A child with a stiff neck

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Mind Map on A child with a stiff neck, created by fatima alkhateeb on 22/09/2018.
fatima alkhateeb
Mind Map by fatima alkhateeb, updated more than 1 year ago
fatima alkhateeb
Created by fatima alkhateeb over 5 years ago
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Resource summary

A child with a stiff neck
  1. Anatomy
    1. Skull
      1. Meninges
        1. CSF
          1. Secretion
            1. From the choroid plexus, which are found on the lateral ventricles, roof of the 3rd ventricle, and the 4th ventricle
            2. Absorption
              1. Absorbed from the superior sagittal sinus through the arachnoid villi
              2. Circulation
                1. Through the ventricular system
            3. Ventricular system
              1. Lateral ventricles
                1. 3rd ventricle
                  1. 4th ventricle
                2. Foramen of Monro
                  1. Cerebral Aqueduct
                    1. Central canal
              2. Meningitis
                1. Inflammation of the protective membranes covering the brain and spinal cord (meninges)
                  1. Causes
                    1. Infectious
                      1. Viral
                        1. Bacterial
                          1. Neisseria Meningitidis
                            1. Listeria monocytogens
                              1. H.Influenza
                                1. Streptococcus agalactiae
                          2. Enterovirus
                            1. Cocxakie virus
                              1. Echovirus
                          3. Fungal
                            1. Cryptococcus newformans
                          4. Non-infectious
                            1. injury (head trauma), drugs and cancer
                            2. Signs and symptoms
                              1. Fever
                                1. Headache
                                  1. Neck stiffness
                                    1. Photophobia
                                2. Pathology
                                  1. 1. penetrate the blood-brain barrier
                                    1. 2. endotoxin and inflammatory mediators
                                      1. 3. leakage of protein and fluid out of the cerebral vasculature
                                        1. 4. causing cerebral edema , increase intracranial pressure
                                          1. 5. lead to a reduction in cerebral perfusion
                                            1. 6. Brain death
                                  2. Investigations
                                    1. Lumbar Puncture
                                      1. Insertion of needle in subarachnoid space at levels
                                        1. In Infants: L4-L5 interspace
                                          1. In Adults:  L3-L4 interspace
                                        2. Indications
                                          1. Diagnostic
                                            1. Therapeutic
                                              1. Anesthesia
                                                1. Injection of Drug (Antibiotic, Chemotherapy)
                                                2. Sample CSF (Infections, Cancers, Subarachnoid Hemorrhage, Neurologic Disorders)
                                                  1. Measure pressure
                                              2. Contra-indications
                                                1. Increased intracranial pressure
                                                  1. Infections at the level of insertion
                                                    1. Uncorrected Coagulopathy
                                                2. Complications
                                                  1. Severe headache
                                                    1. Hemorrhage
                                                      1. Back pain
                                                3. Physical examinations
                                                  1. Vital signs
                                                    1. Meningeal signs
                                                      1. General inspection
                                                        1. Neurological examinations
                                                        2. Kernig's sign
                                                          1. Brudzinski's sign
                                                      2. Management
                                                        1. Newborn
                                                          1. Adult
                                                            1. Elderly
                                                              1. Ampicillin + vancomycin + 3rd generation cephalosporin
                                                              2. Vancomycin + 3rd generation cephalosporins
                                                              3. Ampicillin + 3rd generation cephalosporin + Aminoglycoside
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