Neuro Flashcards by Lani Manners

5 major components

level of consiouness
motor function
eye signs
respirator
vital signs

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what is the earliest and most reliable indicator of increased ICP

level of consiousness
GCS

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normal ICP

0-15

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what is bad ICP

sustained above 20

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what is the way to assess for motor to pain

trapezius squeeze

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GCS

motor
eyes
verbal

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decorticate

into the core
flexion

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decerebrate

externsion
down

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dermatomes is best for

spinal injury

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who might have decreased smell

elderly

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why is pupils PERRL and not PERRLA

A is accommodation and we normally do not turn lights off

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anisocoria

unequal pupils

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diplopia

double vision

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corneal reflex

touch eye and see if reflex

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oculocephalic reflex is also called

dolls eyes

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what is normal for dolls eyes

turn eyes to the side (follow)

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occulovestibular

cold caloric test

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cold caloric test normal

syrginge of cold water into ear and eyes should go to that sidel

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lid lag

eye does not close all the way

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central neurogenic hyperventilation

increase RR

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cushings triad tells us what

INCREASE ICP

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what is cushings triad

widened pulse pressure (increase sbp)
decrease pulse
decrease respiration

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what is herniated

push brain tissue else where

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s/s of basilar fracture

raccoons eyes
halo sign
battle sign

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ptosis

eye drooping

homonymous hemianopsia

lose vision on one side - the side of the name is the side of lacking of vision

vision changes mean it is worse or better

worse

tardive dysnekeisa is caused by

psych meds - newer ones not so much

what is a seizure

increase brain activity usually underlying cause

what are some causes of seizure

alcohol withdrawl electrolyte tumor trauma flashing lights

aura

subjective

what meds to stop the seizure

valium or ativanIV

what to do if having a seizure

put on side clear the area around nothing in mouth

what is lacking in coma

arousal and awareness

are comas always caused by one cause

no can be multiple

what are the 2 main categories of coma

structural metabolic

what do we need to do with our assessment for coma

REPEAT

persistent vegetive state

either full coma or wake up a little but still no awareness

what is known as mini stroke

TIA

know modifiable vs nonmodifable

hemorrhaging vs ischemic

hemorrhaging is bleeding ischemic is occulsion

what is the majority of strokes

ischemic

TIA

transit ischemic attack is a temporary neulogoci defect caused by cerebrovascular disease that leaves no imaging or clinical trace

can ishemic turn into hemorrhagic

yes

greatest risk factor for ischemic stroke

hypertension * also dyslipidemia, diabetes, smoking, carotid atherosclerosis, a fib

treatment for ischemic stroke

fibrinolytic therapy AKA TPA

time for TPA

3-4 hours

brain stem

N/V

hemorrhage

decrease LOC

carotid

numbness language

veretebrobasilar

visual paralysis vertigo

door to CT

25 min

Door to ct READ

45 min

door to thrombolytic therapy

60 min

NIHHS range

0-42

why might want to keep BP generally high in ischemic

ensure blood flow

when do we treat for ischemic - when is BP too high

SBP 220 DBP 120 MAP 130

what do we want to do before TPA adminstration

IV, foley, end cause HIGH BLEEDING RISK

indicator to brain bleed

ICP

BE FAST

balance eyes facial droop arm speach time

causes of a subarachnoid hemorrhage `

cerebral anerysm or AVM bleed

S/s of subarachnoid hemorrhage

WORST HEADACHE EVER

best way to find cerebral aneurysm

CT scanh

how to fix cerebral ansrsum

clip= rupture coil= no rupture

subarchanonoid hemorrhage triple H therapy

hypertensive hypervolemic hemodilutuon

epidural hematoma S/s

lose consciousness lucid rapid deterioration normally feel better after consciousness regained but then could die

acute subdural

deteriorate in first 24 hours

subacute subdural

4-21 days

chronic subdural

after 21 * might not even remember hitting head

intracerebral is associated with

trauma and answesym

diffuse axonal injury

shearing of neurons SPINING/TURNING

how will CT look in diffuse axonal injury

normal - multiple little spots of bleeding

secondary injurt

anything that results from that primary injurt

more seconday

more risk of death

normal ICP

0-15

cerebral perfusion pressure

how much blood pressure flow to brain

normal CPP

70-100

how to calculate CPP

MAP-ICP

Uncial herniation

pushing of Brain tissue else where - cells, CSF, blood

what can cause herniation

increase ICP=sodium, straining, exercise, stress, suctioning, coughing

do not want ICP sustained over20

how to calculate MAP

(2x DBP) + SBP _______________ 3