neurology - Elisabeth Chai

what are the different parts of the brain?

Cerebrum, Frontal, Parietal, Temporal, Occipital, Cerebellum

What is the cerebrum?

Largest, most superior part of the brain —> the 4 lobes make it up

What is the frontal lobe’s role?

Executive decision making

What is the parietal lobe’s role?

Sensory information (touch, temp, pain, pressure)

What is the temporal lobe’s role?

Auditory and Olfactory (smell), language comprehension

What is the occipital lobe’s role?

Visual processing (shape, color, movement)

what is the cerebellum’s role?

balance, posture, motor coordination, learning

What is the brainstem?

connects brain to spinal cord. it also controls involuntary actions (vitals, arousal, autonomic regulation)

What are the parts of the brainstem?

midbrain, pons, medulla

What is the midbrain for?

relay center for visual, auditory, and motor information as well as pain

What is are the pons’ role?

bridge facilitating communication between cerebrum and cerebellum

what is the medulla’s role?

regulating vital autonomic functions like heart rate, breathing, and blood pressure + reflexes

What are the meninges?

membrane that encloses the brain + spinal cord

also contains CSF + absorbs shock and supplies nutrients

What are the layers of the meninges?

dura mater, arachnoid mater, pia mater

What does it mean to be AMS?

any changes to a persons’ baseline level of consciousness, cognition, and orientation

what are the reversible cases of AMS?

MIST

M - metabolic: hypo/hyperglycemia, hypoxia, electrolyte abnormalities, thyroid dysfunction

I - infectious: meningitis, encephalitis, pneumonia, sepsis

S - structural: hemorrhage, stroke, mass, associated shock

T - toxic: intoxication, overdose, withdrawal, poisons

Write the GCS

check slides

What are the 3 types of headches

Tension headache, migraine headache, cluster headache

Describe a tension headache and what it could be triggered by

dull, squeezing pain surrounding the head

triggered by stress, posture, dehydration or skipping meals, caffeine, medications

describe a migraine headache and what it could be triggered by and what helps

throbbing pain usually on one side of the head

triggered by light, noise, exertion

ice, hydration, quiet and dark environment

describe a cluster headache and what triggers it and what helps

severe pain behind one eye, redness, swelling

intense restlessness, agitation, and moving

high concentration 100% O2 via NRB

what should we look for when a headache isn’t just a headache, and could be a sign of underlying conditions?

SNOOP

S - systemic signs: fever, night sweats, weight loss

N - neurological symptoms: weakness, numbness, confusion

O - Onset, Sudden: thunderclap “worst headache of my life”

O - Onset, older age: new onset >50 years, pregnancy

P - pattern change: headaches becoming more severe or frequent, positional or exertion provocations

What is the difference between dizziness and vertigo?

dizziness is a nonspecific term to describe a disturbed sense of well-being

vertigo is a type of dizziness —> illusion of movement of oneself or one’s surroundings (spinning or tilting)

what is the vestibulo-ocular reflex?

a reflex that stabilizes vision by producing rapid eye movement opposite to head motion

what is doll’s eyes indicative of?

severe brainstem damage or brain death

Label the anatomic basis of examination chart

check slides

What are the steps to taking a thorough history?

NOTEM

N - Neurological and non-neurological symptoms: AMS, headache, visual disturbances, speech difficulties, weakness, paralysis, numbness

O - onset of symptoms: when symptoms began, what the patient was doing, sudden vs gradual, triggers?

T - temporal relationships: duration, frequency, any patterns, progression over time

E - exacerbating and alleviating factors: movement, coughing, straining, positioning, orthostatic, exposure to light, temperature, stress, diet, medications

M - medical history: diagnoses, procedures, drug use, exposure, recent trauma