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NURS 3150 (patho) > alteration of the brain, spinal cord, and peripheral nerves (3) > Flashcards

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

1
Q

_____: alteration in brain function caused by external force

A

traumatic brain injury (TBI)

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2
Q

manifestations of a TBI

A

reduced level of consciousness is expected

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3
Q

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)

A

coup injury

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4
Q

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)

A

contrecoup injury

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5
Q

what are the two classifications of TBIs

A

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

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6
Q

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

A

DAI

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7
Q

DAIs are caused from what type of movements

A

twisting movements and acceleration-deceleration forces

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

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8
Q

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

A

mild TBI

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9
Q

_____ 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

A

moderate TBI

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10
Q

_____ 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

A

severe TBI

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11
Q

what is the most severe complication of open TBIs

A

infection

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12
Q

name some manifestations of open TBIs

A

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

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13
Q

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

A

posttraumatic seizures (epilepsy)

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14
Q

who is at highest risk for spinal cord and vertebral injuries

A

young adult men and older individuals

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15
Q

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

A

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

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16
Q

____ spinal cord injuries are due to initial trauma

A

primary

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17
Q

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

A

secondary

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18
Q

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

A

what changes are permanent

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19
Q

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

A

altered breathing or apnea

20
Q

initial s/s of spinal shock

A

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

21
Q

spinal shock is resolved when what returns

A

reflexes or urination

22
Q

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

A

autonomic hyperreflexia (dysreflexia)

23
Q

manifestations of autonomic hyperreflexia

A
  • 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)

24
Q

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

A

seizures

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

25
Q

___: recurring seizures

A

epilepsy

26
Q

what does the priority intervention for epilepsy include

A

oxygen and antiepileptic drugs

27
Q

name two drugs that are used to stop seizures

A

lorazepam and diazepam (benzodiazepines)

28
Q

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

A

status epilepticus

29
Q

seizure sequence

A
  1. aura (sensation that seizure will occur soon)
  2. seizure
  3. postictal state (after seizure)
30
Q

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

A

cerebrovascular disease

31
Q

greatest risk factor for cerebrovascular disease

A

hypertension

32
Q

name the two types of strokes

A

ischemic and hemorrhagic (bleeding/aneurysm)

33
Q

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

A

thrombotic (stationary clot)

34
Q

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

A

embolic (clot moved)

35
Q

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

A

subarachnoid

36
Q

general s/s of a subarachnoid hemorrhage

A
  • meningeal inflammation causing neck stiffness
  • photophobia
  • N/V
  • blurred vision
  • irritability
  • restlessness
  • low-grade fever
  • positive kernig sign and brudzinski sign
37
Q

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

A

arteriovenous vascular malformation

38
Q

what are cardinal signs of infection and inflammation of the CNS

A

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

39
Q

____ meningitis is life-threatening

A

bacterial

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

40
Q

_____ are brain tissue tumors (in the CNS)

A

primary intracerebral tumors

41
Q

what is the most common form of CNS tumor

A

astrocytomas

42
Q

manifestations of primary intracerebral tumors

A

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

43
Q

what are the two forms of treatment for primary intracerebral tumors

A
  • 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)

44
Q

______ are CNS tumors that involve non-brain tissue

A

primary extracerebral tumors

45
Q

what are the most common metastatic carcinomas

A

lung and breast

NURS 3150 (patho) (13 decks)

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