Capsule: Neuro

Question 1

Which xray view shows the occiput?

Answer 1

Towne’s

Question 2

What is done during the primary survey?

Answer 2

Intubation and ventilation, two large bore cannulas (14G), bloods (FBC, U&Es, clotting, glucose, crossmatch), IV fluid, monitoring (pulse, BP, oximetry, RR), ECG, arrange plain films

Question 3

What is done during the secondary survey?

Answer 3

Full examination, medical history, NGT and urinary catheter (unless contraindicated), further imaging

Question 4

The eye component of GCS

Answer 4

Spontaneous opening – 4

To speech – 3

To pain – 2

No response – 1

Question 5

The verbal component of GCS

Answer 5

Orientated response – 5

Confused conversation – 4

Inappropriate words – 3

Incomprehensible sounds – 2

No response to pain – 1

Question 6

The motor component of GCS

Answer 6

Obeys commands – 6

Localises pain – 5

Normal flexion to pain (withdrawal) – 4

Abnormal flexion to pain (decorticate i.e. flexes upper extends lower) – 3

Extends all to pain – 2

No response to pain – 1

Question 7

What is the presence of a fixed dilated pupil highly suggestive of?

Answer 7

Raised ICP requiring urgent neurosurgical intervention

Question 8

How do chronic SDH often px?

Answer 8

A vague history of sx such as fluctuating conciousness, headache, personality change & confusion

Question 9

RFs for SDH

Answer 9

Elderly, susceptible to falls (alcoholics and epileptics), on long term anticoag

Question 10

Where does the blood tend to extend along in SDH?

Answer 10

Falciform ligament & tentorium cerebelli

Question 12

SDH shape on CT

Answer 12

Crescent

Question 13

EDH shape on CT

Answer 13

Biconvex