Traumatic Head Injury and Intra-Cranial Pressure Management

Question 1

RECAP- what is the minimum score on GCS?

Answer 1

3

Question 2

RECAP- what is the maximum score on GCS?

Answer 2

15

Question 3

Which type of fibre cause pupillary constriction?

Answer 3

Parasympathetic fibres of oculomotor nerve

Question 4

Which type of fibre cause pupillary dilation?

Answer 4

Sympathetic fibres from ciliary ganglion

Question 5

If a surgery has the suffix -tomy, what does this mean?

Answer 5

Cutting into something

Question 6

If a surgery has the suffix -ectomy, what does this mean?

Answer 6

Removing something

Question 7

If pupils are small and reactive, which nerve is not affected?

Answer 7

Oculomotor nerve

Question 8

What is found in the brain/skull box to make up the pressure?

Answer 8

Brain
CSF
Blood

Question 9

Which is the dominant side of the brain for the vast majority of people?

Answer 9

Left side

Question 10

What is normal ICP?

Answer 10

<15mmHg
10-20cmH20

(depending on measurement. Also, apparently this is a common question in every stage of exams throughout med, even finals for GP, etc, so defo worth knowing haha)

Question 11

In ICP control, when looking at an ICP graph, how many peaks are there and what does a peak represent?

Answer 11

Three peaks, all corresponding to an arterial pulsation

Question 12

Which part of the brain controls blood pressure?

Answer 12

Medulla

Question 13

What can be used as a temporary attempt to use autoregulation in reduce ICP?

Answer 13

Osmotherapy using mannitol

->mannitol comes from birch tress and is used as a low calories sweetener haha just extra stuff in case it sticks better

Question 14

Describe what can be done to keep ICP down.

Answer 14

Sitting up
Avoid neck compression
Optimise respiratory function
Normal temperature
Avoid low BP and glucose

Question 15

What happens to ICP when they lie down?

Answer 15

Goes up

Question 16

What happens to ICP when they sit up?

Answer 16

Goes down