Possible reasions seizures occur?
Recent or an old head injury
Brain tumor
metabolic problem
genetic disposition
TIPS-AEIOU
T-trauma
I-infectoin
P-psychosis
S-stroke
A-alcoholism
E-Epilepsy
I-insulin
O-overdose
U-uremia
3 parts to the brain(explain)
Brain stem-controls most basic functions(breathing, bp,swallowing,pupil constriction)
Cerebellum-controls muscle and bondy coordination
Cerebrum -divided into right and elft hemispheres
front-contorls emotion and thought
middle controlstouch and movemetn
foramen magnum
Large opening in the base of hte skull where the rest of the nerves jion in the spinal cord and exit
-each vertebra in the neck and back , two nerves branch out
Brain sensitive to change from? (3)
Oxygen , glucose and temperature
3 types of Headaches
Tension headache-most common, caused by muscle contractions in the head and neck.
-attributed to stress
-pain usually described as squeezing , dull , or as an ache
Migraines -second most common, thought to be casued by changes in the blood vessel size in
CVA(2 types )
Cerebrovascualr accident
-interruption of blood flow to the brain
-results in the loss of brain function
Ischemic
Hemorrhagic
Signs+symptoms
facial drooping
sudden weaknessor numbness in the face, arm,leg,or one side of the body
Loss of movement and sensa
Ischemic Stroke
Most common
Results from an embolism or thrombosis
Symptoms may range from nothing at all t ocmplete paralysis
Atherosclerosis in the blood vessels is often the cause
Hemorrhagic Stroke
Results from bleeding insdie the brain
People at high risk include those experiencing stress or exertion
-highest risk are those with high BP
Symptom may be sudden onset of a severe headache
Likely caused by berry aneurysm
TIA
Transient Ischemic Attack
-Normal processes in the body break up a blood clot in the brain
-Blood flow is restored
Patient regains use fo the affected body part
often indicates a serious medical condition that may prove fatal
-When stroke symptoms go away
Right vs Left sdied stroke
Left: may cause aphasia
-speech problems can vary widely
-may cause paralysis to right side
Right: usually patients can udnerstand language and are able to speak ,but their words may be slurred
-may cause paralysis to the left side
patients may be oblviou
Conditions that may Mimic Stroke(3)
Hypoglycemia
Postictal staet
Subdural or epidural bleeding
-epidrual bleeding:bleeding outside dura and under skull
-Subdural bleeding :bleeding udner the dura but outsdie skull
Generalized Seizure
formally called a grand mal seizure
-typically charecterized by unconsciousness and a generalized seer twitching of all muscles
-results fom abnormal discharges from large areas of the brain, usually involving both hemispheres
may also experiene incontine
Simple vs Complex Seizure
Simple: no change in the patients LOC
-may have numbness ,weakness, dizziness , visual chagnes, or unusual smells/tastes
-twitching or brief paralysis
Complex:Altered LOC
-results from abnormal discharges from the temporal lobe of the brain
-Lip smacking,
Tonic-Clonic Seizure
Charecterized by sudden loss of consciousness ,chaotic muscle movement and tone, and apnea
Tonic phase:Bilateral muscle rigidity
Clonic phase: muslce contraction and relaxation lasting 1 to 3 minutes
Signs:
Tachycardia, hyerpventilation,sweating, and inte
Absence Seizure
Formerly called petit mal
-lasts for seconds
-patient fully recovers with a brief lapse of memory
Status Epilepticus
-Seizures lasting more than 5 mins are likely to progess to status epileptics
-multiple seizrus within 5 minutes
Interventions:
-suction the airway
-provide positive -pressure ventilations
-transprot quickly to the hospital
-rendezvous with ALS , if possi
Common causes of seizures(4)
-Epileptic-usually controlled by medictionas
-Strucutral -may be casued by an abnormal area in the brain
-Metabolic-abnormal levels of certain chemicals such as glucose
-Febrile -caused by a high fever
CSS
Cincinnati Prehospital Stroke Scale
FAcial Droop-Ask patient to show teeth or smile
Arm Drift-ask patient to close eyes and hold both arms out with palms up
Speech- ask patient to say " the sky is blue in cincinnati
GCS
Glasgow Coma Scale
Eye opening(4) Best Verbal REsponse(5)
Best motor Response(6)
scoring:13-15- may indicate mild dysfunction
9-12 may indicate moderate dysfunction
8 or less indicates of sever dysfunction
A 41 year old man presents with slow, irregular breathing; hypotension; and dilated pupils .These signs Most likely indicate dysfunction of the :
Brain stem
Hypothalamus
Cerebrum
Cerebellum
Brain Stem
An acute ischemic stroke is causeed by:
A ruptured cerebral artery
increased intracranial pressure
an acute rise in a person's blood pressure
a blocked cerebral artery
Blocked cerebral artery
A 56 Year old man experienced a sudden seer headache and then became unresponsive. He has a history of high BP . The MOST likely cause of his conditoin is a(n):
hemorrhagic stroke
acute ischemic stroke
sever migraine headache
transient ischemic attack
Hemorrhagic Stroke
Unlike an ischemic stroke, a transient ischemic attack is characterized by all of the following EXCEPT:
Symptoms that resolve within 24 hours
symptoms that persist for longer than 24 hours
weakness or paralysis ton one side of the body
an acute onset of c
Symptoms that persist for longer than 24 hours
A patient with a suspected stroke presents with slurred speech that is difficult for you to udnerstand. This is referred to as:
Aphasia
Dysphasia
Dysphagia
Dysarthria
Dysarthria
A type of seizrue that is charecterized by sever twitching of all the body's muscles and lasts for several minuters or logner is called a
Partial seizure
Absence seizure
Tonic-clonic seizure
generalized seizure
Generalized seizure
The MOST important reason for promptly transproting a stroke patient to the hospital is becasue:
A transient ischemic attack can be ruled out
a medications may be given to reverse the stroke
the clot in the cornoary artery may be dissolved
he or she needs
Medications may be given to reverse the stroke
Which of the following are componenets of the cincinnati Prehosiptal Stroke Scale ?
Arm drfit , blood pressure,speech
speech , pupil response, arm drift
Facial symmetry,speech, arm drfit
Pupil response, facial droop, speech
Facial symmetry, speech,arm drift
Your patient opens his eyes when you say his name, is mkaing incomprehensible soudns, and withdraws when you pinch his earlobe. What is his GCS score
9
8
11
12
9
If a patient complains of severe migraine,how hosuld she be transported?
In a brightly lit ambulance so she can see while her vision is impaired
with loud sirens so she can get to the hospital as soon as possible
Without lights and sirens
This patient sho
Without lights and sirens