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Neuro Flashcards

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1
Q

Name the cranial nerves

A

“On Old Olympus Towering Tops A Fin And German Viewed Some Hops”

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

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2
Q

function of CN III

A

oculomotor most EOMs, opening eyelids, pupillary CONSTRICTION

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3
Q

function of CN IV

A

trochlear down & inward movement of eye

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4
Q

function of CN V

A

trigeminal muscles of *mastication, sensation of face/scalp/cornea/mucous membranes/nose

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5
Q

function of CN VI

A

lateral eye movement

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6
Q

function of CN X

A

vagus -talking -swallowing -general sensation from carotid body/carotid reflex

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7
Q

function of CN IX

A

glossopharyngeal -phonation (1/3) -**gag reflex -swallowing -taste (posterior)

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8
Q

function of CN XI

A

spinal accessory -movement of trapezius & sternomastoid muscles (shoulder shrug)

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9
Q

function of CNXII

A

hypoglossal -moves tongue

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10
Q

Which CN are sensory, motor or both?

A

“some say money matters but my brother says big brains matter most” I-S II-S III-M IV-M V-B VI-M VII-B VIII-S IX-B X-B XI-M XII-M

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11
Q

components of MMSE

A

-appearance -behavior -cognition -thought process

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12
Q

Mini Mental Status Exam

A

ORArL, 2, 3, RWD

O:orientation

R: recognition (repeat 3 objects)

A: attention (serial 7s counting backward)

r: Recall (ask to repeat 3 objects again)

L: language

2: identify 2 names of objects
3: follow a 3 step command

R: reading (read statement to yourself, do as it says and read aloud) W: writing

D: drawing (clock drawing)

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13
Q

Maximum score of MMSE

A

30

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14
Q

what score(s) on MMSE is indicative of NO cognitive impairment?

A

24-30

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15
Q

What score on MMSE is indicative of mild cognitive impairment?

A

18-23

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16
Q

amaurosis fugax is a symptom of which disease process?

A

TIA

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17
Q

vertebrobasilar TIA

A

as a result of inadequate blood flow from vertebral arteries

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18
Q

Presentation of vertebrobasilar TIA

A

vertigo

ataxia

dizziness

visual field deficits

weakness confusion

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19
Q

Presentation of carotid TIA

A

(typical CVA presentation) -aphasia -dysarthria -altered LOC -weakness -numbness

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20
Q

Management of TIA

A

ASA

Plavix (75mg QD)

Ticlopidine (Ticlid- a/w agranulocytosis, TTP, &; GI intolerance)

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21
Q

When is carotid endarderectomy indicated after TIA?

A

for >70-80% stenosis of vessels for symptomatic patients

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22
Q

S&S of L (dominant) hemisphere CVA

A
  • right hemiparesis
  • aphasia
  • dysarthria
  • difficulty reading/writing
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23
Q

S&S of R (non-dominant) hemisphere CVA

A
  • left hemiparesis
  • R visual field changes
  • spatial disorientation
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24
Q

What is the treatment of choice for ischemic (thrombotic) strokes?

