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Complex test 2 > Acute Neuro Disorders > Flashcards

Acute Neuro Disorders Flashcards

1
Q

What is an ischemic stroke?

A

A sudden loss of function due to disruption of blood supply to that part of the brain

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2
Q

What is the cause of an ischemic stroke?

A

Plaque narrows blood vessels or an embolism

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3
Q

What is the patho of an ischemic stroke?

A

Neurons cannot maintain aerobic metabolism bc of lack of oxygen, so anaerobic metabolism causes waste to build up and neurons are lost every minute and the brain deteriorates

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4
Q

What is the clinical presentation of an ischemic stroke?

A

Numbness/Weakness on one side of the body, confusion, trouble with speech, vision and gait disturbance, sudden and severe headache, short attention span, memory loss, hostile or frustrated

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5
Q

What is hemiplegia?

A

Paralysis on one side of the body

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6
Q

What is hemiparesis?

A

Weakness on one side of the body

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7
Q

What is homonymous hemianopsia?

A

Loss of vision on one side of the vision field

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8
Q

What are signs and symptoms of an ischemic stroke on the right side of the brain?

A

Left sided weakness and vision problems, easily distracted, impulsive, lack of awareness

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9
Q

What are signs and symptoms of an ischemic stroke on the left side of the brain?

A

Right sided weakness and vision problems, aphasia, altered thinking, slow, cautious.

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10
Q

How can an ischemic stroke be prevented?

A

Control hypertension, stop smoking, healthy diet, exercise, control afib, control carotid stenosis, control diabetes, decrease lipids, and alcohol abstinence.

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11
Q

What is the treatment of an ischemic stroke?

A

TPA within three hours, coumadin for a fib, platelet inhibitors, decrease cholesterol, carotid endartectomy

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12
Q

What is a hemorrhagic stroke?

A

Intracranial bleeding into the brain tissue, cerebral aneurysm, bleeding into subarachnoid space, arteriovenous malformation, and irritation of meningies.

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13
Q

How does a hemorrhagic stroke clinically present itself?

A

bad headache, nuchal rigidity, photophobia, vomitting, LOC change, focal seizures

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14
Q

What is brudzinski’s sign?

A

When someone flexes their knees when they flex their neck

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15
Q

What is kernig’s sign?

A

When someone cant straighten their leg; tight hamstring

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16
Q

How is a hemorrhagic stroke diagnosed?

A

CT, MRI, angiography, LP for blood or infection

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17
Q

What is the treatment of a hemorrhagic stroke?

A

Maintain cerebral perfusion, oxygenate, mobility, safety, and nutrition concerns, may clip the aneurysm to prevent further bleeding.

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18
Q

What is a concussion?

A

An acute head injury that is a mild traumatic brain injury and alteration in brain metabolism.

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19
Q

What is the primary stage of a concussion?

A

The initial damage; mild traumatic injury, transiet loss of consciousness, and amnesia.

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20
Q

What is the secondary stage of a concussion?

A

Complications such as infection, bleeding, and edema from increased ICP

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21
Q

What is a diffuse axonal injury?

A

Shearing of axons of neurons that dont regrow; usually from a car accident or rotational injury. There is no connection to the brain and body, there is a poor prognosis.

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22
Q

What kind of skull fractures can occur?

A

Linear, depressed, open, or basilar.

23
Q

What are signs of a skull fracture?

A

Crepitius of the skull, deformity, and a concern for infection and neurological damage.

24
Q

What are signs of a basilar skull fracture?

A

Racoon eyes, bruising behind the ears, concern with leaking spinal fluid/running nose… direct opening to environment and brain

25
Q

What can head injuries result in?

A

cerebral hematoma, subdural bleed, epidural bleed, contusions, coup-contrecoup injury

26
Q

How does a subdural hematoma clinically present?

A

actue change in LOC, pupillary change, hemiparesis, coma, decrease HR and RR, may mimic a stroke long term

27
Q

How does an epidural hematoma clinically present?

