Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 > Acute 3 > Flashcards

Acute 3 Flashcards

1
Q

What is part of the primary survey in head/spinal injury?

A
  • A-E
  • Neuro obs every 30 mins if GCS <15
  • Look for fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which patients should receive a CT within 1 hour?

A
  • GCS <13 on arrival
  • GCS <15 2 hours post
  • Suspected open or depressed skull fracture
  • Signs of basal skull fracture
  • Seizure post trauma
  • Focal neurological deficit
  • More than 1 episode of vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wha patients should receive a CT within 8 hours?

A
  • Those on warfarin
  • LOC or amnesia + 1 of:
    • > 65
    • History of bleeding or clotting disorder
    • Dangerous mechanism (e.g. fall >5 stairs, car vs pedestrian)
    • > 30mins retrograde amnesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should you do with a patient with GCS of 8 or below?

A

Intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a primary head injury?

A
  • Initial insult
  • Clinicians have no control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a secondary head injury?

A
  • Further head injury from physical and chemical brain changes (e.g. hypoxia, swelling, bleeding)
  • Clinicians reduce and prevent these
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the features of an epidural haematoma?

A
  • Low energy impact
  • LOC –> lucid period with headache –> rapid decline
  • Rupture of middle meningeal artery
  • Associated with temporal bone fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the imaging of choice for suspected intracranial bleed?

A

Non-contrast CT head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does an epidural haematoma show on CT?

A

Hyperdense lentiform lesion limited by suture lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What mass effects may occur as a result of epidural haematoma?

A
  • CN3 palsy (down and out, midriasis)
  • Uncle herniation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of epidural haematoma?

A

Craniotomy and evacuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute subdural haematoma?

A
  • Fresh blood: hyperdense crescentic lesion on CT not limited to suture lines
  • Rupture of bridging veins
  • Caused by acceleration-deceleration injury
  • Treated with decomkpressive craniotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic subdural haematoma?

A
  • Old blood: hypodense crescentic change on CT not limited by suture line
  • Typically occurs in elderly and alcoholics (vessels more friable) a couple weeks after minor head trauma
  • Presents with confusion, LOC, weakness or cortical dysfunction
  • Treated with Burr hole drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the features of subarachnoid haemorrhage?

A
  • Thunderclap headache
  • Meningism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risks factors for subarachnoid haemorrhage?

A
  • Black woman
  • Hypertension
  • Smoking
  • Chronic alcohol use
  • Cocaine use
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What conditions are associated with subarachnoid haemorrhage?

A
  • Sickle cell anaemia
  • Neurofibromatosis
  • Connective tissue disorders
  • Aortic coarctation
  • AD polycystic kidney disease
17
Q

What are the 2 main causes of subarachnoid haemorrhage

A
  • Trauma (usually)
  • Can be due to aneurysm
18
Q

What investigation are done in subarachnoid haemorrhage?

A
  • CT head
  • Lumbar puncture within 12 hours
  • CT angiography to find source
19
Q

What will show on lumbar puncture in subarachnoid haemorrhage?

A
  • Raised red cells (although if decreases on serial punctures then likely due to traumatic LP)
  • Xanthochromia (yellow colour from bilirubin)
20
Q

What its the management of subarachnoid haemorrhage?

A
  • Surgical coiling or clipping
  • Nimodipine (CCB to prevent vasospasm)
  • Management of hydrocephalus and seizure if occur
21
Q

What needs to be assumed in any force that results in LOC?

A

C-spine injury until proven otherwise

22
Q

What is the most commonly injured region of the spine?

A

C-spine followed by thoracolumbar junction

23
Q

What are some A-E consideration for airway in spinal injury?

A
  • Can’t do head tilt, chin lift
  • Laryngeal stimulation will cause massive vagal response
  • This can cause cardiac arrest
  • give atropine to prevent
24
Q

What are some A-E consideration for breathing in spinal injury?

A
  • Diaphragm or IC muscle paralysis can occur
  • More proximal = worse
  • Phrenic nerve roots are C3, 4, 5
  • Intercostal nerve roots are T1-11
25
Q

What are some A-E consideration for circulation in spinal injury?

A
  • Neurogenic shock can occur in level above T6
  • Be careful with resus as can cause acute pulmonary oedema
26
Q

Other things to be aware of in SC injury?

A
  • Urinary retention
  • Can get spinal shock (different to neurogenic shock; flaccidity below levels)
  • American spinal cord injury criteria
27
Q

What is the investigation of choice in suspected C-spine injury?

A

CT C-spine is gold standard

28
Q

What are features of complete spinal cord section?

A
  • UMN signs and radicular pain at level
  • Complete sensory-motor loss below level
29
Q

What are the features of spinal cord hemisection (Brown-Sequard)?

A
  • Ipsilateral: UMN signs at level; LMN signs, DCML (soft touch, vibration, proprioception) and spinothalamic loss (crude touch, paint temperature) below level
  • Contralateral: spinothalamic loss 2 levels below
30
Q

Autonomic dysreflexia?

A
  • Complete spinal cord injury at T6 or above
  • Autonomic stimuli –> sympathetic outflow –> no PNS inhibition
  • Urinary retention or faecal impaction
  • HTN, flushing, sweating and death

Year 4 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions