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Question 1

TBI: Direct vs Indirect

Answer 1

Direct means you got hit in the head, indirect means you got hit somewhere else

Question 2

The most common lobes to be hurt in TBI

Answer 2

frontal and temporal

Question 3

Besides Direct and Indirect, you can categorize TBI as

Answer 3

Primary or Secondary

Question 4

Primary injury

Answer 4

happens at the same time as a head injury

Question 5

Moderate TBI

Answer 5

Lose consciousness for up to 6 hours
Other systemic problems
Problems learning/working

Question 6

Severe TBI

Answer 6

Out for more than 6 hours

Question 7

Major sign of Basilar skull fracture

Answer 7

CSF from the nose and ears

Question 8

Concussion is when the

Answer 8

brain rattles around in the skull

Question 9

A diffuse axonal injury to the brain

Answer 9

means there’s wide spread damage

Question 10

Secondary brain injury

Answer 10

happens After the initial injury

Question 11

As ICP increases, perfusion to the brain

Answer 11

decreases

Question 12

As ICP increases, perfusion to the brain decreases. The brain counteracts this by

Answer 12

vasodilating to encourage perfusion, but that only increases ICP even worse

Question 13

Epidural hematoma means

Answer 13

blood clotting btwn the dura and the inner skull.

Question 14

after an Epidural hematoma, the patient will be

Answer 14

knocked out for a minute, but then wakes up and their lucid

This is an emergency situation

Question 15

Hydrocephalus

Answer 15

too much volume in the CSF

Question 16

An uncal herniation is an

Answer 16

especially dnagerous kind of brain herniation.

It causes pressure on CN 3 so they have eye manifestations
They also lose consciousness quickly

Question 17

2 manifestations of central herniation

Answer 17

pinpoint pupils

Cheyne Stokes

Question 18

TBI: until you have x ray results, treat the patient as if they had

Answer 18

spine injury

Question 19

Loss of feeling, head tilt, and tender in the back can indicate

Answer 19

spine injury

Question 20

The BP of someone with TBI could be

Answer 20

hypo or hyper

Question 21

Cushings Triad

Answer 21

a late sign of ICP.

Severe HTN, wide pulse pressure, bradycardia

Question 22

If a TBI pt gets hypotension and tachycardia, it could mean they’re going into

Answer 22

hypovolemic shock

Question 23

The single most important thing to check for when determining neuro status is

Answer 23

LOC

Question 24

One thing that is ALWAYS a sign of ICP is

Answer 24

papilledema

Question 25

If you suspect CSF leakage, check for

Answer 25

nuchal rigidity (stiff neck) because that could mean there’s blood in the CSF. BUT you can’t check for it until you get the x ray results to r/o spine injury

Question 26

If you just had a mild injury, you prob won’t have

Answer 26

long term problems

Question 27

For TBI, position the HOB

Answer 27

at 30 degrees

Question 28

One of the 4 things you need to qualify as brain dead: ___ of known cause

Answer 28

Coma

Question 29

One of the 4 things you need to qualify as brain dead: Normal

Answer 29

core temp

Question 30

One of the 4 things you need to qualify as brain dead: ___ of at least 100

Answer 30

sys

Question 31

One of the 4 things you need to qualify as brain dead: a ___ exam

Answer 31

neuro

Question 32

___ and ___ are used to treat ICP by pulling out extra fluid

Answer 32

mannitol and furosemide

Question 33

A ___ coma may be needed if you can’t control ICP by other means

Answer 33

barbituate coma

Question 34

Patients with personality/behavior changes after TBI need what in their routine?

Answer 34

structure and consistency

Question 35

If a person with minor head injury is sleeping,

Answer 35

wake them Q 3 or 4 h and check if they’re A and O x 3

Question 36

With minor head injury its common to have headache for

Answer 36

24 hours, but if it gets worse or doesn’t improve you should escalate

Question 37

With a mild head injury, for 48 hours

Answer 37

don’t exercise, blow your nose, or clean your ears