A

tPA -fibrinolytics

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25
What time frame should fibrinolytics be given for ischemic CVA?
\<3-4.5hr
26
3 H's of ICP
hypotension hypoxia hypercapnia
27
Indications of ICP monitoring
- severe head injury who can't be serially neurologically assessed - severe head injury (GCS \<8 + ABN CT scan) - severe head injury (GCS \<8 + normal CT scan & 2 of the following present: age \>40yr, BP \<90, abn posturing)
28
which seizure is most common in children?
absence (petite mal)
29
which diagnostic test is indicated for all new onset seizures?
CT
30
What is the drug of choice if Phenytoin is unresponsive in treatment of seizures?
Phenobarbital
31
Carbamazepime (Tegretol) is used for?
long-acting anticonvulsant maintenance for seizures
32
Ethosuximide (Zarontin) is used for?
long-acting anticonvulsant maintenance for seizures
33
Primidone (mysoline) is used for?
long-acting anticonvulsant maintenance for seizures
34
Valproic acid (depakote) is used for?
long-acting anticonvulsant maintenance for seizures
35
MG is due to?
autoimmune disorder d/t decrease in the # of Ach receptors
36
MG most commonly affects which gender?
females
37
age of onset of MG
20-40yrs, \*\*3rd decade for females; 5-6th decade for males
38
What class of medications are used for tx of MG?
anticholinesterase inhibitors
39
Pyridostigmine bromide (prostigmin) is used for?
MG
40
MS is due to?
autoimmune disease in which body attacks myelin sheaths
41
MG most commonly affects?
\*white woman (european descent, living in temperate zones)
42
Onset of MS is usually when?
20-50yr
43
LAB abnormalites seen w/ MS?
mild lymphocytosis slightly inc protein in CSF \*elevated CSF IgG
44
Guillain -barre is due to?
peripheral nerve disease characterized by demyelination of peripheral nerves
45
Key finding in Guillain -barre
progressive ascending paralysis
46
Which syndrome is usually preceded by a viral infection w/ fever 1-3 weks before onset?
Guillain -barre
47
Which disease should be considered in any patient w/fever & neuro sxs?
meningitis
48
80-90% of meningitis is caused by which organisms?
- strep pnemo - h.influenzae - neisseria meningitidis
49
positive kernigs sign
pain & spasms through hamstring muscles- inability to straighten leg when hip flexed at 90degrees \*pt lays supine with knees bent and attempts to straighten legs
50
positive brudzinskis sign
legs flex at both hips & knees in response to flexion of the head/neck to the chest
51
xanthochromic
yellow in color (seen on CSF fluid)
52
CSF findings of bacterial meningitis
inc opening pressure + WBCs - inc protein - dec glucose
53
ABX in tx of meningitis
-Vanco + Ceftiaxone, PCN G until C&S data available or FQ
54
cushings triad
widening pulse pressure (inc SBP to attempt to maintain CPP) dec HR irregular respirations
55
4 P's of spinal cord injury
paralysis paresthesias pain position
56
At what SCI level, is hand movement maintained?
C7-T1
57
At what SCI level is respiratory compromise seen?
C4
58
Autonomic dysreflexia may occur with SCI at what level(s)?
T4-T6
59
S&S of autonomic dysreflexia
flushing/diaphoresis ABOVE level of injury chills/severe vasoconstriction BELOW level of injury
60
Brown-sequard syndrome
damage to 1/2 of spinal cord
61
Symptoms of brown sequard synrome
Ipsilateral upper motor neuron paralysis & loss of proprioception contralateral loss of pain & temp
62
Treatment for brown sequard
steroids
63
Treatment for cauda equina
MRI steroids \*\*surgery decompression (\*emergency)
64
At what SCI level can neurogenic shock occur?
above T6
65
Parkinsons disease is due to?
insufficient amt of dopamine
66
Age of onset of parkinsons?
usu 45-65
67
myersons sign
repetitive tapping over the bridge of the nose produces a sustained blink response
68
S&S of parkinsons
- tremor - rigidity - bradykinesia - decreased blinking \*myersons sign - wooden facies (flat affect) - imparied swallowing
69
Carbidopa-Levodopa (sinemet) MOA & use?
increases available dopamine; Parkinsons
70
Amantadine (symmetryl) MOA & use?
increases available dopamine; Parkinsons
71
Donepezil (aricept) MOA & use?
acetylcholinesterase inhibitor--\> inc available Ach; Alzheimers
72
Pramipexole (mirapex) MOA & use?
increases available dopamine; Parkinsons
73
Galantamine (Razadyne) MOA & use?
acetylcholinesterase inhibitor--\> inc available Ach; Alzheimers
74
Ropinirole hydrochloride (requip) MOA & use?
increases available dopamine; Parkinsons
75
Benztropine (cogentin) MOA & use?
anticholingeric; help alleviate tremor in Parkinsons
76
Rivastigmine (exelon) MOA & use?
acetylcholinesterase inhibitor--\> inc available Ach; Alzheimers
77
Trihexyphenydril (artane) MOA & use?
anticholingeric; help alleviate tremor in Parkinsons
78
DEMENTIA pneumonic to r/o other diseases
D: drugs E: emotional disorders M: metabolic/endocrine disorders E: eye/ear disordres N: nutritional problems T: tumors I: infection A: atherosclerosis
79
aphasia
difficulty w/speech
80
aprAxia
difficulty w/ performing previously learned tAsk
81
agnOsia
difficulty recognizing an object
82
most common cause of dementia
alzheimers
83
Patho of Alzheimers
d/t Ach deficiency A in Alzhiemers= A for Ach deficiency
84
If SCI at C5-C6, what abilities do they have?
quad; some extension of wrist, index finger & thumb
85
If SCI at C6-C7, what abilities do they have?
\*elbow extension, capable of feeding, dressing

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