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Flashcards

Neurological

Usuário eliminado O usuário eliminou as informações de disciplina Inglês 37 flashcards

Flashcards do conjunto (37)

  1. 1meningesPAD
    pia mater - membrane closest to brain
    arachnoid space - vascular = bleed
    Dura mater
  2. 2CSFtransports nutrients
    protective function around brain and spinal cord
    pressure measured with LP
    glucose/protein levels
    clear fluid - xanthochromia = discolouration
  3. 3Nursing assessment of neurological signsdetermine consciousness - painful stimuli
    cranial nerve function - pupil assessment
    motor function - limb strength
    sensory function - dermatome
    vital signs - low HR, high BP, irregular breathing
  4. 4Consciounessmost sensitive indicator to neurological changes
    largely controlled by RAS
    a diffuse bundle of nerve fibres within the brain stem and midbrain
  5. 5Disorders of consciournessconfusion - reduced awareness, delirium - disorientation, fear, irritability, obtunded - reduced alterness, drowiness, stupor, unresponsive, aroused only by vigorous and repeated stimuli
    vegetative, locked in - total paralysis below 3rd cranial nerve
  6. 6Stimulibegin with auditory
    nail bed pressure
    no longer than 30 seconds
    Painful stimuli will increase ICP
  7. 7Cranial nervesstructure highlights the sensitive relationship between increase in intracranial pressure and changes in cranial nerve function
  8. 8GCSreliable measure of neurological state
    total = E+v+m
  9. 9Seizure management must be observed for r specific indicatorsLOC, limbs involved bi or unilateral, head movement, foaming or discharge from mouth
  10. 10Pupil assessment PEARLlook for:
    direct light reflex -responsive to light
    consensual light reflex - stimulus
    accomodation - focus
    size
    shape
    reactivity
  11. 11Ptosismay indicate myasthenia gravis
    or increase in ICP
  12. 12Pupils and nerve functionCNS 111, 1V, V1 - ocular motor function
    III - motor - shift gaze up and down, inwards and outwards
    III - parasympathetic - constrict pupil, shape lens
    IV motor - gaze in and down
    VI motor - gaze outwards
  13. 13Oculomotor CN 111 nerve compressionone pupil does not respond to light
    interuption to the function of parasympathetic component of oculomotor nerve
    CN 111 - junction of midbrain and tentorial notch
  14. 14Pressure on CN IIIHematoma, tumour, the same side as the dilated pupil
  15. 15Pupils at midpoint and nonreactivemidbrain infarction or herniation
  16. 16Small - nonreactive pupilshaemorrhage
  17. 17Dilated unreactive pupilssevere anoxia, cerebral pressure, rule out drugs like atropine
  18. 18Signs of increase in ICPchanges in conscious state
    pupil size and reaction
    RR pattern
    limb strength changes
    seizures
    incontinence
  19. 19Monro - Kellie hypothesisskull is a rigid vault
    brain parenchyma is nearly incompressible
    blood volume is constant
    venous blood out = arterial blood in
  20. 20Autoregulationrefers to brains ability to change diameter of it's blood vessels automatically to maintain constant cerebral blood flow in response to metabolic needs
  21. 21Autoregulatory reservedifference between current mean CPP and the lower limit of autoregulation
    autoregulation = constant CBF
  22. 22Observations suggesting coning (herniation)changes in conscious state
    pupil size and reaction
    motor dysfcuntions
    RR patterns
    cushing reflex
  23. 23Cushing reflexphysiological response to increase in ICP
    results in triad of:
    increased SBP, pulse pressure, bradycardia, changes to breathing patterns
  24. 24LPinsertion of fine bore needle into subarachnoid space at level of 4th and 5th lumbar vertebrae
    sterile procedure
    CSF should be clear
    patient should be positioned on side of knees bent (foetal) to maximisegap between vertebrae
  25. 25EEGrecoding of electrical activity of brain
  26. 26ICP monitoringan ICP greater than 20 is associated with poor CNS function
  27. 27ICP managementexternal drainage device, blot to monitor pressues
    ICP = IP - acting against blood flow into the skull
    CPP - effective blood supply to the brain
    MAP - pressure to deliver blood into the brain
    CPP = MAP - ICP
  28. 28Burrholedrill used to access the brain through skull
  29. 29Craniotomyprocedure to access the brain
  30. 30Craniectomyremoval of piece of skul
  31. 31CPP = MPA - ICPMap is maintained through inotropes
    the pressure is dynamic
  32. 32Care of a patient with increased ICPminimise interventions
    suction will increased ICP, ventilation (PEEP) will increased
    maintain sedation
    ensure good head positioning
    ensure tracheostomy ties are not intering with venous
  33. 33Signs of increase ICPchanges in Conscious state
    changes in pupil size
    RR
    motor function changes
    seizures
    facial nerve palsy
  34. 34TCDtranscranial doppler
    indicates blood flow to the brain
  35. 35Jugular bulb oximetrycatheter inserted into the jugular vein
    indicates oxygen that had been used by thebrain
    indicates uptake of oxygen by the brain
  36. 36Causes of TBIOpen head injury - traume, gun shots
    closed head injury - MVA, falls
    Deceleration injuries (diffuse axonal injury) - axons and neurons damaged
    contre-coup - brain hits back and front surface causing widespread damage
    anoxia - depleted of oxygen, irreversible
    lesion - benign or cancer
    infections - meningitis
  37. 37—

Informações

Descrição
O usuário eliminou as informações de disciplina FlashCards sobre Neurological , criado por Usuário eliminado em 29-08-2018.
Criado por
Usuário eliminado · ago 2018
Atualizado
29 ago 2018
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27
Histórico
  • Criado por Elizabeth Then · 29 ago 2018
  • Copiado por Elizabeth Then · 29 ago 2018
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