Shared Flashcard Set

Details

Chapter 18
Medical: Neurologic Emergencies
186
Other
Not Applicable
09/01/2016

Additional Other Flashcards

 


 

Cards

Term

 

 

Prevalence

Definition

 

 

Total number of people in a given population with a particular disease

Term

 

 

Incidence

Definition

 

 

Number of people newly diagnosed with a particular disease in a given 1-year period

Term

 

 

What are the two major structures of the nervous system divided into?

Definition

 

 

Central Nervous System (CNS)

and

Peripheral Nervous System (PNS)

Term

 

Which nervous system is responsible for thought, perception, feelings and autonomic body functions?

Definition

 

 

Central Nervous System (CNS)

Term

 

Which nervous system is responsible for transmitting commands from the brain to the body and receiving feedback from the brain?

Definition

 

 

Peripheral Nervous System (PNS)

Term

 

What leaves the brain through the peripheral nervous system and conveys commands to other parts of the body?

Definition

 

 

Efferent Nerves

Term

 

 

What are nerves that send information to the brain?

Definition

 

 

Afferent Nerves

Term

 

What part of the brain is used to filter out unneeded information before it reaches the cerebral cortex?

Definition

 

 

Diecephalon

Term

 

What part of the brain lies between the brainstem and the cerebrum and includes the thalamus and hypothalamus?

Definition

 

 

Diecephalon

Term

 

What portion of the brainstem is responsible for helping to regulate the LOC including patterns of sleep and wakefulness?

Definition

 

 

Midbrain

Term

 

What part of the midbrain is located just inferior to the midbrain and controls respiratory pace and depth?

Definition

 

 

The Pons

Term

 

 

What part of the midbrain controls the blood pressure and pulse rate?

Definition

 

 

Medulla Oblongata

Term

 

 

What two parts of the brain control emotions?

Definition

 

 

Limbic System

and

Hypothalamus

Term

 

 

Where is anger and rage generated within the brain?

Definition

 

 

Limbic system

Term

 

 

Where is pleasure, thirst, and hunger found within the brain?

Definition

 

 

Hypothalamus

Term

 

What lobe of the brain, is located in the posterior, inferior area of the skull, and manages complex motor activity unconsciously?

Definition

 

 

Cerebellum

Term

 

 

What are gaps between nerve cells, across which nervous stimuli are transmitted?

Definition

 

 

Synapses

Term

 

What is an insulating substance that allows the cell to transmit its signal consistently, without shorting out or losing electricity to surrounding fluids and tissues?

Definition

 

 

Myelin

Term

 

 

What is tightly clenched teeth?

Definition

 

 

Trismus

Term

 

 

What is the medical term for drooping, sagging or prolapse of a part of the body?

Definition

 

 

Ptosis

Term

 

 

State in which a person does not respond to verbal or painful stimuli?

Definition

 

 

Coma

Term

 

 

What mneumonic helps you make a broad assessment of the patient's LOC?

Definition

 

 

 

AVPU

Term

 

What is part of the frontal bone and feels like a notch near the bridge of the nose?

Definition

 

 

Supraorbital Foramen

Term

 

 

What is it when patients contract their arms and curl them towards their chest?

Definition

 

Decorticate posturing

Term

 

What posture will the patients point their toes but extend their arms outward and rotate the lower arms in a palms-down manner called pronation?

Definition

 

 

Decerebrate Posturing

Term

 

What are sensory stimulations that cannot be verified by others?

Definition

 

 

Hallucinations

Term

 

 

What are thoughts, ideas or perceived abilities that have no basis in common reality?

Definition

 

 

Delusions

Term

 

 

Unequal pupils

Definition

 

 

 

Anisocoria

Term

 

 

Inability to connect an object with its correct name

Definition

 

 

Agnosia

Term

 

 

Inability to connect an object with its proper use?

