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Unit IV

Provide support, nourishment and protection to neurons? Glial Cells
Are specialized cells that produce the myelin sheath of nerve fibers in the periphery? Oligodendorcytes
Controls ↑ cognitive function, memory retention, voluntary eye movement, voluntary and expressive speech (Broca’s area)? Frontal Lobe
Contains Wernike’s area, which is responsible for receptive speech and for integration of somatic, visual, and auditory data? Temporal Lobe
Composed of the sensory cortex, controlling and interpreting spatial information? Parietal Lobe
Processing sight? Occipital Lobe
Is concerned with emotion, aggression, feeding behavior and sexual response? The Limbic System
Is responsible for regulating arousal and sleep-wake transitions? Reticular Activating System (RAS)
The ventricles and central canal are normally filled with an average of _____ of CSF? 135mL
Olfactory Nerve; (anterior ventral cerebrum)? I CN
Otic Nerve (vision; Thalamus)? II CN
Oculomotor (eye movement muscles and levator palpebrae muscle)? III CN
Trochlear (eye movement muscle, superior oblique muscle)? IV CN
Trigeminal Nerve; (nose, upper/lower jaw, mastication)? V CN
Abducens (lateral rectus of eye)? VI CN
Facial (muscles of expression, cheek, taste anterior 2/3 of mouth)? VII CN
Vestibulocochlear (ear, equillibrium)? VIII CN
Glossopharyngeal (pharynx, posterior tongue/taste)? IX CN
Vagus (PSNS heart, lungs, GI)? X CN
Accessory (sternocleidomastoid and trapezius muscles)? XI CN
Hypoglossal (muscles of the tongue)? XII CN
These preganglionic cell bodies are located in spinal segments T1-L2 (Norepinephrine/Acetylcholine)? SNS
These preganglionic cell bodies are located in the brainstem and spinal segments S2-S4 (only acetylcholine)? PSNS
Anterior blood circulation of the brain? Internal Coratid Arteries
Posterior blood circulation of the brain? Vertebral Arteries
Where is CSF located? Subarachnoid space (Between Arachnoid & Pia)
What are the 3 meninges? Dura, Arachnoid, & Pia mater
Longer subarachnoid space used to obtain CSF during lumbar puncture? 3&4 Lumbar space
Eyes do not move together? Disconjugate Gaze
Fine, rapid jerking movements of the eyes? Nystagmus
Pupils constrict with near vision? Accomodation
Early sign of central herniation? Lack of pupillary constriction
Ptosis? Drooping eyelid
Is tested by having the pt identify light touch & pinprick in each of the 3 divisions of the face? Trigeminal Nerve (V)
Myoclonus? Spasms of the muscles
Slow, writhing, involuntary movements of extremities? Athetosis
Impairment of muscle tone? Dystonia
These tracts carry volitional impulses from the cortex to the cranial and peripheral nerves, respectively? Pyramidal Tract
Useful in assessing vasospasm associated with subarachnoid hemorrhage, altered IC blood flow? Transcranial Doppler
Measures metabolic activity of brain to assess cell death or damage? Positron Emission Tomography (PET)
Inability to recognize bodily defect or disease (Lesion Right Parietal Cortex)? Anosognosia
Loss or impaired language faculty (Left Cerebral Cortex Lesion)? Aphasia/Dysphagia
Lack of coordination in articulating speech (Cerebellar or Cranial Nerve function)? Dysarthria
Inability to recognize form of object touch; lesions in parietal cortex? Astereogenosis
Absence of muscle tone and contractility, inability to voluntarily empty; happens in early stages of spinal cord injury? Atonic (autonomous) bladder dysfunction
What causes a hypertonic bladder (I.e. Dribbling)? Lesions in pyramidal tracts (efferent pathways)
What would cause tetraplegia(quadraplegia)? Transection or mass lesion (Cervical Region)
States that the 3 components must remain at a relatively constant volume w/in the closed skull structure? Monro-Kellie Doctrine
Normal ICP ranges? 5-15 mmHg
How do you calculate cerebral perfusion pressure? MAP:(2DBP+SBP/3)- ICP
What is normal cerebral perfusion pressure? 60-100mmHg
Characterized by systolic HTN w/ widening pulse pressure, Bradycardia & altered respirations? Cushing’s Triad
Results from local disruption of the functional or morphologic integrity of cell membranes & occurs most often in gray matter? Cytotoxic Cerebral Edema
A buildup of fluid in the brain & is manifested by ventricular enlargement? Hydrocephalus
The most sensitive and reliable indicator of pt’s neuro status? Level of Consciousness (LOC)
A medical emergency as this is a sign of brainstem compression & impending death? Cushing’s Triad
Flexion of arms, wrist, & fingers w/ adduction in upper extremities; extension, internal rotation & plantar flexion? Decorticate Posturing
All 4 extremities in rigid extension w/ hyperpronation of forearms & plantar flexion of feet (BAD)? Decerebrate
S/S of increased ICP? Change in: LOC, V/S, Eyes, Motor. HA & Vomiting not preceded by Nausea.
