brain injury Flashcards
1
Q
a life-threatening emergency in patients with spinal cord injury that causes a hypertensive emergency
A
autonomic dysreflexia
2
Q
a condition that involves total loss of sensation and voluntary muscle control below the lesion
A
complete spinal cord lesion
3
Q
a temporary loss of neurologic function with no apparent
structural damage to the brain
A
concussion
4
Q
bruising of the brain surface
A
contusion
5
Q
a condition in which there is preservation of the sensory or motor fibers, or both, below the lesion
A
incomplete spinal cord lesion
6
Q
bladder dysfunction that results from a disorder or dysfunction of the nervous system; may result in either urinary retention or bladder overactivity
A
neurogenic bladder
7
Q
paralysis of the lower extremities with dysfunction of the bowel and bladder from a lesion in the thoracic, lumbar, or sacral region of the spinal cord
A
paraplegia
8
Q
initial damage to the brain that results from the traumatic
event
A
primary injury
9
Q
an insult to the brain subsequent to the original traumatic event
A
secondary injury
10
Q
an injury to the spinal cord, vertebral column, supporting soft tissue, or intervertebral discs caused by trauma
A
spinal cord injury (SCI)
11
Q
varying degrees of paralysis of both arms and legs, with dysfunction of bowel and bladder from a lesion of the cervical segments of the spinal cord
A
tetraplegia
12
Q
formerly called quadriplegia
A
tetraplegia
13
Q
severing of the spinal cord
A
transection
14
Q
severing all the way through the cord
A
complete transection
15
Q
severing partially through the cord
A
incomplete transection
16
Q
an injury to the skull or brain that is severe enough
to interfere with normal functioning
A
traumatic brain injury
17
Q
another word for traumatic brain injury
A
craniocerebral trauma
18
Q
occurs when the head accelerates and then rapidly decelerates or collides with another object and brain tissue is damaged, but there is no opening through the skull and dura
A
closed traumatic brain injury
19
Q
occurs when an object penetrates the skull, enters the brain, and damages the soft brain tissue in its path (penetrating injury)
A
open traumatic brain injury
20
Q
when blunt trauma to the head is so severe that it opens the scalp, skull, and dura to expose the brain
A
open traumatic brain injury
21
Q
encompasses any damage to the head as a result of trauma
A
head injury
22
Q
why would a scalp injury bleed profusely
A
because of the many blood vessels that constrict poorly
23
Q
what are the locations of fractures
A
temporal, frontal, basal
24
Q
a break in the continuity of the bone
A
linear fracture
25
splintered or multiple fracture line
comminuted fracture
26
a fracture where the skull is forcefully displaced downwards
depressed skull fracture
27
scalp laceration or tear in the dura
open fracture
28
dura is intact
closed fracture
29
what are clinical manifestations of head injury
persistent localized pain
swelling
hemorrhage from the nose
blood under the conjunctiva
battle sign
CSF otorrhea
CSF rhinorrhea
30
ecchymosis seen over the mastoid
battle sign
31
what are the diagnostic tests for head injury
computed tomography scan
magnetic resonance imaging scan
32
types of brain injuries
focal
diffuse
33
the brain is bruised and damaged in a specific area because of severe acceleration–deceleration force or blunt trauma.
