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26 Cards in this Set
- Front
- Back
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Primary HA |
No organic cause. Migraines, tension, cluster. 50% are migraines. |
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Migraine s/s VS Cluster HA s/s |
Migraine: may have aura associated with N/V
Cluster: no aura <1hr each waxing and waning strictly unilateral periorbital-temporal locations
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Tension HA |
dull/non-pulsating bilateral, back to front no photophobia
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Temporal Arteritis |
Inflammatory disease of cephalic arteries.
Blood supply to optic nerve so can lead to blindness.
Sed Rate may be Very High |
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Neuro Problems more associated with bleeds (2) |
N/V
Photophobia |
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Ventriculo-Peritoneal Shunts |
Placed to relieve incr ICP due to hydrocephalus. Excess CSF shunted from ventricle to peritoneal cavity.
Complications: infection and malfunction
s/s : fever, distended/tender abdomen(from infx), bulging fontanels(infants) (from malfx shunt), change in LOC (malfx shunt) |
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Seizures : causes |
Electrolyte imbalances (Ph changes) Metabolic changes (fever, blood sugar imbalance) Stress. Fatigue. Nerve structure imbalance(hypoxia), tumors, trauma) Medication noncompliance ETOH/Benzo withdrawals |
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Status Epilepticus |
Series of seizures without recovery period.
Emergency d/t risk for hypoxia.
No paralytics, still seizing in brain, only stopped external signs. |
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CPP : formula, normal limits |
CPP = MAP - ICP
Normal = 70-100mm Hg |
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How to Manage increasing ICP |
Increase the MAP : fluids, blood, pressors
Decrease the intra-cranial volume : diuretics, promote outflow, elevate HOB
Decrease vasodilation (which increases volume) |
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Cushings Response what it indicates, (5) signs |
Indicates impending herniation
Hypertension : trying to perfuse brain tissue Bradycardia : parasympathetic stimulation of vagus nerve. Irregular Respirations Widening Pulse Pressure Pupillary Changes |
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Sub-arachnoid Hemorrhage/Hematoma |
Skull->Dural->Arachnoid->cerebrum and pia
Common w contusions. Bleeding will contaminate CSF.
complications: seizures, incr ICP, hydrocephalus |
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Sub-Dural Hemorrhage/Hematoma |
Skull->Dural->Arachnoid->cerebrum and pia
More likely venous and gradual bleeding.
High risk : elderly, anticoagulants, ETOH |
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Epidural Hemorrhage/Hematoma |
Skull->Dural->Arachnoid->cerebrum and pia
Often d/t middle meningeal artery, r/t temporal skull fx
Arterial, rapidly expanding.
Fast progression to death. "talk and die" phenomenon of "lucid interval" |
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Spinal Cord Injuries : Complete |
Transection.
No sensory/motor fx
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Spinal Cord Injuries : Incomplete : Central Cord Syndrome |
sensory/motor sx more pronounced in upper extremities |
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Spinal Cord Injuries : Incomplete : Anterior Cord Syndrome |
loss of motor, pain and temp. sensation. Preservation of vibration, touch and position perception. |
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Brown-Sequard Syndrome |
Injury to one side of spine(hemisection)
Same side : paralysis/paresis, loss of pressure, touch vibration.
Other side : loss of pain and temp sensation.
(abnormalities on both sides of body, different abnormalities on both sides) |
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Innervation of Phrenic nerve and effects |
Exits at C-3-4-5. C4="breath no more"
intercostal nerves for accessory muscle breathing exit at T1-T12. controls deep breathing, coughing. |
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Spinal Shock |
problem with nerve TRANSMISSION.
No neuro fx below level of injury No spinal reflexes, autonomic fx. Flaccid paralysis.
Reflexes may return in weeks "stunned"
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Neurogenic Shock |
Problem with response to CATECHOLAMINES.
No sympathetic fx below injury. vasodilation, hypotension, bradycardia unopposed vagal(parasympathetic) influence
**skin is warm and dry below injury
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Amyotrophic Lateral Sclerosis (Lou Gehrigs disease) |
Neuro degenerative disease. Affects motor neurons(voluntary movment).
Cognitive fx usually spared, even when on ventilator, they are awake and alert.
frequent tripping, stumbling falls. |
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Mutiple Sclerosis |
Autoimmune condition. CNS is attacked, demyelination.
Physical And cognitive disabilities(ALS-lou gehrigs is ONLY physical) |
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Myasthenia Gravis |
Autoimmune disorder. Antibodies block Acetylcholine receptors. Causing fluctuating muscle weakness and fatiguability.
s/s : muscle weakness during activity, improving with rest.
Tensilon test used to help dx.
Tx : cholinesterase inhibitors, prednisone, plasmapherisis |
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Parkinsons Disease |
Degenerative disease of CNS.
"TRAP" assessment
Tremors: at rest Rigidity : cogwheel movement Akinesia : slowness of movement Postural Instability : balance problem
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Brudzinskis Sign |
Pt supine.
Passively flexes neck chin to chest
Pt involuntarily lifts leg = Positive |
