29 al-ras Flashcards
central nervous sys includes:
brain (cerebrum, cerebellum, brainstem)
spinal cord
nerves
peripheral nervous sys includes:
somatic and autonomic nervous systems. The somatic nervous system transmits sensory and motor signals to and from the central nervous system.
cerebellum controls:
brainstem:
balance and body movements
controls all the life functions including cardiac and respiratory systems, and nerve function
spinal cord carries messages between brain and body via grey and white matter.
the grey matter is made up of:
neural cell bodies and synapses (connections between cells)
white matter is consists of:
fiber pathways
brain and spinal cord cells are easily injured and once injured can/can not be regenerated/reproduced:
can NOT
CNS is protected by the ____, 3 layers of tissue that suspend the brain and spinal cord within the skull and spinal canal.
meninges
PNS has two parts:
31 pairs of spinal nerves (sensory pulses from the skin and organs)
12 pairs of cranial nerves (emerge from teh brainstem and transmit info to/from the brain), performs such things as sight, smell, taste, hearing, face expressions.
brachial plexus controls the:
lumbosacral plexus controls the:
arms
legs
nervous system that controls our voluntary activities, coordinated muscle activity:
somatic (voluntary) nervous sys
skull has two groups bones:
cranium
face bones
spinal column has __ bones (vertebrae), divided into five sections:
33
cervical, thoracic, lumbar, sacral, coccygeal
vertebrae connected by ligaments and separated by cushions called:
intervertebral disks
injury to the head but no opening to the brain:
closed head injury
(open of course would be the brain is exposed)
even small scalp lacerations can result in significant blood loss because the face and scalp have_______.
this can lead to hypovolemic shock, esp in children.
unusually rich bl supplies
high energy direct trauma to the head can cause ____skull fractures and ____ skull fractures.
watch out for fractures to the thinner frontal and parietal bones which can be driven into the brain when fractured.
depressed skull fractures
basilar skull fractures
signs of a basilar skull fracture:
CSF fluid from nose/ears (which can lead to risk of bacterial meningitis)
raccoon eyes
battle sign (bruising behind ear)
which of the following nerves allow sensory and motor impulses to be sent from one nerve to another:
somatic (nope not this one)
connecting
peripheral
autonomic
the most important immediate treatment for patients with a head injury regardless of severity:
establish adequate airway?
common signs of a skull fracture include all of these EXCEPT:
mastoid bruising (battle sign)
ecchymosis around eyes
skull deformity
superficial skull fracturess
superficial skull fractures
which of the following statements regarding secondary brain injury is correct:
results from brain trauma following impact to brain
because cerebral edema develops quickly, its considered a primary injury
hypoxia and hypotension are the 2 most common causes of secondary brain injury
signs often present right after impact to head
hypotension and hypoxia are the 2 most common causes
secondary brain injuries are a multitude of processes that increase the severity of a primary brain injury.
secondary brain injuries can be caused by:
cerebral edema
intracranial hemorrhage
increased intracranial pressure (ICP)
cerebral ischemia
infection
which of the following nerves carries information from the body to the brain via the spinal cord:
motor (not this one)
central
sensory
somatic
when activated the sympathetic nervous system produces all of the fllwign except:
pupillary constriction
increased HR
shunting of bl to vital organs (was not this answer)
dilation of bronchiole smooth muscle
answer:?
the sympathetic nervous system can accelerate heart rate, widen bronchial passages, decrease motility (movement) of the large intestine, constrict blood vessels, cause pupil dilation, activate goose bumps, start sweating and raise blood pressure.
in head injury, seeing hypertension, bradycardia, and biot respirations indicate:
brain stem herniation
ptnt with a head injury and abnormal flexion of extremities has what numerical value for motor response (Glasgow scale):
3
ptnt with head injry and leaking fluid from right ear, indicates:
rupture of tympanic membrane
while assessing conscious ptnt with suspected spinal cord injury you should:
determine if the strength in all extremities is equal
rule out spinal injury if the ptnt denies neck pain
defer spinal immobilization if the ptnt is in ambulatory (in route?)
ask the ptnt to move the head to assess for pain
determine if the strength in all extremities is equal
when conrolling bleeding from a scalp laceration w/a suspected skull fracture:
avoid excessive pressure when applying the bandage
during primary assessment semi conscious 30 yr old ptnt w/slow irregular breathing and slow bounding pulse. your partner maintains in-line stabilization of her head, you should:
perform a focused secondary assessment of the head and neck (not this one)
instruct him to assist ventilations
apply 100% O2 with non-rebreather mask and get vitals
place her on a longboard and prepare for rapid transport
cerebrum contains __% of the brains total volume
75%
dysphagia is:
difficulty swallowing
stroke can cause dysphagia
orthostatic hypotension:
BP drops suddenly after standing from a seating or lying down position
decreased mentation:
same as decreased mental function
ecchymosis:
bruising
abnormal posturing decorticate vs decerebrate
rigid body movements or chronic abnormal body positions. decorticate is stiff with bent arms, clenched fists, curled wrists against chest, legs out straight.
decerebrate is arms and legs held straight out, toes pointed downward, flexed wrists (straight arms), head and neck arched back.
diff between Cheyne stokes and Biot respirations:
Also known as Biot’s respirations, cluster breathing involves groups of rapid, shallow breathing, after which periods of apnea then follow. Unlike Cheyne-Stokes respiration, it does not involve cycles of deep breathing or gradual changes in breathing patterns
Cushing triade:
The Cushing reflex is a physiological nervous system response to acute elevations of intracranial pressure (ICP), resulting in the Cushing triad of widened pulse pressure (increasing systolic, decreasing diastolic) bradycardia, and irregular respirations
a helmet that fits well prevents the head from moving and should be left on (true/false)
true -
as long as their are no airway problems, it doesn’t interfere with ventilation, you can properly mobilize the spine.
the patient is in cardiac arrest.
AND its not a full-face helmet. these ARE removed (would interfere with ventilating interventions)
consult w/med control about decision to remove a helmet (that is in the national registry book, but not a known MD protocol by instructor)
