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NCC content Flashcards

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1
Q

what is caput succedaneum?

A

accumulation of serum above the periosteum

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2
Q

what can a caput be confused with?

A

subgaleal hemorrhage

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3
Q

what is a cephalohematoma?

A

accumulation beneath the periosteum

-not usually present right away at birth, but appears within 24 hours

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4
Q

how long can it take for a cephalohematoma to heal?

A

3 months

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5
Q

what other complications are associated with cephalohematoma?

A
  • skull fracture
  • hyperbili
  • mild anemia
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6
Q

what is a subgaleal hemorrhage?

A
  • extracranial bleed

- bleeding into the subaponeurotic space

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7
Q

what type of instrumentation is associated with a subgaleal hemorrhage?

A

vacuum-assisted delivery

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8
Q

what is a subarachnoid hemorrhage?

A

-intracranial hemorrhage (most common)
bleeding into the subarachnoid space from ruptured vessels
-relatively benign and often asymptomatic

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9
Q

presentation of subarachnoid hemorrhage

A
  • transient seizure activity on day 2-3

- abnormal neuro exam

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10
Q

prognosis for subarachnoid hemorrhage

A

generally good unless a massive hemorrhage develops

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11
Q

what is a subdural hemorrhage?

A
  • intracranial hemorrhage

- hemorrhage between the dura and the arachnoid

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12
Q

presentation of subdural hemorrhage?

A
  • presents within first 12 to 72 hours
  • severity ranges from asymptomatic lesions to massive hemorrhage
  • seizures and neurologic changes
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13
Q

prognosis with subdural hemorrhage

A
  • depends one extent and severity

- ranges from complete recovery to rapid deterioration and death

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14
Q

symptoms of facial nerve palsy

A
  • drooping mouth
  • perpetually open eye
  • ineffective suck and swallowing problems
  • persistant drooling
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15
Q

nerves effected in Erb’s palsy

A

C5 and C6

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16
Q

nerves effected in Klumpke’s palsy

A

C7 to T1

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17
Q

brachial plexus injury prognosis

A
  • full spontaneous recovery if some improvement within 2 weeks
  • partial recovery if initial improvement is delayed until 4 to 6 weeks
  • significant permanent deficit if no improvement by 3 months
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18
Q

what is scaphocephaly?

A

premature closer of the sagittal sutures

elongates in the occipitofrontal diameter

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19
Q

what is brachycephaly?

A

premature closure of the coronal sutures

overgrowth of the vertex and lateral aspects of the head

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20
Q

what is spina bifida occulta?

A
  • a defect in only the vertebral arch

- usually asymptomatic

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21
Q

what is a meningocele? (spina bifida cystica)

Study These Flashcards
A
  • sac contains meninges
  • spinal cord is in normal position and doesn’t protrude
  • dermal covering is often present
22
Q

what is a myelomeningocele? (spina bifida cystica)

Study These Flashcards
A
  • sac contains meninges and neural tissue

- functional abnormalities are dependent on the level of the defect

23
Q

what is an arnold-chiari malformation?

Study These Flashcards
A
  • displacement of the medulla oblongata, the fourth ventricle and some of the cerebellum into the cervical canal
  • CSF flow is impaired
24
Q

what is rachischisis?

Study These Flashcards
A
  • open spinal cord; failure of the neural folds to fuse

- often associated with anencephaly

25
what is anencephaly?
failure of the rostral neuropore to close - missing forebrain, remainder of the brain is degenerative - spontaneous/pain induced movements; intact reflexes
26
anencephaly pregnancy
- increased alpha fetoprotein - polyhydramnios - postterm delivery
27
what is hydranencephaly?
- complete or nearly complete absence of the cerebral hemispheres - intact brain stem
28
etiology of hydranencephaly
- severe hydrocephaly - inutero infection - vascular occlusion
29
clinical manifestations of hydranencephay
may appear normal at birth - irritability/hyper/hypotonia - intact reflexes - usually die early in infancy
30
what causes holoprosencephaly?
failure of the prosencephalon (forebrain) to cleave to the telencephalon and diencephalon
31
why is pachygyria?
-few broad gyro and shallow sulci
32
define hydrocephaly
imbalance between CSF production and absorption from excess formation of CSF, decreased absorption of CSF or obstruction of flow
33
define communicating hydrocephalus
obstruction occurs after CSF exits the ventricles
34
define noncommunicating hydrocephalus
obstruction occurs along the passages connecting the ventricles
35
when do most IVH occur?
50% by 24 hours 90% by 72 hours almost 100% by 1 week
36
describe the germinal matrix
- beneath the ventricular wall - produces glial cells and neurons - primitive and highly vascular - most common area of origination for IVH
37
what happens with bleeding into the germinal matrix?
- hematoma forms | - blood is released into the ventricular system if the hematoma ruptures
38
causes of IVH
- fluctuating cerebral blood flow - arterial hypotension - increased venous pressure impedes cerebral venous return - excess fibrinolytic activity - platelet and coagulation disturbances
39
describe posthemorrhagic hydrocephalus
usually with grade III/IV - blood clot obstruction - obstructive inflammation and scarring (inhibits absorption)
40
treatment of posthemorrhagic hydrocephalus
-maintain normal ICP -prevent compression of the periventricular white matter -sustain cerebral perfusion (serial LPs, VP shunts) -50% resolve with no treatment
41
about PVL
- occurs only in premature infants - 27 to 30 weeks have the highest incidence - often associated with IVH - may be an infectious component - highest incidence PROM + chorio
42
what is PVL
- ischemic lesion - periventricular white matter necrosis - small cysts in white matter (where brain death has occurred)
43
best way to diagnose PVL
-MRI | ultrasound only detects 40-60%
44
prognosis for PVL
- majority will have cerebral palsy, especially of the lower limbs - developmental delays
45
effects of HIE
- conversion to anaerobic metabolism - intracellular pump function failure: accumulation of Na, Ca, and H20 in brain cells, causing cellular death - accumulation of fatty acids and free radicals - excess release of neurotoxic excitatory neurotransmitters - cell apoptosis
46
early phase of HIE
body is trying to compensate - decreased brain temperature - local release of GABA - temporarily decrease cerebral oxygen demand and limit impact
47
latent phase of HIE
when intervention may be effective
48
secondary phase of injury
-apoptosis: programmed cell death
49
how does therapeutic hypothermia work?
- decreases rate of cellular death - decreases cellular metabolism - conserves ATP stores - limits free radical release
50
describe neonatal seizures
A symptom of neurologic dysfunction | -excessive simultaneous electrical discharge or depolarization
51
pathophysiology of neonatal seizures
- excessive excitatory amino acid release | - deficient inhibitory neurotransmitters (GABA)

neurology (1 decks)

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