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11 Cards in this Set
- Front
- Back
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Wannamaker 1-18-08 Neuro eval of Higher cortical function
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Properly name levels of consciousness
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Alertness - Conscious or unconscious: Stimulus needed to awaken: Voice, Touch, Pain
Orientation - Person (Who they are, who others are), Time, Place "Alert and oriented (x1, x2, or x3)" |
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Define coma
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Unconsciousness, unresponsive to any stimuli
No voluntary movement Light: Some reflex activity preserved Deep: No reflex activity |
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Recognize dysphonia signs
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Voice disturbance due to larynx or its innervation
i.e. Laryngitis, vocal chord paralysis = whisper |
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Recognize dysarthria signs
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Motor deficiency
Words slurred, indistinct |
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Recognize expressive (Brocha’s) aphasia
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Nonfluent, slow speech with few words
Words meaningful, small words dropped Comprehension: Good Repetition: Impaired Spontaneous speech: Impaired Senator Tim Johnson (D-South Dakota) |
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Recognize receptive (Wernicke’s) aphasia
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Speech: Fluent, effortless, but sentences lack meaning.
Comprehension: Impaired Repetition: Impaired |
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Recite Pros of C.T. scan for CNS imaging
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Detects fresh hemorrhages
Availability, quicker** Lower cost** Less restrictions v MRI** Without contrast With contrast: Vascular structures, Abnormal endothelial permiability (i.e. tumor or inflammation) |
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Recite limitations of MRI for CNS imaging
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Contraindication: Pacemaker, ferrous foreign body
Relative contraindication: Claustrophobia, non-magnetic metal > artifact (i.e. titanium intracranial aneurysmal clips) |
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Known main indication for EEG and limitation for assessing brain death
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Epilepsy/seizure
Diagnosis, monitor response to therapy Not an indication: Brain Death diagnosis - EEG measures cerebral cortex function, not brainstem |
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Recognize criteria for declaration of brain death
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Structural or metabolic disease known
No drug intoxication, paralyzing agents, or anesthetics Body temp > 34*C (93*F) **Pupils fixed (at 24 hours) **Atropine, Epinephrine effect has worn off **Apnea off ventilator (simultaneous oxygenation) for 10 minutes (extra: pCO2 50+) **No cerebral circulation No reflexes above foramen magnum level such as: **Corneal, gag, occulocephalic reflexes (Doll’s eyes) **No oculovestibular response (Cold caloric) |
