Neuro - Laura Gasparis

Front 1

Which portion of the brain controls temperature?

Back 1

Hypothalamus

Front 2

What is a key difference between damage to upper neurons and damage to lower neurons?

Back 2

Upper neuron damage results in spasticity and lower neuron damage results in flaccidity

Front 3

Decorticate

Back 3

Flexion (in)

Damage above the brain stem

Front 4

Decerebrate

Back 4

Extension (out)

Damage involves the brainstem

Front 5

Relationship between decorticate and decerebrate

Back 5

Decorticate occurs first before decerebrate

Front 6

Area of brain involved in consciousness

Back 6

RAS

Front 7

Oculocephalic reflex definition and significance

Back 7

Dolls eyes
Normal: eyes roll when head turned
Abnormal: eyes stay fixed when head turned
Indicates brainstem is affected

Front 8

Which neurons are being affected to create oculocephalic reflex abnormality?

Back 8

3,6,8

Front 9

What are the three components of the Glasgow Coma Scale?

Back 9

Motor response, Verbal reposne, Eye Opening

Front 10

Why does increased ICP cause dilated pupils?

Back 10

CN III runs out of the midbrain and an increase in pressure decreases the parasympathetic stimulation, resulting in dilation

Front 11

Unequal pupil size

Back 11

Occurs naturally in up to 20% of the population, 1 mm difference or less

Front 12

What causes the Babinski reflex?

Back 12

Pressure on pyramidal tracts in the brain, unilateral brain damage will result in contralateral babinski sign

Front 13

Key difference between epidural hematoma and subdural hematoma

Back 13

Epidural is most often arterial
Subdural is most often venous

Front 14

Pt is diagnosed with epidural bleed, which acute change is most important to observe for?

Back 14

Pupil changes - indicating uncal herniation
Pupil changes are early stage rather than late stage in this case

Front 15

Contusion

Back 15

A concussion for 12+ hours

Front 16

Basilar skull fracture signs

Back 16

Raccoon eyes, battle sign, otorrhea, rhinorrhea, loss of olfaction

Front 17

Which CVA results in aphasia?

Back 17

Left side for most people

Front 18

Why can't someone with increased ICP have hypotonic fluids?

Back 18

Hypotonic fluids will push fluid into brain tissue

Front 19

Treatments for increased ICP

Back 19

Hyperventilate PCO2 25-30
Elevate HOB
Head midline
Mannitol

Front 20

Formula for CPP

Back 20

CPP = MAP - ICP

Front 21

Normal CPP

Back 21

60+

Front 22

Relationship between hypercapnia and ICP

Back 22

Hypercapnia triggers cerebral vasodilation and increases ICP

Front 23

Where is CSF produced and how is it resorbed?

Back 23

Produced by choroid plexes and resorbed by aracnoid villi

60% glucose as in the serum

Front 24

Laboratory signs of bacterial meningitis

Back 24

Elevated protein levels
Decreased glucose levels
Cloudy

Front 25

Laboratory signs of viral meningitis

Back 25

Increased protein
Normal glucose levels
Clear appearance

Front 26

Physical symptoms of meningitis

Back 26

Kernig's sign
Brudzinski's sign
Nuchal rigidity

All indicate meningeal irritation

Front 27

Kernig's sign

Back 27

Pain in neck when flexing thigh and abdomen

Front 28

Brudzinski's sign

Back 28

Flexing of neck causes flexion of hip

Front 29

Brown Sequard Syndrome

Back 29

hemisection of cord

Ipsilateral loss of motor and contralateral loss of pain and temperature

Front 30

Central Cord Syndrome

Back 30

Greater motor loss in upper extremities than lower

Front 31

Damage to which vertebrae will result in loss of breathing?

Back 31

C1-C4

Front 32

What is the result of damage to C5-C6?

Back 32

Quadriplegia with gross arm movements and diaphragmatic breathing intact

Front 33

Spinal shock

Back 33

Loss of autonomic nervous control, areflexia, loss of sensation and flaccid paralysis

Front 34

Autonomic reflexia

Back 34

Spinal shock of the autonomic nervous system
Reflex depression, HTN, bradycardia, poikilothermism, hypoventilation, urinary retention

Front 35

Guillian Barre

Back 35

Problems begin distially and then ascends symmetrically
Ascending paralysis
Return of function goes from proximal to distal

Front 36

CSF chagnes in Guillian Barre

Back 36

Increased protein in CSF

Front 37

Mental status changes with Guillian Barre

Back 37

No altered consciousness

Front 38

Pathophysiology of Guillian Barre

Back 38

Edema and inflammation cause demyelination of spinal nerve rootes

Front 39

UTIs and Guillian Barre

Back 39

Check for urinary retention, neurogenic bladder

Front 40

Treatment for Myasthenia Gravis?

Back 40

Rest allows for improvement

Front 41

Symptoms of MG

Back 41

Ptosis, hoarseness, dyspnea, laryngospasm

Front 42

Precipitating factors for MG

Back 42

Stress, illness, hormonal changes, drugs like quinidine, gentamicin, procainamide

Front 43

Seizures and glucose levels

Back 43

Large glucose consumption with seizures

Front 44

Medications and seizure activity

Back 44

Dilantin does not stop seizure activity
Diazepam/Valium does
Ativan does
Phenobarbital does

Front 45

Which two drugs treat status epilepticus?

Back 45

Diazepam and dilantin

Front 46

Valium dose for seizure

Back 46

10-20 mg IV @ 5 mg/min, onset is immediate

Front 47

Phenobarbital dose for seizure

Back 47

5-8 mg/kg IV @ 60 mg/min, onset 5-20 minutes

Front 48

Neuro changes after giving atropine

Back 48

Pupil dilation