Neurologic Emergencies Flashcards

1
Q

What is the Monro-Kellie Doctrine?

A

80% Brain
10% Blood
10% CSF

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2
Q

Intracranial Pressure

A

Normal ICP: 5-15 mmHg

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3
Q

Herniation

A

Risk if ICP >20 longer than 5 mins

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4
Q

MAP Equation

A

Diastolic + 1/3 (Systolic - Diastolic )

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5
Q

Cerebral Perfusion Pressure

A

CPP = MAP - ICP

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6
Q

Optic Ultrasound

A

Monitors ICP by measuring optic nerve diameter

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7
Q

SjVO2

A

Fiber optic catheters placed into IJ to measure cerebral oxygen supply, perfusion, and consumption.

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8
Q

PbtiO2

A

brain tissue oxygenation monitoring, electrode placed on at-risk tissue

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9
Q

Intracerebral Microdialysis

A

Pulls minute amount of blood out to measure brain neurochemistry

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10
Q

Penumbra

A

Area surrounding the dead tissue is hypoxic, irritated, and is salvageable

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11
Q

Ischemic Stroke: BP Management

A

Systolic: 140-160
Diastolic: 70-90
<180/105 before, during and 24hrs after tPA

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12
Q

tPA

A

Tissue Plasminogen Activator
-0.9 mg/kg max 90mg
-10% over 1 minute, 90% over 60 minute transfusion

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13
Q

TNK

A

Tenecteplase
- Cheaper than tPA
- More favorable
- Given in a single bolus

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14
Q

Subarachnoid Hemorrhage

A

SAH
“Worst headache of life”
“Thunderclap”
Starfish sign on CT

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15
Q

AEIOU TIPS

A

Acidosis
Epilepsy
Insulin
Overdose
Uremia
Trauma
Infection
Psychosis
Seizures

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16
Q

Glasgow Coma Scale

A

Eye opening (1-4)
Verbal responsiveness (1-5)
Motor function (1-6)

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17
Q

Delirium

A

“Acute brain failure”

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18
Q

GCS Eye Opening

A

4-Spontaneous
3-To sound
2- To pressure
1-None

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19
Q

GCS Speech

A

5-Oriented
4-Confused
3-Words
2-Sounds
1-None

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20
Q

GCS Motor Function

A

6-Obeys commands
5-Localized
4-Normal flexion
3-Abnormal Flexion
2-Extension
1-None

21
Q

Contraindications for thrombolytics

A

History of hemorrhagic stroke
CVA last 13 months
SBP >180
Pregnant or 1 month postpartum

22
Q

Lung development unable to sustain life at

A

<23 weeks gestation or < 1lb fetal weight

23
Q

Full term neonatal tidal volume

A

5-7 mL/kg

24
Q

PEEP in neonate

A

4-6 cmH20

25
Q

CPAP

A

First line vent support in neonates
4-6 PEEP
30 - 100% FiO2

26
Q

Surfactant Administration

A

3 mL/kg

27
Q

Meconium Aspiration Syndrome

A

Presents with:
- Atelectasis
- Persistent Pulmonary Hypertension (PPH)
- Pneumothorax
- Pneumothorax

28
Q

Meconium Aspiration Syndrome treatment

A

Monitor for resp distress, treat with PPV, high PEEP, or surfactant

29
Q

Respiratory Distress Syndrome (RDS)

A

Surfactant deficiency related to preterm delivery
 Decrees compliance
Atelectasis
V/Q mismatch
Tachypnea
Increased work of breathing
Ground glass chest radiography

30
Q

Respiratory distress syndrome

A

Treatment
Oxygen administration
CPAP 6–8 cmH20
Intubation, mechanical ventilation
IV. Fluids.
IV antibiotics

31
Q

Gastroschisis

A

Herniation of abdominal contents through abdominal wall
- Usually on right side of umbilicus

32
Q

Gastroschisis treatment

A

Treat like abdominal evisceration

33
Q

Omphalocele

A

Protrusion of viscera attached to the umbilical cord 

Treatment: treat like abdominal evisceration 

34
Q

Congenital diaphragmatic hernia

A

Diaphragm fails to close during prenatal development, abdominal contents present in and thorax 
- scaphoid abdomen
- Bowel sounds over chest 

35
Q

Intestinal Malrotation and Volvulus

A

Malrotation: twisting of small bowel over on his self, resulting in obstruction
Volvulus: strangulation about from malrotation what’s on

36
Q

Normal CPP

A

50-90

37
Q

Cranial Nerve I

A

Olfactory
Smell

38
Q

Cranial Nerve II

A

Optic nerve
Vision

39
Q

Cranial nerve 3

A

Oculomotor nerve
Eye movement, pupil constriction

40
Q

Cranial Nerve IV

A

Trochlear nerve Eye movement

41
Q

Cranial nerve V

A

Trigeminal nerve

Somatosensory information (touch, pain) from the face and head; muscles for chewing.

42
Q

Cranial nerve VI

A

Abducens Nerve
Eye movement

43
Q

Cranial nerve VII

A

Facial Nerve

Taste (anterior 2/3 of tongue); somatosensory information from ear; controls muscles used in facial expression.

44
Q

Cranial Nerve VIII

A

Vestibulocochlear Nerve
Hearing, balance

45
Q

Cranial Nerve IX

A

Glossopharyngeal Nerve
Taste (posterior 1/3 of tongue); Somatosensory information from tongue, tonsil, pharynx; controls some muscles used in swallowing.

46
Q

Cranial Nerve X

A

Vagus Nerve
Sensory, motor and autonomic functions of viscera (glands, digestion, heart rate)

47
Q

Cranial Nerve XI

A

Spinal Accessory Nerve
Controls muscles used in head movement

48
Q

Cranial Nerve XII

A

Hypoglossal Nerve
Controls muscles of tongue