Indications for ICP monitoring? GCS <8 & abnormal CT/MRI
What is normal range of Oxygen in the brain tissue (PbtO2)? 20-40 mmHg (LICOX system)
A decrease in _____ constricts cerebral vessels, increase cerebrovascular resistance & decreases CBF? PaCO2
An increase in ____ relaxes smooth muscle, dilates cerebral vessels, decrease cerebrovascular resistance and increase CBF? PaCO2
An osmotic diuretic & is given IV? Mannitol (Osmitrol) 25%
Used to Tx vasogenic edema surrounding tumors & abscesses but not recommended in the mngt of head-injured pt’s? Dexamethasone (Decadron)
Alpha-2 agonist, used for cont. IV sedation of intubated & mechanically ventilated pts in the ICU for up to 24hrs? Dexamedetomidine (Precedex)
Usual Tx for DI? Fluids, Vasopressin (Pitressin), or Desmopressin Acetate (DDAVP)
Death from head trauma can occur at these 3 times? Immediately after, 2hrs after, or 3 weeks after injury.
The 3 classic s/s of epidural hematoma? Unconsciousness at the scene, Lucid interval, Decreased LOC
Results from injury to the brain tissue & its blood vessels (usually venus)? Subdural Hematoma
Prone to cerebral atrophy & subsequent development of subdural hematoma due to an increase incidence of falls? Chronic Alcoholics
Increase malignant & invasive; among the most devastating of primary brain tumors? Maningioma
Medications to Tx cerebral edema? Dexamethasone (Decadron), Prednisone,, Methylprednisolone (Solu-Medrol)
A method of delivering a highly concentrated dose of radiation precisely directed at a location w/in the brain? Seterostatic Radiosurgery
A group of chemo drugs used to Tx brain tumors? Nitrosoureas, (BCNU)(CCNU)
The first oral chemo agent found to cross the blood-brain barrier? Temozolomide(Temodar)
The inability to understand what other people are telling you? Sensory Receptive Dysphasia
Develops decreased LOC & a HA w/in 48hrs of head injury? Acute Subdural Hematoma
The only contraindication to elevating the head 30-45 degrees post-sxg? Sxg to posterior fossa or if Burr hole has been performed (keep flat or 10-15 degrees)
Key s/s of meningitis? Fever, Severe HA, N/V, nucal rigidity, photophobia
Used to Tx encephalitis caused by HSV infection? Acyclovir (Zevirax) & Vidarabine (Vira-A)
A response to ischemia; series of metabolic events? Ischemic Cascade
Area around core area of ischemia is a border zone of decreased blood flow (Possibly Viable tissue)? Penumbra
A blood clot or other debris circulating in the blood? Embolus
Results in a narrowing of the lumen, which blocks the passage of the blood through the artery? Thrombosis
Is dominant for language skills in R handed persons & most L handed persons; aware of deficits? L Hemisphere
All communication & receptive function is lost? Global Aphasia
A disturbance in the muscular control of speech? Dysarthria
Tends to be impulsive and move quickly, safety problems, impaired judgement? R hemisphere
Tx of choice for pts w/ A-Fib who have had a TIA? Warfarin (Coumadin)
Given to pts to prevent stroke after TIA; notify dentist of mes being taken; stop 10-14 days before sxg? Ticlopidine(Ticlid) & Clopidogrel(Plavix)
Is as effective as Mannitol in decreasing ICP? Dextran(HSD)
Must be administered w/in 3-4/5 hrs of the onset of clinical signs of ischemic stroke? tPA
Screening test for tPA? CT head, occult bleeding, coagulation test, head trauma.
