NEURO 1 BY SIR BROAS Flashcards
(171 cards)
1
Q
What is the function of Cranial Nerve I (Olfactory)?
A
Smell
2
Q
What condition results from damage to Cranial Nerve I?
A
Anosmia
3
Q
What is the function of Cranial Nerve II (Optic)?
A
Vision
4
Q
What are common problems with Cranial Nerve II?
A
Blurred vision
Blindness
5
Q
What is the function of Cranial Nerve III (Oculomotor)?
A
Eye movement (upward), pupil constriction
6
Q
What condition results from damage to CN III?
A
Anisocoria (unequal pupils)
7
Q
Which cranial nerve is the smallest?
A
IV (Trochlear)
8
Q
What is the function of CN IV (Trochlear)?
A
Eye movement (Downward)
9
Q
What is nystagmus?
A
Involuntary eye movement
10
Q
Which cranial nerve is the largest?
A
V (Trigeminal)
11
Q
What are the three branches of the trigeminal nerve?
A
- Maxillary
- Ophthalmic
- Mandibular
12
Q
What condition is related to trigeminal nerve pain?
A
Trigeminal neuralgia (tic douloureux)
13
Q
What is the function of CN VI (Abducens)?
A
Lateral eye movement
14
Q
What symptom indicates CN VI damage?
A
Diplopia (double vision)
15
Q
What is the function of CN VII (Facial)?
A
Facial expression, taste (anterior ⅔ of tongue)
16
Q
What condition results from damage to CN VII?
A
Bell’s palsy
17
Q
What is the function of CN VIII (Acoustic/Vestibulocochlear)?
A
Hearing and balance
18
Q
What are signs of CN VIII issues?
A
Hearing loss, tinnitus, vertigo
19
Q
What instrument is used to test CN VIII?
A
Tuning fork
20
Q
What is the function of CN IX (Glossopharyngeal)?
A
Taste (posterior ⅓), gag reflex
21
Q
What are signs of CN IX damage?
A
Dysphagia, loss of posterior taste
22
Q
Which cranial nerve is the longest?
A
CN X (Vagus)
23
Q
What is the function of CN X?
A
Gag reflex, parasympathetic (PNS) activation
24
Q
What are symptoms of CN X dysfunction?
A
Dysphagia, abnormal GI secretion
25
What is the function of CN XI (Spinal Accessory)?
Movement of head, neck, and shoulders
26
What is the function of CN XII (Hypoglossal)?
Tongue movement
27
What symptoms indicate CN XII damage?
1. Tongue protrusion or deviation
2. Dysarthria (difficulty speaking)
28
What does 'afferent' mean?
Sensory input going to the brain
29
What does 'efferent' mean?
Motor output going from the brain
30
What part of the nervous system controls voluntary muscle movement?
Somatic Nervous System
31
Which neurotransmitters are released in the sympathetic response?
* Norepinephrine
* Epinephrine
* Dopamine
32
What is the normal intracranial pressure (ICP)?
0-15 mmHg
33
According to the Monro-Kellie hypothesis, what happens if one brain component increases?
Increase in ICP
34
What are the three components in the skull per Monro-Kellie doctrine?
Brain mass (80%), CSF (10%), blood (10%)
35
What are the common causes of increased ICP?
S-troke
T-umor
I-nflammation
T-rauma
C-erebral edema
H-ydrocephalus
36
What is the earliest sign of increased ICP?
Change in level of consciousness (LOC)
37
What visual changes are seen early in increased ICP?
B-lurred vision
A-ltered visual acuity
D-iplopia
38
What vital sign changes occur in late stages of increased ICP?
Cushing's Triad: HyperBradyBrady
↑ BP, ↓ RR, ↓ HR, widened pulse pressure
39
What respiratory pattern is associated with late increased ICP?
Cheyne-Stokes breathing (deep, rapid breathing, followed by shallow breathing and apnea)
40
What is papilledema?
