Neuro Terms

Question 1

Hemiparesis

Answer 1

Weakness on one side of the body

Question 2

Hemiplegia

Answer 2

Paralysis in one side of the body

Question 3

Decorticate posturing

Answer 3

Hands to the chest (to the core)
Fists
Feet inward
Cerebral hemisphere damage
Thalamus damage
Midbrain
Less severe

Question 4

Decerebrate posturing

Answer 4

Hands to the sides
Very severe
Elbows extended
Brain stem damage
Soon herniation (will die)

Question 5

Cushings triad

Answer 5

-BP goes up due to SNS compensation
-HR goes down due to PNS compensa
-Irregular resp.rate b/c brain stem pressure (Cheyne stokes- apnea)

Question 6

Clinical manifestations of high ICP

Answer 6

• LOC changes - early
• Ocular signs - late
  -Motor function decrease- late
• Vitals changes - cushings - very late
• Headache (continuous)
• Vomiting (projectile)
• Seizures

Question 7

ICR- intercranial regulation issues

Answer 7

1. Blood flow impaired
2. Brain tissue damaged
3. Neurotransmission compromised
4. Glucose regulation impaired

Question 8

Monro-kellie doctrine

Answer 8

-compensatory- how the brain maintains ICP in the skull
- increase in one brain space will cause decrease in another (compensatory)
- when this fails , you get high ICP
-

Question 9

CPP mmHg measurement

Answer 9

70-90mm Hg

Question 10

CPP is made up of what 2 numbers

Answer 10

MAP - systemic - blood to the brain
ICP- compresses arteries + keeps blood flow going. (5-15mm Hg)

Question 11

Bad ICP is what measurement

Answer 11

> 20mm Hg

Question 12

ICP compensatory mechanisms

Answer 12

1. CSF volume (monro-kellie doctrine)
2. Autoregulation (PaCo2, PaO2, pH)

Question 13

Causes of tissue damage in the brain

Answer 13

-tumour
-abscess
-cerebral edema
-contusion (small bleeds throughout)

Question 14

Causes of blood space changes in the brain

Answer 14

-intracranial hemorrhage
-intracranial hematoma

Question 15

Changes in CSF in brain

Answer 15

• hydrocephalus (ventricles)
• meningitis (inflammation of meninges)

Question 16

Acute neurological disorders

Answer 16

-Bacterial meningitis

Question 17

Most common meningitis in adults

Answer 17

1. Pneumococcus meningitis
2. Meningococcal meningitis

Question 18

Most common meningitis in infants

Answer 18

Group B streptococci

Question 19

Bacterial meningitis progression (9 steps)

Answer 19

1. Bacteria inhaled & sticks to endothelial cells in nasal pharynx
2. Enters blood stream and travels to brain
3. Crosses BBB
4. Infects meninges
5. (Inflammatory response)
   -neutrophils
   -cytotoxic inflammatory agents
   - change in vessel permeability
   - proteins leak out, fluid goes with =tissue edema
6. CSF gets thick w/exudate (cells + protein)
7. CSF thickness decreases CSF flow in brain & spinal cord
8. CSF obstruction and hydrocephalus in ventricles
9. CSF increase + Cerebral edema = ICP increase (leads to decreased blood flow, ischemia , infarction)

Question 20

Meningitis specific manifestations

Answer 20

-throbbing headache (irritation of meninges
-photophobia
-nuchal rigidity (neck stiffness)
-kernig sign
-brudzinski sign

Question 21

Cerebral edema some causes we studied in more detail

Answer 21

1. Brain hemorrhage
2. Bacterial Meningitis
3. Hepatic encephalopathy
4. Brain hematoma
5. Brain herniation