Neurology Flashcards
Decorticate positioning versus decerebrate
decorticate: flexion at elbows. bilateral cerebral dysfunction
decerebrate: extended arms. upper brain stem
normal ICP levels
5-15mmHg
what trial said more harm in steroids after TBI?
CRASH in 2005
which have more DEPRESSANT effects on evoked potential monitoring - inhalational or IV anesthetics?
volatiles.
ketamine and etomidate can attenuate SSEP amplitude
eaton-lambert is:
autoantibodies against presynaptic calcium channel. get stronger with use.
what medications cause direct cerebral vasodilation?
calcium channel blockers, nitro, adenosine, hydralazine
goal for barbiturate coma
burst suppression
congenital myastenic crisis tx
not plasmapheresis bc it isn’t against autoantibodies - it’s a genetic mutation in acetylcholine
hypokalemic periodic paralysis
AVOID HYPERGLYCEMIA - insulin release will drive K out of serum into cells.
corneal reflex afferent and efferent caused by
trigeminal, facial
positive apnea test
failure of a breath when PaCO2 >60
ways to help prevent peripheral nerve injury
intraneural pressure <20 PSI
elderly change in body composition
fatter, less lean muscle mass, decrease in total body water
so smaller central compartment -> boluses have greater effect
but greater volume of distribution with greater fat
what hormones use the CGMP system?
nitric oxide, nitroglycerine, sodium nitroprusside
-> protein kinase G -> platelet inhibition, smooth muscle relaxation
time to elective surgery for balloon angioplasty, ACS without intervention, BMS, DES (and if time-sensitive), and acute store
balloon: 14 ACS/MI without intervention: 60d BMS: 30 DES: 90 if time sensitive, 180 if not acute stroke: 6 weeks