Can be administered up to 6hrs after the onset of ischemic stroke? Intraarterial tPA
Complications of SAH? Re-bleeding before Sxg & Vasospasms
Drugs used to Tx vasospasms r/t SAH? Nimodipine(Nimotop) CCB
Is a predictor of both short- and long-term outcome of stroke pts The NIHSS
Blindness in the same half of each visual field? Homonymous Hemianopsia
Results in decreased safety awareness & places the pt at increased risk for injury? Neglect Syndrome
Can be prevented w/ artificial tears or gel to keep the eyes moist and an eye shield (at night)? Corneal Abrasion
Have trouble w/ proprioception; often are impulsive, impatient & tend to deny problems r/t strokes? R sided brain strokes
These pts exhibit exaggerated mood swings; anger, frustration, anxious, fearful, depressed? L sided brain stroke (Right Hemiplegia)
Occurs when the pt overestimates personal cognitive or capabilities & energy levels? Maladjusted Independence
Is the usual first-line therapy for trigeminal neuralgia? Carbamazepine(Tegretal) or Oxcarbazepine(Trileptal)
Injection of glycerol through the foramen ovale into the trigeminal cisern? Glycerol Rhizotomy
Predominate trigger causes of trigeminal neuralgia pain? Touch & tickle (Temp. changes)
Methods for Tx Bell's Palsy? Moist heat, gentle, electrical stimulation, & Rx exercises.
Drug therapy for Bell's Palsy? Acyclovir(Zovirax) & Prednisone
The most recognized organism associated with Guilian-Barre Syndrome? Campylobacter jejuni
Usually develop 1-3 weeks after an upper respiratory or GI infection? Guilian-Barre Syndrome
Most serious complication of Guilian-Barre Syndrome? Respiratory Failure, SIADH
Collaborative care for GBS? Plasmapheresis within first 2 wks & immunoglobulin(Sandoylobulin)
Is due to the loss of vasomotor tone caused by injury; hypotension, bradycardia, decreased SNS, venous pooling (T6 or higher)? Neurogenic Shock
Decreased reflexes, decreased sensation and flaccid paralysis below the level of the injury? Spinal Shock
Most unstable of all injuries because the ligamentous structures that stabalize the spine are torn? The Flexion-Rotation  injury
Spinal cord level; sympathetic outflow; Temp control and blood vessels? (T1-L4)
Level of the Phrenic Nerve? C3-5
Will cause Tetraplegia? C7 or higher
Will cause Paraplegia? T1 and lower
Control upper limbs? C5-T1
is a result of damage to one half of the spinal cord? Brown-Sequard Syndrome
May be used to Tx delayed gastric emptying; cord damage above T5 (GI)? Metoclopramide(Reglan)
Should be given with in 8hrs of spinal cord injury, contra with penetrating trauma? Methylprednisone(MP)
Side effects of Methylprednisone(MP)? Immunosupression, increased GI bleed, Risk for infection
Used to maintain a MAP of >90mmHg to increase perfusion of the spinal cord? Dopamine(Intropin)
Lesion above _____: Bradycardia, hypotension, postural hypotension absence of vasomotor tone? T5 & Higher
Spasms may be controlled with these antispasmotic drugs? Baclofen(Lioresal), Dantrolene)Dantrium), Tizanidine(Zanaflex)
These injections may be given to Tx severe spasticity? Botulism Toxin Injection
A massive uncompensated cardiovascular reaction mediated by  SNS; life threatening emergency? Autonomic Dysreflexia
Nursing interventions for autonomic dysreflexia? HOB 45, notify MD, Assess cause (bladder or bowel)
Arteriolar vasodilator used to Tx autonomic dysreflexia? Nifedipine(Procardia); decreased BP
S/S of autonomic Dysreflexia? Sudden Acute HA, increased BP, decreased HR, Facial Flushing diaphoresis.
Lack of coordination between detrusor contraction and urethral relaxation? Dyssynergia
Have become the first line therapy for acute migraine attack? Triptans(Sumatriptan[Imitrex])
These drugs cause constriction of coronary arteries? Triptans
Excess dose of Triptans may produce these s/s? Tremors and decreased RR
This antiseizure drug has been shown to prevent migraine HA? Topiramate(Topamax), and Divalproex(Depakote)
A type of nonfluent aphasia; damage to the frontal lobe; understands speech? Broca's Aphasia
A type of fluent aphasia; damage to temporal lobe; difficulty understanding others? Wernicke's Aphasia
Medication used to Tx hiccups & shivering?# Chlorpromazine(Thorazine); antipsychotic.
What are the phases of progression of a seizure? Prodromal, Aural, Ictal, and Postictal phase.
Stiffening of the body? Tonic Phase
Jerking of the extremities? Clonic Phase
Is a brief staring spell that lasts only a few seconds, so it often occurs unnoticed? Absence Seizure (Petit-Mal)
Anticipated medications for seizures? Phenytoin(Dilantin), Ativan, Valium or Versed.
Seizure drugs? Tegretol, & Phenobarbital
Used as an adjunct to medications when Sxg is not feasible? Vagal Nerve Stimulation
Trauma changes the Fxn of the axon, resulting in swelling & disconnection. Clinical s/s ↓LOC, ↑ICP, decortication and decerebration & Global aphasia? Diffuse Axonal Injury (DAI)
Created by: BOjangles1006