Neuro Flashcards
1
Q
Cranial Nerves - 12
A
I. Olfactory II. Optic III. Oculomotor IV. Trochlear V. Trigeminal VI. Abducens VII. Facial VIII. Acoustic IX. Glossopharyngeal X. Vagus XI. Spinal Accessory XII. Hypoglossal
2
Q
Hypoglossal CN
A
XII - tongue movement - motor ; stick out tongue; weakness ? - tongue goes to stronger side
3
Q
Spinal accessory
A
sternocleidomastoid and trapezius muscle control - neck strength and shoulder shrug (against resistance) - motor ;
4
Q
Glossopharyngeal + Vagus
A
gag, swallow, and cough reflexes; voice quality; vagal parasympathetic response - both
5
Q
Acoustic
A
hearing and balance - sensory ; test by whispering
6
Q
Facial CN
A
VII - anterior taste buds + facial muscles - both
7
Q
Trigeminal
A
motor function of temporal and jaw muscles ; sensory on face - both
8
Q
Oculomotor + Tronchlear + Abducens
A
ocular muscle movement - motor - PEARLA
9
Q
Optic
A
visual acuity - sensory ; Snellen chart
10
Q
Olfactory
A
smell - sensory
11
Q
CNS consists of …
A
- Brain - cerebrum, cerebellum, brain stem 2. Spinal cord
12
Q
PNS consists of …
A
- 31 pairs of spinal nerves 2. 12 pairs of cranial 3. Autonomic NS
13
Q
Autonomic NS consists of …
A
- Sympathetic NS - speeds ; anticholinergic 2. Parasympathetic NS - slows; cholinergic - responsible for involuntary movement of smooth muscles present in GI tract, urinary tract and lungs
14
Q
Flexed arms, extended legs, plantar flexion, internal rotation of limbs and feet - “toward the cord” - affecting cortical area of brain
A
Decorticate posturing
15
Q
Extended arms and legs, plantar flexion, external rotations of limbs and feet; dysfunction in the brainstem area
A
Decerebrate posturing
16
Q
No motor function or response
A
Flaccid
17
Q
White fiber tracts that connect the neurons in the brain and spinal cord ; only one … attached to each neuron ( can extend down the entire spinal cord)
A
Axon
18
Q
A white, lipid covering many axons; white matter; … axons have gaps called nodes of Ranvier - play a major role in impulse conduction
A
Myelin sheath
19
Q
Autoimmune disease; characterized by inflammatory response that results in diffuse random or patchy areas of plaque in the white matter of the CNS - myelin sheath is damaged (demyelinated) - impulses still transmitted but not as effective; over time can become completely blocked.
A
Multiple Sclerosis - pathophysiology
20
Q
MS: Classification
A
- Benign MS - 1-2 attacks - complete recovery 2. Relapsing Remitting MS - most common - relapses with partial or full recovery - no progression between attacks 3. Secondary Progressive MS - follows RRMS in 50 % - progressive disability 4. Primary Progressive MS - steady slow progression ; uncommon; little tx available 5. Progressive Relapsing MS - progressive + flare ups ; rare
21
Q
MS: 1.axons of the nerve remains intact - … 2. both myelin and axon are destroyed - …
A
- Pt. will regain all function and sensation during remission 2. Permanent loss of motor and sensory function
22
Q
MS: Etiology
A
- Autoimmune - following stress 2. Viral 3. Familial tendency 4. Cold climates 5. Females - 15-50 (20-40)
23
Q
MS: S/s
A
- Visual disturbances 2. Internuclear opthalmoplegia - abducting eye ( to the side) - nystagmus 3. Sensory sensations - tingling, numbness… 4. Unusual clumsiness, extremity weakness, leg dragging … 5. All symptoms intensified by hyperthermia 6. Lhermitte’s sign - flex neck - electrical sensation - down the back - into legs
24
Q
MS: Visual problems
A
- Nystagmus - involuntary rapid eye movement 2. Diplopia - double vision 3. Blurry vision 4. Scotoma - patchy blindness
25
MS: TX - medications
1. Corticosteroids - exacerbation 2. Immunomodulators - for life to slow or stop 3. immunosuppresant agent
26
Immunosuppresant agent; tx of MS; anticancer; lifetime limit of 8-12 doses - or cardiac damage occurs; shuts down part of immune system causing MS.
