Neurologic Emergencies Flashcards

1
Q

Central Nervous System

A

Responsible for thought, perception, feeling and autonomic body functions
(Brain, brainstem, spinal cord)

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2
Q

Peripheral Nervous System

A

Responsible for transmitting commands from the brain to the body and receiving feedback from the body
(Cranial Nerves, peripheral Nerves)

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3
Q

Efferent Nerves

A

Leave the brain and convey commands to other parts of the body

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4
Q

Afferent Nerves

A

Send signals to the brain

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5
Q

Diencephalon

A

Filters unneeded information before reaching cerebral cortex

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6
Q

Midbrain

A

Responsible for regulating LOC, including patterns of sleep and wakefulness

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7
Q

Brainstem

A

Controls pulse, pressure, and respiratory rate and pattern

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8
Q

Pons

A

Controls respiratory rate and depth

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9
Q

Medulla Oblongata

A

Controls pressure and pulse rate

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10
Q

Limbic System

A

Where rage and anger are generated

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11
Q

Hypothalamus

A

Where pleasure, thirst and hunger are found

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12
Q

Pituitary Glands

A

Receives information from the hypothalamus and then sends chemical to the adrenal glands to release epi and norepi

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13
Q

Adrenal Glands

A

Release epinephrine and norepinephrine

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14
Q

Cerebellum

A

Manages complex motor activity unconsciously (tree of life)

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15
Q

Synapse

A

Connects to the cell by chemicals called neurotransmitters. Doesn’t physically touch the nerve cell

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16
Q

Neurotransmitter

A

Dopamine, acetylcholine, epinephrine, serotonin

These chemicals send signals from one nerve cell to the other

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17
Q

Axon

A

Bridge that connects the synapse to the nucleus

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18
Q

Myelin

A

A sheath that surrounds the nerve cell allowing the cell to transmit its signal consistently without “shorting out”

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19
Q

Vitals for Increased Intercranial Pressure

A

Decreased HR, Decreased RR, Increased BP

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20
Q

Trismus

A

Clenched teeth

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21
Q

Ptosis

A

Drooping, sagging, or prolapse of a part of the body

Bell palsy, stroke

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22
Q

Coma

A

State where patient does not respond to painful stimuli

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23
Q

Supra orbital Foramen

A

Notch near bridge of nose used to elicit pain

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24
Q

Decorticate Posturing

A

Contractions of arms towards their chest and point their toes
Indicative of damage directly below cerebral hemisphere

