alteration of the brain, spinal cord, and peripheral nerves (3)

Question 1

_____: alteration in brain function caused by external force

Answer 1

traumatic brain injury (TBI)

Question 2

manifestations of a TBI

Answer 2

reduced level of consciousness is expected

Question 3

the process of injury for a TBI begins with a ______ injury which is the site of impact

(hit in face = frontal; bit around ear = temporal)

Answer 3

coup injury

Question 4

the second step in the process of injury for a TBI is a _______ injury, which is rebounding and brain tissue hitting the opposite side of the skull

(hit in face = occipital; hit around left ear = right temporal)

Answer 4

contrecoup injury

Question 5

what are the two classifications of TBIs

Answer 5

focal (one area) ot diffuse axonal injury [DAI] (widespread/multiple areas affected)

Question 6

which of the two classifications of TBIs cause less that one-third of deaths but cause the greatest number of severe disability

Answer 6

DAI

Question 7

DAIs are caused from what type of movements

Answer 7

twisting movements and acceleration-deceleration forces

(damage to axonal fibers and white matter in cerebral cortex)

Question 8

____ TBI: immediate but diminishing symptoms; memory deficits; does not lose consciousness

Answer 8

mild TBI

Question 9

_____ TBI:
- Loss of consciousness > 30 min with anterograde amnesia lasting > 24 hours
- Decerebration or decortication with unconsciousness lasting days or weeks
- Permanent deficits in selective attention, memory, vision, language, mood changes

Answer 9

moderate TBI

Question 10

_____ TBI:
- Brainstem damage with loss of consciousness lasting > 24 hours

S/S – increased ICP, respiratory changes, permanent neuro/motor/cognitive deficits

Treatment – brain perfusion, oxygenation, and safety to decrease long-term neuro deficits

Answer 10

severe TBI

Question 11

what is the most severe complication of open TBIs

Answer 11

infection

Question 12

name some manifestations of open TBIs

Answer 12

decreased/loss of LOC, coma (depends on location, severity, bleeding)

Question 13

_____ are a complication that are highest risk among open brain injuries

Answer 13

posttraumatic seizures (epilepsy)

Question 14

who is at highest risk for spinal cord and vertebral injuries

Answer 14

young adult men and older individuals

Question 15

what are two of the most common locations for spinal and vertebral injuries

Answer 15

cervical (auto/sports/falls) and thoracic (falls)

Question 16

____ spinal cord injuries are due to initial trauma

Answer 16

primary

Question 17

_____ spinal cord injuries are due to postinjury bleeding, edema, toxins, and cell death

Answer 17

secondary

Question 18

cord swelling in secondary spinal cord injuries makes what difficult to determine

Answer 18

what changes are permanent

Question 19

cervical injuries can become life-threatening due to ______ or _____

Answer 19

altered breathing or apnea

Question 20

initial s/s of spinal shock

Answer 20

complete loss of reflexes, flaccid paralysis, sensory deficit, loss of bladder/rectal control

Question 21

spinal shock is resolved when what returns

Answer 21

reflexes or urination

Question 22

____ is a life-threatening spinal cord/vertebral injury caused by skin pressure, full bladder, distended bowel, or other stimulus below injury

Answer 22

autonomic hyperreflexia (dysreflexia)

Question 23

manifestations of autonomic hyperreflexia

Answer 23

• sudden massive sympathetic discharge at or above T6
  -headache, blurred vision, sweating/flushing above injury, goosebumps, nasal congestion, nausea
• hypertension (up to 300 systolic); bradycardia (30-40 bpm)

*assess vitals to confirm cause of symptoms)

Question 24

______: sudden disruption in brain electrical activity caused by excessive discharges of neurons

Answer 24

seizures

seizures are symptoms of a disease process… NOT a specific disease

Question 25

___: recurring seizures

Answer 25

epilepsy

Question 26

what does the priority intervention for epilepsy include

Answer 26

oxygen and antiepileptic drugs

Question 27

name two drugs that are used to stop seizures

Answer 27

lorazepam and diazepam (benzodiazepines)

Question 28

______: recurring seizures with limited recovery between; seizures may last more than 30 mins (medical emergency)

Answer 28

status epilepticus

Question 29

seizure sequence

Answer 29

1. aura (sensation that seizure will occur soon) 2. seizure 3. postictal state (after seizure)

Question 30

what is the most common neurologic disorder and the 5th leading cause of death

Answer 30

cerebrovascular disease

Question 31

greatest risk factor for cerebrovascular disease

Answer 31

hypertension

Question 32

name the two types of strokes

Answer 32

ischemic and hemorrhagic (bleeding/aneurysm)

Question 33

______ ischemic strokes are due to atherosclerosis (poor diet/exercise) and inflammation

Answer 33

thrombotic (stationary clot)

Question 34

_____ ischemic strokes are due to a clot the moved from the heart chambers

Answer 34

embolic (clot moved)

Question 35

______ hemorrhage: blood escapes from injured vessels into the subarachnoid space causing inflammation

Answer 35

subarachnoid

Question 36

general s/s of a subarachnoid hemorrhage

Answer 36

- meningeal inflammation causing neck stiffness - photophobia - N/V - blurred vision - irritability - restlessness - low-grade fever - positive kernig sign and brudzinski sign

Question 37

what is the most common type of malformation that likely causes brain hemorrage

Answer 37

arteriovenous vascular malformation

Question 38

what are cardinal signs of infection and inflammation of the CNS

Answer 38

fever, head/neck/spine pain, generalized or focal neurologic dysfunction

Question 39

____ meningitis is life-threatening

Answer 39

bacterial (s/s: Throbbing headache, photophobia, nuchal (neck) rigidity, Kernig & Brudzinski sign, projectile vomiting)

Question 40

_____ are brain tissue tumors (in the CNS)

Answer 40

primary intracerebral tumors

Question 41

what is the most common form of CNS tumor

Answer 41

astrocytomas

Question 42

manifestations of primary intracerebral tumors

Answer 42

headaches, seizures, visual disturbances, loss of equilibrium, cranial nerve dysfunction

Question 43

what are the two forms of treatment for primary intracerebral tumors

Answer 43

- surgical excision or decompression if total excision is not possible -chemotherapy, radiation therapy, or both (blood-brain barrier is an obstacle to the delivery of chemotherapeutic agents)

Question 44

______ are CNS tumors that involve non-brain tissue

Answer 44

primary extracerebral tumors

Question 45

what are the most common metastatic carcinomas

Answer 45

lung and breast