Mitoxantrone hydrochloride ( Novantrone)
27
1. Avonex 2. Betaseron 3. Copaxone
Immunomodulators - tx of relapsing-remitting MS ; remission therapy
1. drug of choice; IM/weekly
2. sub-q daily or 3x's weekly SE: flue like S/s - decrease in 3 mo; nightmares
3. acts like decoy; subcut/daily ; SE: skin decubiti; chest pain (like MI)
28
Bethanechol (Urecholine)
Cholinergic agent - parasympathomimetic ; MS: treat flaccid bladder; neurologic bladder (incontinence)
29
Oxybutynin Chloride (Ditropan)
Anticholinergic (cholinergic blocker; parasympathetic depressant) - tx spastic bladder - MS
30
1. Baclofen 2. Flexeril 3. Robaxin 4. Zanaflex
CNS depressant; sympathetic depressant; treat muscle spasticity + spasms
31
Dandrolene (Dantrium)
CNS direct acting (peripheral) - treat muscle spasticity
32
Decubiti
pressure sore or bed sore - A pressure-induced ulceration of the skin occurring in persons confined to bed for long periods of time
33
1. Decadrone (Dexamethasone) 2. Methylprednisolone (Solu-Medrol)
Corticosteroids
34
Reticular activating system
special cells throughout the brainstem - control awareness + alertness ; the reticular formation are has many connections with the cerebrum, the rest of the brainstem and the cerebellum
35
Caloric test
ice/warm water is forced into ear canal - eyes rotate to opposite/same side of head (Nystagmus) ; performed to evaluate the vestibular (inner ear) portion of auditory nerve ; helps to determine brain death.
36
Obtunded
awakes only momentarily; confused
37
Persistent Vegetative State
awake, but unaware of surroundings
38
Locked-in syndrome
due to brain stem damage - awake and alert , but unable to move or respond, except by blinking eyes; death due to respiratory distress
39
Light vs deep coma
unresponsive, except to painful stimuli vs unresponsive
40
Brain stem consists of
Midbrain Pons Medulla
41
connects brain stem and cerebrum
Midbrain
42
bridges the two halves of the cerebellum to the medulla and cerebrum
Pons
43
site of reflex centers for many vital functions, i.e.: • respiratory • cardiac • vasomotor
Medulla
44
The NS is composed of two types of cells
1. Neurons 2. Neuroglial cells - support, nourishment, and protection for neurons
45
Neuroglial cells - types
1. Astrocytes 2. Oligodendroglia 3. Ependymal cells 4. Microglia
46
A tumor that arises from cells that comprise the supporting tissue of the nervous system; Malignant !!!
Gliomas
47
Pituitary adenoma types : Benign !!!
1. Prolacting secreting - Galacterhea (milk production)
2. ACTH secreting - Cushings syndrome (increase in corticosteroids)
3. Growth hormone secreting
48
controls the hormones released by the adrenal gland that support blood pressure, metabolism, and the body's response to stress
Adrenocorticotrophic hormone (ACTH)
49
Transphenoidal micro surgical approach
through the nasal passage, going along the septum - then through the sphenoid sinus cavity located deep above the back of the throat to the pituitary gland immediately behind it; tx of pituitary adenoma; Mustache dressing - nose is packed - prevent sneezing ( increase ICP).
50
Tumor of the 8th CN, can grow quite large; always benign; S/s - vertigo + ringing in the ears (tinnitus) + staggering gait
Acoustic neuroma
51
Tumor - mass of blood vessels usually congenital ; risk for hemorrhagic stroke; benign
Angioma
52
Benign, highly vascular tumors which originate in the meningeal layer
Meningioma
53
Infratentorial tumor - craniotomy - positioning ; + cervical fx
Bed flat with small pillow for pt.
