Neurologic Emergencies Flashcards Preview

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Flashcards in Neurologic Emergencies Deck (86):
1

Central Nervous System

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

2

Peripheral Nervous System

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

3

Efferent Nerves

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

4

Afferent Nerves

Send signals to the brain

5

Diencephalon

Filters unneeded information before reaching cerebral cortex

6

Midbrain

Responsible for regulating LOC, including patterns of sleep and wakefulness

7

Brainstem

Controls pulse, pressure, and respiratory rate and pattern

8

Pons

Controls respiratory rate and depth

9

Medulla Oblongata

Controls pressure and pulse rate

10

Limbic System

Where rage and anger are generated

11

Hypothalamus

Where pleasure, thirst and hunger are found

12

Pituitary Glands

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

13

Adrenal Glands

Release epinephrine and norepinephrine

14

Cerebellum

Manages complex motor activity unconsciously (tree of life)

15

Synapse

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

16

Neurotransmitter

Dopamine, acetylcholine, epinephrine, serotonin
These chemicals send signals from one nerve cell to the other

17

Axon

Bridge that connects the synapse to the nucleus

18

Myelin

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

19

Vitals for Increased Intercranial Pressure

Decreased HR, Decreased RR, Increased BP

20

Trismus

Clenched teeth

21

Ptosis

Drooping, sagging, or prolapse of a part of the body
(Bell palsy, stroke)

22

Coma

State where patient does not respond to painful stimuli

23

Supra orbital Foramen

Notch near bridge of nose used to elicit pain

24

Decorticate Posturing

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

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).