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7110 > Neuro > Flashcards

Neuro Flashcards

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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
Clinical signs of impending brain herniation
Significant pupillary asymmetry Unilateral or bilateral fixed and dilated pupils Decorticate or decebrate posturing Resp depression
26
What are signs of impending brain herniation (cushings triad)
HTN with widening pulse pressure, Bradycardia, irregular respirations
27
Normal ICP
5-15mmhg
28
when is cerebral autoregulation lost
MAP <50, >100 or ICP >35 for 20-30m
29
why is maintaining MAP important in neuro patients
to ensure CBF and prevent ischemia
30
how to maintain MAP to ensure CBF
Inotropes, vaspressors
31
monitoring/treatments for patients with increased ICP
- 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
nursing interventions for increased ICP
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
3 layers of meninges
Dura mater Arachnoid mater Pia mater
34
Outmost layer of brain
dura mater
35
middle layer of brain
arachnoid mater
36
which layer of brain is deepest
pia mater
37
characteristic of dura mater
thick spongey layer, protects
38
characteristics of arachnoid mater
thin and delicate, weblike and semitransparent
39
Where is the subaarachnoid space
between arachnoid mater and pia matter
40
Characteristics of pia mater
attached to brain
41
occipital lobe
visual cortex
42
parietal lobe
somatosensory cortex
43
temporal lobe
hearing, equilibrium, emotion, memory
44
frontal lobe
motor cortex and association areas, complex thought, ethical behaviour
45
limbic structures
emotions, short term memory, smell
46
basal ganglia
initiation and planning of learned motor activities
47
what is RAS
reticulatar activating system
48
what does RAS do
maintains consciousness, vital regulation for CV, Resp
49
how do brain injuries manifest
LOC, cranial nerve reflexes, GCS, brain hemodynamics
50
where is an epidrual hematoma
epidural space-between skull surface and dura mater (extradural)
51
what injury increases risk of epidural hematoma
skull fracture
52
source of most epidural bleeds (art or venous)
arterial
53
where do subdural hematoma form
between dura and outer arachnoid membrane
54
what type of blood is in subdural hematoma
venous
55
why may symptoms of a venous bleed appear later
slower bleeding
56
where does CSF live
subarachnoid space
57
where does a subarachnoid bleed occur
between pia mater and outer arachnoid membrane
58
what type of bleed is subarachnoid
venous (like subdural) or arterial (anyerusm rupture)
59
what happens when blood is in the CSF
meningial irritation bloody spinal tap sever headache
60
Common stroke symptoms
numbness and weakness on one side of body confusion, trouble speaking/understanding visual disturbance Dizziness, loss of balance Severe headache
61
characteristic of TIA
clot is lysed before permanent tissue. damage occurs
62
how long can a TIA last
minutes to hours
63
goals of care for ischemic stroke
minimize infarct size and perserve function. Aspirin stat or thrombolytic therapy
64
goals of care for hemorrhagic stroke
manage increased ICP
65
Origins of meningitis
viral, fungal, bacterial
66
why does meningitis move quickly in CNS
present in subarachnoid space, moves through CSF
67
S/S meningitis
headache | fever stiff neck, alt LOC. Occasionally, Increased HR, seizures
68
Encephalitis
inflammation of the brain
69
common causes of encephalitis
HSV, Equine virus, West nile virus
70
S/S encephalitis
fever, headache, seizure, confusion, stupor, coma, hallucinations, personality changes
71
characteristics of concussion
alteration or loss of consciousness with no brain damage on CT. Symtpoms present immediatly and resolve quickly

7110 (5 decks)

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