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