Definition

 

 

Apraxia

Term

 

 

A person that is unable to understand speech but able to speal clearly

Definition

 

 

Receptive Aphasia

Term

 

A person that is unable to speak clearly but is able to understand speech

Definition

 

 

Expressive Aphasia

Term

 

 

What is charatcerized by features of both expressive and receptive aphasia?

Definition

 

 

Global Aphasia

Term

 

 

Weakness of one side of the body

Definition

 

 

Hemiparesis

Term

 

 

Paralysis of one side of the body

Definition

 

 

Hemiplegia

Term

 

What is the crossing of nerves as they leave the cerebral cortex, move through the brainstem, and arrive at the spinal cord?

Definition

 

 

Decussation

Term

 

 

Walking patterns

Definition

 

 

 

Gait

Term

 

What is the term used to describe alteration of a person's ability to perform coordinated mtions like walking?

Definition
Ataxia
Term
What is a rapid, jerky muscle contraction that occurs involuntary?
Definition
Myoclonus
Term
What are contractions of the body into bizarre positions?
Definition
Dystonia
Term
What is stiffness of motion?
Definition
Rigidity
Term
What is a fine, oscillating movement usually occuring in the hands and head?







Definition
Tremors
Term
What tremor occurs with the patient at rest and not moving?
Definition
Rest Tremor
Term
What tremor occurs when the patient is asked to reach out and grab an object?
Definition
Intention tremor
Term
What tremor occurs when a body part is placed in a particular position and required to maintain that position for a long time?
Definition
Postural Tremor
Term
What is a rigid, contracted body posture?
Definition
Tonic Activity
Term
What is characterized by rhythmic contraction and relaxation of muscle groups
Definition
Clonic activity
Term
What is a sensation of numbness or tingling
Definition
Paresthesia
Term
What is it when the patient can feel nothing withing a body part?
Definition
Anesthesia
Term
What is the movement of a structure from its normal location into another space?
Definition
Herniation
Term
What are the episodes of cerebral ischemia without any permanent damage?
Definition
Transient Ischemic Attack (TIA)
Term
What is a sensation where the patient experiences before the seizure occurs?
Definition
Aura
Term
Term where seizure begins in one spot and moves wave-like to other locations
Definition
Jacksonian March
Term
A seizure that lasts longer than 4 to 5 minutes or consecutive seizures without a return to consciousness between seizures
Definition
Status epilepticus
Term
What is a sudden and temporary loss of consciousness with accompanying loss of postural tone?
Definition
Syncope
Term
What are the signs ans symptoms that precede a disease or condition
Definition
Prodrome
Term
Chronic deterioration of memory, personality, language skills, perception, reasoning or judgement, with no LOC?
Definition
Dementia
Term
Most common form of dementia ans is a progressive organic condition in which neurons die?
Definition
Alzhiemers Disease
Term
Medical term for growths within the body that serve no useful purpose and are caused by errors that occur during cellular reproduction
Definition
Neoplasm
Term
Autoimmune condition in which the body attacks the myelin of the brain and spinal cord
Definition
Mulitple Sclerosis (MS)
Term
Involuntary, rhythmic eye movement
Definition
Nystagmus
Term
Electrical sensation down the spine or extremities when the head is flexed forward
Definition
Lhermitte sign
Term
Disease in which the immune system attacks portions of the nervous system
Definition
Guillain-Barre Syndrome
Term
What is the exchanging of the plasma within the blood
Definition
Plasmapheresis
Term
What is the slowing down of routine motions
Definition
Bradykinesia
Term
