Ch 4 Trauma Flashcards
What is the primary injury in traumatic brain injury?
Mechanical distortion of the tissue and disruption of the microvasculature by sheer forces
What constitutes secondary injury in traumatic brain injury?
Primarily ischemic from disruption of the vasculature, increased pressures from edema and hemorrhage
What are the consequences of ischemia in traumatic brain injury?
Aggravates initial traumatic injury, frequently fatal
What are the key components of the pathogenesis of traumatic brain injury?
Disruption of blood flow autoregulation, abrupt rise in catecholamines, rapid increase in blood pressure, direct injury to blood vessels
What happens to energy-dependent ion pumps during traumatic brain injury?
They break down, leading to inappropriate depolarization of membranes and excessive release of excitatory amino acids
What is the difference between coup and counter-coup injuries?
Coup injuries occur at the site of impact; counter-coup injuries occur on the opposite side of impact
What characterizes a concussion?
Temporary impairment of neurological function following rapid acceleration/deceleration during head trauma
What are contusions in the context of traumatic brain injury?
Focal to extensive parenchymal arachnoidal hemorrhages and necrosis with significant edema
What is diffuse traumatic axonal injury (TAI)?
Unconsciousness from impact with shearing forces disrupting nerve fibers or impairing axonal transport
What are lacerations in traumatic brain injury?
Most severe form of traumatic injury with disruption of arachnoidal membranes and underlying parenchyma
What is a common type of hemorrhage in traumatic brain injury?
Extensive subarachnoid or intracerebral hemorrhages
What are Gitter cells?
Large, foamy macrophages that remove necrotic debris
What do hemosiderophages contain?
Brown/gold pigment globules
Does brain tissue regenerate after trauma?
No, brain tissue does not regenerate
What is the hallmark of spinal cord injury histopathology?
Axonal damage, characterized by axonal swelling with spheroids within dilated myelin sheaths
What is IVDD?
Intervertebral disc disease, often occurring between T10-L3
What is the difference between Hansen type I and type II disc injuries?
Type I is disc extrusion; Type II is disc protrusion
What are the possible pathomechanisms of spinal cord injury?
Vascular damage, hemorrhage, excitotoxicity, inflammatory mediators, reactive oxygen species
What is the significance of elevated serum GFAP?
It is associated with spinal cord injury/myelomalacia
What type of cells are primarily involved in the inflammation response after spinal cord injury?
Neutrophils first, then macrophages/microglia
What is a common complication if lacerations are associated with bone fractures?
Increased risk of infection
