Chapter 28- Head And Spine Injuries Flashcards
What are the two anatomic components of the nervous system?
Central nervous system and peripheral nervous system
What is the central nervous system
The central nervous system is composed of the brain and the spinal cord
What is the peripheral nervous system
The peripheral nervous system conduct sensory and motor impulses from the skin and other organs to the spinal chord
What is the cerebellum for?
Coordinates balance and body movements
The brainstem
Controls all functions that are necessary for life, including cardiac and respiratory systems and nerve function transmissions
Cerebrum
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
What are the four lobes of the brain?
Frontal, parietal, occipital, and temporal
The spinal chord
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.
What is gray matter
Composed of neural cell bodies and synapses, which are connections between nerve cells
What is white matter?
Consists of fiber pathways
Meninges
Three distinct layers of tissue that enclose the brain and the spinal cord within the skull and the spinal canal
What are the three layers of the meninges?
Dura matter, arachnoid, pia matter
Dura matter
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
Arachnoid and pia matter
Inner two layers of the meninges, much thinner then dura matter, and contains blood vessels that nourish the brain and spinal chord
Cerebral spinal fluid (CSF)
Primarily acts as a shock absorber, there is approximately 125 250 mL in the brain any one time
What are the two parts of the peripheral nervous system?
31 pairs of spinal nerves, and 12 pairs of cranial nerves
Cranial nerves
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
What are the two major types of peripheral nerves?
Sensory, and motor
Sensory nerves
Perceives only one type of information, and carries that information from the body to the brain through the spinal cord
Motor nerves
There is one for each muscle, carrying information from the central nervous system to the muscles
Voluntary activities
The actions that we consciously perform, in which sensory input determines the specific muscular activity
Involuntary activities
The actions that are not under our conscious control, such as breathing
Somatic nervous system (voluntary)
The part of the nervous system that regulates or controls our voluntary activities
What is the mechanism of the somatic nervous system?
The brain interprets the sensory information that it receives from the peripheral and cranial nerves in response by sending signals to the voluntary muscles
Autonomic nervous system
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
What twosystems is the Autonomic nervous system divided into?
Sympathetic nervous system and the parasympathetic nervous system
Sympathetic nervous system
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)
Parasympathetic nervous system
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
Intervertebral disks
Cushions separating each vertebrae. Allows the trunk to bend
Signs and symptoms of head injury
- 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
Raccoon eyes
ecchymosis that appears under the eye
Battle sign
Ecchymosis that occurs behind someone’s ear over the mastoid process
Linear school fracture
Non-displaced skull fracture
Depressed skull fracture
Results from high-energy direct trauma to the head with a blunt object. Bony fragment maybe driven into the brain, resulting in injury.
Basilar skull fracture
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
Traumatic brain injury (TBI)
A Trumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes
Primary injury (direct)
Results instantaneously from impact to the head
Secondary injury (indirect)
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
Coup-contrecoup injury
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
Cerebral edema
Swelling of the brain
Intracranial pressure (ICP)
The pressure within the cranial vault
Epidural hematoma
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
Subdural hematoma
An accumulation of blood beneath the Dura matter but outside of the brain. Usually happens in falls or injuries involving strong deceleration forces
Intracerebral hematoma
Bleeding within the brain tissue. May occur from penetrating injury to the head or a rapid deceleration injury.
Subarachnoid hemorrhage
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
Concussion
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
Retrograde amnesia
When the patient can remember everything but the events leading up to the injury (concussion)
Anterograde (post traumatic) amnesia
Inability to remember events after the injury
Axial loading injuries
Injuries where load is applied along the vertical or longitudinal axis of the spine
Treat the patient with a head injury according to what three principals?
- Establish an adequate airway. Begin and maintain ventilation and provide supplemental oxygen
- Control bleeding, and provide adequate circulation to maintain cerebral perfusion. Begin CPR
- Assess the patients baseline of consciousness, and continuously monitor it
What are the signs of Cushing triad?
Increased blood pressure, decreased heart rate, irregular respirations. It’s also referred to as herniation syndrome
How to control bleeding of a scalp laceration
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
Eyes forward position
Gently lift the head until the eyes are looking straight forwards, it makes immobilization easier
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:
- muscle spasms in the neck
- substantial increased pain
- numbness, tingling or weakness in the arms and legs
- compromised airway of ventilations