What is a group of conditions in which the nerves leaving the spinal cord are damaged
Definition
Peripheral Neuropathy
Term
3rd leading cause of death in the US
Definition
Stroke
Term
What part of the midbrain is the reason you get tired often at the same time of the day
Definition
Reticular Activating System (RAS)
Term
What part of the brain is also responsible for controlling BP, pulse rate and resp rate and pattern
Definition
Brainstem
Term
What is the fundamental element of the nervous system
Definition
Neuron
Term
What does the synapse connect to the next cell by?
Definition
Neurotransmitters
Term
What part of the brain controls vision and storage of visual memories
Definition
Occipital Lobe
Term
What part of the brain controls sense of touch and texture and storage of tactile memories
Definition
Parietal Lobe
Term
What part of the brain controls hearing, smell, language, and storage of sound and odor memories
Definition
Temporal Lobe
Term
What part of the brain is responsible for voluntary muscle control and storage of spatial memories
Definition
Frontal Lobe
Term
What part of the brain controls judgement and prediction of consequences of a person's actions ans abstract intellectual functions?
Definition
Prefrontal Lobe
Term
What part of the brain controls basic emotions and basic reflexes, such as chewing and swallowing
Definition
Limbic System
Term
What part of the brain is the relay center that prioritizes signals to hone in on important messages
Definition
Diencephalon (thalamus)
Term
What part of the brain controls emotion, temperature control, and interfaces with the endocrine system
Definition
Diencephalon (hypothalamus)
Term
What part of the brain controls LOC, reticular activating system, muscle tone and posture?
Definition
Midbrain
Term
What part of the brain controls resp pattern and depth
Definition
Pons
Term
What part of the brain controls pulse rate, BP, and resp rate
Definition
Medulla Oblongata
Term
What makes up the brainstem
Definition
Midbrain, Pons, and Medulla Oblangata
Term
What is in control of reflexes and the relay of information to and from the body?
Definition
Spinal Cord
Term
What gives you an overview of the pt and his or her current state
Definition
General Impression
Term
What are the trigeminal, glossopharyngeal, vagus, and hypoglossal nerves responsible for
Definition
Airway Control
Term
What is the classic sound that is created if a partial obstruction of the upper airway is present
Definition
Stridor
Term
What is a high-pitched sound, usually heard during inspiration
Definition
Stridor
Term
What is caused by a decreased pulse rate, decreased resp rate, and widened pulse pressure (systolic hypertension)
Definition
Cushings reflex
Term
What is sensory stimulation that can be confirmed by others
Definition
Common reality
Term
What is breaking with common reality and existing mainly within an internal world
Definition
Psychosis
Term
Fear, anger and helplessness are common emotions of what state
Definition
Psychosis
Term
What can be a cause of anger, frustration or aggression
Definition
Low Glucose or Oxygen level
Term
How should you approach the eyes to limit corneal reflex
Definition
45 degree angle
Term
A condition in which the body generates antibodies against its own acetylcholine receptors, causing muscle weakness, often in the face
Definition
Myasthenia Gravis
Term
What indicates that there is some degree of misfiring of neurons between the occipital lobe and temporal lobe
Definition
Agnosia
Term
What indicates that there is some degree of misfiring of neurons between the temporal lobe and frontal lobe
Definition
Apraxia
Term
What part of the brain does receptive aphasia indicate is damaged
Definition
Temporal Lobe
Term

What part of the brain is damaged with expressive aphasia

 

