Neurological Emergencies

Question 1

Afferent

Answer 1

Sensory nerves

Question 2

Efferent

Answer 2

Motor nerves

Question 3

Cerebral blood supply

Answer 3

From vertebral arteries (20%) and internal carotids (80%)

Question 4

Circle of Willis

Answer 4

Complete circle around brain and pituitary gland

Safeguard if blockage in 1 artery

Question 5

2 Cerebral blood supply factoids

Answer 5

20% of body’s blood to brain

25% of body’s glucose to brain

Question 6

Meninges

Answer 6

Dura mater
Arachnoid mater
Pia mater

Question 7

Cerebellum

Answer 7

Balance, coordination and vision

Question 8

Cerebrum

Answer 8

Language and memory, learning analysis

Question 9

Cerebrum lobe

Answer 9

Frontal- personality
Parietal
Temporal- Speach
Occipital- Vision

Question 10

RAS

Answer 10

Reticular activating system

Question 11

Dorsal nerve root

Answer 11

Afferent

Question 12

Ventral nerve root

Answer 12

Efferent

Question 13

Broca

Answer 13

(expressive) Aphasia

speech is difficult to initiate, non-fluent, labored, and halting

Question 14

Wernicke

Answer 14

(receptive) Aphasia

Speech is preserved, but language content is incorrect.

Question 15

Paralysis

Answer 15

Loss of function, or voluntary movement, typically one side of the body or another

Question 16

Paresthesia

Answer 16

Abnormal sensation felt in body, usually in extremities, often referred to as numbness or tingling

Question 17

Hemiplegia

Answer 17

Paralysis of one lateral half of the body

Question 18

Hemiparesis

Answer 18

Muscular weakness or partial paralysis to one side of the body

Question 19

Aphasia

Answer 19

Unable to speak

Question 20

Aphagia

Answer 20

Unable to swallow

Question 21

AEIOUTIPS

Answer 21

A	Alcohol, Anoxia
E	Epilepsy – Seizure disorder
I	Insulin (hypoglycemia/ hyperglycemia)
O	overdose
U	uremia (renal failure)
T	trauma (head injury  and/or hypovolemia)
I	infection (CNS, septicemia, septic shock)
P	psych (psych meds can alter)
S	Stroke, CVA

Question 22

ALOC differential diagnosis in the field

Answer 22

Medical
Trauma
Psychiatric

Question 23

Structural coma

Answer 23

lesions CA, CVA, trauma

unilateral dysfunction, pupil changes

Question 24

Metabolic states

Answer 24

Toxic states, drugs, diabetes, hypoxia

bilateral dysfunction, pupils may be equal

Question 25

Medulla increased ICP

Answer 25

respiration Altered , pulse decrease, B/P widening PP (kushings triad)

Question 26

TIA

Answer 26

resolves w/in 24 hours | spasm or blockage leading to cell ischemia

Question 27

Stroke

Answer 27

3 hour IV TPA time limit | 4 hour from onset of symptoms

Question 28

CVA

Answer 28

Thrombus or Embolus

Question 29

7 "D's"

Answer 29

``` DETECTION DISPATCH DELIVERY DOOR (ER) data decision drug, IV tpa ```

Question 30

LASS

Answer 30

``` age >45 no Hx seizure onset of symptoms in last 24hrs Pt was ambulatory at baseline Blood glucose 60-400 Unilateral asymmetry in 1 -Facial droop -Grip weakness or absence -arm drift(pronation) ```

Question 31

Focal seizure

Answer 31

specific motor, sensory or psychomotor phenomena

Question 32

Jacksonian

Answer 32

clonic convulsive movements or abnormal sensations begining in one hand or foot and "marching" to major muscle group.

Question 33

Psychomotor

Answer 33

Complex partial Temporal lobe seizures Seizures characterized by 1-2 minute loss of contact with surroundings (transient ALOC) Patient staggers or performs complex automatic behaviors, for example; climbing stairs. May present a sudden unexplained fits of rage Patient does not understand what is happening and may refuse aid due to confusion for 1 to 2 minutes after seizure Can be triggered by loud noises or rapid light movement Often preceded by specific auras (smell, taste or sound)

Question 34

Petite Mal

Answer 34

Absence Seizure- 10-30seconds

Question 35

Status epilepticus

Answer 35

2+ seizures

Question 36

Dystonia

Answer 36

Involuntary muscle contraction and distorted posture

Question 37

ptosis

Answer 37

eye droop

Question 38

Headaches are

Answer 38

Vascular

Question 39

Parkinson's Disease

Answer 39

50K new cases annually

Question 40

GCS =

Answer 40

EVM/eyes, verbal, motor | 4,5,6

Question 41

GCS Score

Answer 41

15

Question 42

Infarct, injury, ischemic part of the brain

Answer 42

Penumbra