Swelling of the optic disc
41
What type of vomiting is seen in increased ICP?
Projectile vomiting
42
What does a positive Babinski reflex in an adult indicate?
Neurological dysfunction (late sign)
43
What position helps lower ICP?
1. Semi-fowler's/low fowler's (HOB: 30-45)
2. Head in neutral alignment (promote venous drainage)
44
What medication reduces cerebral edema?
Dexamethasone (Decadron)
45
What diuretic is used to decrease ICP by pulling fluid from brain tissue?
Mannitol (Osmitrol)
46
What is a loop diuretic used for ICP management?
Furosemide (Lasix)
47
Why should patients with ICP avoid coughing or straining?
It increases ICP
48
What medication is given to reduce vomiting in ICP?
Ondansetron (Zofran)
49
What is the best parameter to monitor worsening ICP?
Level of consciousness (LOC)
50
What is the most common artery involved in strokes?
Middle cerebral artery (MCA)
51
What is the difference between thrombotic and embolic strokes?
Thrombotic = clot formed in brain; Embolic = clot traveled to brain
52
What are early signs of a stroke?
B- alance (poor/uncoordinated)
E-ye (double vision - diplopia)
H-eadache
F-acial drooping (nasolabial folds)
A-rms (dropping/numbness)
S-peech (slurred)
T-ime
53
What is a TIA?
Transient Ischemic Attack – warning sign that resolves in 24-72 hours
54
What is homonymous hemianopsia?
Loss of half of the visual field
55
Which side should you approach in homonymous hemianopsia?
Unaffected side
56
What is unilateral neglect?
Ignoring the paralyzed or affected side
57
What are the 5 P’s of circulation used in stroke assessments?
Pain, pallor, pulse, paresthesia (numbness), paralysis
58
What is the first test to identify stroke type?
CT scan
59
What diagnostic test confirms brain tissue damage?
MRI
60
What lab value must be normal before giving TPA?
No-signs of bleeding
P-latelet count
I-NR
G-lucose
61
What is the BP requirement for TPA administration?
<185/110
62
What is the time window for giving TPA?
Within 3–4.5 hours of stroke onset
63
What is a seizure?
Sudden, excessive discharge of electricity in the cerebral cortex
64
What is epilepsy?
Recurring seizures or seizure history
65
When are febrile seizures considered normal?
<5 years old
66
What makes a seizure pathologic?
Occurs in children >5 years old
67
What are common causes of seizures?
Metabolic imbalance, alcohol withdrawal, infection, injury, stress
68
What anticonvulsant is commonly used to prevent seizures?
Phenytoin (Dilantin)
69
What are side effects of phenytoin?
Gingival hyperplasia, ataxia, nystagmus, agranulocytosis, hairy tongue
70
What should be used for oral care with phenytoin?
Soft-bristled toothbrush
71
What is the DOC for trigeminal neuralgia and manic episodes?
Carbamazepine
72
What seizure type is Valproic Acid commonly used for?
Petit mal and grand mal seizures
73
What should be avoided in seizure patients?
Alcohol, restraining, putting objects in mouth
74
What position should a seizure patient be placed in?
Side-lying (to prevent aspiration)
75
What is an aura in seizure?
A warning sign before a seizure, e.g., flashing lights, odd smells, taste
76
What is the most common type of generalized seizure?
Tonic-clonic (grand mal)
77
What happens during the tonic phase?
Stiffening/extension of muscles
78
What happens during the clonic phase?
Repetitive muscle jerking
79
What is the postictal phase?
Lethargy or drowsiness after a seizure
80
What acronym summarizes tonic-clonic seizure events?
AELTP: Aura, Epileptic cry, Loss of consciousness, Tonic-clonic, Postictal
81
What are symptoms of petit mal (absence) seizures?
Blank stare, decreased blinking, pausing during conversation
82
What age group is most affected by absence seizures?
