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Flashcards in Neurological Conditions Deck (13)
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1
Q

Methods to asses a patients neurological state

A
AVPU
Alert & Orientated (A&O) Assessment 
Glasgow Coma Scale (GCS) 
PEARL Assessment –
Patient Observation
2
Q

assessing neurological state, Alert and Oriented method A&O

A

Alert and Orientated
There are four areas to consider
Person, Place, Day and Event
Can they recall their name? Where they are? What time or day it is? What’s just happened?
Day tests long term memory
Place & event tests short term memory
However be aware of patients normal mental state (dementia).

3
Q

Glasgow Coma Scale, scores and areas assessed

A

9-12 = Moderate LOC
Less than8 = Severe LOC

EYE OPENING RESPONSE - 1-4

  1. spontaneously
  2. to speech
  3. To pain
  4. No Response

VERBAL RESPONSE 1-5

  1. orientated to time, place etc
  2. confused
  3. inappropriate words
  4. incomprehensible Sounds
  5. No Response

MOTOR RESPONSE 1-6

  1. Obeys Command
  2. Moves to Localised Pain
  3. Flex to withdraw from pain
  4. abnormal flexion
  5. abnormal extension
  6. No response
4
Q

PEARL - what can cause changes to pupil size or reaction

A

Shape can be changed by trauma, glaucoma or increased ICP
Stimulants, Alcohol & Hypoxia tend to cause bi-lateral dilation
Opiates however cause bi-lateral constriction
Unequal pupils can be a sign of increase Intra Cranial Pressure
Anything greater than 1mm of difference is worth noting
As pressure in the skull increases the brainstem is squeezed interrupting the signal to a pupil.

5
Q

3 types of skull fracture

A

Fractured vault
Depressed fracture
Basal skull fracture.

6
Q

Treatment of a head injury

A

Primary survey with C-Spine consideration CAcBCDE!

Secondary survey top to toe

Treat any injuries

Monitor casualty including GCS.

7
Q

4 Types of Brain Injury

A

Concussion -

Compression

Laceration

Herniation

8
Q

Describe a Concussion

A

Due to trauma, the brain can literally be shaken inside the cranium
May cause temporary symptoms and brief reduction in LOC but the casualty makes a full recovery

9
Q

Concussion Signs and Symptoms

A
Dizziness
Nausea
Amnesia around the time of injury or immediately preceding
Headache
Confusion
Brief loss of consciousness
Possible head wound
Should make full recovery.
10
Q

Describe Inter-cranial Pressure

A

More serious brain injuries, which can cause increased pressure within the vault due to bleeding or swelling and inflammation can cause Increase ICP. This may be due to trauma, hemorrhagic stroke, infections and other medical problems.
Comes in 3 levels

11
Q

3 Symptoms of Intercranial pressure ICP known as?

A

Cushings Triad
Hypertension (with widening pulse pressure)
Bradycardia,
Irregular Respirations

12
Q

Signs and Symptoms of the 3 Levels of Intercranial Pressure

A
Level One
BP rises, pulse slows
Pupils constrict but react
Cheyne-Stokes breathing
Localises to pain
Decorticate posturing.

Level Two
BP continues to rise, pulse rate decreases further
Pupils fixed at 3-5 mm, or may react slowly
breathing or neurogenic hyperventilation
Reacts to pain with decerebrate posturing.

Level Three
One or both pupils fixed and dilated (“blown”)
Ataxic or medullary ventilation
Unresponsive
BP drops, pulse becomes rapid and irregular
Flaccid (soft, hanging loosely or no tone).

13
Q

Assessing Pain SOCRATES

A
Site
Onset
Character
Radiates
Associated Symptoms
Time/duration
Exacerbating or relieving factors
Severity.