TM Review (end)

Neuroanatomy Overview

• Pituitary Gland

  • Tied to the hypothalamus

  • Function:

  • Regulates various hormones in the body

• Hypothalamus

• Midbrain

  • Represented by H in diagrams

• Pons

  • Represented by J in diagrams

• Medulla Oblongata

  • Represented by K in diagrams

  • Essential for autonomic functions:

  • Breathing: If compromised, breathing ceases

• Cerebellum

  • Represented by L in diagrams

  • Functions:

  • Coordination and balance in movements

• Tentorium Cerebelli

  • Represented by M in diagrams

  • Structure akin to cartilage in the brain

  • Important in herniation due to brain bleeds

• Occipital Lobe

  • Represented by N in diagrams

Meninges

• Three Layers of Meninges

  • Listed with PAD sequence:

  • Superficial to Deep:

    • Pia Mater (P)

    • Arachnoid Mater (A)

    • Dura Mater (D)

• Subarachnoid Bleed

  • Occurs beneath the arachnoid layer

  • Symptoms:

  • Sudden, severe headache often described as "the worst headache of my life"

Autonomic Nervous System

• Sympathetic vs. Parasympathetic System

  • Key functions and responses:

  • Sympathetic: Fight or flight response, increases heart rate, blood pressure, and dilates bronchioles

  • Parasympathetic: Rest and digest, promotes relaxation and decrease in heart rate

  • Eye Responses:

  • Sympathetic: Mydriasis (pupil dilation)

  • Parasympathetic: Miosis (pupil constriction)

Heart Failure

• Right-Sided Heart Failure Symptoms

  • Symptoms include:

  • Pitting edema

  • Hypotension

  • Fatigue due to poor cardiac output

  • Causes include Chronic Obstructive Pulmonary Disease (COPD)

• Left-Sided Heart Failure

  • Symptoms include:

  • Pulmonary edema

  • Treatments:

  • Nitro

  • CPAP for CHF exacerbation

  • Lasix (Furosemide) administration for fluid overload

  • Dosage:

    • Typical initial dose is 40mg

Neurological Conditions

• Dysphagia vs. Dysphasia

  • Dysphagia: Difficulty swallowing

  • Often seen in conditions like epiglottitis

  • Dysphasia: Difficulty in speech or understanding language

• Agnosia

  • Defined as the inability to recognize familiar objects or sounds

• Dysarthria

  • Difficulty in articulating speech due to muscle weakness

Metabolic Acidosis

• Characteristics:

  • Defined by a pH lower than 7.35

  • Conditions associated include:

  • Diabetic Ketoacidosis (DKA)

  • Renal failure

  • Example Lab Values:

  • pH = 7.25 (acidic)

  • CO_2 levels usually drop below 35

  • Bicarbonate < 22

Seizures

• Treatment Priorities during Seizures:

  • Protect from injury

  • Maintain airway

  • Administer oxygen

  • Provide Benzodiazepines (e.g., Lorazepam) as necessary

Stroke Assessment

• Types of Stroke:

  • Ischemic Stroke: Occurs due to blockage of blood flow

  • Hemorrhagic Stroke: Results from a ruptured blood vessel

• Symptoms to Recognize:

  • Last known normal assessment is crucial

• Penumbra: Area around a stroke that is salvageable

Cushing's Triad

• Characteristics:

  • Bradycardia

  • Irregular respirations

  • Change in pupil size

  • Indicates increased intracranial pressure

Respiratory Conditions Overview

• ARDS (Acute Respiratory Distress Syndrome):

  • Defined by fluid accumulation in alveoli

  • Leads to poor gas exchange and potential refractory hypoxemia

• Cystic Fibrosis Treatment:

  • Use of albuterol and mucus-clearance therapies

Addison's Disease

• Symptoms of Addison's Disease:

  • Fatigue, hypotension, weakness, and skin changes

  • Patients may crave salt due to sodium loss

• Crisis Management:

  • Requires immediate steroid administration for adrenal crisis

Summary of Key Lab Values

• Normal Sodium Levels:

  • 135-145 mEq/L

• Normal Potassium Levels:

  • 3.5-5.0 mEq/L

• Metabolic Acidosis Identifiers:

  • Low pH, low bicarbonate levels corresponding to clinical states

Electrophysiology (ECG)

• Understanding Strain Patterns and Voltage Criteria:

  • Assess for Left Ventricular Hypertrophy (LVH)

  • Recognition of STEMI vs. NSTEMI based on ECG findings