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Neuro Trauma Flashcards

(78 cards)

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1
Q

meningitis hallmark

A

HA
Fever
Stiff neck

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2
Q

real clue to pay attention to with a patient

A

mental status change!

esp. with space occupying lesions

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3
Q

inflammation of meninges that line the brain and spinal cord

A

meningitis definition

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4
Q

inflammation of brain

A

encephalitis

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5
Q

MCC of encephalitis

A

viral infections

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6
Q

umbrella term used to describe several different medical conditions that cause a malfunction or failure of the Autonomic Nervous System (ANS)

A

Dysautonomia

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7
Q

generic term for presence of a greater than normal number of cells in cerebrospinal fluid

A

Pleocytosis

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8
Q

Functional tissue of a specific organ

A

Parenchyma

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9
Q

Micro-hemorrhages with small vessel leakage into surrounding tissue

A

Parenchyma contusion

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10
Q

Complete separation of tissue (type of parenchymal)

A

laceration parenchymal

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11
Q

injury occurs under the site of impact with an object

A

coup

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12
Q

injury occurs on the side opposite the area that was initially impacted

A

contrecoup

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13
Q

Symptoms of coup/contrecoup are directly related to…

nausea, vomiting, atxia, etc.

A

new pressure within the cranial cavity that creates swelling of the brain and micro-hemorrhages of the vessels

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14
Q

Torque injuries of brain

A

when coup and contrecoup occur, the brain sloshes and rotates. This creates a torque pressure and alteration on the brain stem. This effects the lifelines of respiration rates and heart rates.

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15
Q

Coup and Contrecoup cervical injuries

A

results in flexion/extension (compression and extension) fractures and/or connective tissue damages. Often times, the connective tissues are stronger and cause avulsion fractures of the cervical vertebrae (bone fragments are torn away from the main bone segment).

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16
Q

Inflammation / infection of the meninges and brain

two different things with the same presentation

A

Meningitis+ Encephalitis: Meningoencephalitis

aka Encephalomeningitis

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17
Q

Aseptic meningitis/encephalitis

A

due to a virus - not as contagious or deadly

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18
Q

meninges of the brain (superficial to deep)

A

dura mater
arachnoid mater
pia mater

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19
Q

Triad of Cushing’s Syndrome

A

As you increase ICP, see:

  • elevated BP with widened pulse pressure
  • decreased pulse rate
  • irregular breathing patterns
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20
Q

