Chapter 18

Question 1

two functioning components for remaining conscious

Answer 1

intact reticular activating system and at least one cerebral hemisphere

Question 2

Reticular activating system

Answer 2

a network of nerve cells in the brainstem that constantly transmit environmental and sensory stimuli to and from the cerebrum.

Question 3

coma

Answer 3

An unconscious state in which the patient does not respond to painful stimuli

Question 4

structural causes of AMS

Answer 4

Brain tumor

Hemorrhage in the cranium but outside of the brain

Hemorrhage in the brain tissue

Direct brain tissue damage from trauma to the brain

Degenerative disease of the brain

Brain abscess or infection

Question 5

toxic metabolic causes of AMS

Answer 5

Severe hypoxia or anoxia (reduced oxygen or no oxygen)

Abnormal blood glucose conditions (high blood glucose or low blood glucose)

Liver failure

Kidney failure

Poisoning (e.g., carbon monoxide, cyanide)

Question 6

other cause of AMS

Answer 6

shock

drugs that depress CNS

Post Seizure

infection

Cardiac rhythm disturbance

stroke

Question 7

s/s of ams associated with trauma

Answer 7

obvious signs of trauma

Abnormal respiratory pattern

Increased or decreased heart rate

Unequal pupils

High or low blood pressure

Battle’s Sign (discoloration behind the ears—late sign)

Raccoon eyes (discoloration around the eyes—late sign)

Pale, cool, moist skin

decorticate posturing or decerebate posturing

Question 8

s/s of AMS with non trauma

Answer 8

Abnormal respiratory pattern

Dry or moist skin

Cool or hot skin

Pinpoint, midsize, dilated, or unequal pupils

Stiff neck

Lacerations to the tongue indicating seizure activity

High systolic blood pressure and low heart rate

Loss of bowel or bladder control

Abnormally high or abnormally low blood glucose reading

Question 9

what is AEIOU-TIPPS used for?

Answer 9

used to easily recall possible causes of altered mental status

Question 10

AEIOU-TIPPS

Answer 10

alcohol intoxication
epilepsy (seizure)
insulin (diabetic)
oxygen (hypoxia)
Uremia (kidney failure)
Trauma
Infection
Psychiatric
Poisoning
Shock

Question 11

neurologic deficit

Answer 11

any deficiency in the functioning of the brain or nervous system. Altered mental status, slurred or absent speech, paralysis, weakness, and numbness are all signs and symptoms of neurologic deficit.

Question 12

stroke

Answer 12

sudden disruption in blood flow to the brain that results in brain cell damage

Question 13

FAST is used for?

Answer 13

identifying stroke

Question 14

FAST

Answer 14

Facial Droop
Arm weakness
Speech difficulty
Time last known to be well

Question 15

LAMS (los angeles motor Scale)

Answer 15

Facial Droop 0-1
arm drift 0-2
speech 0-1
grip 0-2

total 0-6, 4 or above needs more advanced treatment

Question 16

ischemic penumbra

Answer 16

The area of ischemia during the stroke, where the brain cells are electrically silent from a lack of ATP but are still alive

Question 17

infarct zone

Answer 17

area of dead tissue caused by absence of blood flow

Question 18

ischemic stroke

Answer 18

stroke caused by clot blocking blood to brain most common 87 percent of all strokes

Question 19

hemorrhagic stroke

Answer 19

caused by rupture of blood vessel in the brain that allows blood to leak and collect in/around brain tissue
responsible for 13 percent of strokes

Question 20

thrombotic stroke

Answer 20

caused by stationary clot that forms in and blocks cerebral artery

Question 21

cerebral embolism

Answer 21

embolus lodges in cerebral artery

Question 22

embolic stroke

Answer 22

stroke caused from embolus lodging in cerebral artery

Question 23

atrial fibrillation

Answer 23

irregularly irregular heart rhythm highly associated with cerebral embolism

Question 24

hemorrhagic stroke two types of weakened vessels

Answer 24

aneurysm, AVM

Question 25

arteriovenous malformation

Answer 25

tangle of abnormally formed blood vessels in the brain or on its surface, which divert blood directly from the artery to the vein, bypassing the capillaries

