A little bit of everything
This is the best possible Glasgow Coma Scale score.
What is 15?
(eye = 4)
(verbal = 5)
(motor = 6)
This assessment focuses on the patient's response in the following three areas: Eye opening, Verbal, Motor.
Glascow Coma Scale
What type of hematoma usually occurs as a result of an arterial rupture?
Epidural hematoma
What is the amount of time from symptom onset can a person receive TpA?
3-4.5 hours from symptom onset
The part of the autonomic nervous system responsible for fight or fight?
Sympathetic nervous system
What are the 2 priorities for someone with a suspected SCI?
•Airway Management/O2
•Stabilize cervical spine – prevent further injury
What are the goals of treatment following brain tumors?
•Goals:
•Maintain normal ICP
•Maximize neurological functioning
•Active control of pain and discomfort
•Long-term implications with respect to prognosis, cognitive, & physical functioning
This is the normal volume of cerebrospinal fluid (CSF)
150 mls
What are nerve conduction studies?
Test for transmission of impulses within nerves from muscle tissue
Name the type of injury that leads to a secondary impact?
Countrecoup
Describe Cushings Triad
Cushing’s triad refers to a set of signs that are indicative of increased intracranial pressure (ICP), or increased pressure in the brain. Cushing’s triad consists of bradycardia (also known as a low heart rate), irregular respirations, and a widened pulse pressure.
Name the normal properties of CSF?
Clear
USG 1.007
blood: none
Glucose: 2/3 of serum value
Protein: 15-20 dL
What would you expect to see with someone who suffered a SCI at C5-C6?
Quadriplegia with gross arm movements, phrenic nerve intact
Describe neutropenic precautions:
Neutropenic precautions:
No fresh fruits and vegetables during hospitalization or eating out · Unpasteurized foods (examples are milk, orange juice, cheese, and honey), · Raw or undercooked meats or eggs · Do not eat out of date food or foods left at room temperature >2 hours · Avoid acidic and abrasive foods · Do not eat from a salad bar · Do not share food utensils. · Avoid flowers: cut or dried and live plants. *Wash hands thoroughly with antibacterial soap after children play outdoors. · Avoid crowds or exposure to people with colds or contagious illnesses. · Do not share towels or personal items · Do not receive live virus vaccines and avoid exposure to people who have received live virus vaccines in the last 30 days. The injectable flu vaccines are given to Oncology patients every year and families are encouraged to receive them. The nasal spray vaccine is not permitted. · Limit contact with pets (litter boxes, bird cages, fish and reptile tanks) · Do not swim in ponds, lakes, and rivers · Do not use hot tubs and or a Jacuzzi · Wear a mask in construction areas · Avoid tobacco products · Regular dental care/cleanings are recommended only when patient is not neutropenic. · Do not get a body piercing or tattoo · Avoid tampons during periods of neutropenia · Do not suppress fever until it has been evaluated by a physician
What type of patient would you expect to see a GSC of 6?
The patient may be unresponsive
With this type of test, all people in the scanning area (while the magnet is on) must remove all jewelry, electronics, and phones to prevent damage to themselves or the magnet.
MRI
How do you test for halo sign and what are you looking for?
The presence of CSF in drainage
Clear or yellowish ring around a drop of fluid on gauze
Name the two main types of CVA and describe the differences?
Ischemic and hemorrhagic
How many T vertebra are there?
12
What are the priorities for a patient following an Anterior cervical fusion?
•airway, possible swelling or hemorrhage at surgical site, watch for tracheal deviation
Discuss acoustic neuroma
CN VIII_ hearing and balance; therefore, vertigo may be a s/s
An acoustic neuroma (vestibular schwannoma) is a benign tumor that develops on the balance (vestibular) and hearing, or auditory (cochlear) nerves leading from your inner ear to the brain, as shown in the top image. The pressure on the nerve from the tumor may cause hearing loss and imbalance.
These can be excitatory or inhibitory. They are chemical messengers that transmit impulses from one cell to another.
What are neurotransmitters?
This is a priority assessment for a lumbar puncture (meaning these are negative findings that we continuously assess for)
Bleeding and CSF leakage
Name the different phases that can occur with a subdural hematoma?
§Acute. Immediately to 24 hours post injury
§Subacute. Within 2 weeks of injury
§Chronic. 2 weeks to months or years
Name 2 modifiable and 2 non-modifiable risk factors for stroke?
non-Modifiable:
Age
Gender
African American
History of prior Stroke
Family history
Name a type of glial cell?
What are:
mircroglial cells?
macroglial cells?
ependymal cells?
What should you anticipate to have available for someone with a suspected C1-C2 injury?
A ventilator
Quadriplegia with loss of spontaneous respiratory function
How is increased ICP harmful?
Interferes with blood flow to brain tissue
Can distort and push brain tissue around
Causes compression which can result in brain herniation
BRAIN HERNIATION IS LIFE THREATENING!!!
What is normal ICP values?
0-15mmHg - Treat if 20mmHg or above
Who is the best Jeopardy maker in all the land?
Well.....Dr. Appling of course!
Describe the different types of posturing?
§Decorticate posturing
§Cerebral hemisphere
§Cervical spine
§Decerebrate posturing
§Midbrain or Pons
What is the acronym that should be taught to identify a possible CVA?
FAST
Describe dermatomes.
Follow a pathway in the spine
Describe the S and S of someone experiencing Brown-Sequard syndrome.
Brown-Sequard syndrome (BSS) is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.
Name 2 complications that can result from brain tumors?
•Diabetes insipidus (DI)
•Large amounts of urine from deficiency of ADH (from posterior pituitary gland)
•SIADH: Syndrome of inappropriate antidiuretic hormone
•Fluid retention from overproduction of vasopressin or antidiuretic hormone