Term
| Cranial nerve/s responsible for pupillary reactions: |
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Definition
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Term
| Cranial nerves responsible for conjugate/disconjugate gaze? |
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Definition
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Definition
- visual acuity
- visual fields
- fundoscopic exam
- pupillary responses |
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Term
| Cranial nerve responsible for sensation to face and chewing muscles? |
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Definition
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| Cranial nerve responsible for facial symmetry: |
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Definition
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| Cranial nerve/s responsible for corneal reflex: |
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Definition
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Term
| How to assess CN IX and X: |
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Definition
| palate elevation and gag reflex |
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Term
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Definition
| head turn and shoulder shrug |
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Definition
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Definition
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Definition
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| pointer and middle finger: |
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Definition
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Definition
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Definition
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| Tests for meningeal irritation: |
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Definition
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Term
| Test for nerve root irritation: |
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Definition
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Term
| Dementia affects __ without affecting ___. |
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Definition
- affects cognition
- without affecting consciousness |
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Term
| Coma is due to dysfunction of: |
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Definition
| - both cerebral hemispheres and/or the upper brain stem |
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Term
| Signs of infection/sepsis: |
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Definition
- Increased heart rate
- Decreased blood pressure |
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Term
| Signs of impending herniation: |
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Definition
- Decreased heart rate
- Increased blood pressure |
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Term
| causes of Cheyne stokes breathing: |
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Definition
- Metabolic encephalopathy
- Bihemispheric lesions |
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Term
| causes of central neurogenic hyperventilation (Kussmaul's repsirations): |
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Definition
- metabolic acidosis
- herniation |
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Term
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Definition
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Term
| Cluster breathing/Biot's breathing: |
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Definition
| Pontine/Cerebellar Breathing |
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Term
| Ataxic (Biot's) respirations: |
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Definition
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Term
| findings of cortical lesions: |
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Definition
- hyperactive DTRs
- clonus
- Babinski sign positive |
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Term
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Definition
| - corticospinal tract lesion from cortex to upper midbrain |
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Term
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Definition
| - corticospinal tract lesion at pons or upper medulla |
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Term
| Gaze preference __ the hemiparesis and __ the lesion is consistent with a large ceerebral hemisphere lesion. |
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Definition
- AWAY from the hemiparesis
- TOWARDS the lesion |
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Term
| Frontal eye fields normally moves eyes to the __ side, while lateral eye fields normally move eyes to the ___ side. |
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Definition
- contralateral
- ipsilateral |
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Term
| Gaze preference ___ the hemiparesis and __ from the lesion is consistent with a lesion in the pons of the brainstem. |
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Definition
- towards the hemiparesis
- away from the lesion |
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Term
| Looking away from the hemiparesis signifies a ___ lesion, while looking towards the hemiparesis significes a __ lesion. |
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Definition
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Term
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Definition
- slow, horizontal conjugate eye movements
- intact brainstem
- bilateral hemispheric dysfunction (anoxia) |
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Term
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Definition
- downward jerking of both eyes followed by slow return to mid-position
- pontine lesion
- need to rule out locked in state |
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Term
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Definition
- Awake but quadriplegic with paralyzed horizontal eye movements
- Vertical eye movement intact
- Communicate by looking down/blinking
- Large pontine lesions (hemorrhage/infarct)
- Prognosis favorable, recovery possible |
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Term
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Definition
- normally eyes should move in opposite direction of rotated head (present doll's eyes= normal)
- if lesion in MIDBRAIN OR PONS (CN III-VIII)- eyes will remain fixed and move in the same direction as the head= dolls eyes absent- abnormal |
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Term
| Abnormal Oculovestibular aka Calorics aka COWS signifies a lesion where? |
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Definition
| - Brainstem (CN III-CNVIII) |
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Term
Oculocephalic- Doll's Eyes
Oculovestibular- Calorics- COWS |
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Definition
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Term
| Exam findings and causes of pt with non-focal exam wdn intact brainstem reflexes: |
