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Emergency care and transport of the sick and injured textbook > Chapter 28- Head And Spine Injuries > Flashcards

Chapter 28- Head And Spine Injuries Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What are the two anatomic components of the nervous system?

A

Central nervous system and peripheral nervous system

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2
Q

What is the central nervous system

A

The central nervous system is composed of the brain and the spinal cord

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3
Q

What is the peripheral nervous system

A

The peripheral nervous system conduct sensory and motor impulses from the skin and other organs to the spinal chord

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4
Q

What is the cerebellum for?

A

Coordinates balance and body movements

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5
Q

The brainstem

A

Controls all functions that are necessary for life, including cardiac and respiratory systems and nerve function transmissions

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6
Q

Cerebrum

A

Contains about 75% of the brains total volume. Controls most voluntary motor function and conscious thought. It’s the main part of the brain and divided into two hemispheres and four lines

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7
Q

What are the four lobes of the brain?

A

Frontal, parietal, occipital, and temporal

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8
Q

The spinal chord

A

Mostly made up of fibers that extend from the brains nerve cells. The spinal cord carries messages between the brain and the body by the gray and white matter.

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9
Q

What is gray matter

A

Composed of neural cell bodies and synapses, which are connections between nerve cells

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10
Q

What is white matter?

A

Consists of fiber pathways

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11
Q

Meninges

A

Three distinct layers of tissue that enclose the brain and the spinal cord within the skull and the spinal canal

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12
Q

What are the three layers of the meninges?

A

Dura matter, arachnoid, pia matter

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13
Q

Dura matter

A

A tough fibrous layer that closely resembles leather, it forms a sac to contain the CNS, with small openings for the peripheral nerves to exit

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14
Q

Arachnoid and pia matter

A

Inner two layers of the meninges, much thinner then dura matter, and contains blood vessels that nourish the brain and spinal chord

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15
Q

Cerebral spinal fluid (CSF)

A

Primarily acts as a shock absorber, there is approximately 125 250 mL in the brain any one time

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16
Q

What are the two parts of the peripheral nervous system?

A

31 pairs of spinal nerves, and 12 pairs of cranial nerves

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17
Q

Cranial nerves

A

The 12 pairs of nerves that emerge from the brainstem and transmit information directly to or from the brain. I mostly perform special functions in the head and face, including sight, smell, taste, hearing, and facial expressions

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18
Q

What are the two major types of peripheral nerves?

A

Sensory, and motor

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19
Q

Sensory nerves

A

Perceives only one type of information, and carries that information from the body to the brain through the spinal cord

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20
Q

Motor nerves

A

There is one for each muscle, carrying information from the central nervous system to the muscles

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21
Q

Voluntary activities

A

The actions that we consciously perform, in which sensory input determines the specific muscular activity

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22
Q

Involuntary activities

A

The actions that are not under our conscious control, such as breathing

23
Q

Somatic nervous system (voluntary)

A

The part of the nervous system that regulates or controls our voluntary activities

24
Q

What is the mechanism of the somatic nervous system?

A

The brain interprets the sensory information that it receives from the peripheral and cranial nerves in response by sending signals to the voluntary muscles

25
Q

Autonomic nervous system

A

Body functions that occur without conscious effort. It controls many of the functions of many of the bodies vital organs over which the brain has no voluntary control

26
Q

What twosystems is the Autonomic nervous system divided into?

A

Sympathetic nervous system and the parasympathetic nervous system

27
Q

Sympathetic nervous system

A

In a threatening situation, the sympathetic nervous system reacts to the stress with the fight or flight response. The pupils dilate, smooth also in the Longs dilate, heart rate increases, and blood pressure rises. Epinephrine is released into the system (adrenaline)

28
Q

Parasympathetic nervous system

A

It’s the opposite effect on the body of the sympathetic nervous system. It causes blood vessels to dilate, slowing the heart rate, and relaxing the muscles sphincters. The body attempt to maintain Homeostasis