54
Hydrocephalus - increased CSF related to obstraction of the flow of CSF or displacement of the lateral ventricles by the expending lesions - increased ICP - S/s and TX
S/s : 1. gait disturbance 2. incontinence 3. confusion
TX: Ventriculoperitoneal or ventricular jugular shunt
55
Halo sign
red stain of blood surrounded with yellow "halo" stain, which is CSF. Need to test with a glucose strip to ensure this is what stain is showing - then call doctor
56
S/s of increased ICP
1. Headache 2. Deteriorating LOC 3. Restlessness 4. Irritability 5. Dilated or pinpoint pupils that are slow to react or nonreactive to light
57
DI - diabetes insipidus
failure of posterior pituitary gland to release ADH - failure of renal tubules to reabsorb water - urine output is increased (polyuria) - dehydration ( polydipsia) , hypovolemic shock ; Hypernatremia
58
Vasopressin (Pitressin) - IV
Desmopressin acetate (DDAVP) - IV or nasal spray
antidiuretic hormone; tx of diabetes insipidus
59
SIADH
syndrome of inappropriate ADH - posterior pituitary gland releases too much ADH - water retention - loss of thirst, weight gain, muscle weakness, decreased LOC; Hyponatremia (dilutional)
60
1. Epidural - between skull and dura - least invasive - least accurate
2. Subarachnoid screw - CSF flows - small sample - cannot drain CSF
3. Intraventricular - most invasive - most accurate (transducer) - can drain CSF if ICP is elevated
ICP monitoring devices
61
1. Brudzinski's sign 2. Kernig's sign
1. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed. 2. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
62
The spinal cord is composed of 31 pairs of spinal nerves:
• 8 cervical • 12 thoracic • 5 lumbar • 5 sacral • 1 coccygeal
63
Dorsal root
Posterior. Contains the sensory portion; afferent in nature (from the body inward to the cord). Part of the body picks up a sensory stimulus which travels ↑ cord to the brain.
64
Ventral root
Anterior. Is efferent in nature. Impulses travel outward from the brain ↓ cord → body. Contains the motor portion.
65
UMN lesions
1. Loss of voluntary movements;
2. Tense muscles - increased tone
3. Spastic muscles
4. Hyperactive reflexes
66
LMN lesions
1. Loss of voluntary movements
2. Decreased muscle tone
3. Muscle atrophy
4. Absent or dimished reflexes
67
Autoimmune disease; loss of motor neurons in the anterior (ventral) horns of the spinal cord + motor nuclei of the lower brain stem - muscle atrophy - both upper and lower motor neurons ; death due to respiratory failure; bowel and bladder are not affected - pt remains continent
Amyotropic Lateral Sclerosis (ALS) - Lou Gehrig's Disease
68
Riluzole (Rilutek)
tx of ALS - slows progression of the disease
69
Brain injury; Jarring of the brain-possibly microscopic hemorrhages; closed injury; mild; up to 5 min ( neurological s/s) to 48 hours (headache + N/V); tx: unconscious 5 min - hospital for observation.
Concussion
70
Brain injury; brain is bruised; loss of consciousness \> 24 hrs; 60 % behavioral changes; may recover completely.
Contusion
71
Skull fractures types
1. Open - depressed ( corrective sx) & non-depressed; basilar 2. Closed - coup/ contre coup
72
Open skull fracture - Basilar
base of the skull; CSF leakage; motorcycle accidents; swelling may affect brain stem; Battles sign
73
Battles sign
a palpable bogginess of the area behind the ear that may indicate a fracture of a bone of the lower skull; basilar skull fracture
74
Intracranial hemorrhages
1. Epidural 2. Subdural 3. Subarachnoid - due to blunt trauma, aneurysm 4. Intracerebral
75
Bleeding between the inner skull and the dura; compression of surrounding tissue; due to head trauma; **_EMERGENCY_**- bleeding from meningeal artery; loss consciousness - lucid - changes in MS - coma - death; tx: burr hole opening to evacuate blood + repair the artery
Epidural hemorrhage
76
Bleeding between dural membrane and arachnoid membrane; venous in origin - s/s develop more slowly; 48 hrs-2 weeks; tx: surgical burr hole;
Subdural hemorrhage
77
Bleeding withing the brain tissue; due to head injury, hypertension, diseases that reduce platelets (ITP, leukemia); nothing can be done; \< 5-10 ml - may be reabsorbed without consequences
Intracerebral bleed
78
The wall of a cerebral artery or vein weakens, dilates and forms a sac - ruptured - subarachnoid bleed ; common - Berry aneurysm ( Circle of Willis); - after rupture - cerebral vasospasm + increase in ICP; dx: cerebral angiography
Cerebral aneurysm
79
Osmotic diuretic - pulling fluid from brain tissue into vasculature ; used to tx increased ICP ; most effective given IV boluses ( filter needle) ; + Lasix ( to help to pee it out) ; Monitor: I&O, serum electrolytes + serum osmolarity; Assess increase in urinary output and decrease in ICP
Mannitol
80
An infection by bacteria that have origin in another part of body (sinus, ear or teeth); tx: antibiotics; dx: CSF positive for bacteria (strep or staph) ; CT - abnormal tissue density; EEG: abnormal.
