neuro questions

what is tone?

Stolov, 1966, defined the tone in the muscle as "the resistance of the muscle to passive elongation or stretching"

ICU Care mnemonic FAST HUG BID updated to FAST HUGS BID

Critically ill patients need "FAST HUGS BID" (an updated mne... : Critical Care Medicine
Critically ill patients need "FAST HUGS BID" (an updated mne... : Critical Care Medicine: "Critically ill patients need 'FAST HUGS BID' (an updated mnemonic)"

F feeding/fluids
A ananlgesia
S sedation
T thromoboprophylaxis
H head up position
U -Ulcerprophylaxis
G-glycemic control
S -Spontaneous breathing trial

B -bowel care
I indewelling catheter removal
D deescalation of antibiotics

Corrigan's pulse / sign

Watson's water hammer pulse (whp), also known as collapsing pulse, cannonball pulse or pulsus celer, is used to describe a pulse with a rapid upstroke and descent, characteristically described in aortic regurgitation.

Although the term Corrigan's pulse has been used at times synonymously with whp,

Corrigan's pulse/sign is largely used to describe the abrupt distension and quick collapse of carotid pulse in aortic regurgitation whereas

the term 'water hammer pulse' is used for the characteristic pulse seen in peripheral arteries like the radial artery. It may be seen in a number of other conditions and with hyperdynamic circulation

Anti-coagulation for venous thromboembolism

Enoxaparin 1mg/kg twice daily in pts with normal renal function for 4-days alongwith

Warfarin 5mg per day

Target INR is 2-3

Other options are tinzaparin, fondaparinux or ufh

IV PPI in PEPTIC ULCER +/- Bleeding

Peptic ulcer bleeding:             Inj. Omeprazole

40mg  i.v.bolus then
6.7mg/h continuousinfusionx72h(160mg/d  after bolus) OR

80mg i.v. bolus  then  8mg/h  continuous  infusionx72h (192mg/dafterbolus)

Bleeding or severeerosive esophagitis: 40mgi.v.oncedailyfor7to10days

Pathologic hypersecretion/ZollingerEllisonsyndrome Stressulcerprophylaxis :

80mgi.v.every12hours;mayincreaseto80mgevery8hoursifneeded;may titratetohigherdosesdependingonacidoutput 80mgi.v.every12hfor24hfollowedby40

FRANKEL GRADING SYSTEM for SPINAL INJURY

FRANKEL GRADING SYSTEM for SPINAL INJURY


I.  Grade A (Complete neurological injury)
- no motor or sensory function clinically detected below the level of the injury.

II. Grade B (Preserved sensation only)
- no motor function clinically detected below the level of the injury; sensory function remains below the level of the injury but may include only partial function (sacral sparing qualifies as preserved sensation).

III. Grade C (Preserved motor non-functional)
- some motor function observed below the level of the injury, but is of no practical use to the patient.

IV. Grade D (Preserved motor function)
- useful motor function below the level of the injury; patient can move lower limbs and walk with or without aid, but does not have a normal gait or strength in all motor groups.

V. Grade E (Normal motor)
- No clinically detected abnormality in motor or sensory function with normal sphincter function
- abnormal reflexes and subjective sensory abnormalities may be present.

trosseau test in hypocalcemia

raising pressure in cuff to20-30 mm of hg more than sytolic B.P. for 3 minutes will cause precipitation of tetanic spasms in that arm.