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47 Cards in this Set
- Front
- Back
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What kind of respiratory pattern indicated most severe ICP?
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- ataxic
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What is a basilar skull fracture?
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- less likely to have early cortical signs (cardinal signs: HA, papilledema, projectile vomiting)
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What is nuchal rigidity?
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- sign of inflammation of meninges
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What are the vital signs with head injuries?
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- Most serious = 180/58 (this is an example of Cushing's Triad)
- Cushing's Triad = increase systolic BP, widened pulse pressure & bradycardia |
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What are brainstem surgeries?
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- infratentorial
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What are absence seizures?
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- trance-like stares; don't remember
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What head injuries have meningeal tearing?
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- rhinorrhea
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What is the CVA expressive speech area?
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- left frontal lobe, Broca's
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What is autonomic dysreflexia?
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- life threatening Cardio response to distended bladder or bowel after high thoracic/cervical cord injury
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What is hydrocehphalus?
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- interference with CSF pathway & ventricular enlargement
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Pain:
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- pain is subjective
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What is Parkinsons?
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- disease is caused by dopamine dificiency
- causes: tremors, rigidity, & bradykinesia |
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What are signs of early stage Multiple Sclerosis?
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- visual disturbances
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What is the mental assessment for early stages of Alzheimers?
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- short term memory loss
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What are S/S of cerebral palsy?
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- encephalopathy with nonprogressive motor loss & ataxia
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Amyotrophic lateral Sclerosis (ALS):
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- progressive upper/lower motor neuron
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Myasthenia Gravis:
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autoimmune; decreases ACh -> decrease in muscle activation
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Guillian-Barre Syndrome:
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rapid, ascending sensory/motor paralysis, unusally reversible
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Myelomenigocele:
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- protrusion meningeal sac & spinal cord from neural tube defect
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Meningocele:
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- protrusion meningeal sac from neural tube defect
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PKU:
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- autosomal recessive error in production of phenylalanine hydroxylase; risk of mental retardation if increase of phenylalanine
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Tay-Sachs:
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- autosomal recessive error in lysosomal storage affecting lipid metabolism; CNS damage
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Cerebral Palsy:
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- nonprogressive motor impairment; often due to decrease O2; results in dyskinesia
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Reye Syndrome:
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- type of encephalophathy, increase risk of use ASA in children
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ecchymosis: raccoon eyes & Battle's sign
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- sign of internal bleeding
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S/S of IICP ~ Cardinal Sign*
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- Cardinal Sign of IICP = headache, projectile vomiting, papilledema
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papilledema
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- sweeling of optic disc = sign of HTN & Intracranial Pressure
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Infections of CNS =
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- Meningitis & Encephalitis
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Penumbra
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- this is the ischemic zone around the infarction which can expand to an infarction
* Cannot be seen in CT scan |
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CVA causes:
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- thrombus
- embolus - hemorrhage = hallmark: headache precedes; aneurysm |
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Manifestations/Indications of CVA:
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- Altered LOC
- Altered speech - HA - Dsyphagia - Contralateral hemiparesis - Contralateral hemiplegia - sudden personality changes - apraxia = don't remember what things are - Unilateral neglect = forget about side affect by stroke - sudden dizziness & loss of balance - Agnosia = recognizing items |
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Dysarthria vs Dysphasia vs Aphasia
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- Dysarthria = impaired articulation
- Dysphasia - impaired comprehension - Aphasia = total loss of: 1) verbal & writen = motor - Broca's Area; 2) comprehension; what is seen & heard = sensory - Wernicke's Area - most common = both Broca's & Wernicke's Aphasia |
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IICP due to increase blood - caused by?
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- hemorrhage
- increase CO2 & decrease O2 - HTN (too high decreases CP) - Hypotension (too low decreases CP) |
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IICP due to increase CSF - caused by?
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Hydrocephalus =
- obstruction of flow - decreased reabsorption of CSF & increased production of CSP * adult = no potential for cranium to expand * child = before cranial sutures close -> skull to expand |
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Stages of Intracranial Compensation/Decompensation: Stage I
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- vasoconstriction of venous system
- CSF displacement + autoregulation = change in blood vessel size to meet metabolic needs when altered ICP |
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Stages of Intracranial Compensation/Decompensation: Stage II
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- compensation & autoregulation continues
- systemic arterial vasocontriction - Early signs of altered LOC |
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Stages of Intracranial Compensation/Decompensation: Stage III
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- Beginning of Decompensation
1) compensation & autoregulation fails 2) ICP approached Atrial Pressure 3) Brain hypoxia & hypercapnia -> vasodilation 4) Increase ICP = decrease CPP (cerebral perfusion pressure) -> ISCHEMIA & ACIDOSIS S/S: decrease LOC; altered respiratory patterns; widened pulse pressure; bradycardia |
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Stages of Intracranial Compensation/Decompensation: Stage IV
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- Severe IICP -> herniation from areas of greater pressure to least -> toward tentorium
*S/S: progressive LOC (lethargy to coma); pupils - bilateral (worst); progressively worst respiration - ataxic (worst); VS: CUSHING'S TRIAD (increase systolic BP, widened pulse, bradycardia, progressing to ventricular asystole) |
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ICP waves:
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- A waves & Plateau waves cause brain damage if > 4-5 minutes
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Decorticate
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- flexor position
- hands over chest |
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Decerebrate
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- extensor position
- hands down by sides |
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Decorticate & Decerebrate
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- one hand on chest & one hand down by side
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Stages of Intracranial Compensation/Decompensation: Stage IV
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- Severe IICP -> herniation from areas of greater pressure to least -> toward tentorium
*S/S: progressive LOC (lethargy to coma); pupils - bilateral (worst); progressively worst respiration - ataxic (worst); VS: CUSHING'S TRIAD (increase systolic BP, widened pulse, bradycardia, progressing to ventricular asystole) |
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ICP waves:
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- A waves & Plateau waves cause brain damage if > 4-5 minutes
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Decorticate
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- flexor position
- hands over chest |
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Decerebrate
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- extensor position
- hands down by sides |
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Decorticate & Decerebrate
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- one hand on chest & one hand down by side
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