CH. 34 HEAD AND SPINE TRAUMA Flashcards by Nicholas de Guzman

a condition that occurs with flexion injuries or fractures, resulting in the displacement of bony fragments into the anterior portion of the spinal cord; findings include paralysis below the level of insult and loss of pain, temperature, and touch sensation

anterior cord syndrome

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loss of memory relating to events that occurred after the injury

anterograde post traumatic amnesia

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the middle membrane of the three meninges that enclose the brain and the spinal cord

arachnoid

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the bones that function in hearing and are located deep within the cavities of the temporal bone

auditory ossicles

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a potentially life threatening late complication of spinal cord injury in which a massive, uninhibited, uncompensated cardiovascular response occurs due to stimulation of the sympathetic nervous system below the level of injury; also known as autonomic hyperreflexia

autonomic dysreflexia

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an increase in mean arterial pressure to compensate for decreased cerebral perfusion pressure; compensatory mechanism for the body to shunt blood to brain; manifests as hypertension

autoregulation

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long, slender extension of a neuron that conducts electrical impulses away from the neuronal stoma

axon

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when the toe moves upwards in response to stimulation of the sole foot

babinski reflex

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structures located deep within the cerebrum, diencephalon, and midbrain that have an important role in coordination of motor movements and posture

basal ganglia

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usually occur following diffuse impact to the head; results from extension of linear fraction to the base of the skull and can be difficult to diagnose with a radiograph

basilar skull fractures

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brusing over the mastoid bone behind the ear commonly seen following a basilar skull fracture also called auricular ecchymosis

battle signs

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characterized by an irregular rate, patterns and volume of breathing with intermittent periods of apnea; called ataxic respirations

biot respirations

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part of the central nervous system located within the cranium; contains neurons that serve different functions

brain

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the midbrain, pons, and medulla

brainstem

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a condition associated with penetrating trauma with hemisection of the spinal cord and complete damage to all spinal tracts on the involved side

brown-sequard syndrome

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the location where the spinal cord separates and is composed of nerve roots

cauda equina

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a neurologic condition caused by compression of the bundle of nerve roots located at the end of the spinal cord

cauda equina syndrome

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a condition that results from hyperextension injuries to the cervical area that cause damage with hemorrhage or edema to the central cervical ligament; findings include greater loss of function in the upper extremities with variable sensory loss of pain and temp

central cord syndrome

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the system containing the brain and spinal cord

central nervous system

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deep, rapid respirations; similar to kussmaul but without an acetone breath odor; commonly found in a brainstem injury

central neurogenic hyperventilation

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the region of the brain essential in coordinating muscle movements in the body; also called the athlete’s brain

cerebellum

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occurs when the brain is jarred around in the skull; a mild diffuse brain injury that does not result in structural damage or permanent neurologic impairment

cerebral concussion

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a focal brain injury in which brain tissue is bruised and damaged in a defined area

cerebral contusion

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the largest portion of the cerebrum

cerebral cortex

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cerebral water that causes swelling of the brain

cerebral edema

the pressure of blood flow through the brain

cerebral perfusion pressure (CPP)

fluid produced in the ventricles of the brain that flows in the subarachnoid space and bathes the meninges

cerebrospinal fluid (CSF)

the largest portion of the brain; responsible for higher functions such as reasoning; divided into right and left hemisphere or halves

cerebrum

the respirations that are fast and then become slow with intervening periods of apnea; commonly seen following brainstem injury

cheyne stokes respirations

specialized cells within the hollow areas in the ventricles of the brain that produce CSF

choroid plexus

total disruption of all tracts of the spinal cord with all cord mediated functions below the level of transection lost permanently

complete spinal injury

the point where the parietal bones join with the frontal bone

coronal suture

dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds

coup-contrecoup injury

cranium

cranial vault

a horizontal bone perforated with numerous foramina for the passage of the olfactory nerve filaments from the nasal cavity

cribriform plate

a prominent bony ridge in the center of the anterior fossa and the point of attachment of the meninges

crista galli

minimum cerebral perfusion pressure required to adequately perfuse the brain; 60 mm Hg in the adult

critical minimum threshold

hypertension (widening pressure), bradycardia, and irregular respirations; typically associated with ICP

cushing triad

abnormal posture characterized by extension of the arms and legs indicating pressure on the brainstem

decerebrate (extensor) posturing

abnormal posture characterized by flexion and extension of the legs; indicates pressure on the brainstem

