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7110 > Neuro > Flashcards

Neuro Flashcards

1
Q

pneumonic for alt LOC

A

AEIOUTIPS

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2
Q

A in AEIOUTIPS

A

acidosis, alcohol

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3
Q

E in AEIOUTIPS

A

Epilepsy

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4
Q

I in AEIOUTIPS

A

Insulin reaction

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5
Q

O in AEIOUTIPS

A

overdose

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6
Q

U in AEIOUTIPS

A

Uremia, underdose

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7
Q

T in AEIOUTIPS

A

Trauma, Tumor

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8
Q

I in AEIOUTIPS

A

Infection

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9
Q

P in AEIOUTIPS

A

Psychosis

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10
Q

S in AEIOUTIPS

A

Stroke

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11
Q

CVA

A

sudden loss of brain fx, neuro deficits that last 24h or more

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12
Q

what are the main risks with decreased LOC

A

Aspiration, inability to protect airway, seizure, death

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13
Q

what is ICP

A

pressure exerted on ventricles by CSF

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14
Q

Equation for CPP

A

Map-ICP

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15
Q

% of brain matter

A

80

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16
Q

% of CSF

A

10

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17
Q

% of blood in brain

A

10

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18
Q

Monro Kellie hypothesis

A

Postulates there is reciprocal compensation between intracranial compartments. Increase in one means decrease in other

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19
Q

What happens first when ICP increases

A

CSF moves down spinal cord
CSF production decreased/ reabsorption increased
Small amount of distension in dura mater

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20
Q

what happens second in increased ICP

A

Pressure builds, venous system is compressed. ICP rises as brain is compressed

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21
Q

What happens last in increased ICP

A

compensation fails. Increased CO2 causes cerebral vasodilation, increasing blood flow and increasing ICP

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22
Q

what does CO2 do in brain vasculature

A

Causes increased ICP by increasing perfusion to brain

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23
Q

Why does the venous system fail when ICP increases

A

it is compressed, outflow of blood is blocked and beings to accumulate

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24
Q

Clinical symptoms of increased ICP

A

headache
Nausea/vomitting
Alt LOC

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25
Q

Clinical signs of impending brain herniation

A

Significant pupillary asymmetry
Unilateral or bilateral fixed and dilated pupils
Decorticate or decebrate posturing
Resp depression

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26
Q

What are signs of impending brain herniation (cushings triad)

A

HTN with widening pulse pressure, Bradycardia, irregular respirations

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27
Q

Normal ICP

A

5-15mmhg

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28
Q

when is cerebral autoregulation lost

A

MAP <50, >100 or ICP >35 for 20-30m

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29
Q

why is maintaining MAP important in neuro patients

A

to ensure CBF and prevent ischemia

30
Q

how to maintain MAP to ensure CBF

A

Inotropes, vaspressors

31
Q

monitoring/treatments for patients with increased ICP

A
  • Ventilation status
  • Drainage of CSF with ICP monitoring system
  • Maintain MAP >90
  • IV bolus or albumin
  • Pressors to maintain MAP
  • Sedation/analgesia to decrease workload
  • Maintain Sats
32
Q

nursing interventions for increased ICP

A
  1. Dim lights
  2. Decompress stomach to reduce gastric pressure
  3. Hyperventilate to blow off Co2
  4. Mannitol
  5. Avoid hip flexion (increases P in abd cavity)
  6. Manage BP
  7. Increase HOB to drain jugular veins
33
Q

3 layers of meninges

A

Dura mater
Arachnoid mater
Pia mater

34
Q

Outmost layer of brain

A

dura mater

35
Q

middle layer of brain

A

arachnoid mater

36
Q

which layer of brain is deepest

A

pia mater

37
Q

characteristic of dura mater

A

thick spongey layer, protects

38
Q

characteristics of arachnoid mater

A

thin and delicate, weblike and semitransparent

39
Q

Where is the subaarachnoid space

A

between arachnoid mater and pia matter

40
Q

Characteristics of pia mater

A

attached to brain

41
Q

occipital lobe

A

visual cortex

42
Q

parietal lobe

A

somatosensory cortex

43
Q

temporal lobe

A

hearing, equilibrium, emotion, memory

44
Q

frontal lobe

A

motor cortex and association areas, complex thought, ethical behaviour

45
Q

limbic structures

A

emotions, short term memory, smell

46
Q

basal ganglia

A

initiation and planning of learned motor activities

47
Q

what is RAS

A

reticulatar activating system

48
Q

what does RAS do

A

maintains consciousness, vital regulation for CV, Resp

49
Q

how do brain injuries manifest

A

LOC, cranial nerve reflexes, GCS, brain hemodynamics

50
Q

where is an epidrual hematoma

A

epidural space-between skull surface and dura mater (extradural)

51
Q

what injury increases risk of epidural hematoma

A

skull fracture

52
Q

source of most epidural bleeds (art or venous)

A

arterial

53
Q

where do subdural hematoma form

A

between dura and outer arachnoid membrane

54
Q

what type of blood is in subdural hematoma

A

venous

55
Q

why may symptoms of a venous bleed appear later

A

slower bleeding

56
Q

where does CSF live

A

subarachnoid space

57
Q

where does a subarachnoid bleed occur

A

between pia mater and outer arachnoid membrane

58
Q

what type of bleed is subarachnoid

A

venous (like subdural) or arterial (anyerusm rupture)

59
Q

what happens when blood is in the CSF

A

meningial irritation
bloody spinal tap
sever headache

60
Q

Common stroke symptoms

A

numbness and weakness on one side of body
confusion, trouble speaking/understanding
visual disturbance
Dizziness, loss of balance
Severe headache

61
Q

characteristic of TIA

A

clot is lysed before permanent tissue. damage occurs

62
Q

how long can a TIA last

A

minutes to hours

63
Q

goals of care for ischemic stroke

A

minimize infarct size and perserve function. Aspirin stat or thrombolytic therapy

64
Q

goals of care for hemorrhagic stroke

A

manage increased ICP

65
Q

Origins of meningitis

A

viral, fungal, bacterial

66
Q

why does meningitis move quickly in CNS

A

present in subarachnoid space, moves through CSF

67
Q

S/S meningitis

A

headache

fever stiff neck, alt LOC. Occasionally, Increased HR, seizures

68
Q

Encephalitis

A

inflammation of the brain

69
Q

common causes of encephalitis

A

HSV, Equine virus, West nile virus

70
Q

S/S encephalitis

A

fever, headache, seizure, confusion, stupor, coma, hallucinations, personality changes

71
Q

characteristics of concussion

A

alteration or loss of consciousness with no brain damage on CT. Symtpoms present immediatly and resolve quickly

7110 (5 decks)

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