1Quadriplegia affects ______ because of an injury to the ______ area of the spine
- all four extremities
- cervical
2Paraplegia= injury to the spinal cord in the _____, ____, or _____ region affecting _______
- thoracic, lumbar, or sacral
- lower extremities
3Neurogenic shock is a type of _____ shock characterized by
Distributive shock
-Disruption of autonomic pathway --> lossw of sympathetic tone --> dec. SVR leading to hypotension, bradycardia, and peripheral vasodilation.
- Unlikely to occur w/ SCI below T6
4Autonomic dysreflexia
-A noxious stimulus causes an exaggerated sympathetic response that triggers below level of injury leading to vasoconstriction, hypertension, and reflexive bradycardia
- assoc. w/ SCI @ or above T6
5TBI is the leading cause of injury related deaths and disabilities in ______ to ____ and _____ to ____. _____ > _____
- newborn-4yo
- 15-19yo
- males>females
6CN I= _______. Function = _____. arises from ______
- Olfactory (sensory)
- Smell
- Arises from primary olfactory cortex (temporal
lobe)
7CN II= ______. Function= _____. arises from _____
- Optic (Sensory)
- Vision
- Arises from from eye retinas
8CN III= ______. Function= _____________
- Oculomotor (Motor)
- Eye movement, Raises upper eyelid, elevates eye, abducts & adducts eyeball w/ proprioception, constricts pupils, & controls visual focusing (ciliaris)
9CN IV= ______. Function= _____. arises from _____
- Trochlear (primarily motor; sensory)
- eye ball movement: Innervates superior oblique muscles (abducts, depresses, internally rotates eyeball)
- dorsal midbrain; runs around
midbrain, follows oculomotor nerve through
superior orbital fissure
10CN V= ______. Function= _____. arises from _____
- Trigeminal (sensory/motor)
- facial movement, chewing, temperature, touch, pain
- Emerges from pons, travels to trigeminal ganglion
11CN VI= ______. Function= _____.
- Abducens (motor)
- eyeball movement
- Innervates lateral rectus muscle (abducts eye)
12CN VII= ______. Function= _____.
- Facial (Sensory/Motor)
- taste, saliva, tears, facial movement
(facial expressions)
13CN VIII= ______. Function= _____.
- Vestibulocochlear (Sensory)
- hearing, equilibrium
14CN IX= ______. Function= _____.
- Glossopharyngeal
- swallowing, monitoring BP/oxygen/CO2
15CN X= ______. Function= _____.
- Vagus (Sensory/Motor)
- Smooth muscle control, digestive
enzyme secretion, swallowing, taste, HR, &
breathing
16CN XI= ______. Function= _____.
- Accessory (Motor)
- swallowing; head, shoulder movement
17CN XII= ______. Function= _____.
- Hypoglossal (Motor)
- tongue movement, speech, swallowing
18Botulism patho: Clostridium botulinum bacteria produce botulinum toxin, which blocks _______ from NM junction nerve endings, causing progressive ________. most commonly affects _____
- ACh release
- descending muscle weakness/paralysis
- infants <6 mo
19C. botulinum is _____ and found in soil, can make its way into food products like ______ or ingested/ inhaled from ____ or _____
- spore-forming
- unpasteurized honey
- soil or vacuum cleaner dust
20You should suspect botulism in any infant with _____ and _______, ________, _______, or ________
- hypotonia and difficulty with sucking, feeding, swallowing, or crying
21Brain abscesses most common organisms= _______, _____ & ______ including ______, _____, & _____
- anaerobic cocci and gram-neg and gram-pos anaerobic bacilli
- including Staph aureus, Enterobacter, and Strep spp.
22suicide warning signs mnemonic= IS PATH WARM
- Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood changes
23Arteriovenous malformation (AVM) is a Congenital intracranial malformation distinguished by a persistently ____________ within the brain w/o an interposed or developed ______
- abnormal connection between arteries and veins
- capillary bed
24AVMs Presents between ____ & _______ of life. Infant presentation: __________
- 2nd & 4th decade
- vein of Galant
25AVM CT shows presence of ___________ with ______ surrounding the AVM
- hyperdense tubular structures
- calcifications
26Delerium pharmacotherapy: ______, ______, or _____. all can ______ → Avoid ______
- Haldol, droperidol or risperidone
- prolong QTC
- benzos
27TOXIC-METABOLIC ENCEPHALOPATHY: _____ dysfunction causing _____, _____, & _____
- cerebral
- ALOC, behavior changes & seizures.
