Paramedic Test #8 - Chapter 18 - Neurologic Emergencies
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What is the CNS?
Central Nervous System is responsible for thought perception, feeling, and autonomic body functions.
What is the PNS?
Peripheral Nervous System is responsible for transmitting commands from the brain to the body and receiving feedback from the body.
What are efferent nerves?
Nerves that leave the brain through the peripheral nervous system and convey commands to other parts of the body.
What are afferent nerves?
Nerves that send information to the brain.
What does the pons do?
Controls respiratory pace and depth. Located inferior to the midbrain.
What does the medulla oblongata do?
Blood pressure and pulse controls.
What does the limbic system control?
Emotions. Rage and anger.
What does the hypothalamus control?
Part of the diencephalon where pleasure, thirst, and hunger are found. Links to the endocrine system - pituitary gland, adrenal glands
What does the cerebellum do?
Manages complex motor skills. Located in the posterior, inferior area of the skull.
What are the nerve structures?
- Nucleus - transmits signals
- Dentrites - signal the next cell's nucleus
- Axon - pathway
- Myelin sheath - insulating coating along axons that allow neurons to transmit the signal efficiently.
What is Cushing's Reflex?
Caused by increased intercranial pressure -
- Decreased pulse rate
- Decreased respiratory rate
- Widened pulse pressure (systolic hypertension)
What is anisocoria?
Unequal size of the pupils.
What is ptosis?
Drooping, sagging, or prolapse of a part of the body.
What is AVPU?
- Mnemonic for assessment of a patient's LOC.
- Awake and alert to person, place, and day
- Verbal response
- Painful stimuli
What is decorticate posturing?
Patient contracts their arms and toward their chest, and point their toes. Damage to directly below the cerebral hemispheres.
What is decerebrate posturing?
Patient extends their arms outward and orate the lower arms in a palms down posture. More severe. Damage is near brainstem.
What is the GCS?
- Glasgow Coma Scale
- Eye – 4
- Verbal – 5
- Motor – 6
- 4 Spontaneous
- 3 Voice
- 2 Pain Stimulation
- 1 None
- 5 Oriented
- 4 Disoriented
- 3 Inappropriate words
- 2 Incomprehensible
- 1 None
- 6 Obeys
- 5 Localizes pain
- 4 Withdraws from pain
- 3 Decorticate
- 2 Decerebrate
- 1 None
- 13-15 Mild
- 9-12 Moderate
- 8 or less Critical
What are hallucinations?
Seeing things, hearing voices, feeling things that aren't there.
What are delusions?
Thoughts or perceived abilities not based in reality - superman
What is psychosis?
Not being able to determine what is real.
What is corneal reflex?
Tapping a patient between the eyes to determine LOC and cough and gag reflex.
What is aniscoria?
Unequal pupil sizes.
What is myasthenia gravis?
Weakness of the voluntary skeletal muscles.
What is agnosia?
Unable to tell you the names of certain items. Keys
What is apraxia?
Unable to tell you the use of certain items. What does the key do?
What is receptive aphasia?
Unable to understand (receive) speech, but able to speak clearly.
What is expressive aphasia?
Unable to speak (express himself) clearly, but is able to understand speech.
What is global aphasia?
Expressive and receptive aphasia. Cannot follow commands or answer questions.
What is hemiparesis?
Weakness on one side of the body.
What is hemiplegia?
Paralysis on one side of the body.
What is decussation?
The crossing of the nerves as they leave the cerebral cortex, move through the brain stem and arrive at the spinal cord.
What is ataxia?
Alteration of a person's ability to perform coordinated motions such as walking.
What is myloclonus?
Rapid, jerky muscle contractions that occur involuntarily.
What is dystonia?
Part of the body contracts and remains contracted.
What is rest tremor?
Fine, oscillating movement that occurs when the patient is at rest and not moving.
What is intention tremor?
Fine, oscillating movement when the patient is asked to reach out and grab an object.
What is a postural tremor?
Fine, oscillating movement when a patient body part is placed in a particular position and required to maintain that position for a long period of time.
What is tonic activity?
Rigid, contracted body posture. Body may shake from severity of the contraction.
What is clonic activity?
Rhythmic contraction and relaxation of certain muscle groups. Bizarre, non-purposeful movement of any body part.
What is parethesia?
Sensation of numbness or tingling.
What is anesthesia?
Can feel nothing in that body part.
What are the two types of strokes?
- Ischemic 75% (AKA occlusive) -
- Blood vessel is blocked so that tissue distal to the blockage will die.
Hemorrhagic 25% - slow bleed in the cranium. Symptoms (headache) will get worse over time.
What is CPP?
Cerebral Perfusion Pressure = Mean Arterial Pressure - Intercranial Pressure.
- MAP = Average pressure withing the blood vessels at any given time.
- MAP = Dias + 1/3(Sys-Dias)
What are TIAs
Transient ischemic attacks - episodes of cerebral ischemia without any permanent damage.
What is AEIOU-TIPS?
Mneumonic for remembering the causes for ALOC.
- Alcohol / Acidosis
- Uremia (kidney failure)
What are tonic/clonic seizures?
Grand mal seizures.
What is Postictal?
Rest period of the brain following a seizure, on the way to pre-seizure LOC.
What are absence seizures?
Petit mal seizures with little or no movement. Might only be several seconds long, typical in children.
What are pseudoseizures?
Generalized neurologic events, similar to tonic/clonic events, but with psychiatric origin.
What is status epilepticus?
Seizure that lasts longer than 4-5 minutes without a return to consciousness between seizures. 20% will die because of high metabolism and no glycogen to the brain.
What is syncope?
Sudden and temporary loss of consciousness with accompanying loss of postural tone.
What is prodrome?
Signs and symptoms that precede a disease.
What is neoplasm?
Growths within the body that serve no useful purpose and are caused by errors during cell production.
What are daughter cells?
When a parent cell divides into two identical duplicates
What is Alzheimer's disease?
Buildup of plaque in the brain causing neuron death. Chronic memory loss. 8-10 years
What is Pick disease?
Damage to neurons int he frontal and temporal lobe. Socially inappropriate behavior, such as stealing and obsessive behaviors. 6 years.
What is Huntington's Disease?
Adult-onset genetic disorder marked by severe loss of neurons. Fidgetiness, bradykinesia, diff standing, memory loss.
What is Creutzfeldt-Jakob disease?
Prion infection from contaminated beef. Cognitive deteriorization, always fatal.
What is Wernecke encephalopathy?
Thiamine Vitamin B deficiency, as in long term alcoholics. Ataxia, confusion, agitation, general weakness.
What is MS?
Multiple Sclerosis is an automimmune condition in which the body attacks the myelin of the brain and spinal cord.
What is nystagmus?
Involuntary, rhythmic eye movement.
What is Guillain-Barre syndrome?
Immune system attacks portions of the nervous system. May start with respiratory or GI infection or weakness.
What is ALS?
Amyotrophic lateral sclerosis - Lou Gehrig disease. Strikes the voluntary motor neurons.
What is bradykinesia?
Slowing down of routine motions.
What is hydrocephalus?
Error in the movement or absorption of CSF. Build up.
What is spin bifida?
Neural tube fails to close and part of the nervous system remains outside the body.
What is Cerebral Palsy?
Developmental condition in which damage is done to the brain, hypoxia probable cause.
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