62 terms

Outdoor Emergency Care (5th Edition): Chapter 11

Central nervous system
What's in the CNS
Brain and spinal cord
the form of sugar that circulates in the blood and provides the major source of energy for body tissues. When its level is low, we feel hunger.
What kinds of energy does CNS use?
Oxygen, glucose, and others
Altered Mental Status, condition in which a person's level of awareness has changed. Change in level of awareness/responsiveness
Higher cortical functions
thinking, reasoning, memorizing, long term planning, complex movements, language
Brain stem
Connection to spinal cord. Filters information flow between peripheral nervous system and the rest of the brain.
What is the brain stem in charge of?
Breathing, swallowing, responsiveness, heart function, blood pressure
the "little brain" at the rear of the brainstem; functions include processing sensory input and coordinating movement output and balance. CerebeLLUM, baLANCE
What is the cerebellum in charge of
Balance and coordination
Area of the brain responsible for all voluntary activities of the body
What is the cerebrum in charge of
Emotion, thought, speech, integration, memory, sensation, motor function
Endocrine system
Glands secrete hormones that regulate processes such as growth, reproduction, and nutrient use (metabolism) by body cells.
Chemical messengers, mostly those manufactured by the endocrine glands, that are produced in one tissue and affect another
Regulates the level of sugar in the blood. Produces insulin and Glucagon
A protein hormone synthesized in the pancreas that regulates blood sugar levels by facilitating the uptake of glucose into tissues. Enables transfer of glucose from blood into cells.
A protein hormone secreted by pancreatic endocrine cells that raises blood glucose levels; an opposite hormone to insulin.
Storage form of glucose
Relationship of insulin and glucagon
Insulin lowers blood sugar, glucagon raises it
How much glucose does the brain use?
25% of body's glucose
an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech.
Causes of AMS
Insufficient oxygen, low blood sugar, infection, nutrient imbalance, structural brain abnormalities such as trauma/tumors/brain blood clots, toxic substances, or individual behavior
Alcohol + Acidosis
Epilepsy + Environment + Electrolytes
Oxygen (Hypoxia) + Overdose
Uremia (Kidney failure/problems)

Trauma + Tumors
Infection (CNS, sepsis)
Poison + Psychiatric problems
Seizures + Stroke + Syncope
Body pH < 7.35
presence of urinary waste in the blood
Dangerous infection of the blood
"Passing out", loss of consciousness or fainting
a sudden surge of electrical activity in the brain that affects how a person feels or acts for a short time
chronic brain disorder characterized by recurrent seizure activity
Partial Seizure
Can be simple or complex based on responsiveness, can involve sensory changes, involuntary skeletal muscle activity, or combo of any. Involves involuntary jerking of limb
Jacksonian March seizure
When a simple partial motor seizure of a specific muscle group spreads out
Signs of simple partial motor seizure
Grunting or other sorts of vocalizations, tensing of torso muscles, facial twitching (on one side)
Signs of simple partial sensory seizure
Complaints of blurred vision, seeing spots or flashing lights, abnormal smells, buzzing noises, hot/cold sensations, tingling , numbness, abnormal metallic taste.
Signs of complex partial seizure
Lip smacking, tugging at clothes, head twisting, body turning
Generalized seizure
A seizure characterized by severe twitching of all of the body's muscles that may last several minutes or more; formerly known as a grand mal seizure.
Absence seizure
seizure involving a brief loss of consciousness without motor involvement; previously termed petit mal (little bad) seizure
Grand mal seizure
a type of generalized epileptic seizure in which nerve cells fire in high-frequency bursts, usually accompanied by involuntary rhythmic contractions of the body
Tonic activity
Stiffening of the muscles
Clonic activity
Spasmic jerking of muscles during a seizure
Subjective sensation that precedes a seizure
Pre-ictal phase
restlessness and/or altered behavior prior to start of seizure
Ictal phase
full seizure, begins with tonic muscle activity during which patient may cry out/fall to the ground. Clonic activity may begin after this. Patient may be unresponsive, may grunt/gasp.
Post-ictal phase
The final phase of a generalized seizure, during which the patient becomes extremely fatigued. May urinate/defacate due to relaxation of muscles.
Diabetes Mellitus
a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both
Normal blood sugar levels for human body
70-110 mg/dL
(occurring) after a seizure or attack
Best position of transport for patients after seizure
Lateral recumbent position
Common technique for patients with garbled speech
Have them repeat a common phrase
Cincinnati Prehospital Stroke Scale
Facial droop, arm drift, abnormal speech
status​ epilepticus
a dangerous condition in which epileptic seizures follow one another without recovery of consciousness between them
Excessive exertion of urine. Early sign of diabetes
Excessive thirst and fluid intake. Early sign of diabetes
Type 1 Diabetes
Jvenile onset, autoimmune disorder. Cells attack the pancreas and destroy cells responsible for making insulin.
Type 2 Diabetes
Adult onset (though juvenile can get it with obesity), cells resistant to insulin, prevent glucose from entering cells.
Gestational diabetes mellitus, only during pregnancy
Not enough blood sugar (<70 mg/dL).
Symptoms of hypoglycemia
Anxiety, dizziness, tachycardia, diaphoresis, tremor, headache
profuse sweating
Too much blood sugar (>180 mg/dL). Prolonged onset, not instantaneous. Nausea, vomiting, abdominal pain, varying AMS status
Global GNS Abnormality
Responsiveness, overly/abnormally stimulated state
Focal GNS Abnormality
Motor weakness, balance/vision/speech abnormality
Assessing for stroke
Motor-sensory exam: Hold arms out in front of patient. Look for one/both arms drifting.
Ask to repeat a simple phrase.