Brain abscess
81
An inflammation of the brain tissue with no purulent exudate; caused by mosquitoes (west nile); ticks; vaccines; Tx; supportive; antiviral meds; dx: WBC elevated (lymphocytes)
Encephalitis
82
An acute infection of the meninges - arachnoid and pia mater; types: bacterial, viral ( after chickenpox, mumps) and fungul (AIDS pts)
Meningitis
83
Most dangerous, contagious and deadly type of meningitis ???
Meningococcal ( Neisseria) - spreads by secretions; often presents with rash and petechiae - often kills within hours of onset
84
1. Ergotamine + Caffeine (Cafergot) 2. Ergotamine tartate (Ergostat) 3. Dihydroergotamine mesylate (Migranal) 4. Methysergite maleate (Sansert)
Ergotamines - tx migraines - activating serotonin receptors - vasoconstriction - abortive therapy
85
Triptans
Abortive therapy - migraines - activating serotonin receptors - vasoconstriction ; SE: actual or suspected cardiovascular diseases - risk for coronary vasospasm ; Use contraception; Don't take with SSRI and St. John's wort (tx of depression) SE: flushing, tingling, hot sensations.
86
Autoimmune response to a viral infection or vaccines; T cells attack and destroy myelin of the PNS (Schwann cells); initial 2 we; plateau 2 we; recovery 2 ye; Complication - loss of respiratory function
Guillain-Barre Syndrome
87
Bell's Palsy
facial paralysis; VII CN - facial ; rapid onset; lasts 3-5 weeks; Inflammation causes pressure on the nerve which is in a snug channel; S/s - like stroke - one side of the face is paralyzed; tx: steroids; pain meds; eye care ( manually close); facial exercise and massage
88
Trigeminal neuralgia
motor function of temporal and jaw muscles ; sensory on face - both ; pain provoked by movement and stimulation : brushing teeth, chewing, washing face; due to inflammation? or pressure on the nerve ? tx: seizures meds: blood levels drawn for therapeutic range.
89
Glascow Coma Scale
90
Sympathetic NS vs Parasympathetic NS
91
Changes in vital signs ( low BP & HR) due to impaired communication between upper and lower motor neurons; - impaired sympathetic NS activity - massive vasodialation (low BP) - unoposed parasympathetic NS (low HR) - Emergency - low BP - low perfusion to injured cord - no O2 - edema & ischemia increase ;
Neurogenic shock - complication of spinal cord injuries
92
Neurogenic shock - TX
1. Volume expanders ( Dextran )
2. Dopamine - to vasoconstrict
3. Elevate legs , sequentials , abdominal binder
93
Unconscious pt must never be placed on their ...
backs - danger of aspiration !!!
94
Interventional neurosurgery - repairing aneurysms - coil or glue procedure - Post op care
1. Keep pt on his back with HOB at or below 30 degrees
2. Keep affected leg straight (femoral arterial sheath) - 6 hrs after sheath is removed
3. Pain meds
4. Monitor site for bleeding or hematoma - 5 Ps
5. Assess neurological status
6. Urine output
7. Check BS - if pt is on Decadron (steroid)
8. Coil - heparin post op; aspirin for life
9. Glue - MAP \< 90 - antihypertensives
95
Demyelination of the peripheral nerves ( they regenerate ) - ascending paralysis ( lower limbs before upper) - muscle weakness + paralysis; causes unknown - post viral ? vaccination ?; Pt. can recover fully ( 1 year) or have long standing neurological deficits
Guillain - Barre Syndrome
96
Plasmaphoresis and Guillain-Barre Syndrome
removes circulating antibodies thought to be responsible for the disease - plasma is selectively separated from whole blood - blood cells returned to the pt without the plasma - plasma replaces itself or albumin (colloid) is given ; should be done within several days after the onset of the illness
97
Plasmapheresis - Complications + Nursing Interventions
98
Disease that affects the trigeminal - V CN; - sensory branch to face and scalp ; Main issue - Pain; TX: Antiseizure meds (Neurontin) - tx nerve pain.
