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Patho Exam 2 ETSU > Brain > Flashcards

Brain Flashcards

1
Q

___ brain injury is caused by direct impact

Focal: one area

Diffuse: more than one area

A

Primary brain injury

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2
Q

Altered brain function due to external force. Closed or open head trauma is called ___ brain injury

A

Traumatic

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3
Q

__ brain injury indirect consequence of primary injury.

Ex ischemia due to vascular interruption

A

Secondary brain injury

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4
Q

The hallmark of a severe tbi is loss of consciousness for 6 hours or more

A

Know

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5
Q

Gas glow grading

Best response is 15
Comatose client 8 or less
Total unresponsive is 3

A

Know

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6
Q

Diffuse injuries
Diffuse axonal injury
Blast
Confusion

Focal
Contusion
Penetrating

A

Know

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7
Q

___ brain injury fan he closed (blunt) or open (penetrating)

Closed is more common, head strikes a surface or moving object strikes head. Or by blast waves. Dura mater remains intact and tissues are not allowed exposed to environment

Causes both focal and diffuse axonal injury

Open: penetrating trauma. Break in dura mater and exposed cranial content

A

Focal

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8
Q

___ injury directly below point of impact

*closed brain injury

A

Coup

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9
Q

___ injury is when the head bounces back and you get injury on opposite side

*closed brain injury

A

Contrecoup injury

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10
Q

Closed brain injury the force of the impact on typically produces contusions. Contusions Usually in frontal and temporal

A

Know

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11
Q

Bleeding between dura mater and skull

A

Epidural hematoma

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12
Q

Bleeding between dura mater and arachnoid membrane of the body

Headache confusion drowsiness

10-20% of persons with TBI

A

Subdural hematoma

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13
Q

___ hematoma bleeding within brain. 2-3% of people with TBI also seen with stroke

A

Intracerebral hematoma

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14
Q

With any brain injury, monitor ICP and advanced imaging EEG, MRI, control ICP

A

Know

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15
Q

If someone says worst headache of their life think of subarachnoid hemorrhage

A

Know

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16
Q

___ brain injury breaks the dura and exposes the cranial contents to the environment

Causes both focal and diffuse injuries

A

Open brain injury

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17
Q

Something shot at head and causing injury

A

Missile injury

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18
Q

___ injury is splintering of the bone

A

Compound

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19
Q

Identified as a coma that lasts 6 or more hours after TBI

Involves widespread area of brain

Acceleration and deceleration or rotational forced cause axonial damage. Shearing, tearing, stretching or nerve fibers.

Long term neuro issues

Whiplash injury *

Trouble responding, behavior and cognitive changes

A

Diffuse brain injury axonal injury

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20
Q

___ indirect result of primary brain injury, trauma and stroke syndrome, systemic processes (hypotension, hypoxemia, Amemia) cerebral processes (inflammation, cerebral edema)

**Management is to prevent hypoxia and maintain cerebral perfusion

A

Secondary brain injury

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21
Q 
Mild TBI (mild concussion) 
Glasgow coma 13-15, blunt trauma to head, no or short loss of consciousness, confusion for minutes and retrograde amnesia

Moderate TBI( moderate concussion)
GCS 9-12
Loss of consciousness 30 minutes to 6 hours
Confusion with amnesia longer than 24 hours

Severe TBI
GCS 3-8
Loss of consciousness longer than 6 hours
Severe cognitive system defects
Pupil changes, cardiac and respiratory systems, abnormal reflexes & posture abnormal, severe cognitive defect

A

Know

22
Q

Complications of TBI

Post concussion syndrome
Lasts weeks or months post mild concussion
Symptomatic relief with observation

Post traumatic seizures
Occurs within days, lasts up to 2-5 years post injury
Seizure prevention initiated early with moderate to severe TBI

Chronic traumatic encephalopathy
Progressive cementing disease
Violent behaviors
Repeated injury

A

Know

23
Q

Spinal cord injury

___ occurs with initial mechanical trauma and immediate tissue destruction

A

Primary

24
Q

Spinal cord injury

___ pathophysiologic cascade of events that begin immediately after injury and continues for weeks

Life threatening

A

Secondary

25
Q

Vertebral injury
•most often occur at C1-C2 c4-c7 and t10-L2

SCI most commonly occur die to vertebral injuries

Rest from acceleration, deceleration, deformation forces

Simple fracture- single break that usually affects transverse or spinus process

Compressed (wedged) fracture- vertebral body is compressed anteriorly

Comminuted( burst)fracture- shattered vertebral body

Dislocation- our of place

A

Know

26
Q

All cervical spinal cord trauma except for axial compression

A

Know

27
Q

Normal activity of spinal cord ceases below level of injury. Temporary and lasts 2-3 days