29
Q

Intervertebral disks

A

Cushions separating each vertebrae. Allows the trunk to bend

30
Q

Signs and symptoms of head injury

A
  • Lacerations, contusions, or hematomas to the scalp
  • soft area or skull depression on palpation
  • irregular breathing pattern
  • A period of unconsciousness
  • seizures
  • dizziness
  • visual complaints
  • nausea or vomiting
  • failure for the pupils to react too light, or pupils unequal size
  • unusual behavior
31
Q

Raccoon eyes

A

ecchymosis that appears under the eye

32
Q

Battle sign

A

Ecchymosis that occurs behind someone’s ear over the mastoid process

33
Q

Linear school fracture

A

Non-displaced skull fracture

34
Q

Depressed skull fracture

A

Results from high-energy direct trauma to the head with a blunt object. Bony fragment maybe driven into the brain, resulting in injury.

35
Q

Basilar skull fracture

A

Associated with high-energy trauma, but usually occur following diffuse impact to the head. Result from extension of a linear fracture to the base of the skull. Macy raccoon I was, battle signs, or CSF drainage from the ears

36
Q

Traumatic brain injury (TBI)

A

A Trumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes

37
Q

Primary injury (direct)

A

Results instantaneously from impact to the head

38
Q

Secondary injury (indirect)

A

Refers to a multitude of processes that increase the severity of a primary brain injury and negatively impact the outcome. Cerebral Adema, intracranial hemorrhage, increased intracranial pressure, cerebral ischemia, and infection

39
Q

Coup-contrecoup injury

A

When the brain strikes the front of the skull on an object, in the head falls back against something in the brain slams into the rear of the school. For example, rapid deceleration in a car

40
Q

Cerebral edema

A

Swelling of the brain

41
Q

Intracranial pressure (ICP)

A

The pressure within the cranial vault

42
Q

Epidural hematoma

A

In accumulation of blood between the Skull and Dura matter. Usually occurs in a blow to the head that produces a linear fraction of the temporal bone

43
Q

Subdural hematoma

A

An accumulation of blood beneath the Dura matter but outside of the brain. Usually happens in falls or injuries involving strong deceleration forces

44
Q

Intracerebral hematoma

A

Bleeding within the brain tissue. May occur from penetrating injury to the head or a rapid deceleration injury.

45
Q

Subarachnoid hemorrhage

A

Bleeding occurs into the subarachnoid space where CSF circulates. It results in bloody CSF and signs of meningeal irritation. Common causes include trauma or rupture of an aneurysm

46
Q

Concussion

A

A closed injury with a temporary altercation or loss of part or all of the brains ability to function without demonstrable damage to the brain

47
Q

Retrograde amnesia

A

When the patient can remember everything but the events leading up to the injury (concussion)

48
Q

Anterograde (post traumatic) amnesia

A

Inability to remember events after the injury

49
Q

Axial loading injuries

A

Injuries where load is applied along the vertical or longitudinal axis of the spine

50
Q

Treat the patient with a head injury according to what three principals?

A
  1. Establish an adequate airway. Begin and maintain ventilation and provide supplemental oxygen
  2. Control bleeding, and provide adequate circulation to maintain cerebral perfusion. Begin CPR
  3. Assess the patients baseline of consciousness, and continuously monitor it
51
Q

What are the signs of Cushing triad?

A

Increased blood pressure, decreased heart rate, irregular respirations. It’s also referred to as herniation syndrome

52
Q

How to control bleeding of a scalp laceration

A

A. Use a dry sterile dressing to fold torn skin flaps back down onto the skin bed before applying pressure
B. If you do not suspect an open brain injury or skull fracture, apply firm compression for several minutes to control bleeding
C. Secure the compression dressing in place with soft, self adhering roller bandage

53
Q

Eyes forward position

A

Gently lift the head until the eyes are looking straight forwards, it makes immobilization easier

54
Q

You should never force the head into a neutral inline position. Do not move the head any farther if the patient reports any of the following symptoms:

A
  • muscle spasms in the neck
  • substantial increased pain
  • numbness, tingling or weakness in the arms and legs
  • compromised airway of ventilations

Emergency care and transport of the sick and injured textbook (37 decks)

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