Trigeminal Neuralgia
99
Acute paralysis of CN VII but may also affect CN V ; motor part - Ptosis ( drooping) - can't close the eye completely - risk for corneal abrasion or dry eye - lybricate patch at night ; sensory part - Pain ; Usually recover within a few weeks
Bell's Palsy - Facial paralysis
100
Migranes - Preventive medications - 2 migranes / week
1. Beta-blockers - Inderal
2. Tricyclic antidepressants - Elavil & Tofranil
3. Antiseizure - Depakote, Neurontin
4. Ergotamines - Migranal
101
Migranes - Abortive medications
1. Acetaminophen / NSAIDs; Excedrin ( acetam. + aspirin + caffeine )
2. Ergotamines - Cafergot
3. Triptans - Imitrex
102
Ergotamines + Triptans - !!! Caution
Vasoconstrict - use with caution in pts with hx of CAD, angina, PVD
103
Autoimmune disorder causing a decrease in the neurotransmitter acetylcholine at the neuromascular synaptic junction ; mainly affects face and eyes (muscles intervated by the cranial nerves)- drooping, difficulty chewing; dysphasia; dysarthria; weakness; trouble with secretions ; affects skeletal and respiratory muscles as well.
Myasthenia Gravis
104
Anticholinesterase medication - cholinesterase (enzyme that breaks down acetylcholine) inhibitors
TX of Myasthenia Gravis - Mestinon + Prostigmin - every 4-6 hrs; PO; 45-60 min before meals
105
Mestinon + Prostigmin - SE
Cholinesterase inhibbitors - diarrhea, cramping, increased salivation - until body adjust
106
Myasthenia Gravis - DX
1. Blood test - acetylcholine receptor antibody ( not positive in every pt)
2. Tensilon test - give drug to increase acetylcholine (short life) - within a minute - improvement in S/s
COMPLICATION - PNS - bradycardia ( Atropin )
107
Myasthenic crisis vs cholinergic crisis
Meds not on time ; throwing up due to illness or infection vs too much meds
108
Medications that should be avoided with myasthenia gravis
1. Morphine
2. Curare
3. Quinine (antimalarial)
4. Quinidine + Procainamide -Antiarrhythmic drugs
5. Mycin-type antibiotics
6. Drugs containing magnesium
109
MS - DX
1. MRI - can see plaques - intefere with impulse to the muscle
2. LP - SCF - immunoglobulins (IgG)
3. Evoked potential studies - auditory, visual
110
Multiple Sclerosis - exacerbation/ acute phase tx
1. Steroids - big doses - Solu-Medrol
2. ACTH ( hormone from pituitary gland - adrenal cortex - increase secretion of corticosteroids )
111
Priority nursing diagnosis for patient with spinal cord injuries at C 5 or higher
1. Ineffective Airway Clearence
2. Ineffective Breathing Pattern
3. Impaired Gas Exchange
Closely monitor the pt for pneumonia, PE, atelectasis - this problems decrease life expectancy of SCI patients - leading cause of death
112
Decadron + Solu-Medrol - use and SE
High doses steroids are given asap after spinal cord injury to reduce edema ; IV; SE: Infection, elevated serum glucose, stress ulcers ; low K.
113
Intervertabral disc herniation and degenerative disk disease - most common regions ?
Lumbur (5) - legs + Cervical (7) - shoulders and arms
114
Intervertebral disk herniation + degenerative disc disease - non-surgical management
1. NSAIDs
2. Medrol Dosepak - steroid
3. Muscle relaxants - Robaxin + Flexeril - may help control severe muscle spasticity (UMN injuries) ; spasms
SE: severe drowsiness + sedation
115
Sciatic Pain
pain, weakness, numbness or tingling in the leg - herniated disk - lumbar region (5)
116
Microdiskectomy
Involves microscopic surgery directly through 1-inch incision ; endoscope - remove herniated disk - relieve pressure ; 24 hrs - in and out
117
Removal of part of laminae and facet joints to obtain access to the disk space ; when repeated laminectomies are performed or if the spine is unstable - spinal fusion is performed to stabilize affected area ; chips of bone are removed (from iliac crest) or obtained from donor bone and are grafted between vertebrae for support and to strenghten the back - metal implants (titanium pins, screws, plates or rods) may be used to ensure the fusion of the spine
Laminectomy
118
Laminectomy - post op - correct turning - log rolling
Every 2 hours from side to back and vice versa ; pt turns as a unit while his or her back is kept as **_strainght_** as possible
119
Anterior cervical diskectomy and fusion - cervical corpectomy
The priority of care is maintaining airway - swelling from surgery can narrow the trachea causing a partial obstruction
No lifting
No driving until physician permission
No strenuous activities
Walk every day
Wear brace or collar per surgeons prescription
120
S/s of spinal tumor - depends on location (thoracic 12 - most common)
1. Pais due to pressure on the spinal cord nerve roots
2. Numbness
3. Tingling
4. Loss of bladder/bowel function
5. Foot drop
121
Spinal shock
trauma to cord itself - flaccid paralysis initially - 4 hrs-2 weeks - until pt comes out of this state - can't assess how much function pt will have - all reflexes are gone - no peristalsis - Risk - paralytic ileus (NG tube) ; Foley.
