CHP 19: NEURO EMERGENCIES Flashcards
(140 cards)
1
Q
two components of central nervous system
A
brain and spinal cord
2
Q
two components of peripheral nervous system
A
spinal and peripheral nerves
3
Q
two main areas where emotions come from in the brain
A
limbic system (anger) and hypothalamus (pleasure, thirst/hunger)
4
Q
occipital lobe function
A
vision/visual memories
5
Q
parietal lobe function
A
touch/texture
6
Q
temporal lobe function
A
hearing and smell, language, sound and odor memories
7
Q
frontal lobe 2 cortexes and functions
A
motor cortex: voluntary muscle control and spatial awareness
prefrontal cortex: judgement
8
Q
limbic system function
A
basic emotions and reflexes
9
Q
diencephalon (thalamus) function
A
relay center
10
Q
diencephalon (hypothalamus)
A
emotions, temp control
11
Q
midbrain function
A
LOC, RAS (consciousness), muscle tone
12
Q
pons function
A
respiratory pattern and depth
13
Q
medulla oblongata function
A
HR, BP, RR
14
Q
cranial vs peripheral nerves
A
cranial: send info to brain
peripheral: send commands to body
15
Q
part of cell body that sends signals
A
axon
16
Q
part of cell body that receives signals
A
dendrite
17
Q
what three things does the GCS test
A
eye opening, verbal response, motor response
18
Q
what is posturing
A
abnormal body positioning that indicates damage to the brain
19
Q
decorticate vs decerebrate posturing and their GCS scores
A
decorticate: abnormal flexing (curl towards their body) - GCS of 3
decerebrate: abnormal extension (extending away from body) - GCS of 2
20
Q
in what patient do you hyperventilate
A
signs of ICP and impending herniation
21
Q
eupnea and its causes
A
normal breathing
22
Q
tachypnea and its causes
A
rapid and shallow
stimulants, exercise, lung issues
23
Q
bradypnea and its causes
A
slow rate
opioids, sedatives, alcohol
24
Q
apnea and its causes
A
absence of breathing
hypoxia, heart attack
25
hyperpnea and its causes
increased rate and depth of breathing
stimulants, OD, exercise
26
Cheyne-Stokes respirations and its causes
gradual increase in rate and depth followed by gradual decrease and periods of apnea "torsades of breathing"
pre-death pattern, brainstem injury, brain herniation
27
biot/ataxic and its causes
extremely irregular with periods of apnea
brainstem injury, ICP
28
Kussmaul and its causes
deep, gasping respirations
acidosis, diabetic ketoacidosis
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apneustic and its causes
prolonged inspiratory phase and short expiratory phase with bradypnea
brainstem injury
30
4 signs of Cushings reflex and what it indicates
decreased HR, decreased/irregular RR, increased BP, widened pulse pressure (systolic hypertension)
ICP
31
4 things that happen during shock
increased HR and RR, decreased BP, narrowed pulse pressure
32
what is anisocoria
unequal pupils greater than 1mm difference
33
two popular seizure medications
phenytoin (Dilantin) and phenobarbital (Solfoton)
34
what is ptosis and what can it indicate (2)
drooping or sagging of the eyelids
Bell palsy or stroke
35
state in which a person does not respond to verbal or painful stimuli
coma
36
difference between hallucinations and delusions
hallucinations: sensory stimulation that others cannot verify
delusions: thoughts/ideas that are not based on common reality
37
what is psychosis
patient can no longer determine what is real and what is a product of the mind
38
3 patient protective reflexes
cough, gag, and corneal
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stimulants cause pupillary _____ and depressants cause pupillary _____
dilation
constriction
40
cranial nerve 1 and its function
olfactory - smell
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cranial nerve 2 and its function
optic - vision
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cranial nerve 3 and its function
oculomotor - movement of eye, pupil, and eyelid
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cranial nerve 4 and its function
trochlear - movement of eye
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cranial nerve 5 and its function
trigeminal - chewing, pain, temp, feeling of mouth/face
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cranial nerve 6 and its function
abducens - movement of eye
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cranial nerve 7 and its function
facial - movement of face, tears, salivation and taste
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cranial nerve 8 and its function
auditory - hearing and balance
48
cranial nerve 9 and its function
glossopharyngeal - swallowing, tase, sensations in mouth and pharynx
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cranial nerve 10 and its function
vagus - sensation and movement of pharynx, larynx, thorax, and GI
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cranial nerve 11 and its function
accessory - movement of head and shoulders
51
cranial nerve 12 and its function
