
Eyes- visual changes
React- MEDEVAC immediately, note time of symptoms

239
Q

What are two subtypes of hemorrhagic or intracranial hemorrhagic stroke (ICH)

A

Intracerebral Hemorrhage

Subarachnoid hemorrhage

240
Q

What are the initial interventions for ischemic stroke?

A

Maintain oxygenation > 94%

Elevate head to 30 degrees

241
Q

When should you lower blood pressure for a stroke patient?

A

Only if Bp is 220/120, lower by 15%.

242
Q

What drug is given to stroke patients to reduce BP?

A

Labetalol

10-20mg IV, same or double dose every 10-20 mins, max is 150mg

243
Q

What medication may be given with MO guidance?

A

Aspirin 325mg

244
Q

What is the hallmark symptom of restless leg syndrome?

A

unpleasant or uncomfortable urge to move legs that is transiently relieved with movement, usually deep sensation.

245
Q

What is the treatment for restless leg syndrome?

A

Ferrous Sulfate, after labs
325mg x3 day for 3-6 months

Avoid aggravating drugs/substances
Increase exercise
Leg massages

246
Q

At what Glasgow Coma Scale must you intubate?

A

Less than 8, intubate

247
Q

What is a reversal for opioids?

A

Naloxone IV, IM, SubQ

.4-2mg repeat doses 2-3 mins

248
Q

What is the most common type of cranial trauma?

A

Linear fracture (75%)

249
Q

What cranial trauma injury has a high likelihood of infection?

A

Open fracture

250
Q

What are the thin areas of the skull susceptible to fractures?

A

Temporal

Nasal Sinuses

251
Q

What are signs of a basilar skull fracture?

A

Battle signs
raccoon eyes
hemotympanum
CSF rhino/otorrhea

252
Q

What is cushings triad?

A

Bradycardia
Hypertension
Respiratory irregularity

253
Q

What can be given for osmotic therapy in a patient with ICP

A

Mannitol 1g/1kg IV

7.5% hypertonic NaCl 250 bolus

254
Q

What occurs in 85% of patients with a skull fracture?

A

Arterial injury, usually middle meningeal artery

255
Q

What is a classic presentation of an epidural hemorrhage?

A

Immediate LOC, lucid interval

256
Q

What is the clinical presentation for subdural hematoma?

A

Acute presents in 1-2 days

Chronic -15 days or more

257
Q

What is the clinical presentation of a Subarachnoid Hemorrhage?

A

Thunder Clap

Nucal rigidity

258
Q

What are the mortality rates for the types of hematomas?

A

subdural - 60%

subarachnoid-51 %

259
Q

What are the most common reasons for a spinal cord injury?

A

MVA 47%
Falls 23%
Violence 14%
Sports 9%

260
Q

Treatment of spinal cord injury?

A

ABCs
C-Spine
Foley if bladder paralysis
Sedate if needed

261
Q

What medication may be given for spinal cord injury with MO consult?

A

Methylprednisolone 125mg IM/IV Q4-6H prn

262
Q

What is the NEXUS Criteria (NSAID)

A 
Used to determine need for x-ray
N-focal neurological deficit
S-Midline spinal tenderness
A-Altered mental status
I-Intoxicated
D-Distracting injuries
263
Q

What causes radiculopathy?

A

Lumbar disk herniation

264
Q

What are the most common disks affected in radiculopathy?

A

L5-S1 (90%)

265
Q

What is a medical emergency in herniated disk injury that could present with saddle sensation?

A

Cauda equina syndrome

266
Q

During a straight leg test, what is the sign that occurs with worsening pain with the manuever?

A

Lasegue’s Sign

267
Q

What is the clinical presentation for cauda equina?

A

Pain/n/t in lower back, down 1 or both legs
foot drop
bowel/bladder control
problems with sex

268
Q

What can cause cauda equina?

A

Herniated disk
Infection or inflammation
Cancer
Spinal Stenosis

269
Q

What is the treatment for carpal tunnel syndrome?

A

Modify hand activity, affected wrist in splint for up to 3 months.
Steroids or NSAIDs
Refer is sxs persist more than 3 months

270
Q

What are the test for carpal tunnel syndrome?

A

Tinel’s

Phalan’s

271
Q

What is the lower motor neuron CN affected in Bell’s palsy?

A

VII

272
Q

What is the clinical presentation of bell’s palsy?

A

Abrupt onset of unilateral face paralysis
ipsilateral restriction of eye closure
tearing or eye dryness
bell’s phenomenon

273
Q

What is the difference between bell’s palsy and stroke?

A

Stroke-no paralysis of the forehead

274
Q

Treatment of bell’s palsy

A

Protect/lubricate eye
Steroid-Prednisone 60mg x7 days then taper 5 days
Antiviral-Valacyclovir 1000mg 3x/day x7 days

275
Q

What are the possible etiologies of Meningitis?

A

Bacterial
Fungal
Spirochete

276
Q

What are common bacterial etiologies for meningitis?

A

Streptococcus pneumonia
Neisseria Meningitides
Listeria Monocytogenes

277
Q

What are common viral etiologies for meningitis

A

enterovirus
herpes simplex virus
West nile virus

278
Q

Differential between meningitis and encephalitis?

A

Meningitis-cerebral function usually intact

Encephalitis-usually associated with AMS

279
Q

Two test for meningitis

A

Brudzinski

Kernig

280
Q

What is the treatment of meningitis?

A

Ceftriaxone 2g IV Q12H
Vanc
Dexamethasone .15mg/kg IV Q6H
Acyclovir for HSV suspect

281
Q

Meningitis contact prophylaxis treatement?

A

Ciprofloxacin 500mg X1

282
Q

What are the types of chronic pain?

A

Nociceptive
Neuropathic
Centralized

283
Q

What are the stages of Nonrapid eye movement (NREM) sleep?

A

1 light
2 less aware, deeper
3 deepest sleep stage

284
Q

What are medication treatments for insomnia?

A

Melatonin 3-5mg PO
Trazodone 50mg po
Vistaril 25-50 mg po
Diphenhydramine 25-50 mg po

285
Q

What are the two types of vertigo?

A

Peripheral

Central

286
Q

Which type of vertigo is associated with tinnitus and hearing loss?

A

Peripheral

287
Q

What is the test that will help determine peripheral vs central vertigo?

A

Dix Halpike

IDC Stuff (67 decks)

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