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Block 3: Neuro > Clin Med: Neuro III > Flashcards

Clin Med: Neuro III Flashcards

1
Q

Mass effect

A

some encroachment upon the ventricles of the brain (causing some deformity of the ventricles)

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2
Q

Midline shift

A

pushes the brain over (ex: hematoma or mass)

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3
Q

Both mass effect & midline shift are generally associated with…

A

neurological abnormality w/ the patient

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52
Q

Glasgow Coma Scale (GCS) severity levels

A
  • Mild (13-15)
  • Moderate (9-12)
  • Severe (<8)
53
Q

GCS: Eye opening response

A
  1. Spontaneously
  2. To speech
  3. To pain
  4. No response
54
Q

GCS: Verbal response

A
  1. Oriented to time, person, & place
  2. Confused
  3. Inappropriate words
  4. Incomprehensible sounds
  5. No response
55
Q

GCS: Motor response

A
  1. Obeys command
  2. Moves to localized pain
  3. Flex to withdraw from pain
  4. Abnormal flexion
  5. Abnormal extension
  6. No response
56
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57
Q

Canadian CT: Exclusion Criteria

A
  • age < 16yo
  • Pt on blood thinners
  • seizure after injury
58
Q

Canadian CT: High Risk Criteria

A
  • GCS <15 at 2hrs post-injury
  • ?? open or depressed skull frax
  • Sign of basilar skull frax?
  • > /= 2 episodes of vomiting
  • > /= 65 years
59
Q

What are signs of a basilar skill frax?

A
  • Hemotympanum
  • racoon eyes
  • Battle’s sign
  • CSF oto-/rhinorrhea
60
Q

Canadian CT: Medium Risk Criteria

A
  • retrograde amnesia >/= 30 mins
  • “Dangerous” mechanism
61
Q

Concussion admission if:

A
  • GCS < 15 after imaging
  • CT scan is indicated, but is not available
  • persistent worrisome signs, such as vomiting, severe HA, intoxication, other injuries, meningeal signs, or CSF leak
62
Q

C4 injury causes

A

tetraplegia

63
Q

C6 injury causes

A

tetraplegia

64
Q

T6 injury causes

A

paraplegia

65
Q

L1 injury causes

A

paraplegia

66
Q

When closed intervention used in spinal cord injuries?

A

Only for cervical spine fracture with subluxation

67
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69
Q

What level spinal injury are highest risk of death?

A

C1-C3

70
Q

Complete Spinal Cord Injury

A

complete loss of motor & sensory function below the SCI

71
Q

Central Cord Syndrome is usually what type of injury?

A

hyperextension injury

72
Q

Central cord syndrome: classic patient

A

elderly w/ underlying spinal stenosis or osteophytes

73
Q

Central cord syndrome: S/S

A

Greater motor impairment in upper body vs lower body, sensory loss in lower body variable

74
Q

Central cord syndrome: Prognosis

A

Prognosis good, though full recovery is rare

75
Q

Anterior cord syndrome is usually what type of injury?

A

flexion injury of the cervical region

76
Q

Anterior cord syndrome: classic patient

A

Younger pts, due to dislocation or subluxation, from flexion injuries

77
Q

Anterior cord syndrome: S/S

A

Motor paralysis and loss of pain/temp sensation (LE>UE)

78
Q

Anterior cord syndrome: Prognosis

A

Only 10-20% chance of motor recovery

79
Q

Brown Sequard Syndrome is usually what type of injury?

A

penetrating trauma

80
Q

Brown Sequard Syndrome: S/S

A
  • Contralateral loss of pain, temp, light touch
  • Ipsilateral loss of motor function, vibration, proprioception
81
Q

Brown Sequard Syndrome: Prognosis

A

Excellent prognosis, most regain full function

Block 3: Neuro (10 decks)

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