A

a brief loss of consciousness, then lucid, then restless, acigated, and confused and then coma and death.

28
Q

How should a head injury be assessed?

A

A full neuro assessment, glascow coma scale, pupil changes may be the first sign of increase ICP

29
Q

How are head injuries diagnosed?

A

CT scan, MRI, doppler, ultrasound, EEG with stimulation to sound and light, cerebral angiography, MRI and angiography

30
Q

How are hematomas treated?

A

surgical evacuation, frequent neuro assessments, may need a drain

31
Q

How are contusions treated?

A

Prevent increase in ICP, may need long term care.

32
Q

What is the normal ICP?

A

5-15

33
Q

What can cause increased ICP?

A

increase in brain volume, increase in CSF, (hydrocephalus), cerebral blood volume increase (These 3 things are called the Monro-Kellie Doctorine)

34
Q

How does increased ICP clinically present itself?

A

A change in LOC and pupil response, wide pulse pressure, decreased HR and RR

35
Q

What can increased ICP cause?

A

Irreversible brain damage, death and herniation

36
Q

What are some devices to monitor ICP?

A

Intraventricular catheter, subarachnoid screq, epidural probe, intraparanchymal catheter

37
Q

How can increased ICP be managed?

A

Maintain oxygenation to maintain cerebral perfusion, elevate HOB, care with suctioning, calm atmosphere, sedation, tylenol for pain, osmotic diuretic, i&o, corticosteroid, dilantin

38
Q

What are some side effects of head injuries?

A

Diabetes insipidus- ADH deficiency or SIADH- excess ADH

39
Q

What are signs and treatment of diabetes insipidus?

A

extreme thirst, polyuria, dilute urine, dehydration; replace ADH, fluid volume, and give vasopressin

40
Q

What are signs of SIADH?

A

Fluid overload, little urine, cerebral swelling

41
Q

What is brain herniation?

A

When brain tissue moves from an area of high to low pressure and moves through the foramen ovale.

42
Q

What is the classic sign of brain herniation?

A

Unilateral pupils with sluggish reaction; need an emergency craniotomy

43
Q

What is brain death?

A

Irreversible cessation of brain function; no brain stem function for 24 hours without sedation and at a normal temperature.

44
Q

How is brain death diagnosed?

A

Two physicians must diagnose it with an apnea test, look at fixed pupils, angiogram with no cerebral blood flow, flat eeg, cold caloric and doll eyes test

45
Q

What is an apnea test?

A

When the patient goes off oxygen and arterial blood is drawn at 5 and 10 mins; if it is at 60 it fails the test

46
Q

What is a seizure?

A

Abnormal motor, sensory, autonomic, or psychic activity from excessive discharge of cerebral neurons; normal functioning is disrupted and parts or all of the brain may be affected.

47
Q

What can be the cause of a seizure?

A

Cerebrovascular disease, hypoxemia, alcohol, fever, tumor, hypertension, aneurysm, head injury, epilepsy.

48
Q

What are manifestations of a seizure?

A

loss of consciousness, excessive movement, behaviour, mood, and perception changes.

49
Q

How is a seizure diagnosed?

A

CT, MRI, EEG, evoked potential

50
Q

What medications can be given for a seizure?

A

Diazepam, lorazepam to stop the seizure, tegretol and dilantin

51
Q

What are some things to do when a patient is having a seizure?

A

Turn the patient on their side, protect their head, monitor their airway, give oxygen, suction, IV line

52
Q

What are cerebral lesions?

A

Space occupying lesions like hematomas, tumors, or gliomas

53
Q

What are manifestations of a cerebral lesion?

A

Headache, gait disturbance, visual impairment, personality change, altered mentation, weakness, seizure

54
Q

What is the treatment of a cerebral lesion?

A

Maintain cerebral functioning, monitor ICP, craniotomy to debulk tumor

Complex test 2 (9 decks)

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