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57 Cards in this Set
- Front
- Back
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what are the common indications for a LP?
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meningeal signs
encephalitis suspect MS |
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what will you see in the LP of a pt. with MS?
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monoclonal bands
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what are the contraindications to doing a LP?
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increased ICP
brainstem herniation active local infection a puncture site bleeding disorder (give plts) |
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what is the most common patient position for a diagnostic LP?
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lateral decubitus
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what is the most common therapeutic patient position for a LP/epidural?
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sitting
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what are potential complications from a LP?
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infection
brain herniates spinal h/a r/t dec. csf pressure |
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in what position is a pt's spinal h/a usually the best?
-lying -sitting |
lying
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how many tubes of csf is drawn with an LP, and where do each of them go?
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4 tubes
1-? 2-chemistries 3-cell count 4-special tests |
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why is tube #1 not used for a cell count?
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due to the potential blood in the tube from a traumatic tap
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if a pt. has a CSF leak with a spinal h/a not relieved after a few days of bedrest, what is the tx?
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send to anesthesiology for a blood patch
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what is the normal amt of lymphocytes seen in the csf?
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less than or equal to 5
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what are the normal amt of neutrophils seen the csf?
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none would be the appropriate number
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what is the normal csf pressure?
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7-20 cm H20
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what are the causes of low pressure?
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dehydration
needle in the wrong position |
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what are the causes of high pressure with in the spinal cord?
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space occupying lesion
bleeding into the cord CVA infection |
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what is the first thing to do when you get the needle into the subarachnoid space?
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check the spinal pressure
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what is xanthochromia?
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yellow to orange csf due to disease, or bleeding
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what is the normal level of protein seen within the csf?
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<50mg/dL, in serum protein is measured in grams
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what does a high level of csf protein indicative of?
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infection
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what is the normal glucose level within the csf?
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45-70mg/dL
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if a pt. has a low level of spinal glucose what is this indicative of?
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bacterial infection
viral will have no rise or fall in glucose |
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what will you see in the csf that indicates MS?
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oligoclonal bands
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in acute bacterial meningitis, what will the LP results be?
-pressure -leukocytes -protein -glucose |
elevated pressure
high leukocytes (hundreds to thousands) elevated protein up to or > 1000 low glucose |
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in acute viral meningitis what will the csf findings show?
-pressure -leukocytes -protein -glucose |
-normal to slightly elevated pressure
-5 to few hundred, occas. over a 1000 leukocytes -protein normal or sl. elevated -glucose is normal |
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what is the normal protein level within the csf?
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under 50mg/dL, high protein in the csf in indicative of infection
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nerve conduction studies have 2 components, what are they?
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sensory and motor
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what can ncv diagnose?
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CTS
ulnar nerve compression DM neuropathy nerve root compression |
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what does sensory information does a ncv test?
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the amount of time it takes for an impulse to get from proximal to distal, or one nerve to another
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what motor information does a ncv test?
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measuring the amount of time it takes for a muscle to respond to a nerve impulse
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what does snap stand for? what is an abnormal result?
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sensory nerve action potential, if abnormal, the time will be extended, it will take loner for sensory nerve conduction
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if the motor portion of a ncv, is extended, what does this mean?
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time will be extended from the nerve impulse until motor movement of the muscle
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what is the motor ncv checking of the muscle, and what muscle in the arm is usually tested?
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adductor pollicis
it checks for action potential |
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name some diseases of demylination that will show abnormal ncv studies?
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ms
dm neuropathy guillian barre syndrome |
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what is an emg?
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needle electromyography
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how should you prepare your pt for an emg?
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tell them it involves needles
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what does an emg test?
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capture muscle activity and the action potential is recorded
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what does a normal emg waveform look like with insertion?
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3 turns and then back to baseline without flucuations-like an eeg
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neurogenic MUAP will show what type of waveform upon insertion?
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motor unit problem like DM neuropathy.
the waveform will be multiphasic, lots of turns and then doesn't finish flat. |
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what will a myopathic MUAP waveform look like? and what is it indicative of?
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low amplitude waveforms means a primary muscle problem.
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what is a recruitment and interference pattern a cause of?
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the pt doing maxmum movement
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what is an interference pattern a result of on an EMG?
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found in an ALS patient
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transcranial magnetic stimulation is used to test what body system?
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corticospinal system
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what are evoked potentials?
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tests done by neurologists, tests that stimulate the visual cortex, requires intact CN 8, tests the brain stem
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in what disease conditions would evoked potential tests be appropriate?
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MS
intermittent visual loss optic neuritis |
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in a pt with an acoustic neuroma, what are the chief s/s and what is the test of choice?
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hearing loss and dizziness are chief complaints
BAEP, checks somatosensory evoked potentials |
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audiologic testing is a great name for what?
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hearing test (acquity)
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what is the normal dBHL?
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-10 to 20 is considered normal
anything over 70 is severe hearing loss |
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what is the frequency in hertz used to test hearing acquity?
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500-8000 hz
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pure tone testing are specifically testing what?
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hair cells just inside round window as these are the first to go
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what is more common? low freqency hearing loss or high frequency hearing loss
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low frequency hearing loss
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what are the 2 types of hearing acquity testing?
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speech discrimination-can't understand what is being said to them, can't read back
masking-putting white noise in unaffected ear to see if pt can hear on questionably affected ear. |
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what is vestibular testing done for? what problem?
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for dizzy problems
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what is the name of the test that records eye movements?
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electronystagmography-stimulate the eye and see if they develop nystagmus
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what is the name of the eye movement test?
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static test
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what is the name of the dynamic eye movement tests?
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saccade
smooth pursuit optokinetic testing |
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what is the barbaric vestibular test?
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caloric testing
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what vestibular test measures proprioceptive testing?
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posturography
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