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Neuro Information

Neuro info for exam 1

QuestionAnswer
Where is the needle placed for a lumbar puncture (Spinal Tap)? Subarachnoid Space
What are potential complications with a lumbar puncture (spinal tap)? CSF leakage, infection, invertebral disk damage, and brain herniation.
When are Lumbar punctures contraindicated? On patient's with papilledema, suspected intracranial lesions, increased ICP, or infection of the skin at the puncture site.
Preprocedure care for the LP patient? Educate, obtain consent, empty bladder & bowels, obtain LP tray, and have lab form available.
What position is the client in for a LP? Lateral Recumbency
How much CSF is removed during a LP? 2-3 ml per tube, with a total of 4 tubes.
What is the normal opening pressure in a LP? 6-13 mm with exceeding levels of 15mm being the abnormal
Why should fluids be encouraged following a LP? It helps to restore the CSF volume and helps with headaches.
What can using a smaller needle during a Lumbar puncture help with? Headaches
How is a myelogram done? A LP is performed and some CSF is released.
What is a myelogram? an x-ray study in which a contrast is injected into the subarachnoid space to examine the spinal canal.
What is a myelogram used for? To visualize intradural nerve root in clients when an MRI cannot be done.
What does the caloric (Oculovestibular Reflex) test do? Provides info about the function of the vestibular portion of the Cranial Nerve VIII & pathways in the pons and midbrain. Also aids in the Dx of brain stem lesions.
When is OVR contraindicated? In pt's who are conscious, have a ruptured tympanic membrane or ear discharge.
What response in the Doll's Eye test indicates that the brain stem is functioning? The clients eyes move to the right when the clients head is turned to the left and vice versa.
What is cranial nerve I's function? (Olfactory) Smell
What is cranial nerve II's function? (Optic) Vision
What is cranial nerve III's function? (Oculomotor) Extraocular eye movements & elevation of eyelid
What is cranial nerve IV's function? (Trochlear) Extraocular eye movement, corneal reflex
What is cranial nerve V's function? (Trigeminal) Facial sensations, chewing
What is cranial nerve VI's function? (Abducens) Lateral eye movement
What is cranial nerve VII's function? (Facial) Facial expression, taste, salivation.
What is cranial nerve VIII's function? (Acoustic or Vestibulocochlear) equilibrium, hearing
What is cranial nerve IX's function? (Glossopharyngeal) taste, gag reflex, swallowing
What is cranial nerve X's function? (Vagus) sensation in pharynx, larynx, & external ear; swallowing
What is cranial nerve XI's function? (Spinal Accessory) Neck & Shoulder movement
What is cranial nerve XII's function? (Hypoglossal) Tongue movement
What is the treatment for Parkinson's Disease? Amantadine (Symmetrel), Levodopa (L-Dopa, Sinemet), Bromocriptive (Parlodel), & Maoi Inhibitors (Eldepryl)
What meds are given for Myasthenia Gravis? Neostigmine (Prostigmin), Pyridostigmine (Mestinon), & Azathioprine (Imuran)
What meds are given for Guillain Barre? None
What meds are given for Multiple Sclerosis? Corticosteroids (Dexamethasone), Immuno- Suppressive Agents (Hexamethylamine), Baclofen, Dantrium, And Diazepam (Valium)
What meds are given for seizures? Klonopin, Tegretol, Zarontin, Neurontin (Gabapentin), Felbatol, Dilantin, Mysoline (Primodone), Depakote (valproic acid), Valium, Phenobarbital.
What meds are given for Increased ICP? O2, Mannitol (Osmitrol), Urea (Ureaphil), Pancuronium (Pavulon)
Decorticate Posturing abnormal flexion, adduction toward chest; damage to the cortical spinal tract
Decerebrate posturing abnormal extension, extends and pronates; indicates upper brain stem lesion
Nystigmus eye movement
What 3 areas are tested with the Glasgow coma scale? Eye opening, motor response, & verbal response.
What is the hallmark sign of increased ICP? projectile vomiting
What are signs and symptoms of increased ICP? Pupils dilated & non reactive, increased heart rate, headache, increased blood pressure.
What is the normal ICP level? 5-15
What is the hallmark sign for Dilantin toxicity? Gingival Hyperplasia
What are s/s of Multiple Sclerosis? Diplopia, tremors, weakness, numbness, URI, bowel and bladder problems
What is multiple sclerosis? Demyelination of the white matter of the brain stem, spinal cord, optic nerve, and cerebrum, resulting in the destruction of the myelin sheath
What are the s/s of Parkinsons? Fine tremors progressing, pill rolling of fingers, muscular weakness with rigidity, mask like appearance, shuffling gait, monotonous speech, drooling.
What is myasthenia gravis? Interference of nerve impulses across myoneural junction.
What is Amyotrophic Lateral Sclerosis (ALS)? Motor neuron disease AKA Lou Gehrig's or charcot's disease.
How do you treat ALS? Riluzol (Rilutek)
Where does a basilar skull fracture take place? In bones over the base of the frontal and temporal lobes.
Diffuse Axonal Injury most severe injury to brain stem, may present with abnormal posturing (decerebrate & decorticate)
Subdural Hematoma between dura mater and arachnoid mater classified as acute, chronic, and subacute.
Epidural hematoma between skull and dura mater, usually associated with skull fractures
What are the s/s of Cushing's Triad? Agonal (barely) breathing, systolic HTN, wide pulse pressure
Hyperalgesia increased sense of pain
Hypalgesia decreased sense of pain
Agraphesthesia inability to identify symbols traced on palm when the eyes are closed
Astereognosis loss of sense of 3-dimensional discrimination
Analgesia absense of sense of pain
Hypoesthesia reduced sense of touch
Hyperesthesia overperception of touch
Anesthesia absence of sense of touch
Paresthesia distortions of sensory stimuli (light touch may be experienced as pain)
Dyesthesia localized, irritating sensations, such as warmth, cold, itching, tingling, tickling, crawling.
Created by: Belinda028
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