Brainscape's Knowledge GenomeTM

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


See full index

COMAT: Surgery > Neurology > Flashcards

Neurology Flashcards

1
Q

what is part of the GCS scoring system?

A 
E - eye opening
- 4 = open spontaneously
- 3 = opens to voice (command)
M - motor response
- 6 = obeys commands
- 5 = localizes painful stimulus
- 4 = withdraws from pain
V - verbal response
- 5 = appropriate and oriented
- 4 = confused
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what indicates coma by GCS score?

A

<8

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

what does unilateral, dilated, nonreactive pupil suggest?

A

focal mass lesion with ipsilateral herniation and compression of CN III

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

what do bilateral fixed and dilated pupils suggest?

A

diffusely increased ICP

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

what are the four signs of basilar skull fracture?

A

raccoons eyes - periorbital ecchymoses
battle’s sign - post auricular ecchymoses
hemotympanum
CSF - rhinorrhea/otorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the initial radiographic neuroimaging in trauma?

A

head CT scan
C-spine CT scan
T/L spine AP and lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

should the trauma head CT scan be with or without IV contrast?

A

without

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is Cushing’s reflex?

A

physiologic response to increased ICP:

  • hypertension
  • bradycardia
  • decreased RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the acronym for the treatment of elevated ICP?

A

ICP HEAD

  • intubate
  • calm (sedate)
  • place drain (ventriculostomy)/paralysis
  • hyperventilate to pCO2 =35
  • elevate head
  • adequate blood pressure
  • diuretic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how does hyperventilation decrease ICP?

A

by decreasing pCO2, resulting in cerebral vasoconstriction (and thus less intracranial volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does cranial nerve examination localize the injury in a comatose patient?

A

CNs proceed caudally in the brainstem as numbered:

  • presence of corneal reflex (CN V+VII) indicates intact pons
  • intact gag reflex (CN IX + X) indicates functioning upper medulla
  • CN VI palsy is often false localizing sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is acute treatment of seizures after head trauma?

A

benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is seizure prophylaxis after severe head injury?

A

phenytoin for 7d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the significance of hyponatremia after head injury?

A

SIADH must be ruled out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an epidural hematoma?

A

collection of blood between the skull and dura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what causes an epidural hematoma?

A

usually occurs in association with a skull fracture as bone fragments lacerate meningeal arteries

17
Q

which artery is associated with epidural hematoma?

A

middle meningeal artery

18
Q

what is the most common sign of an epidural hematoma?

A

ipsilateral blown pupil

19
Q

what is the classic history with an epidural hematoma?

A

LOC followed by a ‘lucid interval’ followed by neurologic deterioration

20
Q

what are the classic CT findings with an epidural hematoma?

A

lenticular (lens) shaped hematoma

21
Q

what is the surgical treatment for an epidural hematoma?

A

surgical evacuation

22
Q

what is a subdural hematoma?

A

blood collection under the dura

23
Q

what are the three types of subdural hematomas?

A

acute - symptoms within 48hrs of injury
subacute - symptoms within 3-14d of injury
chronic - symptoms after 2wks or longer

24
Q

what is the treatment of epidural and subdural hematoma?

A 
mass effect (pressure) must be reduced
- craniotomy with clot evacuation is usually required
25
Q

what classic findings appear on head CT for a subdural hematoma?

A

curved, crescent-shaped hematoma

26
Q

what is a traumatic subarachnoid hemorrhage?

A

head trauma resulting in blood below the arachnoid membrane and above the pia

27
Q

what is the treatment for a traumatic subarachnoid hemorrhage?

A

anticonvulsants and observation

28
Q

what is a cerebral contusion?

A

hemorrhagic contusion of brain parenchyma

29
Q

what are the coup and countercoupe injuries?

A

coup - injury at the site of impact

contrecoup - injury at the site opposite the point of impact

30
Q

what is DAI?

A

diffuse axonal injury

- shear injury to brain parenchyma from rapid deceleration injury

31
Q

what is the best diagnostic test for DAI

A

MRI

32
Q

what can present after blunt trauma with neurologic deficits and a normal brain CT scan?

A

DAI, carotid artery injury

33
Q

what is a depressed skull fracture?

A

fracture in which one or more fragments of the skull are forced below the inner table of the skull

34
Q

what are the indications for surgery?

A 
contaminated wound requiring cleaning and debridement
severe deformity
impingement on cortex
open fracture
CSF leak

COMAT: Surgery (17 decks)

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