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Neurology
med emergenceis
| Question | Answer |
|---|---|
| resting potential and action potential of a neuron? | RP: -70 AP: -55mV |
| what causes depolarization in a neuron? | influx of sodium |
| what type of conduction is used in unmyelinated neurons versus myelinated? how much faster is myelinated? | unmyelinated = continuous conduction myelinated = saltatory ; up to 30x faster |
| what is the distribution of masses within the cranium? brain tissue, blood, and CSF % | brain = 80% blood = 10% CSF 10% |
| what is it called when the pressure-volume relationship between ICP, volume of CSF/blood/tissue and CPP changes; "one goes up the others go down" | Monro-Kellie Doctrine |
| when someone has expressive aphasia, what area of the brain is experiencing damage? | the Broca's area; cannot speak although understands |
| when someone has receptive aphasia, what area of the brain is experiencing damage? | Wernicke's area; cannot comprehend |
| what's included in the diencephalon? | thalamus and hypothalamus |
| what does the thalamus control? what medications impact this area? | RAS: sensory and information filter; dissociative agents like ketamine work here; wakefulness, consciousness, and REM sleep |
| what does hypothalamus do? why is it important in regards to the nervous and endocrine system? | temp regulation, hormone production, autonomic functions; it is the link between nervous and endocrine system via pituitary |
| how much of total blood flow and glucose does the brain consume each minute? | blood 20%, sugar 25% |
| the pyramidal tract supplies motor function on the ipsilateral or contralateral side? | ipsilateral |
| the posterior columns provide position and vibration sensation on the ipsilateral or contralateral side? | ipsilateral |
| the spinothalamic tract provides pain, temperature sensation to the ipsilateral or contralateral side? | contralateral below level of injury |
| What does CN1 do? | olfactory: smell |
| what does CN2 do? | optic: sight and vision |
| what does CN3 do? | oculomotor: pupil dilation/constriction, superior/inferior rectus and inferior oblique movement |
| what does CN4 do? | trochlear: superior oblique muscle movement down and in |
| what does CN5 do? | trigeminal nerve: sensory to ophthalmic (forehead), maxillary (cheek), mandibular (chin) motor: mastication |
| what does CN6 do? | abducens: lateral rectus muscle outward movement |
| what does CN7 do? | facial: sensory to anterior 2/3 tongue motor: facial muscles/expression |
| what does CN8 do? | vestibulocochlear: sensory hearing and balance |
| what does CN9 do? | glossopharyngeal: sensory posterior pharynx and taste to posterior 1/3 of tongue motor: posterior palate/pharynx swallowing |
| what does CN10 do? | vagus: sensory taste to posterior tongue motor: posterior palate and pharynx (swallowing and speech), major parasympathetic nerve touches every organ |
| what does CN11 do? | accessory: trapezius and SCM muscle movements |
| what does CN12 do? | hypoglossal: tongue movement |
| what does AEIOU-TIPS stand for when it comes to AMS? | alcohol, epilepsy, infection, opiates/OD, uremia, trauma, insulin, poisoning, psychosis, stroke |
| how many types of stroke are there? | ischemic or hemorrhagic |
| types of ischemic stroke? What does embolic vs thrombotic mean? most common cause for ischemia in stroke and MI | embolic and thrombotic most commonly is thromboembolism embolic = travels, thrombotic = at site from plaque rupture of clotting cascade most common cause for ischemic obstruction is plaque rupture |
| what's included in the Cincinnati Prehospital Stroke Scale (CPSS)? | facial droop, arm drift, speech |
| how much tPA is administered in the hospital for stroke patients that meet criteria? | 0.8 mg/kg max of 90mg |
| generalized vs partial seizures | generalized: begins in small area of brain but spreads to involve entire cerebral cortex with wide spread dysfunction associated with unconsciousness partial: localized to one area of the body in one hemisphere of the brain |
| grand mal versus petit mal seizures | grand-mal: most common major motor seizure with loss of consciousness petit mal (absence): generalized non-convulsive; brief LOC (blank stare), motionless, unresponsive, brief loss of contact with environment |
| which seizure has a postictal phase and which can resume normal activity immediately after? | postictal = grand mal resume as normal = petit mal |
| generalized seizure types? | grand mal, petit mal, pseudo (hysterical) |
| types of partial seizures? | simple and complex |
| simple partial seizure (motor, sensory, jacksonian) described as? | chaotic movement to one area of the body usually involving one hemisphere of brain |
| complex partial seizures are also known as what? what is characteristic of it? | temporal lobe or psychomotor distinct auras, impairment in awareness of surroundings; purposeless movements unintelligible sounds, deja vu, 1-2 minutes |
| what qualifies it to be status epilepticus? | series of 2+ generalized seizures without return of consciousness |
| a temporary unilateral facial paralysis affecting CN VII (facial nerve); symptoms usually subsiding on their own within 2 weeks but should activate stroke alert anyway because cannot be sure | bells palsy |
| CN V (trigeminal) experiencing lightening/electrical shocking spasms that are extremely painful and known as "suicide nerve" | trigeminal neuralgia |
| subtle onset of memory loss with slow progression of dementia over several years marked by diffuse atrophy of the cerebral cortex and enlarged ventricles | alzheimers |
| progressive degeneration and necrosis of skeletal muscle fibers replacing the muscle with fat and connective tissue | muscular dystrophy |
| demyelinating disorder characterized by inflammation and selective destruction of CNS myelin; autoimmune disorder where T cells destroy myelin | MS |
| acute onset immune mediated demyelinating neuropathy of PNS causing nerve inflammation leading to muscle weakness. It's triggered by a variety of bacteria and viruses; with ascending muscle weakness and symmetric flaccid paralysis | Guillain-Barre syndrome |
| progressive degenerative disorder of the basal ganglia resulting from low dopamine levels; contains lewy bodies which are abnormal proteins develop in neurons- pill rolling tremors and stonelike face | parkinsons |
| damage or dysfunction to brain, brainstem, and spinal cord caused by stroke, MS, tumors, trauma, parkinsons that is not fatal but disabling chronic pain | central pain syndrome |
| a devastating progressive neurologic disorder selectively affects motor function; death within 2-5 years | ALS |
| Main excitatory NT and main inhibitory NR? | excitatory is glutamate, inhibitory is GABA |
| how does alcohol and benzo's depress the nervous system/cognitive function? | increase function of GABA, influc of chloride causes hyperpolarization, increasing the distance from resting to action potential |
Created by:
Lindsey.George