A

Spinal shock

28
Q

Vasogenic shock, occurs with injury above T6, caused by absence of sympathetic activity and unopposed parasympathetic tone

A

Neurogenic shock

29
Q

Sudden massive reflex sympathetic discharge because descending inhibition is blocked.
Stimulation of the sensory receptors * below the level of the cord lesion*

Most common cause is distended bladder or distended rectum ***

Stroke, seizures, death

A

Autonomic hyperreflexia (dysreflexia)

30
Q

The autonomic nervous system

The sympathetic stimulates fight or flight- everything speeds up.

Parasympathetic inhibitory- slows everything down

A

Know

31
Q

Any abnormality of the brain caused by a process in the blood vessels

  • most frequently occurring neurologic disorder
  • ischemia with or without infarction (death of brain tissue)
A

Cerebrovascular accident

32
Q

Leading cause of disability *

Third in females and 5th in makes as leading cause of death in US. 25% are recurrent

A

CVA

33
Q

Occurs when there is obstruction to arterial blood flow to the brain due to clot or low perfusion

*type of stroke

A

Ischemia stroke

34
Q

___ stroke is obstruction by thrombus in arteries supplying the brain

A

Thrombotic

35
Q

Episode of neurological dysfunction that lasts no more than one hours. Temporary destruction of brain blood flow

A

TIA

36
Q

___ stroke is where thrombus fragments obstructing brain vessels (from heart)**

A

Embolic

37
Q

*SYSTEMIC hypoperfusion decreases blood supply to brain

A

Know

38
Q

____ infarction when a area of the brain loses blood supply due to vascular occlusion

Central core of irreversible ischemia and necrosis, surrounded by ischemia *penumbra- prompt infusion of thrombolytic agents may restore perfusion in penumbra preventing necrosis

A

Central infarction

39
Q

Rim of boarderline hypoxic tissue

A

Penumbra

40
Q

Bleeding occurs in brain tissue or subarachnoid and subdural spaces. HTN is primary cause of this type of stroke

A

Hemorrhagic

41
Q

Dilated area or ballooning of cerebral vessel in the brain bc the vessel is weak. Born with it, trauma, smoking or hereditary

Most common indicator of this is hemorrhage

A

Aneurysm

42
Q

Escape of blood into subarachnoid space

A

Hemorrhage

43
Q

A mass of dilated vessels, no capillary bed in between. Present at birth can be a symptomatic or have headache and seizures

A

Arteriovenous malformation

44
Q

Inflammation of brain or spinal cord

A

Meningitis

45
Q

Acute inflammation of the brain, *usually of viral origin

*herpes simplex 1

Can be mild or life threatening

A

Encephalitis

46
Q

For encephalitis keep intracranial pressure as normal as you can and treat cause

A

Know

47
Q

Chronic progressive immune mediated inflammatory disease

Multiple areas of myelin loss.

*disrupts nerve conduction

Weaknesses
Impaired gait
Visual disturbances

More common in women ages 20-40

A

Multiple sclerosis

48
Q

__ ___ ___ is Acquired inflammatory disease that causes demyelination of peripheral nerves

Acute onset, ascending motor paralysis

Humoral and cellular immunologic reaction

Lower extremities, after infection

Months-2 year to recover

A

Guillain barre syndrome

49
Q

Acquired chronic autoimmune disease. Results from defect in nerve impulse transmission at neuromuscular junction

Rare and more common in women

Prob with thymus gland

A

Myasthenia gravis

50
Q

a primary brain tumor that originate from brain substance

Extra cerebral tumors is outside of the brain..

Astrocytoma makes up 75% of all tumors of brain and spinal cord and is most common glioma

A

Know

51
Q

Metastatic brain tumor is most prevalent brain tumor and comes from outside of the brain an spread to the brain

A

Know

52
Q

Spinal cord tumor are rare

Intramedullary tumor originate from spinal cord

Extramedullary tumor outside of spinal cord

Compressive syndrome motor and sensory function affected when tumor gets bigger-pain

Irritating syndrome- result of compressed nerve roots, numbness and weakness, continuous pain

A

Know

Patho Exam 2 ETSU (6 decks)

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