SCRN Exam 2023 Questions and Answers (Graded A)

Four lobes of the cerebral cortex and cerebrum - Answer- Frontal Parietal Temporal Occipital Oxygen supplemental need - Answer- 93% BP goal post tPA - Answer- 180/105 Vast majority of fatal hemorrhages occur within - Answer- the first 12 hours hyperthermia management - Answer- strict 38.0 or 100.4 tylenol for fevers Neurogenic fevers with an early increase in temperature After 24 hours - Answer- can restart antihypertensive blood pressure goals if they did not receive tPA - Answer- systolic 220 diastolic 120 ** do not want to bring BP down fast d/t risk for hypotension Co2 is a potent vasodilator - Answer- leads to an increase in ICP more blood volume to brain Mild hyperventilation for low CO2 leads to lower ICP and vasoconstriction Hypocarbia in extreme can lower cerebral blood flow by too much Door to physician - Answer- 10 min door to team - Answer- 15 min Door to CT - Answer- 25 min Door to interpretation - Answer- 45 min door to tPA - Answer- 60 min BP if they did not receive TPA - Answer- 220/120 Acute care management - Answer- continue to monitor neurological status begin early mobilization of patient close observation during transition sitting to standing intracranial hemorrhage - Answer- hypertensive bleed venous thrombosis trauma subarachnoid hemorrhage - Answer- trauma aneurysmal non-aneurysmal venous thrombosis ischemic stroke - Answer- large vessel occlusions (LVO) usually from embolic sources ICA MCA ACA PCA PICA AICA Basilar Small vessel occlusions - Answer- generally from atherosclerosis vessels that feed cerebrum - Answer- MCA PCA ACA vessels that feeds the cerebellum - Answer- AICA PICA SCA vessels that feed the brainstem - Answer- basilar pontine stroke mimics - Answer- seizures metabolic syndromes complex migraines degenerative neurologic conditions CNS tumors drug toxicity CNS abscess Bell's palsy Neuroplasticity - Answer- the ability within the brain to constantly change both the structure and function of many cells in response to experience or trauma adaptive or maladaptive rehab is key SAH bp goal - Answer- 140 ICH blood pressure goal - Answer- 160 Frontal lobe - Answer- motor, behavioral expression, motor and sensory maps Parietal lobe - Answer- sensation, optic radiations carrying sensory input from the eyes, language centers (typically left side of the brain) -- broca's and wernicke's Dysarthria - Answer- slurred speech reflecting poor motor control of the muscles associated with speech and language Occipital lobe - Answer- vision and interpretation of visual sensory signals Temporal lobe - Answer- coding visual memory and processing auditory and visual sensory input and language comprehension Basal ganglia - Answer- coordinating center for several nerve tracts including coordinating muscle movement Globus pallidus - Answer- component of the basal ganglia instrumental in control of voluntary muscle movement Limbic system - Answer- group of nuclear and critical structures that encode memory and regulate autonomic nervous system and endocrine function in response to emotional situations Limbic System: Hypothalamus - Answer- coordinates ANS with endocrine function, control of body temperature, circadian rhythm, and body water osmolality Amygdala: limbic system - Answer- plays a crucial role in the management of stress, rage, and anxiety Center for memory and emotions Cingulate gyrus (limbic system) - Answer- develop emotions and encode memory Hippocampus (limbic system) - Answer- contains centers for memory and learning, regulation of corticosteroid production and spatial relations Most common cause of SAH - Answer- aneurysm rupture Result in intracerebral hemorrhage - Answer- AVM rupture amyloid angiopathy Tentorium - Answer- dural fold that separates the cerebrum from the cerebellum Pia mater - Answer- the innermost meningeal layer that fits the brain Dura mater - Answer- outermost layer of the brain Arachnoid mater - Answer- middle layer of the meninges The front lobe contains - Answer- motor strip It is located at the back of the frontal lobe Wernicke's area - Answer- located at the junction of the temporal and parietal lobes Sensory strip - Answer- Located along the Parietal Lobe, this registers and provides all sensations Postcentral gyrus - Answer- located in the parietal lobe where the sensory strip lies The strip of parietal cortex, just behind the central sulcus, that receives somatosensory information from the entire body Homunculus - Answer- diagram that depicts what body parts are controlled by the motor/ sensory strips Thalamus - Answer- relays auditory, somatosensory, visual, and gustatory signals between the cortex and brainstem Diencephalon - Answer- thalamus, hypothalamus, and pineal gland Relays sensory information among brain regions and controls many autonomic functions of the peripheral nervous system Temporal lobe - Answer- where wernicke's area lies responsible for receptive speech Medulla oblongata - Answer- Part of the brainstem that controls heart rate and respiration ; connects to the spinal cord