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FINALS 304 LEC (22-23) > CHAPTER 16: MANAGEMENT OF PATIENT WITH NEUROLOGIC TRAUMA > Flashcards

CHAPTER 16: MANAGEMENT OF PATIENT WITH NEUROLOGIC TRAUMA Flashcards

1
Q

describes an injury that is the result of an external
force and is of sufficient magnitude to interfere
with daily life and prompts the seeking of
treatment.

A

Traumatic Brain Injury (TBI) or craniocerebral trauma

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2
Q

Classifications of Head Injury

A

Primary Injury
Secondary Injury

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3
Q

consequence of direct contact to the head/brain
during the instant of initial injury, causing extracranial
focal injuries (e.g., contusions, lacerations, external
hematomas, and skull fractures)

A

Primary Injury

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4
Q

evolves over the ensuing hours and days after the
initial injury and results from inadequate delivery of
nutrients and oxygen to the cells

A

Secondary Injury

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5
Q

Minor injury but the scalp bleeds profusely because blood vessels constricts poorly; May result in an abrasion, contusion, laceration

A

Scalp Injury

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6
Q

Break in the skull due to forceful trauma; may occur with or without brain damage.

A

Skull Fracture

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7
Q

Types of Skull Fracture

A

Simple Linear
Comminuted
Depressed
Basilar

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8
Q

Skull Fracture: Break in the continuity of the bone

A

Simple Linear

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9
Q

Skull Fracture: Splintered on multiple fracture line

A

Comminuted

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10
Q

Skull Fracture: Bone fragments are embedded into brain tissue

A

Depressed

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11
Q

Skull Fracture: Fracture at the base of the skull

A

Basilar

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12
Q

What are the clinical manifestations of basilar fracture?

A

Battle’s Sign - mastoid bruising (ilalim ng ears)
Racoon’s Eye - ecchymosis in the eyes
Otorrhea - CSF escape in the ears
Rhinorrhea - CSF escape in the nose

Rationale: Basilar fracture tends to traverse to the paranasal sinus thus produce hemorrhage in the nose, pharynx & ears

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13
Q

Mastoid bruising

A

Battle’s Sign

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14
Q

Ecchymosis in the eyes

A

Racoon’s eye

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15
Q

CSF escape in the ears

A

Otorrhea

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16
Q

CSF escape in the nose

A

Rhinorrhea

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17
Q

Medical Management for non-depressed

A

Close monitoring for 24 hrs; mgh; no surgery

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18
Q

Medical Management for depressed

A

require surgery with elevation of the skull and débridement, usually within 24 hours of injury.

19
Q

Mechanisms of Brain Injury

A

Closed (Blunt) Injury
Open Brain Injury

20
Q

head accelerates & then rapidly decelerates or collide with another object & brain tissue is damaged but there is no opening through skull or dura

A

Closed (Blunt) Injury

21
Q

an object penetrates the skull, enters the brain, damages the soft brain tissue or when blunt trauma is severe that it opens the scalp, skull and dura to expose the brain

A

Open Brain Injury

22
Q

Type of Brain Injury: the brain is BRUISED and damaged in a specific area because of severe acceleration–deceleration force or blunt trauma

A

Contusion

23
Q

Type of Brain Injury: Hematomas are collections of blood in the brain that may be epidural (above the dura), subdural (below the dura), or intracerebral (within the brain)

A

Intracranial Hemorrhage

24
Q

Collection of blood in the epidural (extradural) space between the skull and the dura mater.

A

Epidural Hematoma

25
Q

a collection of blood between the dura and the brain, a space normally occupied by a thin cushion of fluid

A

Subdural Hematoma

26
Q

Medical Management of Intracerebral Hemorrhage and Hematoma

A

➢control of ICP
➢careful administration of fluids, electrolytes,
➢antihypertensive medications

27
Q

Surgical Management of Intracerebral Hemorrhage and Hematoma

A

> craniotomy or craniectomy permits removal of the blood clot and control of hemorrhage

28
Q

temporary loss of neurologic function with no apparent structural damage of the brain. ; mechanism of injury is usually blunt trauma from an acceleration–deceleration force, a direct blow, or a blast injury

A

Concussion

29
Q

results from widespread
shearing (tearing) and rotational forces
that produce damage
throughout the brain—to
axons in the cerebral
hemispheres, corpus
callosum, and brainstem.

A

Diffuse Axonal Injury

30
Q

3 Cardinal Signs of Brain Death

A

Coma
the absence of brainstem reflexes
Apnea

31
Q

Test to Confirm Brain Death

A

cerebral blood flow studies
electroencephalogram (EEG)
transcranial Doppler
brainstem auditory-evoked potential,

32
Q

A tool for assessing a patient’s response to stimuli

A

Glasgow Coma Scale
Scores range from 3 (deep coma) to 15 (normal)

33
Q

What does the GCS contain?

A

Eye-opening response
Best verbal response
Best motor response

34
Q

What is used to assess LOC at regular intervals?

A

GCS
Rationale: changes in the LOC precede all other changes in vital and neurologic signs.

35
Q

What is monitored at frequent intervals to assess the intracranial status?

A

Vital Signs

36
Q

Vital Signs: Signs of increasing ICP include:

A

✓ slowing of the heart rate (bradycardia),
✓ increasing systolic blood pressure
✓ widening pulse pressure (Cushing reflex)
✓ respirations become rapid
✓ blood pressure may decrease
✓ pulse slows further
✓ temperature is maintained at less than 38°C
✓ Tachycardia and arterial hypotension may indicate that bleeding is occurring elsewhere in the body

37
Q

Which areas do SCI commonly occur?

A

C5, C6, C7, T12, L1
Rationale: This area has a greater range of mobility in the vertebral column in this areas

38
Q

Causes of SCI

A

MVA
Gun shots
Falls
Sports injuries

39
Q

SCI Classification: result of the initial insult or trauma,
usually permanent

A

Primary Injury

40
Q

SCI Classification: resulting from SCI include edema and hemorrhage

A

Secondary injury

41
Q

TYPE of SCI: ➢signifies loss of both sensory and
voluntary motor communication from
the brain to the periphery, resulting in
paraplegia or tetraplegia

A

Complete Spinal Cord Lesion

42
Q

TYPE OF SCI: ➢denotes that the ability of the spinal
cord to relay messages to and from the
brain is not completely absent

A

Incomplete Spinal Cord Lesion

43
Q

➢complete injury in the
thoracic area causes
complete paralysis in the
legs but the arms can still
function

A

paraplegia

44
Q

➢paralysis of all four
extremities; formerly
called quadriplegia

A

tetraplegia/quadriplegia

FINALS 304 LEC (22-23) (3 decks)

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