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Neuro final
| Question | Answer |
|---|---|
| DECEREBRATE POSTURE | WORSE! rigid position assumed by a pt who has lost cerebral control of spinal reflexes, usually as a result of an intracranial catastrophe. Pt's arms are stiff and extended, forearms are pronated, & the deep tendon reflexes exaggerated. ARMS OUT |
| DECORTICATE POSTURE | the characteristic posture of a pt with a lesion at or above the upper brainstem. Pt is rigidly still with arms flexed, fists clenched and legs extended.ARMS IN |
| LOC | most reliable indicator of neurological status |
| GLASGOW COMA TEST | best PREDICTOR of how well pt will do. Lower score (7) = worse outcome. Highest = 15. not good if pt has posturing. |
| LOC - ALERT | follows commands; responds appropriately to stimuli |
| LOC - LETHARGIC | delayed response to verbal stimuli. May drift off, but can be aroused easily |
| LOC - STUPOROUS | needs vigorous stimulation to arouse |
| LOC - COMATOSE | no response to verbal or painful stimuli |
| ATAXIA | defective muscular coordination manifested when voluntary muscles are attempted. |
| ROMBERG TEST (motor function) | equilibrium/ataxia test. Stand and close eyes - if they sway, there is problem. |
| NYSTAGMUS | involuntary back and forth movement of eyes. |
| DYSKINESIA | deffect in ability to perform voluntary movements. PARKINSON |
| call dr | if there is pupul assessment change/ LOC |
| DILANTIN | common drug to control seizure/epilepsy. Need to know levels. Give instructions on what to do.take same time q day! |
| SEIZURE COMPLICATION | hypoxic. Give O2 mask |
| AURA | some people experience this preceding a seizure. It is a sensation such as dizziness, numbness, visual or hearing disturbance, perception of an offensive odor or pain |
| POSTICTAL STAGE | altered state of consciousness that a person enters after experiencing a seizure. It usually lasts bet 5 & 30 minutes, but longer in the case of larger or more severe seizures and is charac by drowsiness, confusion, nausea, htn, headache or migraine |
| GENERALIZED SEIZURE | these happens when all or most of the brain is affected. So much of the brain is involved that people blank out. |
| GENERALIZED SEIZURE - generalized tonic clonic seizure | used to be called GRAND MAL. The person blanks out, falls, stiffens then jerks uncontrollably for a minute or two. Rarely a medical emergency. |
| GENERALIZED SEIZURE - myoclonic seizure | lasts shorter time. It causes a massive muscle jerk that may throw the person who has it to the ground. |
| GENERALIZED SEIZURE - atonic seizure | causes sudden falls. It lasts only a few moments but can happen frequently. |
| GENERALIZED SEIZURE - absecence seizure | is very brief, lasts only a few seconds and looks like a blank stare, or daydreaming. While it is occuring, the person is completely unaware of his surroundings. It begins and ends suddenly. |
| GENERALIZED SEIZURE - infantile spasms | occurs in babies. They are clusters of brief jerking or jackknife movements. |
| PARTIAL SEIZURE | these happen when only part of the brain is affected, although they can spread to the whole brain and cause generalized tonic clonic seizures. |
| PARTIAL SEIZURE - simple partial | affects the senses, feelings, emotions and movement. Things may look bigger or smaller, there may be hallucinations of sight or sound. People can feel unexplained pain or fear or anger. People do not blank out. |
| PARTIAL SEIZURE - complex partial | may start like a simple partial seizure but progresses to cause loss of awareness and automatic movments that look like a trance like state. Lasts only a min or two but confusion afterwards may last much longer. |
| TENSION HEADACHE | result from prolonged muscle contraction from anxiety, stress, or stimuli from other sources, such as brain tumor or an absecessed tooth. Pain location may vary/ |
| MIGRAINE HEADACHE | due to intracranial vasoconstriction followed by vasodilation. Triggered by menstruation, ovulation, alcohol, some food, stress. Pain usually unilateral, often begins in the templee or eye area & is very intense |
| PARKINSON'S DISEASE | affects the basal ganglia responsible for automatic movements such as blinking, walking, eating, posture, muscle tone & facial expression. A DEFICIENCY OF DOPAMINE, A NEUROTRANSMITTER, CONTRIBUTES TO THE LOSS OF MOTOR FUNCTION |