122
Amyotropic Lateral Sclerosis - DX
1. Increased CK
2. Abnormal EMG - electromyogram - give shocks to see how muscle responses - fasciculations (twitching)
3. Dysarthria + Dysphagia
123
Cushings syndrome
124
Dilantin - SE
Antiepileptic - Antiseizure med - Gingival hyperplasia (overgrowth of gum tissue) - Dental care !!!
125
Cushings triad
classic but late sign of increased ICP
1. Severe hypertension
2. Widened pulse pressure
3. Bradycardia
126
ICP
keep below 20
127
Meningitis S/s:
1. Fever
2. Headache
3. Nuchal rigidity ( neck stiffness)
4. Increase in WBC
5. Brudzinskis and Kernigs signs
128
SIDH - TX
1. Fluid restriction - ( 800 ml/ 24 hrs)
2. If Na very low ( \< 125) - 3 % Saline solution - small amount , slowly - monitor closely - **_Risk for cerebral edema !!!_**
129
Craniotomy -
1. Supratentorial - cerebrum
2. Infratentorial - cerebellum
130
Brain Tumors - S/s - depends on location
1. Changes in personality or behavior (frontal lobe)
2. Headache
3. N+V
4. Seizures
5. Visual disturbances (occipital lobe)
6. Balance and coordination problems ( cerebellum) - ataxia, falls
131
Antiseizure meds and SE
1. Dilantin, Tegretol, Klonopin, Neurontin , Depakote, Valium
SE: drowsiness, lethargy, sleepiness, sedation (until get adjusted ) Do not drive !!!; Blood dyscrasia (CBC)
132
PO corticosteroids
give in the morning ; with food (breackfast)
133
Stereotactic Radiosurgery - advantages
for deep seated brain tumors : shrink (radiation) - no incision
1. noninvasive nature
2. lower risk, cost, morbidity , length of hospital stay , recovery time
134
Autonomic Dysreflexia - T6 or higher - pathophysiology
Noxious stimulus (distended bladder or bowel) - stimulates SNS - vasoconstriction - **_pounding headache + severe hypertension**_ (Risk - Stroke) - baroreceptors of carotid sinus + aortic arch stimulate vagus nerve (PNS) - _**decreased HR + nausea**_ - dilates skin vessels above level of injury - _**flushing, diaphoresis, nasal congestion _**
135
Autonomic Dysreflexia - Nursing Management
1. Head up
2. Call for help
3. Assess for + remove noxious stimulus ( catheterize, disimpact )
4. Monitor BP Q 10-15 min
5. CCB (IV) or Nitrates (Nitroglycerin, Procardia) - sublingual
136
Niphedipine (Procardia)
Nimodipine (Nimotop)
Verapamil (Calan)
Calcium Channel Blockers - tx cerebral vasospasm , hypertension
137
Ruptured aneurysm S/s
Severe headache , N&V - die quickly if massive hemorrhage
138
Aneurysm that is leaking - S/s
headache , stiff back and legs, intermittent nausea
139
Strokes - FAST
140
Complications of aneurysm
1. Vasospasm - 4-10 days after initial bleed - ischemic episode - brain tissue death
tx: Prevent !!! - control BP - CCB ( Procardia, Verapamil, Nimotop)
2. Re-bleed - bleed that seals itself can re-bleed within 24-48 hrs or 7-10 days later
141
Cervical injury suspected - how to open airway
Jaw thrust - fingers behind the mandible - push forward - will bring tongue forward
142
Tetraplegia, also known as quadriplegia
Complete paralysis of the body from the neck down.
143
Paraplegia
impairment in motor or sensory function of the lower extremities
144
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