decorticate (flexor) posturing

result from high energy direct trauma to a small surface area of the head with a blunt object; commonly results in bony fragments being driven into the brain causing injury

depressed skull fractures

areas of the body innervated by sensor components of spinal nerves

dematomes

the part of the brain between the brainstem and the cerebrum that includes the thalamus, sub thalamus, and hypothalamus

diencephalon

diffuse brain injury that is caused by stretching, shearing, or tearing of the nerve fibers with subsequent axonal damage

diffuse axonal injury (DAI)

any injury that affects the entire injury

diffuse brain injury

the outermost layer of the three meninges that enclose the brain and the spinal cord; it is the toughest meningeal layer

dura mater

an accumulation of blood between the skull and dura

epidural hematoma

the joint on which each vertebra articulates with adjacent vertebrae

facet joint

a type of injury that results from forward movement of the head, as a result of rapid deceleration, such as in a car crash, or with a direct blow to the occiput

flexion injury

a specific grossly observable brain injury

focal brain injury

the soft spots in the skull of an infant and newborn where the sutures of the skull have not yet grown together

fontanelles

the large opening at the base of a skull through which the spinal cord exits the brain

foramen magnum

small natural openings perforations or orifices such as in the bones of the cranial vault; plural of foramen

foramina

the portion of the brain that is responsible for voluntary motor actions and personality traits

frontal lobe

tough tendinous layer of the scalp

galea aponeurotica

a widely accepted method of assessing level of consciousness that is based on three independent measurements: eye opening, verbal response, motor response

glasgow coma scale

the bony anterior part of the roof of the mouth

hard palate

a traumatic insult to the head that may result in injury to soft tissue, bony structures, or the brain

head injury

process in which tissue is forced out of its normal position, such as when the brain is forced from the cranial vault, either through the foramen magnum or over the tentorium

herniation

hyper acute pain to touch

hyperesthesia

extension of a limb or other body part beyond its usual range of motion

hyperextension

a high body temperature

hyperpyrexia

inferior portion of the diencephalon responsible for control of many body functions like heart rate, digestion, sexual development, temperature regulation, emotion, hunger, thirst, and regulation of sleep cycle

hypothalamus

spinal cord injury in which there is some degree of cord mediated function; initial dysfunction may be temporary and there may be potential for recovery

incomplete spinal cord injury

bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchyma hematoma

intracerebral hematoma

the pressure within the cranial vault; normally 0 to 15 mm Hg in adults

intracranial pressure

the point where the occipital bones attach to the parietal bones

lambdoid suture

arise from the posterior pedicles and fuse to form the posterior spinous processes

lamina

structures within the cerebrum and diencephalon that influence emotions motivation mood and sensations of pain and pleasure

limbic system

account of 80% of skull fractures and referred to as non displaced skull fractures and occur in temporal parietal region of the skull and not associated with deformities of the skull

linear skull fractures

a cone shaped section of bone at the base of the temporal bone

mastoid process

the average pressure against the arterial wall during a cardiac cycle

mean arterial pressure

continuous inferiorly with the spinal cord; serves as a conduction pathway for ascending and descending nerve tracts; coordinates heart rate, blood vessel diameter, breathing, swallowing, vomitting, coughing, and sneezing

medulla

a set of three tough membranes, the dura mater, arachnoid, and pia mater, that encloses the entire brain and spinal cord

meninges

regions of the body innervated by the motor components of spinal nerves

myotomes

the chamber inside the nose that lies between the floor of the cranium and the rood of the mouth

nasal cavity

injury to a nerve at the level of the spinal cord

nerve root injury

shock caused by massive vasodilation and pooling of blood in the peripheral vessels to the extent that adequate perfusion cannot be maintained

neurogenic shock

the body of a neuron or nerve cell

neuronal soma

articular surfaces on the occipital bone in which the skull articulates with the atlas on the vertebral column

occipital condyles

the portion of the brain that is responsible for the processing of visual information

occipital lobe

nerves that participate in the transmission of scent impulses

olfactory nerves

an irregularly shaped bone found in the posterior part of the nasal cavity

palatine bone

subdivision of the autonomic nervous system; involved in control of involuntary vegetative functions meditated largely by the vagus nerve through the chemical acetylcholine

parasympathetic nervous system

the portion of the brain that is the site for reception and evaluation of most sensory information except for smell hearing and vision