28Guillain-Barré Syndrome is an Acute ____________ of the ________ manifested by ______ & _______
- inflammatory demyelinating polyneuropathy
- peripheral nervous system
- progressive flaccid paralysis and areflexia
29Guillain-Barré LP findings= elevated _____ > ___ and absence of ______
- Protein
- > 45mg/dL
- Pleocytosis
30Guillain-Barré Electromyogram (EMG) findings= _______ and _______ consistent with ________
- diffuse demyelination and delayed motor conduction
- consistent with lower motor neuron disease
31IVIG tx for Guillain-Barré _________, _______, & ______
- blocks macrophage receptors, inhibit antibody production, inhibit complement binding and neutralizing pathologic antibodies
32Plasmapheresis tx for Guillain-Barré _________ responsible for _______
removes circulating humoral factors responsible for demyelination
33Pseudotumor Cerebri: Idiopathic Intracranial HTN is an ________ with _______ composition—no evidence of ________ or _______ abnormality.
- Elevated ICP
- normal CSF
- intracranial pathology or neuroimaging
34Idiopathic Intracranial HHTN primarily affects ______ of _____ age who are _______
- females of childbearing
- overweight
35Normal LP opening pressure in children is _____ to ______ cm H2O
- 10 to 28
36Bacterial meningitis is usually from _______ in children & commonly caused by ______ & _____ in the neonate. Other causes include _____, ______, & _____
- upper respiratory tract infection
- group B strep and E. coli in the neonate
- listeria, Neisseria, haemophilus influenzae
37Bacterial meningitis LP findings= _____, _____, & ____. Repeat LP ____ to ____ hours after abx started.
- low glucose, high protein, high WBC count
- 24-48
38Bacterial meningitis tx empiric ______ & _____ until culture results. _____ & _____ for infants. _________ for 48 hours.
- vancomycin and Rocephin
- ampicillin and Rocephin
- dexamethasone 0.15mg/kg q6hours
39Viral meningitis is commonly caused by ______. other causes: _____ & _____
- enteroviruses
- HSV & arboviruses
40_______ is used to prevent Viral meningitis
Hib vaccine (PCV13)
41Myasthenia Gravis (MG) is a ________ disease due to _______ destruction of the ________ at the neuromuscular junction
- chronic neuromuscular
- autoimmune
- acetylcholine receptors
42Hallmark sign of Myasthenia Gravis is ______ that ________ and ________
- Muscle weakness
- worsens during periods of exercise/activity
- improves after periods of rest
43Spinal Muscular Atrophy (SMA) is an ______ loss of ________, aka _______ cells. SMA type _____ is most sever making up ___% of cases
- autosomal recessive
- lower motor neurons
- anterior horn
- Type 1
44In SMA weakness tends to be more severe in the ________ muscles than in the ______ muscles & tends to _____
- proximal
- distal
- worsen with time
45CK levels are typically _____ with SMA, unlike with other neuromuscular disorders
- normal
46SMA tx includes _____ & ______
Gene replacement therapy and Disease-modifying therapy
47A seizure is a disturbance of brain function caused by _______ within the neuronal system
- paroxysmal discharges
48Status epilepticus is defined as
a seizure with 5 minutes or more of continuous clinical or electrographic seizure activity or recurrent seizure activity without recovery between seizures.
49Refractory status epilepticus is considered in patients with ongoing seizure activity after ______
the administration of two appropriately dosed
anticonvulsant medications
50 Generalized seizure originates and engages ______
bilateral hemispheres
51Absence seizures are brief, usually_____ second periods of ______ or ______
- 15-20
- impaired consciousness or confusion
52Myoclonic seizures are characterized by
jerky involuntary movements, typically for a brief period (<1sec), with trunk flexion and spasmodic limb movements.
53Clonic seizures are ______ & ____ movements of _____, _____, & _____
- rhythmic repetitive
- head, trunk and extremities
54Tonic seizures are _______ or _____ of ______, _____, & _______
- sustained extension or flexion
- head, trunk and extremities
55One of the most significant adverse effects of fosphenytoin is
-cardiac arrhythmia or hypotension during infusion d/t rapid infusion rate or Effect of the drug on ventricular automaticity
56______ is administered to patients with status epilepticus at an initial dose of ______ intravenously. Lorazepam can be used for patients with status epilepticus; however, the initial dose is _____ intravenously.
-Phenobarbital 10 to 20 mg/kg
-0.05 to 0.1 mg/kg