alteration of the brain, spinal cord, and peripheral nerves (3) Flashcards
_____: alteration in brain function caused by external force
traumatic brain injury (TBI)
manifestations of a TBI
reduced level of consciousness is expected
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)
coup injury
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)
contrecoup injury
what are the two classifications of TBIs
focal (one area) ot diffuse axonal injury [DAI] (widespread/multiple areas affected)
which of the two classifications of TBIs cause less that one-third of deaths but cause the greatest number of severe disability
DAI
DAIs are caused from what type of movements
twisting movements and acceleration-deceleration forces
(damage to axonal fibers and white matter in cerebral cortex)
____ TBI: immediate but diminishing symptoms; memory deficits; does not lose consciousness
mild TBI
_____ 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
moderate TBI
_____ 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
severe TBI
what is the most severe complication of open TBIs
infection
name some manifestations of open TBIs
decreased/loss of LOC, coma (depends on location, severity, bleeding)
_____ are a complication that are highest risk among open brain injuries
posttraumatic seizures (epilepsy)
who is at highest risk for spinal cord and vertebral injuries
young adult men and older individuals
what are two of the most common locations for spinal and vertebral injuries
cervical (auto/sports/falls) and thoracic (falls)
____ spinal cord injuries are due to initial trauma
primary
_____ spinal cord injuries are due to postinjury bleeding, edema, toxins, and cell death
secondary
cord swelling in secondary spinal cord injuries makes what difficult to determine
what changes are permanent
cervical injuries can become life-threatening due to ______ or _____
altered breathing or apnea
initial s/s of spinal shock
complete loss of reflexes, flaccid paralysis, sensory deficit, loss of bladder/rectal control
spinal shock is resolved when what returns
reflexes or urination
____ is a life-threatening spinal cord/vertebral injury caused by skin pressure, full bladder, distended bowel, or other stimulus below injury
autonomic hyperreflexia (dysreflexia)
manifestations of autonomic hyperreflexia
- 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)
______: sudden disruption in brain electrical activity caused by excessive discharges of neurons
seizures
seizures are symptoms of a disease process… NOT a specific disease
___: recurring seizures
epilepsy
what does the priority intervention for epilepsy include
oxygen and antiepileptic drugs
name two drugs that are used to stop seizures
lorazepam and diazepam (benzodiazepines)
______: recurring seizures with limited recovery between; seizures may last more than 30 mins (medical emergency)
status epilepticus
seizure sequence
- aura (sensation that seizure will occur soon)
- seizure
- postictal state (after seizure)
what is the most common neurologic disorder and the 5th leading cause of death
cerebrovascular disease
greatest risk factor for cerebrovascular disease
hypertension
name the two types of strokes
ischemic and hemorrhagic (bleeding/aneurysm)
______ ischemic strokes are due to atherosclerosis (poor diet/exercise) and inflammation
thrombotic (stationary clot)
_____ ischemic strokes are due to a clot the moved from the heart chambers
embolic (clot moved)
______ hemorrhage: blood escapes from injured vessels into the subarachnoid space causing inflammation
subarachnoid
general s/s of a subarachnoid hemorrhage
- meningeal inflammation causing neck stiffness
- photophobia
- N/V
- blurred vision
- irritability
- restlessness
- low-grade fever
- positive kernig sign and brudzinski sign
what is the most common type of malformation that likely causes brain hemorrage
arteriovenous vascular malformation
what are cardinal signs of infection and inflammation of the CNS
fever, head/neck/spine pain, generalized or focal neurologic dysfunction
____ meningitis is life-threatening
bacterial
(s/s: Throbbing headache, photophobia, nuchal (neck) rigidity, Kernig & Brudzinski sign, projectile vomiting)
_____ are brain tissue tumors (in the CNS)
primary intracerebral tumors
what is the most common form of CNS tumor
astrocytomas
manifestations of primary intracerebral tumors
headaches, seizures, visual disturbances, loss of equilibrium, cranial nerve dysfunction
what are the two forms of treatment for primary intracerebral tumors
- 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)
______ are CNS tumors that involve non-brain tissue
primary extracerebral tumors
what are the most common metastatic carcinomas
lung and breast