epidural

A

above the dura mater

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21
Q

subdural

A

below the dura mater

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22
Q

subacrachnoid

A

below the arachnoid

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23
Q

bleeds below pia mater

A

usually venous bleeds

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24
Q

When the periosteum is torn…

A

check for depressed skull fracture

mental status changes –> more severe and should be admitted

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25
a state of prolonged unconsciousness
coma
26
Exists when there is a brain tissue insult with transient alteration in mental status
concussion
27
Complex disorder in which various symptoms Headaches, dizziness, concentration difficulties Can last for weeks and sometimes months after the injury
Post-concussion syndrome
28
Lightheadedness, fatigue, nausea, numbness, ataxia, confusion, disorientation, hallucinations, HA’s
Generalized Hypoxia
29
cyanosis
local hypoxia
30
Neurological abnormality affecting muscle coordination and movements. Non-specific manifestation of CNS dysfunction Causes: CVA, Tumors, MS, Hypothyroidism, Vitamin B-12 deficiency…
ataxia
31
Virus transmitted by arthropod vectors Probably most common: Ticks Mosquitoes
Arbovirus
32
Named by their transmission-route through the intestine (enteric = intestinal) Examples: Polio, Hand-foot-mouth dz, Encephalitis, Pericarditis
Enterovirus
33
Eyes move in the direction opposite to that of the head movement.
Positive / normal doll's eye reflex
34
Eyes move in the direction of the head movement
Negative doll's eye reflex signifies severe brain damage or brain death
35
Four bacteria most commonly responsible for meningitis/encephalitis/brain abscesses
``` Strep pneumoniae (45-61%) Neisseria meningitides (13-16%) Haemophilus influenzae type B (5-7%) Listeria monocytogenes (2-4%) ```
36
Four bacteria most commonly responsible for meningitis/encephalitis/brain abscesses in infants <2months of age
Group B strep
37
MC to remember for Dr. Hatch for all ages is....
Strep pneumoniae
38
For Dr. Hatch, children less than three months with fever (101 rectal), no matter what...
they get a full work up and admission. Concerned for meningitis ESP when no response to Tylenol and ibuprofen (10mg/kg)
39
brain abscess vs. meningitis/encephalitis...
brain abscess often does not have a fever
40
common causes of viral encephalitis and treatment
herpes simplex virus arboviruses treat with acyclovir
41
Empiric treatment of meningitis/encephalitis
ceftriaxone (rocephin)
42
risk factors of intracranial abscess includes...
endocarditis congential heart disease recent neurosurgery inadequately treated subacute/chronic ear, nose, mastoid, dental infection
43
Prions cause what three neurodegenerative brain diseases
Creutzfeldt-Jakob Fatal Familial Insomnia Kuru disease
44
meningitis rash
purpuric rash that does not blanch
45
Posturing of meningitis
decerebrate (more severe and deadly) decorticate (turn inwards towards core)
46
When you suspect ICP, perform ____ before an ___, due to prevention of ___.
When you suspect ICP, perform CT before an LP, due to prevention of brain herniation through relief of the ICP. Check papilledema to see if there is swelling of optic disc - performed when you don't have a CT. If present, NO LP!!
47
Common risks of LP's
Post procedure headache - prevented by hydration (2L of normal saline) & after the procedure, do not allow the patient to sit up - keep them flat for an hour. Then sit up at 30degrees for one more hour. Then sit upright for another hour.
48
Acute inflammatory demyelinating polyradiculopathy Considered an autoimmune disorder
Guillian-Barre Syndrome (GBS)
49
Most cases of GBS are preceded by an infection following...
Viral or febrile illness Campylobacter jejuni Vaccinations Surgery / Trauma
50
Classic GBS generally preceded by viral prodromal sx’s, followed by acute / sub-acute ascending symmetric weakness or paralysis and loss of DTR’s
Guillian-Barre Syndrome (GBS)
51
Does Guillian-Barre Syndrome (GBS) affect diaphragm?
Yes - requires intubation/mechanical ventilation
52
When these conditions occur, consider GBS
- HIV peripheral neuropathy - Neurotoxic fish/shellfish poisoning - Spinal cord compression/syndromes - Tick paralysis - Vitamin deficiencies - West Nile
53
For GBS, the LP should show...
elevated protein and low cell counts
54
Treatment for GBS
AIRWAY management AVOID corticosteriods - may not be beneficial and can be harmful
55
Acute peripheral facial (Facial, CN VII) nerve palsy
Bell's palsy
56
Bell's palsy is difficult to dx due to resemblance of a...
stroke! or Ramsay Hunt syndrome! (herpes zoster in the eye/CN 7 and 2)
57
Bell's palsy common risk factors include...
Recent fever, viral infection, tooth extraction, chilling episode from cold exposure
58
Facial nerve paralysis associated with ipsilateral zoster Vertigo and ipsilateral hearing loss (CN VII) Tinnitus Otalgia Headaches Fever Cervical adenopathy
Ramsay Hunt Syndrome Often times starts as blisters in the conchal bowl of the pinna
59
Cardinal sign of bell's palsy that helps to distinguish between stroke and Ramsay Hunt
unable to raise eyebrows and furrow the forehead
60
If the patient can raise the eyebrow / wrinkle forehead
then it is NOT Bell’s Palsy!!
61
If unable to close affected eye =
If unable to close affected eye = Bell's palsy
62
Difference b/w Bell's Palsy and stroke...
Bell's Palsy will not be able to wrinkle the forehead as all three divisions of the trigeminal nerve are affected.
63
Coma state is a...
spectrum. Ranges from awake/confused to frank/dense state of unresponsiveness.
64
Thiamine of coma cocktail
treats for alcohol intoxication
65
Glucose of coma cocktail
treats for diabetics
66
Narcan of coma cocktail
treats for opioid OD
67
Oxygen of coma cocktail
treats for hypoxia
68
Romazicon of coma cocktail
treats for benzos
69
Common age-related causes of Altered Mental Status and Coma: | Infant
infection trauma abuse metabolic
70
Common age-related causes of Altered Mental Status and Coma: | Child
toxic ingestion
71
Common age-related causes of Altered Mental Status and Coma: | Adolescent, young adult
toxic ingestion recreational drug use trauma
72
Common age-related causes of Altered Mental Status and Coma: | elderly
``` med changes OTC meds infection (check skin, lungs, urine) alterations in living environment stroke trauma ```
73
Post concussion syndrome treatment for headaches
1. amitriptyline 2. propranolol 3. neurontin
74
On CT, epidurals (arterial) are shaped like...
lemons
75
On CT, subdurals (venous) are shaped like...
bananas
76
Full comatose LOC followed by fully lucid interval with subsequent rapid neurological demise
epidural bleed
77
Progressive drop in LOC is likely a ___ bleed
Subdural bleed
78
Subdurals are common in...
elderly, alcoholics, children <2

Neurology (12 decks)

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