Question 26

Hemorrhagic Stroke with Bleeding in Brain Tissue (Intracerebral) s/s

Answer 26

Headache Nausea and vomiting Weakness to one side of the body Decreased level of consciousness

Question 27

Hemorrhagic Stroke with Bleeding in the Subarachnoid Space (Subarachnoid)

Answer 27

Worst headache Intolerance to light Vomiting Decreased level of consciousness

Question 28

categories of stroke

Answer 28

anterior circulation posterior circulation

Question 29

anterior circulation stroke

Answer 29

occurs from the blockage of a cerebral artery that perfuses the cerebrum and cerebral cortex. The cerebrum is composed of the right and left hemispheres of the brain. The anterior circulation vessels perfuse approximately four-fifths of the brain.

Question 30

anterior circulation stroke s/s

Answer 30

 Weakness, clumsiness, heaviness, or complete paralysis of the hand, arm, leg or face on one side of the body (unilateral) numbness tingling, loss of sensation on one side of the body language disturbance: aphasia Total or partial loss of vision in one eye (monocular blindness) might occur. The patient might also describe his vision disturbance as a dropped curtain, fog, or a grayout or blackout. eye gaze, eye looks toward side of stroke

Question 31

aphasia

Answer 31

difficulty speaking/understanding speech

Question 32

expressive aphasia

Answer 32

knowledge of what you want to say, but cant say it

Question 33

receptive aphasia

Answer 33

difficulty understanding what is said to you

Question 34

global aphasia

Answer 34

cant understand or speak, most severe form of aphasia

Question 35

posterior circulation stroke s/s

Answer 35

Weakness, clumsiness, heaviness, or complete paralysis of the hand, arm, leg, or face on one (unilateral) or both (bilateral) sides numbness, tingling, or loss of sensation can occur to the hand, arm, leg, or face on the right, left, or both sides of the body language disturbance: dysarthria might complain of double vision (diplopia) or bouncing or moving visual objects vertigo or ataxia

Question 36

dysarthria

Answer 36

slurred or difficult-to-understand speech caused by weakness or paralysis of the muscles used to form words.

Question 37

posterior circulation stroke

Answer 37

one-fifth of the brain; however, it is responsible for supplying blood to the brainstem and cerebellum.

Question 38

ataxia

Answer 38

loss of coordination

Question 39

vertigo

Answer 39

spinning sensation

Question 40

Transient Ischemic Attack (TIA)

Answer 40

"mini Stroke" brief episode of stroke like symptoms typically disappears with in minutes but can last up to an hour,

Question 41

cryptogenic stroke

Answer 41

one that cannot be conclusively attributed to an embolism originating from the heart, thrombosis in an artery, or small artery disease despite extensive medical diagnostic testing.

Question 42

vascular headache

Answer 42

occur because of dilation or distention of vessels or inflammation within the cranium

Question 43

migraine

Answer 43

thought to be caused by spasm of vessels followed by vasodilation and a change in the chemicals that transmit nervous impulses in the brain. Migraines are often described as throbbing and can be generalized or localized to one side of the head. commonly experiences sensitivity to light (photosensitivity), nausea, vomiting, and sweating

Question 44

cluster headache

Answer 44

occur repetitively, in clusters. They are similar to migraines because they are believed to have a vascular origin. The pain is usually found on only one side of the head or face in the temporal region or around the eye and is excruciating. might also complain of excessive tear production on the side of the pain, nasal congestion or runny nose (rhinorrhea), and nausea

Question 45

tension headaches

Answer 45

thought to be caused by contraction of the muscles of the neck and scalp. The pain is usually described as “tight” or “viselike.” This is the most common type of recurring headache found in children, adolescents, and adults

Question 46

organic headaches

Answer 46

Also called traction or inflammatory headaches, these are not simply headache conditions but rather are symptoms of another condition. They may be a result of tumors, infection, stroke, or inflammatory disorders within the cranium such as a hemorrhage or meningitis.

Question 47

A&O x0-4

Answer 47

Alert to self, place, time and event