Children
83
What is status epilepticus?
Continuous seizure lasting >5 minutes or repeated seizures without recovery
84
What are emergency meds for status epilepticus?
Diazepam + Phenytoin + D50W
85
What is added if alcohol withdrawal is suspected in status epilepticus?
IV Thiamine
86
What test confirms seizure activity?
EEG (Electroencephalography)
87
What to avoid before EEG?
Coffee, sedatives, and oily hair products
88
What type of scan is used to identify brain lesions in seizure patients?
CT scan
89
What should the nurse do during a seizure?
Stay with patient, protect head, time the seizure, note activity
90
After a seizure, what is given first?
Oxygen
91
Why should nothing be placed between the teeth during a seizure?
To prevent choking or dental injury
92
What is the nursing priority post-seizure?
Airway and patient reorientation
93
What is Multiple Sclerosis (MS)?
Autoimmune disorder causing demyelination in the CNS
94
What age and sex is most affected by MS?
Women aged 20–50 years
95
What are the 3 components of Charcot’s triad in MS?
Scanning speech, intention tremor, nystagmus
96
What is Uhthoff’s sign in MS?
Worsening of symptoms with heat
97
What is the confirmatory test for MS?
MRI
98
What does CSF analysis show in MS?
↑ protein and oligoclonal bands
99
What test is used to evaluate cerebellar balance in MS?
Romberg’s test
100
What medications are used for MS exacerbation?
Corticosteroids (e.g., Dexamethasone, Prednisone)
101
What medications reduce spasticity in MS?
Baclofen, Dantrolene
102
What medication helps with MS-related fatigue?
Amantadine
103
What is the DOC for long-term immunomodulation in MS?
β-Interferons (Avonex, Rebif)
104
What neurotransmitters are deficient in Alzheimer’s disease?
SANS: Somatostatin, Acetylcholine, Norepinephrine, Substance P
105
What is the initial sign of Alzheimer’s disease?
Progressive memory loss
106
What are the 5 A’s of Alzheimer’s disease?
Amnesia, Anomia, Agnosia, Apraxia, Aphasia
107
What is the DOC for Alzheimer’s?
Donepezil (Aricept)
108
What is the confirmatory test for Alzheimer’s disease?
Autopsy
109
What is a key nursing intervention in Alzheimer’s?
Provide a safe environment
110
What neurotransmitter is decreased in Parkinson’s disease?
Dopamine
111
What is the classic triad of Parkinson’s disease?
Resting tremor, rigidity, bradykinesia
112
What is the DOC for Parkinson’s disease?
Sinemet (Levodopa + Carbidopa)
113
What drug improves rigidity in Parkinson’s?
Benztropine (Cogentin) or Artane
114
What is the most common surgical treatment for Parkinson’s?
Deep brain stimulation
115
What nutritional advice is given for Parkinson’s?
Low protein in the morning, high protein in the evening
116
What is Myasthenia Gravis (MG)?
Autoimmune disorder affecting acetylcholine receptors at neuromuscular junction
117
What is the initial sign of MG?
Ptosis (drooping eyelids)
118
What is the confirmatory diagnostic test for MG?
Tensilon test (Edrophonium Chloride)
119
What medication is given to MG patients to increase ACH?
Pyridostigmine (Mestinon)
120
What surgery helps reduce symptoms in MG?
Thymectomy
121
What is a Myasthenic Crisis caused by?
Undermedication, infection, or stress
122
What is a Cholinergic Crisis caused by?
Overmedication with anticholinesterase
123
What are SLUDGE symptoms in Cholinergic Crisis?
Salivation, Lacrimation, Urination, Diarrhea, GI upset, Emesis
124
What is the antidote for Cholinergic Crisis?
Atropine sulfate
125
What is Guillain–Barré Syndrome (GBS)?