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25
Decebearate Posturing
Contract arms and wrists outwards and point their toes | Indicative of damage near the brainstem
26
GCS
``` Eyes Opening- 4 Spontaneous 3 Voice 2 Pain 1 None Verbal- 5 Oriented 4 Disoriented 3 Innapropiate Words 2 Incompetent 1 None Motor- 6 Obeys 5 Localizes 4 Withdraws 3 Decorticate 2 Deceberate 1 None ```
27
Hallucinations
Hear voices, see snakes, feel insects, all that are within their mind
28
Delusions
Thoughts or perceived abilities that are not based on reality
29
Psychosis
Patient can not tell what is real or inside his mind
30
Corneal Reflex
Tap between the eyes to determine gag reflex
31
Pupillary Response
``` Shine from 45 degree angle Thickness of dime is about a millimeter Dialated with adrenaline Constricted when relaxed <1mm is not abnormal ```
32
Agnosia
Unable to tell you names of an object
33
Apraxia
Unable to use a common object
34
Receptive Aphasia
Unable to understand speech, but able to speak clearly
35
Expressive Aphasia
Unable to speak clearly, but understand speech
36
Global Aphasia
Unable to talk or understand
37
Hemiparesis
Weakness of one side of the body
38
Hemiplegia
Paralysis of one side of the body
39
Gait
Walking pattern | Parkinson's is abnormal
40
Ataxia
Unable to perform coordinated motions such as walking
41
Myoclonus
Rapid, jerky, muscle contraction that occurs involuntarily
42
Dystonia
Part of body contracts and remains contracted | Use diphenhydramine for cure
43
Tonic
Rigid, contracted body posture
44
Hypertnic
Rigid, ARCHED back
45
Clonic
Rhythmic contraction with tonic and hypertonic phases
46
Paresthesia
Numbness or tingling
47
Anesthesia
Complete block of feeling or sensation
48
Strokes
Ischemic (75%) & Hemmorrhagic (25%)
49
Ischemic Stroke
Occlusion or blockage within the brain Thrombus or embolus Tissue begins to die but the brain does not become worse, just that isolated area
50
Hemorrhagic Stroke
Tend to get worse over time due to increased pressure and brain herniation "Worse headache of my life"
51
Assessment of Stroke
Language- slurred speech, Aphasia, ptosis, apraxia Movement- Hemiparesis, hemiplegia, arm drift, facial droop, ataxia Sensory- headache, blindness Cognitive- LOC, seizures, coma Cardiac- hypertension
52
Management of Stroke
- No atropine. The ICP is causing the bradycardia - maintain BP at least 110-120 - slight hyperventilate at 16-20bpm - etCO2 high 20's low 30's
53
Ischemic Stroke Fibrinolytic times
Less than 3 hours
54
Transient Ischemic Attack
Episodes of cerebral ischemia without permanent damage | Symptoms relieved within 24 hours
55
Coma
``` Use mnemonic AEIOUTIPS Alcohol, acidosis Epilepsy. Benzodiazepines Insulin. D50 or glucagon Overdose. Romazicon, narcan, glucagon Uremia. Temp, glucose, oxygen Trauma. Spine, pressure Infection. Pressure Psychosis. Oxygen, glucose, temp Stroke. Oxygen, glucose, temp ```
56
Seizures
Sudden, erratic firing of neurons
57
Tonic/Clonic Seizures
``` "Grand mal" Aura LOC Consider ventilation, airway Tonic and IM benzo Hypertonic Clonic Postictal ```
58
Absence Seizures
"Petit mal" Little or NO movement (eyelids, finger shaking, stop walking) Last several seconds
59
Pseudoseizures
Psychological "fake" seizure
60
Jacksonian March
Spreading of localized seizure and spreading through the body
61
Partial Seizure
Localized to one part of the body
62
Status Epilepticus
A seizure that lasts longer than 4 to 5 minutes or consecutive seizures without return of consciousness between seizures
63
Prodromal
Signs or symptoms following and event | Fall- dizziness, weakness
64
Management of migraine headaches
``` Toradol 30mg Demrerol 25mg Morphine 2-4mg Fentanyl 25mcg Zofran 4mg Phenegran 12.5-25mg ```
65
Demntia
Chronic deterioration of memory, personality, language skills, perception, reasoning, or judgement with no LOC -check BGL,
66
Wernicke encephalopathy dementia
Mostly reversible Lack of vitamin B1 from malnourishment administer thiamine 100-200mg IVP before any glucose May have hypo or hyper deficiencies
67
Neoplasms
Growths within the body | Benign or malignant
68
Metastasis
Process by which cancerous cells move from their site of origin
69
Assessment of Neoplasm
May have months of headaches and suddenly have a seizure
70
MS (Multiple Sclerosis)
Autoimmune disorder in which the body attacks the myelin sheath of brain and spinal cord
71
Assessment of MS
Nystagmus, involuntary movement of the eyes Impairment of pain, touch and sensory Lhermitte Sign- experiencing electrical sensation when head is flexed forward
72
Management of MS
Administering anti-inflammatory can decrease length of attack
73
Gillian-Barré Syndrome
Immune system attacks portions of the Nervous System | Begins in the feet and works up towards the head
74
ALS (Lou Gehrig Disease)
Disease that strike voluntary motor neurons Assessment- fatigues, general weakness, difficulty doing daily activities. Destruction of neurons eventually stop the patient from breathing
75
Parkinson's Disease
Past injuries to the brain have influence. | Assessment- tremors, postural instability, ridgidity, bradykinesia
76
Bradykinesia
When patient takes small steps when turning with abnormal gait
77
Dystonia
Severe muscle cramps that cause bizarre contortions or postures Assessment- usually take antipsychotic medications Management- diphenhydramine 25-50mg
78
Trigeminal Neuroglia
Stabbing or shock pain in the face | Involves cranial Nerve V
79
Ménière Disease
Increased fluid within the ear | Tinnitus, dizziness, hearing loss, can cause permanent deafness
80
Encephalitis
Caused from herpes simplex virus | Stiff neck, fever, malaise, vomiting, confusion and seizure
81
Meningitis
Inflammation of meninges KernignSign- unable to straighten leg when hips flexed BrudzinskiSign- flexed knees when neck flexed
82
Poliomyelitis
Viral infections caused by fecal-oral route | Virus attacks motor neurons in brain
83
Peripheral Neuropathy
Group of conditions in which Nerves leaving spinal cord are damaged Assessment- as BGL rises, damages occurs to peripheral nerves
84
Hydrocephalus
Hydro- means water Cephalosporins- means head Only 120ml of CSF is present in CNS OUR BODIES PRODUCE .3ml/min Hydrocephalus is the body's ability to produce adequate amounts of CSF but does not ride body of it fast enough Assessment- lethargy, irritiability, vomiting, sun-setting eyes Management- a shunt is placed in ventricle in brain. Drains CSF from brain to the abdomen. Be prepared for seizures with complications of shunt.
85
Spine Bifida
Part of spine remains outside of the body.
86
Cerebral Palsy
Damage done to the brain (frontal lobe).