| GUILLAIN-BARRE SYNDROME (acute inflammatory polyneuropathy) | inflammatory disorder charac by abrupt onset of symmetrical paresis (weakness) that progresses to paralysis. Characterized by progressive weakness and numbness that begins in the legs and ascends up the body. Comp: respiratory due to diaphram paralysis |
| INTRACRANIAL PRESSURE (normal) | 0-15 |
| INCREASED INTRACRANIAL PRESSURE | rise in CO2 constricts cerebral arteries so hyperventilation will decrease ICP (temp fix). LETHARGY IS THE MOST SIGNIFICANT SIGN! |
| MANNITOL (INC ICP) | drug of choice to decrease Inc ICP. Osmotic diuretic. Need to monitor I&O. |
| care for pt with INC ICP | mannitol, drain CSF, hyperventilation, head elevated at 30%, minimize handling care, hyperventilate the pt. |
| CUSHING RESPONSE | reflex due to cerebral ischemia that causes an increase in systemic blood pressure to maintain cerebral perfusion during increased intracranial pressure. |
| CUSHING RESPONSE - 3 classic symptoms | widening pulse pressure, HTN, bradycardia |
| s/s of ICP | vomitting, headache, dilated pupil on affected side, hemiparesis or hemiplegia, decorticate than decerebrate posturing, decreasing LOC, inc sys bp, inc than dec pulse rate, rising temp |
| HISTORY OF MIGRAINE | classic symptom - no neurological type symptom. No hemiplegia, weakness |
| SPINAL CORD INJURIES | most common cause = MVA |
| MENINGITIS | inflammation of the meninges. Normal wbc = 10,000. lumbar puncture will have elevated WBC, RBC, protein as well as CLOUDY FLUID. s/s - nuchal rigidity (stiffness of back of neck) |
| ENCEPHALITIS | inflammation of the brain. Infectious disease that is characterized by changes in both white and gray matter of the spinal cord and brain. More serious than meningitis. Classic sign = SEVERE HEADACHE |
| TIC DOULOUREUX (TRIGEMINAL NEURALGIA) | one or more branches of the trigimenal nerve (5th cranial nerve) become painful (mandibular, maxillary & opthalmic) |
| TIC DOULOUREUX (TRIGEMINAL NEURALGIA) S/S | pain comes in paroxysms many times a day (severe pain). Face may twitch and eyes tear. "trigger spots' may precipitate an attack. (slight touch, cool breeze, temp change) |
| BELL'S PALSY | inflammation of the SEVENTH CRANIAL nerve blocking motor impulses to facial nerves. It goes away. s/s facial droop. Tx : artificial tears and tape eyes shut to prevent dryness |
| MULTIPLE SCLEROSIS | NO CURE. Chronic progressive disease of the nervous system. Also called a demyelinating disease becausee it causes permanent degeneration and destruction of myelin. Affects voluntary movement. |
| EPIDURAL HEMATOMA | EMERGENCY!! Arterial bleeding and accumulation of blood on top of the dura. BURR holes to remove the clot. |
| SUBDURAL HEMATOMA | occurs as a result of venous bleeding and the accumulation of blood in the space below the dura |
| INTRACRANIAL PRESSURE | ventricular cathether in head, shows pressure |
| SPINAL CORD SHOCK | (NEUROGENIC SHOCK) sudden depression of reflex activity below the level of injury. |
| SPINAL CORD SHOCK complication | may last up to 6 wks post injury. |
| SPINAL CORD SHOCK s/s | hypotension (), bradycardia, dec resp rate, flaccid paralysis, WARM, DRY SKIN, no perspiration below level of injury. |
| SPINAL CORD SHOCK tx | VASOPRESSOR - dopamine (hypotension), atropine for bradycardia (to inc HR), fluids, cath foley - due to gastric distension |
| CONCUSSION | a temporary loss of cerebral function w/ no damage to cerebral tissue. Neuro check q2 hrs. if LETHARGIC, go back to dr. do not give narc (may mask symptoms) or motrin (may cause bleeding) |
| CONTUSSION | bruising and possibly hemorrhage of superficial cerebral tissue occurs. NEED TO BE OBSERVED. Neuro checks q15 min, observe for Inc ICP, bed rest. Monitor vs frequently |
| LETHARGY | earliest sign of ICP |
| LEAKING SPINAL FLUID | comes out from ears or nose. Positive for glucose. Clear. CALL DR |
| meds seizure - STOP | ATIVAN (anti anxiety), valium, verced |
| meds seizure - CONTROL | DILANTIN |
| MYASTHENIA GRAVIS | neuromuscular disorder characterized by severe fatigue of one or more groups of skeletal muscles after repeated use. Affects FACE more than anything. DX: IV admin of TENSILON which relieves symptoms. TX: MESTINON |
| BABINSKI REFLEX | if normal, curl down near plantar section of toes. If abnormal (positive sign), dorsiflexion of big toe & fanning out of other toes |
Created by:
jekjes
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