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Definition
- Exam: reactive pupils, full eye movements, symmetric motor responses
- Causes: Toxic/Metabolic, CNS infection, Hydrocephalus |
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Term
| A patient with focal hemispheric signs will have __ __, __ __ __, and __ __. These patients require neuroimaging. The cause is most likely __ like a __, __, or ___ ___. |
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Definition
- contralateral hemiparesis
- visual field defects
- gaze paresis
- structural
- stroke
- tumor
- subdural hematoma |
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Term
| A pt with focal brainstem signs would have __ __ __, __ __, and ___. These require neuroimaging. Most likely caused by a brainstem lesion like a __ or __, or a __ __ that is ___. |
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Definition
- abnormal pupil responses
- CN palsies
- posturing
- tumor or stroke
- cerebral mass that is herniating |
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Term
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Definition
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Term
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Definition
- Trauma
- Tumor
- Hemorrhagic stroke |
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Definition
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Definition
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Definition
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Definition
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| artery involved with epidural hematoma: |
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Definition
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Term
| immediate LOC followed by lucid interval: |
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Definition
| Epidural hematoma (middle meningeal artery) |
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Term
| Bulging convex pattern on head CT: |
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Definition
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Term
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Definition
| tearing of bridging veins |
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Term
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Definition
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Term
| Subacute subdural hematoma: |
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Definition
| symptoms after 24 hours and up to 2 weeks after the injury |
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Term
| Chronic subdural hematoma: |
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Definition
| symptoms develop 2 weeks or more after the injury |
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Term
| crescent hematoma on CT scan: |
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Definition
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Term
| For pts with GCS < 8, __ and __ to keep PCO2 between__ and __. Use osmotic diuresis with __ 20% 1.0-1.5 mg/kg IV. |
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Definition
- intubate and hyperventilate
- 28 and 32
- Mannitol |
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Term
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Definition
Call or return for any of these:
- Increased or persistent headache unrelieved by Tylenol or ASA
- Persistent vomiting
- Inability to concentrate
- Dizziness
- Problems walking, talking, chewing, or swallowing
- Seizures
- Incontinence
- Change in personality or behavior
- Inceraseing drowsiness or inability to be aroused |
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Term
| Pathognomic for spinal cord injury: |
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Definition
| - bilateral weakness with sensory level |
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Term
| Indicated with spinal cord injuries: |
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Definition
| - Methylprednisolone, 30 mg/kg IV bolus over 15 minutes, follwed by 5.4 mg/kg IV over 23 hours |
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Term
| Characteristics of a T10 cord lesion: |
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Definition
- Spastic paraplegia (arms motor 5/5)
- T10 sensory level (UE intact)
- Biceps and Triceps DTR 1+
- Knee and ankle jerk reflexes 3+
- (+) Babinski sign
- FTN and RAMs intact in bilateral upper extremeties |
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Term
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Definition
Hemisection of the cord, Rigth T10
- disruption of right corticospinal tract> RLE plegia, +3 RLE knee jerk and ankle reflex, RLE Babinksi sign
- disruption of right posterior columns> decreased vibration and proprioception on right
- disruption of right spinothalamaic tract> decreased light touch and pin prick on LLE |
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Term
| Non-modifiable risk factors for CVA: |
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Definition
- increasing age
- male
- AA
- family history |
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Term
| Modifiable risk factors for CVA: |
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Definition
- Smoking
- HTN
- DM
- Hyperlipidemia
- Atrial fibrillation
- history of TIAs |
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Term
| Manifestations of Anterior Cerebral Artery Stroke: |
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Definition
DeeP CD Face spared.
- Decreased concentration
- Personality changes
- Contralateral sensorimotor deficits
- Distal > Proximal
- Face spared |
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Term
| Manifestatinos of Middle Cerebral Artery Stroke: |
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Definition
CCCAA
- Contralateral visual field defects (homonymous hemianopsia)
- Contralateral sensorimotor deficits (proximal> distal)
- Contralateral CNVII palsy
- Aphasia if dom hemisphere affected
- Apraxia and hemi-neglect with involvment of nondominant hemisphere |
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Term
| Manifestations of posterior cerebral artery stroke: |
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Definition
CCCV
- Contralateral hemisensory loss
- Contralateral visual field deficit (homonymous hemianopsia)
- Cortical blindness
- Visual agnosia |
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Term
| symptoms of vertebrobasilar insufficiency: |
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Definition
ACMSA
- Altered mental status/coma
- Cranial nerve palsies: diplopia,vertigo, dysarthria
- Motor weakness
- Sensory loss
- Ataxia |
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Term
| BP contraindication for thrombolytics: |
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Definition
| systolic >185 OR diastolic > 110 |
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Term
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Definition
- Supportive care
- Neuro consult
- DVT prophylaxis
- Plasmaphoresis
- IV immunoglobulins
- Ventilatory support if needed
majority recover in 3 months to 1 year |
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