contusion
34
characteristics of contusions
loss of consciousness
hemorrhage
edema
35
contusion effects of injury peak after what time
18 to 36 hours
36
types of hematoma
epidural (above the dura)
subdural (below the dura)
intracerebral (within the brain)
37
this subdural hematoma is caused some kind of head injury
acute subdural hematoma
38
brain damage that occurs directly under the point of impact
coup injury
39
occurs on the opposite side of the brain from where the head is stuck
countercoup injury
40
brain is bruised and damaged in a specific area
cerebral contusion
41
where is the origin of the epidural hematoma
middle meningeal artery
42
what is the cause of epidural hematoma
skull fracture
43
a period when patient is awake and conversant (time where compensator mechanism is working)
lucid interval
44
where is the origin of the bleeding of subdural hematoma
venous
45
types of subdural hematoma
chronic and acute
46
subdural hematoma associated with major head injuries
acute subdural hematoma
47
what are manifestations of acute subdural hematoma
rapidly developing symptoms
altered level of consciousness
pupillary signs
hemiparesis
48
what are the sighs of rapidly expanding mass
coma
cushing's triad (hypertension, bradycardia, bradypnea)
49
this type of subdural hematoma develops from minor head injuries and are common among older adults
chronic subdural hematoma
50
what are the manifestations of chronic subdural hematoma
severe headache (on and off)
alternating focal neurologic signs
personality changes
mental deterioration
focal seizures
51
what is the location of intracerebral hematoma
cerebral parenchyma
52
what are the causes of intracerebral hematoma
head injuries involving severe force to the head over a small area
raptured aneurysm
hypertension
bleeding disorders
53
what are the manifestations of intracerebral hematoma
neurologic deficits - initial sign
headache
54
what are the medical management of intracerebral hematoma
supportive care
control of icp
fluid and electrolyte replacement
antihypertensive
55
what are the surgical management for intracerebral hematoma
craniotomy
craniectomy
56
what is a mild form of neurologic brain injury
concussion
57
what is the cause of a concussion
blunt trauma from
- acceleration-deceleration force
- direct blow
- blast injury
58
what are the clinical manifestations of frontal lobe involvement in concussions
bizarre, irrational behavior
59
what are the clinical manifestations of temporal lobe involvement
temporary amnesia or disorientation
60
why are narcotics avoided for concussion pain
it may alter the neurologic exam
61
how many days til the patient can gradually return to nonsport activities
2-3 days
62
a region in an organ or tissue which has suffered damage through injury or disease
lesion
63
what are the parts of the spinal cord
- 7 cervical spine
- 12 thoracic spine
- 5 lumbar spine
- coccyx
64
responsible for stimulating movement and feeling
spinal cord root
65
what nerves supply the head, neck, shoulders, arms, and hands
cervical nerves (8 pairs)
66
what cervical nerves control neck muscles
c1-c3
67
what cervical nerves control the diaphragm
c4
68
what cervical nerves control the deltoid
c5
69
what cervical nerve controls the wrist
c6
70
what cervical nerve controls the triceps
c7
71
what cervical nerve controls the fingers
c7 - c8
72
these spinal cord roots connects portions of the upper abdomen and muscles in the back and chest areas
thoracis nerves (12 pairs)
73
what thoracic nerve controls the hand
t1
74
what thoracic nerve controls the intercostals
t2-t12
75
what nerve controls the abdominals
t7-L1
76
what thoracic nerve controls ejaculation
t11-L2
77
what spinal cord root feeds the lower back and legs
lumbar nerves (5 pairs)
78
what lumbar nerve controls the hips
L2
79
what lumbar nerve controls the quadriceps
L3
80
what lumbar nerves control the hamstrings-knee
L4-L5
81
what lumbar nerves control the foot
L4-S1
82
what spinal cord root supplies the buttocks, legs, feet, anal and genital areas of the body
sacral nerves (5 pairs)
83
what sacral nerve controls penile erection
S2
84
what sacral nerve controls the bowel and bladder
S2-S3
85
what are the risk factors of spinal cord injury
younger age
male gender
alcohol and drug use
86
what are the major causes of death for people with spinal cord injury
pneumonia
pulmonary embolism
sepsis
87
what are the mechanisms of sci
concussion - patient fully recovers
contusion
laceration
compression - due to slipped disk or tumor
transection - severed spinal cord
88
what are the vertebrae commonly involved in spinal cord injury
C5-C7 - deltoid, wrist, fingers
T12 - intercostals, ejaculation
L1 - abdominals, intercostals
89
what causes tetraplegia
C4 or C6 injury
90
what causes paraplegia
T6-L1 injury
91
what sci has this clinical manifestation
- injury at c2 and c3 are usually fatal
cervical sci
92
what sci has this clinical manifestation
- tetraplegia
cervical sci
93
what sci has this clinical manifestation
- respiratory muscle paralysis
