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Neuro69
Unit IV
| Question | Answer |
|---|---|
| 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) |
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BOjangles1006
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