Clinical Assessment of Neurosurgical Patient Flashcards
What is the assessment for unconscious patient?
ABCs, GCS and pupils
What is CPP?
Cerebral perfusion pressure
CPP = MAP - ICP
Monro-Kellie Doctrine
What can cause pupil dysfunction?
Herniation
What imaging is used for unconscious patient?
MRI
Diffusion Tensor Imaging
What are the main functions of the frontal lobe?
Voluntary control of muscles - precentral gyrus
Speech
High order - restraint, initiative and order
Gait, saccadic eye movement and bladder control
What could show on frontal lobe examination?
Decorticate posture, altered behaviour, pyramidal weakness, UMN signs, pronator drift and speech
What is the function of the orbitofrontal cortex?
Mediates empathetic, civil and socially appropriate behaviour
Restraint
What is the function of the dorsolateral prefrontal cortex?
Executive function
Order
What is the function of the SMC?
Initiative
Supplementary motor cortex
How is language examined?
Ensure hearing is intact, handedness, fluency - Broca’s, Normal aphasia, repetition, 2 step command - Wernicke’s, cerebellar speech, orofacial movement, reading and writing
What are the functions of the parietal lobe?
Primary somatosensory area - body image representation
Visuospatial coordination
Language
Numeracy
How is cortical sensory syndromes in parietal lobe tested?
Sensory inattention, asteroagnosia, dygraphasthesia and two point discrimination
What symptoms could be seen when examining the parietal lobe?
Dominant side - Gertsman’s syndrome
Non dominant syndrome - hemineglect and constructional apraxia
What are the functions of the temporal lobe?
Process of auditory input - Heschl, language, encoding declarative long term memory - hippocampus, emotion - amygdala and visual fields
What can be some symptoms if the cerebellum has a problem?
Dysdiadochokinesia, ataxia, nystagmus, intentional tremor, slurred speech, hypotonia and past pointing