cervical sci
94
what sci has this clinical manifestation
- bowel and bladder retention
cervical sci/thoracic sci/lumbar sci
95
what sci has this clinical manifestation
- paraplegia
thoracic sci/lumbar sci/sacral sci
96
what sci has this clinical manifestation
- poor control of upper trunk
thoracic sci
97
what sci has this clinical manifestation
- autonomic dysreflexia
thoracic sci (lesion above t6)
98
what sci has this clinical manifestation
- allows erection but no ejaculation
sacral sci (injury above s2)
99
what sci has this clinical manifestation
- prevents erection and ejaculation
sacral sci (injury between s2-s4)
100
what sci has this clinical manifestation
- bowel and bladder incontinence
sacral sci
101
this is moving the patient as one unit. it maintains spinal alignment
logrolling
102
this is given within the first 24-48 hours
high dose of methylprednisolone Iv
103
why is high dose of methyprednisolone IV a controversial method
it only offers slight benefit for sci
104
this prevents hypoxemia which can worsen neurologic deficits
oxygenation
105
what should be taken care of if endotracheal intubation is needed
neck flexion and extension
106
this is the restoration of preinjury position
reduction
107
this provides immobilization of the c spine while allowing early ambulation
halo and vest
108
this provides immobilization of the c spine while allowing early ambulation
halo and vest
109
this reflects a sudden depression of reflex activity in the spinal cord below level of injury
spinal shock
110
what are the clinical manifestations of spinal cord shock
paralysis
absent reflexes
hypotension
bradycardia
bowel and bladder retention
111
this develops as a result of the loss of autonomic nervous system function below the level of the lesion
neurogenic shock
112
what are the clinical manifestations of neurogenic shock
hypotension
bradycardia
decreased cardiac output
venous pooling in extremities
peripheral vasodilation
absence of perspiration in paralyzed areas of body
113
a complication resulting from immobility
venous thromboembolism
114
places the patient at risk to develop deep vein thrombosis and/or pulmonary embolism
venous thromboembolism
115
what is the clinical manifestation of deep vein thrombosis
positive homan's sign
116
what are the clinical manifestations of pulmonary embolism
pleuritic chest pain
anxiety
shortness of breath
abnormal arterial blood gas (increased PaCO2 and decreased PaO2)
117
what are the preventive management for venous thromboembolism
low dose anticoagulation using warfarin
sequential pneumatic compression device
118
why should you never massage the calves or thighs of a patient who is immobile
because it might dislodge an undetected thromboembolus
119
this causes hyperstimulation of the SNS
autonomic dysreflexia
120
what are the triggers of autonomic dyreflexia
bladder distention
fecal impaction
skin stimulation (pressure sore above level of lesion)
121
what are the clinical manifestations of autonomic dyreflexia
severe headache
blurring of vision
nasal congestion
hypertension
bradycardia
sweating above lesion
goose flesh below lesion
122
what should u do to lower the bp of a patient suffering autonomic dysreflexia
place them in a sitting position to lower bp by gravity
123
what should u do to a patient suffering autonomic dysreflexia to prevent bladder distention
catheterize as indicated
124
what should u do to a patient suffering autonomic dysreflexia to prevent fecal impaction
perform manual extraction as indicated
125
what should u do to prevent skin stimulation in a person suffering from autonomic dysreflexia
facilitate turning to sides to prevent pressure sores
126
this is a ganglionic blocking agent for the treatment of autonomy dysreflexia
hexamethonium chloride
127
this is a vasodilator for the treatment of autonomy dysreflexia
sodium nitroprusside
128
what should u use to wash wounded area at home and in hospital
soap and water/sterile nss
129
how many minutes should u apply pressure for scalp abrasion
10 minutes
130
what should u use to remain sterility during application of pressure on bleeding site
clean gloves/gauze
131
what should u do to reduce swelling and pain
apply ice compress for 20 minutes
132
how many minutes should you apply ice compress for a scalp abrasion
20 minutes
133
hat are the signs and symptoms for increased icp
restlessness
anisocoria
headache
projectile vomiting
134
what is another word for controling bleeding
hemostasis
135
how many hours should u delay the closure for scalp laceration
24 hours
136
when should you administer tetanus toxoid for a patient with scalp laceration
if the last known dosage was >5 years ago
137
this is the ecchymosis on the periorbital area
raccoon eyes
138
this is the CSF leak from the ears
CSF otorrhea
139
this is the CSF leak from the nose
CSF rhinorrhea
140
what is the management for acute subdural hematoma
emergency craniotomy
141
what is the management for chronic subdural hematoma
burr hole (multiple)
craniotomy