Acute ascending symmetrical paralysis due to demyelination of peripheral nerves
126
What is the initial sign of GBS?
Clumsiness or leg weakness
127
What does CSF show in GBS?
↑ Protein, normal WBC
128
What arrhythmia risk is unique to GBS?
Autonomic instability (bradycardia, tachycardia, arrhythmias)
129
What drug is DOC for GBS-related arrhythmias?
Amiodarone
130
What is the key nursing priority in GBS?
Airway and respiratory support
131
What therapy can shorten recovery in GBS?
Plasmapheresis or IV Immunoglobulin (IVIG)
132
What is the purpose of a CT scan in neuro assessment?
To identify type of stroke (hemorrhagic vs ischemic)
133
What diagnostic test confirms MS?
MRI – shows demyelinated plaques
134
What is the purpose of a lumbar puncture in MS?
Detects ↑ protein and oligoclonal bands
135
What is the most reliable sign of CSF leakage?
Halo sign or + glucose in drainage
136
What is the purpose of an EEG?
Detects abnormal brain waves in seizures
137
What should patients avoid before EEG?
Caffeine, oily hair products, sedatives
138
What is the purpose of cerebral arteriography?
Visualizes blood vessels in the brain
139
What allergy should be assessed before cerebral arteriography?
Seafood or iodine
140
What does a carotid ultrasound assess?
Plaques and blood flow in carotid arteries
141
When is an echocardiogram used in stroke assessment?
To find embolic clots from the heart
142
What corticosteroid is used to reduce cerebral edema?
Dexamethasone (Decadron)
143
What osmotic diuretic is used to reduce ICP?
Mannitol (Osmitrol)
144
What loop diuretic supports Mannitol therapy?
Furosemide (Lasix)
145
What stool softener prevents straining in ICP?
Docusate sodium (Colace)
146
What antiemetic is used for ICP-related vomiting?
Ondansetron (Zofran)
147
What seizure med has gingival hyperplasia as a side effect?
Phenytoin (Dilantin)
148
What supplement should be avoided while on warfarin?
Vitamin K (found in green leafy vegetables)
149
What is the antidote for warfarin toxicity?
Vitamin K (Aquamephyton)
150
What is the antidote for heparin overdose?
Protamine sulfate
151
What is the antidote for cholinergic crisis?
Atropine sulfate
152
What thrombolytics are used in acute stroke?
TPA, Alteplase, Reteplase, Tenecteplase
153
Within how many hours should TPA be given?
Within 3–4.5 hours of stroke onset
154
What BP value contraindicates TPA use?
BP >185/110
155
What lab values must be checked before TPA?
Glucose, INR, platelet count
156
What is the best indicator of effective thrombolytic therapy?
Epistaxis (controlled bleeding indicates therapeutic effect)
157
What side effect is common with streptokinase?
Urticaria and pruritus
158
What lab is monitored for patients on heparin?
aPTT (normal: 30–40 sec)
159
What lab is monitored for patients on warfarin?
PT/INR (normal INR: <1; therapeutic: 2–3)
160
What medication is known to cause tinnitus?
Aspirin
161
What medication used in Parkinson’s disease may darken urine or stool?
Levodopa
162
What is the GCS range for mild brain injury?
13–15
163
What is the GCS range for moderate brain injury?
9–12
164
What GCS indicates severe brain injury?
8 or below
165
At what GCS should you prepare for intubation?
GCS of 8
166
What nursing priority is used to prevent aspiration in stroke?
NGT feeding and thickened fluids
167
What is the best position to prevent aspiration in dysphagia patients?
Upright or side-lying on unaffected side
168
What safety device is used in seizure patients?
Padded side rails
169
What is the priority action during a seizure?
Protect airway and prevent injury
170
What kind of shoes are best for Parkinson’s patients?
Rubber-soled, no heels
171
Why should protein be low in the morning for Parkinson’s patients?
High protein impairs Levodopa absorption
