Neurological Assessment Flashcards

1
Q

What are the three section of GCS and how much score does each one have?

A

Eye Opening - 4
Verbal Response - 5
Motor Response - 6

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2
Q

GCS what does each score on the eyes section mean.

A

4 - unprompted eye opening
3 - “Hello open your eyes”
2 - Trap squeeze ( Pain )
1 - No eye opening

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3
Q

GCS what does each score on the verbal section mean?

A

5 - “what month is is”, “where are you”“name”
4 - Full coherent sentences
3 - Random words out of context
2 - Noise and Sounds
1 - No verbal response

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4
Q

GCS what does each score on the motor section mean?

A

6- “Grip my finger” - Obeys command
5 - Trap squeeze - Localises pain
4 - Flexion/withdrawal from pain
3 - Abnormal flexion to pain
2 - Extension to pain
1 - No response

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5
Q

Mild to severe head injury score on GCS

A

Mild head injury = GCS 13-15
Moderate head injury = GCS 9-12
Severe head injury = GCS 3-8 (suggests coma with need for intubation)

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6
Q

What does PEARL stand for in neurological assessment?

A

Pupils
Equal
And
Reacting to
Light

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7
Q

When should we assess pupils?

A

Head injury
Haemorrhagic stroke
Opioid overdose
Brain stem function

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8
Q

What are some signs of a skull fracture

A

Battle signs (bruising around back of ears)
Racoon eyes (bruising around eyes)

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9
Q

What is a Transient Ischemic Attack (TIA)

A

Temporary disruption in the blood supply to the brain will cause stroke like symptoms.

TIA is a medical emergency, risk of stroke is up to 10% in the week following a TIA.

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10
Q

How long does it take a TIA to resolve

A

Self Resolves within 24 hours

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11
Q

What are the two type of stroke and what percentage are they likely to occur

A

Ischemic = 85%
Haemorrhagic = 15%

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12
Q

What increases the risk of strokes in children

A

Congenital heart disease increases risk by 19x
Thrombolytic stroke risk is 6x higher after a recent illness such as chickenpox.

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13
Q

What does FAST stand for

A

Face
Arms
Speech
Time

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14
Q

What is expressive aphasia (neurological assessment)

A

Unable to produce meaningful words or sentences, although their comprehension remains in tact, their ability to express is not.

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15
Q

What is receptive aphasia (neurological assessment) (speech)

A

unable to produce vast sentences/speech at a normal rate, but there will be no meaning or value to what they are saying.

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16
Q

What is anomic aphasia (neurological assessment) (speech)

A

Word finding difficulties
Eg A watch is a pen

17
Q

What is dysphagia (neurological assessment) (speech)

A

Difficulty with swallowing

18
Q

What is meningococcal disease

A

A life threatening infection of the meninges. Its a term to describe to major illnesses - meningitis and septicaemia.

19
Q

What is a petechial meningitis rash

A

Small, red pin prick rash. Non blanching

20
Q

What is purpuric meningitis rash

A

0.5 cm point rashes. purple/pink. Non blanching.

21
Q

What are the causes of meningitis

A

Infection (bacterial, fungal, viral)
Parasite
Inflammatory disease

22
Q

What are the signs and symptoms of meningitis?

A

Pyrexia
Rapid progression of fever
Irritability
Seizures (5-20%)
Neck Stiffness
Headache
Confusion (50%)
Altered levels of consciousness
Pallor
Photophobia
Floppy baby (Hypotonia)

23
Q

What is hypotonia

A

Loss of muscle control, goes floppy (floppy baby)

24
Q

Paramedic treatment of meningitis

A

Think Sepsis
O2 at 15lpm
If suspected septicaemia, put pt on IM/IV ABX - Benzypenicillin

25
What are the four different types of seizure
Generalised Febrile Absence Focal
26
What are generalised seizures
Tonic Clonic - loss of consciousness with stiffness and jerking of limbs
27
What are febrile seizures
3 months to 5 yrs old. Seizure due to high fever.
28
What are absent seizures
End of activity of responsiveness, the pt has 'turned of'
29
What are focal seizures
One portion of the brain with overactive discharge. Consciousness its sometimes saved.
30
What are some common causes of seizures
Infection - meningitis Metabolic derangements (sodium levels) Drugs (cocaine, amphetamines) Ethanol withdrawal Intracranial mass Head injury
31
Paramedic seizure management
Recovery position Consider airway adjuncts Suctioning 02 - High flow Diazepam - Rectal if no IV access
32
What three key questions should we ask regarding headaches
Is this this the worst headache you've had Is it different from your usual headache Is this a new headache
33
What are tension headaches
Most common type Provoked by stress or fatigue No focal neurology Generalised or posterior/occiput (back of head)
34
What are cluster headaches
Sharp, unilateral pressure Headaches are in a cluster, repeat attacks Rare Men affected 3x more than woman
35
What are migraines
More common in woman Recurrent Typically last 4-72 hours Unilateral N&V Can be severe and dehabilitating
36
What is sinusitis
Caused by inflamed sinuses Can require Abx (antibiotics) if bacterial Pain worse if patient leans forward Chronic sinusitis can require surgery