Nrnp 6651 Exam 2024 Latest Version

coup-contrecoup injury - ANSWER-Dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds.Scalp laceration: what, effect, management - ANSWER-Primary head injuryprofuse bleeding - signs of hypovolemiaApply direct pressureSuture/ staple laceration Lidocaine 1% with epi to control bleeding, not close to nose/ earsSkull fracture: types, effect, management - ANSWER-Primary head injurySimple: no displacement of bone. Observe and protect spineDepressed: bone fragment depressing thickness of scullSurgery for debridement. Give tetanus and seizure precautionsBasilar: fracture at floor of skullRaccoon eye - periorbital bruisingbattle's sign: mastoid bruisingotorrhea/ rhinorrhea - halo sign: do not obstruct flowGive Ab'sOral intubation and oral gastric instead of nasalBrain injury: types, effect, management – ANSWER-Primary head injuryConcussion: reversible change in brain functioningloss of consciousness, amnesiaDo not give opioids, admit for unconsciousness greater than 2minContusion: bruising to surface of brain with edemaFrontal and temporal regionBrainstem contusion: posturing, variable temp, variable vital signsN/V, dizziness, visual changesseizure precautionsHematoma - neuro: types, effect, management - ANSWER-Epidural hematoma: commonly temporal/ parietal region with skull fracture, causing bleeding into epidural spaceLoss of consciousnessRapid deterioration: obtunded, contralateral hemiparesis, ipsilateral pupil dilationCT scan (non contrast)Treatment based on Brain trauma