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Neuro Information
Neuro info for exam 1
| Question | Answer |
|---|---|
| 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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