Definition
Frontal Lobe
Term
Fuel that runs the brain
Definition
Glucose
Term
What are the 2 basic types of strokes
Definition
Ischemic (75%) and Hemorrhagic (25%)
Term
Stroke caused by an occlusion or blockage
Definition
Ischemic Stroke
Term
What is one of the hallmarks of a hemorrhagic stroke
Definition
Worst headache of my life
Term
What is the pressure of blood within the cranial vault
Definition
Cerebral Perfusion Pressure (CPP)
Term
How many people will have a stroke soon after they have a TIA?
Definition
More than 1/3
Term
#1 Preventable cause of strokes and TIA's
Definition
Hypertension
Term
What is uremia
Definition
Kidney Failure
Term
Sudden, erratic firing of neurons
Definition
Seizure
Term
What is the rest period of the brain
Definition
Postictal
Term
How many pt's in status epilepticus will die
Definition
Nearly 20%
Term
What type of headaches are caused by changes in the size of blood vessels at the base of the brain
Definition
Migraines
Term
What are rare vascular headaches that begin in the face as a minor pain around one eye
Definition
Cluster headaches
Term
What are caused by inflammation or infection within the sinus cavities of the face
Definition
Sinus headaches
Term
What presents with dementia and is caused by a vitamin b1 deficiency
Definition
Wernicke Encephalopathy
Term
Sudden state of confusion or disorientation
Definition
Delirium
Term
What is the hallmark sign of dementia
Definition
Confusion
Term
What is the process by which cancerous cells move to sites distant from their site of origin
Definition
Metastasis
Term
What is a disease that strikes the voluntary motor neurons
Definition
Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig Disease
Term
What is a neurologic condition in which past injuries to the brain can have an influence
Definition
Parkinson Disease
Term
What portion of the brain that produces dopamine has been found to be damaged in patients with parkinsons disease
Definition
Substantia Nigra
Term
Severe, abnormal muscle spasms that cause bizarre contortions, repetitive motions, or postures?
Definition
Dystonias
Term
Inflammation of the brain?
Definition
Encephalitis
Term
Inflammation of the meninge, the outer covering of the CNS?
Definition
Meningitis
Term
What is the most common form of encephalitis and meningitis when it presents in the acute phase
Definition
Infectious Pathology
Term
Most common sign of infectious disease?
Definition
Fever
Term
Proteins that are released by gram-negative bacteria when they die?
Definition
Endotoxins
Term
Proteins that are secreted by some bacteria or fungi to aid in death and digestion of other cells?
Definition
Exotoxins
Term
What are caused by an infectious agent within the brain or spinal cord?
Definition
Abscesses
Term
What is a viral infection transmitted by the fecal-oral route
Definition
Poliomyelitis
Term
Death of nerve fibers as a late consequence of polio: the syndrome is characterized by swallowing difficulties, weakness, fatigue, and breathing problems
Definition
Postpolio Syndrome
Term
Water in the head?
Definition
Hydrocephalus
Term
Downward deviation of the eyes?
Definition
Sun-setting eyes
Term
What tube drains out CSF out of the skull and typically into the abdomen?
Definition
Ventriculoperitoneal (VP) Shunt
Term
What is a developmental anomaly in which a portion of the spinal cord or meninges protrudes outside the spinal column or even outside the body, usually in the area of the lumbar spine?
Definition
Spina Bifida
Term
What is the developmental condition in which damage is done to the brain, often the frontal lobe
Definition
Cerebral Palsy (CP)
Term
What frees the cerebral cortex for higher activities
Definition
Brainstem
Term
What is the portion of the axon where the neurotransmitters are manufactured
Definition
Axon Terminal
Term
A 29-year-old man, who was recently prescribed an antipsychotic medication, presents with an acute onset of bizarre contortions of the face. Treatment should include:
Definition
Diphenhydramine, 25 mg
Term
A 33-year-old woman had an apparent syncopal episode. According to her husband, she complained of dizziness shortly before the episode. He further states that he caught her before she fell to the ground. Upon your arrival, the patient is conscious but confused and is sitting in a chair. Her blood pressure is 90/60 mm Hg, pulse rate is 110 beats/min and weak, and respirations are 22 breaths/min and regular. Her blood glucose level is 74 mg/dL. The MOST likely cause of her syncopal episode is:
Definition
Dehydration
Term
A 39-year-old woman presents with signs and symptoms of an acute hemorrhagic stroke. She is responsive to deep painful stimuli only and has bilaterally dilated and sluggishly reactive pupils. Her respirations are slow and irregular, blood pressure is 80/50 mm Hg, and pulse is 40 and bounding. Initial treatment for this patient involves:
Definition
Positive pressure ventilatory support
Term
