CH 12 Head & Spinal- Concussions Flashcards
what does the brainstem include
-medulla oblongata, pons, & midbrain
-vital link for incoming & outgoing fibers pass through. Vital center for breathing & basic life functions
what does the cerebellum function
-posterior to the brain stem
- responsible for subconcious control of motor activity
what does the diencephalon include & function
-thalamus, hypothalamus, epithalamus
-homeostasis, information filtering
what does the cerebrum include & function
-supported on the diencephalon
-seat of intelligence
(main brain)
Parietal lobe detects what?
-sensations of the body (tactile senses)
-touch, pressure, tickle, itch, vibration, proprioception & kinesthesia
define somatosensation
sensations of the body
what is the frontal lobe responsible for?
-for what a person intends to do & how they accomplish it
-executive functions
-intellect, cognition, reasoning, persistence, planning
what does the temporal lobe responsible for?
-primary auditory cortex
-memory storage & declaritive memory
what is Wernikes area & what lobe is it
-speech comprehension
-temporal lobe
occipital lobe responsibility
- primary visual cortex (interpret)
-higher order vision (colour, texture, shapes, locations, meaning to you)
head injuries vs injuries to the head
Injuries to the head- could be a superficial injury (cut, scrape, scalp cut…)
Head injury- involves brain trauma
what are some injuries to the head? (4)
- skull fractures
- objects impaled in the skull
- cerebral hematoma
- injuries to the brain
Skull fractures: S/S & what should you treat it as
-visible damage to scalp
-deformity of the skull/face
-pain
swelling
fluid from nose, ears, mouth or head wound (CSF)
-unusual pupil size
-raccoon eyes
-battle signs
Treat as SMR
Skull fractures: orbit injury- Define & what might patient complain of (4)
def’n: A fracture of the bones that form the eye sockets (orbits)
S/S:
- double or decreased vision
-numbness above eyebrow or over cheek
-massive discharge of fluid from nose
- eyes may not be able to follow fingers
skull fractures: what to do(4)
- fractures to lower orbit are most common
- cold packs around injuried orbit to help reduce swelling
- place in rapid transport category
- often associated w/ concussions
Impaled objects: management (what to do) (4)
- leave it in place
- stabilize ith with bulky dressing
- dress area around the wound with sterile gauze, but allow the blood to drain
- avoid putting direct pressure on the head
what is a cerebral hematoma
internal bleeding of the brain
-can be artery or vien
-can occur rapid or slow
-most important sign is change in LOR using glascow coma scale
types of hematomas (4)
- epidural hematoma
- subdural hematoma
- subarachnoid hematoma
- intracerebral hematoma
define epidural hematoma
arterial bleed between skull & dura mater
epidural hematoma : MOI & S/S
MOI: low velocity blow to the head (ex) falls or blunt objects to the head
S/S: appear quickly
-brief loss of LOR followed by regained responsivness
-then rapid decline
-pupils dialated, sluggish or non reactive
-impaired motor function of body on opposite side of injury
define subdural hematoma
venous bleed in the subdural space
subdural hematoma: mOI & S/S
MOI: violent blow to head (puck to head/ball to head)
S/S:
- neurological defects can develop immediately or up to days later
-S/S can be slow to appear
-headaches
-visual disturbances
-personality changes
-difficulty speaking
-deficits in motor function
define subarachnoid hematoma
arterial bleed in subarachnoid space. Fills in all the spaces around the brain
subarachnoid hematoma: MOI & S/S
MOI: ruptured aneurysm or head injury
S/S:
-severe headache
-vomititng
-seizures
-confusion
-lowered LOR
define intracerebral hematoma
damaged blood vessels of the brain itself
intracerebral hematoma: MOI & S/S
MOI: blunt force or penetrating trauma. Often more than 1 contusion & can enlarge over time
S/S:
-Neurological symptoms depend on location & size of hematoma
define cushings triad & physiological responses (3)
Def’n: physiological nervous system response to acute elevations of intracranial pressure
- increased BP
- bradycardia (<60bpm)
- irregular/sporatic respirations
sport related concussion definition (SRC)
Traumatic brain injury caused by direct blow to the head, neck or body resulting in a force being transmitted to the brain that occurs in sports or exercise.
features defining clinical nature of sport related concussion (5)
- functional injury (brain cannot communicate normally w/body systems)
- S/S may present immediately or over minutes to hours
- no abnormality seen on imaging (MRI)
- results in a range of clinical S/S that may not include loss in responsiveness
- does not have specific diagnosis criteria
consussion: resolution
-majority of concussions reslove in 7-10 days period
-recovery time frame is longer with children, adolescents, ADHD & Dyslexia
Concussion: MOI
- direct (coup)
-causes local damage to the brain
-followed by contrecoup
(ex) head smashes forward against wall/boards - Indirect (contrecoup)
- counter blow on opposite side of brain
-brain accelerates & deccelerates
(ex) neck extends/bounces off the wall/board you just smashed your forehead on
Concussion: S/S domains (6)
- symptoms
- physical signs
- balance impairement
- behaviour changes
- cognitive impairment
- sleep disturbances
Concussion: S/S symtoms (3)
somatic
cognitive
emotional
Concussion: S/S physical signs (3)
loss of consciousness
amnesia
neurological deficit
Concussion: S/S balance impairment (1)
gait unsteadiness
Concussion: S/S behaviour changes (3)
irritability
aggression
sadness
Concussion: S/S cognitive impairment (1)
slowed reaction times
Concussion: S/S sleep disturbances (3)
drowsiness
falling asleep
staying asleep
