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48 Cards in this Set
- Front
- Back
Which portion of the brain controls temperature? |
Hypothalamus
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What is a key difference between damage to upper neurons and damage to lower neurons? |
Upper neuron damage results in spasticity and lower neuron damage results in flaccidity
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Decorticate |
Flexion (in)
Damage above the brain stem |
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Decerebrate
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Extension (out)
Damage involves the brainstem |
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Relationship between decorticate and decerebrate |
Decorticate occurs first before decerebrate
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Area of brain involved in consciousness
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RAS
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Oculocephalic reflex definition and significance
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Dolls eyes
Normal: eyes roll when head turned Abnormal: eyes stay fixed when head turned Indicates brainstem is affected |
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Which neurons are being affected to create oculocephalic reflex abnormality?
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3,6,8
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What are the three components of the Glasgow Coma Scale?
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Motor response, Verbal reposne, Eye Opening
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Why does increased ICP cause dilated pupils?
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CN III runs out of the midbrain and an increase in pressure decreases the parasympathetic stimulation, resulting in dilation
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Unequal pupil size
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Occurs naturally in up to 20% of the population, 1 mm difference or less
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What causes the Babinski reflex? |
Pressure on pyramidal tracts in the brain, unilateral brain damage will result in contralateral babinski sign
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Key difference between epidural hematoma and subdural hematoma |
Epidural is most often arterial
Subdural is most often venous |
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Pt is diagnosed with epidural bleed, which acute change is most important to observe for?
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Pupil changes - indicating uncal herniation
Pupil changes are early stage rather than late stage in this case |
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Contusion
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A concussion for 12+ hours
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Basilar skull fracture signs
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Raccoon eyes, battle sign, otorrhea, rhinorrhea, loss of olfaction
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Which CVA results in aphasia? |
Left side for most people
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Why can't someone with increased ICP have hypotonic fluids? |
Hypotonic fluids will push fluid into brain tissue
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Treatments for increased ICP
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Hyperventilate PCO2 25-30
Elevate HOB Head midline Mannitol |
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Formula for CPP |
CPP = MAP - ICP
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Normal CPP
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60+
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Relationship between hypercapnia and ICP
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Hypercapnia triggers cerebral vasodilation and increases ICP
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Where is CSF produced and how is it resorbed?
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Produced by choroid plexes and resorbed by aracnoid villi
60% glucose as in the serum |
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Laboratory signs of bacterial meningitis
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Elevated protein levels
Decreased glucose levels Cloudy |
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Laboratory signs of viral meningitis
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Increased protein
Normal glucose levels Clear appearance |
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Physical symptoms of meningitis
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Kernig's sign
Brudzinski's sign Nuchal rigidity All indicate meningeal irritation |
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Kernig's sign
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Pain in neck when flexing thigh and abdomen
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Brudzinski's sign
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Flexing of neck causes flexion of hip
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Brown Sequard Syndrome
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hemisection of cord
Ipsilateral loss of motor and contralateral loss of pain and temperature |
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Central Cord Syndrome
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Greater motor loss in upper extremities than lower
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Damage to which vertebrae will result in loss of breathing?
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C1-C4
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What is the result of damage to C5-C6?
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Quadriplegia with gross arm movements and diaphragmatic breathing intact
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Spinal shock
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Loss of autonomic nervous control, areflexia, loss of sensation and flaccid paralysis
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Autonomic reflexia
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Spinal shock of the autonomic nervous system
Reflex depression, HTN, bradycardia, poikilothermism, hypoventilation, urinary retention |
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Guillian Barre
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Problems begin distially and then ascends symmetrically
Ascending paralysis Return of function goes from proximal to distal |
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CSF chagnes in Guillian Barre
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Increased protein in CSF
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Mental status changes with Guillian Barre
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No altered consciousness
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Pathophysiology of Guillian Barre
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Edema and inflammation cause demyelination of spinal nerve rootes
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UTIs and Guillian Barre
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Check for urinary retention, neurogenic bladder
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Treatment for Myasthenia Gravis?
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Rest allows for improvement
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Symptoms of MG
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Ptosis, hoarseness, dyspnea, laryngospasm
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Precipitating factors for MG
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Stress, illness, hormonal changes, drugs like quinidine, gentamicin, procainamide
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Seizures and glucose levels
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Large glucose consumption with seizures
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Medications and seizure activity
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Dilantin does not stop seizure activity
Diazepam/Valium does Ativan does Phenobarbital does |
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Which two drugs treat status epilepticus?
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Diazepam and dilantin
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Valium dose for seizure
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10-20 mg IV @ 5 mg/min, onset is immediate
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Phenobarbital dose for seizure
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5-8 mg/kg IV @ 60 mg/min, onset 5-20 minutes
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Neuro changes after giving atropine
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Pupil dilation
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