A 51-year-old man complains of chronic headaches that have worsened progressively over the past 3 months. Today, he called 9-1-1 because his headache is severe and he is nauseated. His vital signs are stable and he is breathing adequately. The patient denies any medical problems and states that he has been taking acetaminophen for the headaches. You should be MOST suspicious for:
Definition
intracranial neoplasm
Term
A 56-year-old diabetic woman presents with numbness and tingling to both of her hands that have gradually intensified over the past few weeks. Your assessment reveals stable vital signs, adequate breathing, and a blood glucose level of 190 mg/dL. The cardiac monitor reveals a normal sinus rhythm. The patient tells you that she has eaten but has not taken her insulin yet. You should:
Definition
provide supportive care and safely transport her to the hospital
Term
A loss of balance and equilibrium suggests injury to the:
Definition
cerebellum
Term
A neoplasm is MOST accurately defined as a:
Definition
new growth
Term
A patient experiences severe, shock-like or stabbing pain to one side of the face. This is consistent with:
Definition
trigeminal neuralgia
Term
A patient who is unable to use a common object is said to be:
Definition
apraxic
Term
A patient with a Glasgow Coma Scale score of 8 or less
Definition
may require definitive airway control
Term
A patient with a unilateral eyelid droop when smiling
Definition
may be experiencing Bell palsy
Term
A patient with suspected meningitis involuntarily flexes her knees when her head is flexed toward her chest. This is called:
Definition
Brudkinski sign
Term
A person's level of consciousness is regulated by the:
Definition
reticular activating system
Term
A staggering gait is MOST suggestive of damage to the:
Definition
cerebellum
Term
A synapse is:
Definition
a slight gap between nerve cells
Term
A woman brings her 18-year-old son to your EMS station. The patient is actively seizing and, according to the mother, has been seizing for the past 10 minutes. She states that her son has a history of seizures and takes Depakote. The patient is cyanotic, is breathing erratically, and has generalized muscle twitching to all extremities. You should:
Definition
open his airway and begin assisting his ventilations, establish an IV or IO line, and administer 5 to 10 mg of diazepam
Term
According to the Los Angeles Prehospital Stroke Screen, the possibility of a stroke is increased if:
Definition
BGL is between 60-400 mg/dL
Term
All of the following are examples of acute cerebrovascular emergencies, EXCEPT:
Definition
accumulation of atherosclerotic plaque
Term
All of the following cranial nerves are responsible for airway control, EXCEPT the:
Definition
abducens
Term
Among other functions, the medulla oblongata:
Definition
Controls BP and HR
Term
An adult who opens her eyes in response to verbal stimuli, is disoriented, and pushes your hand away when you palpate a painful area has a Glasgow Coma Scale score of:
Definition
12
Term
An elderly man presents with slurred speech, confusion, and unilateral facial asymmetry. When asked to squeeze your hands, the strength in his left hand is markedly less than the strength in his right hand. The patient's wife tells you that her husband has type 2 diabetes and hypertension. On the basis of your clinical findings, you should
Definition
Rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke
Term
An elderly man who is a resident of a skilled nursing facility is found unresponsive by a staff nurse. When you and your partner arrive, you assess the patient and note that his respirations are slow and shallow; his heart rate is slow, weak, and irregular; and his skin is cool and clammy. You should
Definition
assist ventilations ans assess his oxygen saturation
Term
An idiopathic seizure is one in which:
Definition
cause is unknown
Term
Because the facial nerve does not decussate, a stroke to the right cerebral hemisphere would MOST likely cause
Definition
left-sided weakness and a right-sided facial droop
Term
Common causes of trismus in an unresponsive patient include all of the following, EXCEPT:
Definition
opiate toxicity
Term
Common signs and symptoms of a cerebral abscess include:
Definition
high-grade fever, persistent localized headache, confusion, and focal impairment
Term
During a generalized tonic/clonic seizure, the patient is rigid and his back is arched. This represents the _________ phase of the seizure
Definition
hypertonic
Term
Emotions such as rage and anger are generated in the:
Definition
limbic system
Term
Hyperventilating a patient who has increased intracranial pressure (ICP) will:
Definition
constrict the cerebral vasculature and decrease cerebral perfusion
Term
n contrast to a benign neoplasm, a malignant neoplasm
Definition
can metastasize to other parts of the body
Term
In contrast to patients in shock, patients with increased intracranial pressure MOST often experience
Definition
widened pulse pressure
Term
Increased intracranial pressure hydrocephalus occurs when:
Definition
the movement of CSF decreases, but the production of CSF does not
Term
Patients with trismus often require:
Definition