hypoglossal - movement of tongue
52
3 primary forms of aphasia
unable to understand speech but able to speak, unable to speak but able to understand, combination of both
53
what is hemiparesis
weakness of one side of the body
54
what is hemiplegia
paralysis on one side of the body
55
what is ataxia
alteration of person's ability to perform coordinated motions such as walking
56
what is myoclonus
rapid, jerky muscle contraction that occurs involuntarily
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what is dystonia
part of body contracts and remains contracted
58
what is a rest tremor
patient shakes while relaxed but disappears with voluntary movement
59
what is an intention tremor
patient shaking when demonstrating movement towards a target (touching nose) and increases as they get closer to target
60
what is postural tremor
occurs when a body part is placed in a position and required to maintain that position for extended period
61
tonic vs clonic activity
tonic: rigid, contracted body posture
clonic: rhythmic contraction and relaxation
62
what is paresthesia
sensation of numbness or tingling
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what is anesthesia
patient can feel nothing within a body part
64
American Stroke Association recommends stroke alert be activated in onset time of symptoms is less than how many hours
4.5
65
what is the backup drug if you cannot obtain IV access for dextrose
glucagon
66
what is the normal cerebral perfusion pressure (CPP) range
70-90 mmHg
67
what is multifactorial
diseases or conditions caused by more than one factor
68
sudden neurologic conditions are usually caused by what two things
emboli or aneurysms
69
two basic types of strokes
ischemic (occlusive) and hemorrhagic
70
which type of stroke is self-limiting and why
ischemic - only tissue distal to the block can be affected
71
which type of stroke has the hallmark "worst headache of my life"
hemorrhagic
72
normal ICP range in adults
10-15 mmHg
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what is herniation
movement of a structure from its normal location into another space
74
what is the large opening at the inferior portion of the skull through which the spinal cord exits
foramen magnum
75
the three large vessels for a large vessel occlusion
basilar, internal carotid terminus, middle cerebral artery
76
what is agnosia
inability to identify people or objects
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what is apraxia
inability to perform purposeful actions
78
what is the BE-FAST mnemonic
to assess for stroke
balance, eyesight, face, arms, speech, time
79
fibrinolytics needs to be administered within how many hours of onset for ischemic strokes
3-4.5 hours
80
what medication should be withheld from stroke patients
aspirin (can help ischemic but harm hemorrhagic, no way to tell difference in the field)
81
what are TIAs
transient ischemic attacks - episodes of cerebral ischemia that do not inflict permanent damage, many resolve within 1 hour
82
what three features are used to classify seizures
where it began in brain, patient's level of consciousness during seizure, motor symptoms/features associated with seizure
83
generalized vs focal seizures
generalized: involve both sides of brain and affect awareness
focal: begin on one side of brain and awareness may remain intact
84
what is nystagmus
involuntary, rhythmic eye movement
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6 steps of seizures
LOC, tonic phase, hypertonic phase, clonic phase, post seizure, postictal phase
86
what is a nonmotor seizure
"petit mal" brief changes in awareness and little/no movement, common in children
87
stroke vs seizure prodromal signs and symptoms
stroke: headache
seizure: odd taste in mouth, seeing lights/hearing sounds, twitching
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stroke vs seizure activity during event
stroke: muscle weakness often on one side
seizure: generalized body movement that typically stops within 12 mins
89
stroke vs seizure response after event
stroke: may completely resolve, may have no change, may worsen
seizure: slow return of orientation
90
how is status epilepticus defined
seizure lasting longer than 4-5 minutes or consecutive seizures without return of consciousness
91
what is the most common cause of syncope in younger adults
vasovagal syncope in response to fear, stress, or pain
92
what are prodromes
signs or symptoms that precede a disease or condition
93
causes of muscle tension headaches and how they're characterized
stress, high cortisol levels, depression which cause tension in face and head
dull ache and stiffness
94
causes of migraine headaches and how they're characterized
minor instability in clusters of neurons and changes in size of blood vessels at base of brain
throbbing, nausea, photophobia
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cause of cluster headaches and how they're characterized