parietal lobe

thick lateral bony struts that connect the vertebral body with the spinous and transverse processes and make up the lateral and posterior portions of the spinal foramen

pedicles

bruising under or around the orbits that is commonly seen following a basilar skull fracture

periorbital eccyhmosis

injury to a nerve anywhere in the body that is outside of the spinal cord

peripheral nerve injury

the innermost and thinnest of the three meninges that enclose the brain and spinal cord, rests directly on the brain and the spinal cord

pia mater

a cluster of nerve roots that permits peripheral nerve roots to rejoin and function as a group

plexus

lies below the midbrain and above the medulla and contains important nerve fibers, including those for sleep, respiration, and the medullary respiratory center

pons

a condition associated with extension injuries with isolated injury to the dorsal column; presents as decreased sensation to light touch, proprioception, and vibration while leaving most other motor and sensory functions intact

posterior cord syndrome

formed by the fusion of the posterior lamina, this is an attachment site for muscles and ligaments

posterior spinous process

an injury to the brain and its associated structures that is a direct result of impact to the head

primary brain injury

injury to the spinal cord that is a direct result of trauma- for example, transection of the spinal cord from penetrating trauma or displacement of ligaments and bone fragments, resulting in compression of the spinal cord

primary spinal cord injury

the ability to perceive the position and movement of one's body or limbs

proprioception

bruising under or around the orbits that is commonly seen following a basilar skull fracture also called periorbital ecchymosis

raccoon eyes

located in the upper brainstem; responsible for maintenance of consciousness specifically one's level of arousal

reticular activating system (RAS)

loss of memory relating to events that occurred before the injury

retrograde amnesia

a type of injury typically resulting from high acceleration forces; can result in a stable unilateral facet dislocation in the c-spine

rotation flexion injury

the point of the skull where the parietal bones join

sagittal suture

the after effects of the primary injury including abnormal processes such as cerebral edema, ICP, cerebral ischemia, hypoxia, and infection; often delayed following primary brain injury

secondary brain injury

injury to the spinal cord, thought to be the result in a progression of inflammatory responses from spinal cord injury

secondary spinal cord injury

the structure at the top of the axial skeleton that houses the brain and consists of 28 bones that comprise the auditory ossicles, the cranium and the face

skull

the act of declaring that a spinal injury is not present

spinal clearance

the part of the central nervous system that extends downward from the brain through the foramen magnum and is protected by the spine

spinal cord

the temporary local neurologic condition that occurs immediately after trauma; swelling and edema of the spinal cord begin immediately after injury, with severe pain and potential paralysis

spinal shock

stretching or tearing of ligaments

sprain

stretching or tearing of muscles or tendons

strain

bleeding into the subarachnoid space, where the CSF circulates

subarachnoid hemorrhage

the space located between the pia mater and the arachnoid

subarachnoid space

an accumulation of blood beneath the dura but outside the brain

subdural hematoma

bleeding between the periosteum of the skull and the galea aponeurosis

subgaleal hemorrhage

a partial dislocation

subluxation

the part of the diencephalon that is involved in controlling the motor functions

sub thalamus

bleeding between the subgaleal area of the skull and the galea aponeurosis

supragaleal hematoma

subdivision of the ANS that governs the body's fight or flight reaction inducing smooth muscle contraction or relaxation of the vessels and bronchioles

sympathetic nervous system

the portion of the brain that has an important role in hearing and memory

temporal lobe

a structure that separates the cerebral hemispheres from the cerebellum and brainstem

tentorium

the part of the diencephalon that processes most of the sensory input and influences mood and general body movements especially those associated with fear or rage

thalamus

the junction of each pedicle and lamina on each side of a vertebra; these project laterally and posteriorly and form points of attachment for muscles and ligaments

transverse spinous process

a traumatic insult to the brain capable of producing physical, intellectual, emotional, social, vocational changes

traumatic brain injury | TBI

clenching of the teeth owing to spasm of the jaw muscles

trismus

specialized hollow areas of the brain

ventricles

anterior weight bearing structure in the spine made of cancellous bone and surrounded by a layer of hand compact bone that provide support and stability

vertebral body

a type of injury typically resulting from a direct blow to the crown of the skull or rapid deceleration from a fall through the feet, legs, and pelvis, possibly causing a burst fracture or disk herniation

vertical compression

the bone that extends along the front of the skull below the orbit

zygomatic arch