sedation or chemical paralysis to facilitate airway control

Term
Spasmodic torticollis is characterized by:
Definition
neck muscle contraction, which twists the head to one side
Term
The involuntary, rhythmic movement of the eyes is called:
Definition
nystagmus
Term
The MOST common sign of an infectious disease is the presence of:
Definition
fever
Term
What portion of the brainstem regulates respiratory rate and depth?
Definition
pons
Term
When neurons are deprived of oxygen and glucose
Definition
they convert to anaerobic metabolism
Term
When performing the arm drift test on a patient with a suspected stroke, a positive finding is characterized by:
Definition
one arm drifting downward and turning toward the body when the patient's eyes are closed
Term
Which of the following conditions is a neural tube defect in which part of the nervous system remains outside the body?
Definition
spina bifida
Term
Which of the following cranial nerves are assessed when you ask a patient to follow your finger as you move it in an "H" shape?
Definition
Trochlear, oculomotor, abducens
Term
Which of the following cranial nerves regulates movement of the head and shoulders?
Definition
Accessory
Term
Which of the following is an example of receptive aphasia?
Definition
You ask a patient who the president is and he or she says, "January."
Term
Which of the following would MOST likely cause a sustained increase in intracranial pressure?
Definition
intracranial tumor
Term
You are assessing an unresponsive 66-year-old man with a history of two prior strokes. According to the patient's wife, he complained of a severe headache and then passed out. His respiratory effort is poor, blood pressure is elevated markedly, and pulse is slow and bounding. The glucometer reads "error." You should:
Definition
assist ventilations, apply the cardiac monitor, start an IV line with normal saline, administer 12.5 g of 50% dextrose, and reassess his level of consciousness
Term
You are dispatched to a local pharmacy, where a 24-year-old woman experienced an apparent seizure. During your assessment, you note that the patient is conscious but combative. The patient's supervisor states that she has a history of seizures and takes Tegretol. The patient's blood pressure is 146/90 mm Hg, pulse rate is 110 beats/min and regular, and respirations are 24 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes
Definition
administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren
Term
You are dispatched to a residence for a 44-year-old woman with a severe headache. You arrive to find the patient lying on her sofa with a wet washcloth on her forehead. She tells you that she has a history of migraine headaches and that this is one of her "typical" headaches. She also complains of nausea and photophobia. Her blood pressure is 170/94 mm Hg, pulse rate is 120 beats/min and regular, and respirations are 22 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes:
Definition
oxygen as tolerated, starting an IV line and administering ondansetron, and transporting without lights or siren
Term
You are dispatched to a residence for a middle-aged woman with generalized weakness of approximately 18 hours' duration. Your primary assessment reveals right-sided hemiparesis, a left-sided facial droop, and bilaterally equal and reactive pupils. Further assessment reveals that her blood glucose level is 70 mg/dL. En route to the hospital, you note increased movement of her right arm. She is receiving oxygen via nasal cannula and has a patent IV line in place. Which of the following statements regarding this scenario is correct?
Definition
Although the patient is likely experiencing a TIA, you should treat her as though she is experiencing a stroke
Supporting users have an ad free experience!