Child with Neurologic Alteration Flashcards

(37 cards)

1
Q

CNS is composed of ________

A

brain and spinal cord

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2
Q

Myelinization of the nerves begins in the ____ of gestation and is completed by ________.

A

3rd month; adolescence

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3
Q

Brain and spinal cord are covered by the _______.

A

meninges

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4
Q

CSF surrounds the _____ and ________.

A

brain and spinal cord

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5
Q

Brain consists of three sections

A

cerebrum, cerebellum and brainstem

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6
Q

There are _______ pairs of never

A

12

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7
Q

Testing of the cranial nerves can indicate ______ and _____ of CNS injury

A

location and degree

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8
Q

Auto regulation is also known as ______.

This process allows ______ to change in diameter in response to changes in _____ ______ ______.

A

self-regulation; cerebral arteries ; cerebral perfusion pressure.

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9
Q

auto regulation can be impaired by _____,______,_____.

A

trauma , ischemia and ICP

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10
Q

What is increased intracranial pressure (IICP)

A

Results in disturbance in the auto-regulation of the pressure exerted by the blood, brain, CSF, and other space-occupying fluid/mass within the CNS

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11
Q

ICP is defined as pressure sustained at _____mm hg or ____ for _____ minutes or longer

A

20; higher ; 5

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12
Q

What causes IICP?
_______ or ______ of CSF
Space occupying ____-_____,______

A

overproduction or malabsorption;
lesion-tumor, hematoma ;

infection and head trauma

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13
Q

Manifestations of IICP in infant are?

A
poor feeding or vomiting, 
irritability, restlessness or lethargy
bulging fontanel**
high-pitched cry
Increased head circumference**
separation of cranial sutures***
distended scalp veins
eyes deviated downward ***late sign
increased or decreased sings to pain ***
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14
Q

IICP manifestations for child are ?

A
Headache
diplopia
mood swings 
slurred speech
papilledema - after 48 hours 
altered LOC
N/V especially in the AM
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15
Q

Neuro Examination

GCS assesses ___,____,____

A

eye opening, verbal response and motor response.

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16
Q

GCS ranges from ___ to ____

17
Q

GCS of 15 indicates

A

no change in LOC

18
Q

a GCS of 3 indicates

A

deep coma and poor prognosis

19
Q

Neuro Exam - Behavior such as _______

A

parent’s reporting child isn’t acting like himself

20
Q

Neuro Exam - decreased response to _____ stimuli is a significant sign of alteration in level of consciousness

21
Q

Neuro Exam- pupil eval

Compression of the ____ cranial nerve, results in pupil _____ with _____ or ____ constriction

A

3rd
dilation
sluggish or absent

22
Q

Neuro Exam- Pupil Eval
a fixed _____ pupil is an ominous sign of an ____ child
other signs include ____ and ______

A

dilated ; unconscious

ptosis ; ovoid pupil

23
Q

Neuro exam Motor Function
A child with increased ICP exhibits changes in motor function. _______ movement will decrease and ____ posturing may be observed

A

purposeful ;abnormal

24
Q

Neuro exam - motor function
Flexion also known as
Plantar ______

A

decorticate posturing
** hug the upper extremities and extension of the lower extremities
flexion

25
NE- motor function extension or ______ extension of the upper extremities with _____ rotation lower extremities will ____ with _____ rotation a change from flexion to extension indicates
decerebrate posturing internal of the upper arm and wrist extend with internal of kneed and feet deterioration
26
Vital- neuro exam Cushing response _______ systolic BP with _____ pulse pressure _____cardia and a change in _______ rate and pattern. this is usually present just _____ or at the time of brain stem herniation. The body is trying to ______
increased;widened brady; respiration; before compensate this is a late sign
27
Standard terms for LOC | Full consciousness
awake, alert, oriented, interacts with environment
28
Confused
lacks ability to think clearly and rapidly
29
delirous
impairment of reality with hallucination possible
30
disoriented
lacks ability to recognize place or time or person
31
obtunded
sleeps and once aroused has limited interaction with environment
32
stupor- requires ____ to arouse
requires stimulation to arouse
33
Coma vigorous stimulation produces no _____
response
34
in child with ICP avoid ____ and position _____ with HOB elevated to ____ degrees closely monitor for ____ levels
stimulation ; midline;30 | glucose
35
fluid for ICP
NS with child with hypovolemia and osmotic diuretic (mannitol or hypertonic saline , sedation and analgesia and anticonvulsant meds. hyperventilation if there is signs of cerebral herniation
36
Spina bifida is a ______ | classified as _____ closure of the _____
congenital NTD | incomplete closure of the vertebrae
37
Spina bifida occulta | spina bifida cystica
closed in lower lumbar area