serotonin and histamine levels accompanied by anxiety
pain around one eye lasting 30-45mins
96
cause of sinus headaches and how they're characterized
inflammation or infection of sinus cavities
worst on waking, increases when patient bends over, accompanied with sore throat/nasal discharge
97
Alzheimer disease cause and presentation
cause: neuronal death from plaque buildup in brain
presentation: chronic memory loss, decrease in judgement
98
Pick disease cause and presentation
cause: damage to neurons in frontal/temporal lobes
presentation: socially inappropriate behavior, rest tremors
99
Huntington disease cause and presentation
cause: genetic disorder marked by severe loss of neurons
presentation: tics, irritability, memory loss, difficulty standing
100
Creutzfeldt-Jakob disease cause and presentation
cause: proteins clump together with resultant death of neurons
presentation: myoclonic jerking, cognitive deterioration, unstable gait
101
Wernicke encephalopathy cause and presentation
cause: thiamine deficiency from malnutrition or chronic alcoholism
presentation: ataxia, confusion, agitation, weakness, peripheral neuopathy
102
AIDS dementia cause and presentation
cause: HIV and destruction of nervous system cells
presentation: impaired memory loss, progresses to paralysis, mutism, vegetative state
103
what is neoplasm
growths within body serving no useful purpose from cellular reproduction errors
104
what is metastasis
process which cancerous cells move to sites distant from their origin site
105
common symptoms of spinal tumors
back pain, weakness, ataxia, loss of limb sensation, deformity along spine
106
what are demyelinating disorders
occur after damage is done to myelin sheath and prevents smooth signal transmission from neuron to neuron
107
what are degenerating disorders
progressive damage/death of neurons
108
what are motor disorders
destruction of motor neurons
109
what is MS
multiple sclerosis - autoimmune condition in which body attacks myelin of the brain and spinal cord
110
what is Lhermitte sign
electric sensation down the spine or extremities when head is flexed forward
111
what is Guillain-Barre syndrome
tingling and weakness that starts in legs and moves up to eventual paralysis
112
what causes Parkinson disease
damage to substantia nigra (area of brain responsive for production of dopamine)
113
four characteristics of classic Parkinson presentation
tremors, postural instability, rigidity, bradykinesia
114
what is bradykinesia
shuffle in straight line with feet close together, taking small steps to turn
115
what is aphagia
difficulty swallowing
116
what does ALS effect
voluntary motor neurons
117
acoustic neuroma - nerve effected and presentation
VIII and VII - unilateral hearing loss, headache, facial numbness, balance issues
118
bell palsy S/S
eyelid ptosis, facial droop, excessive salivation, loss of taste
119
glossopharyngeal neuralgia - nerve effected and presentation
IX - severe, unilateral pain in the tongue, throat, and middle ear
120
hemifacial spasm - nerve effected and presentation
VII - involuntary unilateral facial movements
121
Meniere disease - nerve effected and presentation
VIII - spontaneous unilateral tinnitus, dizziness, hearing loss, fullness in the ear
122
Trigeminal neuralgia - nerve effected and presentation
V - stabbing pain on one side of face
123
what medication can provide relief from vertigo
benzos
124
what type of medications can cause secondary dystonia
antipsychotics
125
what is spasmodic torticollis
neck muscles contract, twisting head to one side and pulling it forward/backward
126
what is oculogyric crisis
deviation of eyes in any direction
127
what is oromandibular dystonia
contractions of face, tongue in and out of mouth
128
what is blepharospasm
eyelid spasms/blinking
129
what is athetosis
slow writhing in face and distal extremities
130
what is upper limb dystonia
cramping of hands, elbows, arms
131
what is choreiform movements
quick jerky irregular movements in face, arms, and hands
132
what is spasmodic dysphonia
involuntary contraction of vocal cords
133
what is encephalitis
inflammation of the brain
134
what is meningitis
inflammation of the meninges
135
presentation of encephalitis
fever, headache, nausea/vomiting - personality changes, stiff neck, confusion, photophobia, lethary, confusion, seizure
136
presentation of bacterial meningitis
upper respiratory infection - headache, fever, chills, Kernig sign, Brudzinski sign, ICP
(peds - high-pitched cry and bulging fontanelles)
137
key presentation difference in viral meningitis vs bacterial
viral meningitis does not have ICP
138
how is poliomyelitis transmitted
viral infection through fecal-oral route
139
what is peripheral neuropathy and most common form
nerves leaving spinal cord are damaged, causing distorted signals
diabetic neuropathy
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