Class 15 Flashcards
Traumatic brain injury
any injury that affects the skin, skull or the brain
causes of traumatic brain injury
motor vehicle accidents, blunt trauma, falling, sports and violence
groups at risk for traumatic brain injury
young adults (for MVAs), children and toddlers (for falls) and males of any age
a penetrating injury is also called?
an open injury
in a penetrating injury, the skull is _____ and the brain/meninges are _____?
the skull is not intact and the brain/meninges are exposed
a blunt injury is also called a?
closed injury
In a blunt injury, the skull is _____ and the brain/meninges are ______?
the skull is intact and the brain/meninges are not exposed
what is the more common mechanism of traumatic brain injury?
blunt injury
A focal brain injury is often associated with?
a direct impact to the head
Focal injuries are?
localized
Diffuse injuries are?
widespread and not limited to a localized area
What is an example of a diffuse brain injury?
shaken baby syndrome
What are the 3 types of focal brain injuries?
skull fractures, contusions and hematomas
What are the 3 types of skull fractures?
- linear
- depressed
- basilar
In which type of skull fractures are racoon eyes and battle’s sign seen?
basilar
contusion
bruising of brain tissue
contusions are frequently located on the?
frontal and temporal lobes
which type of injuries are often coup-countercoup injuries?
contusions
coup-countercoup injuries
two contusions on opposite sides of the brain. May result in two focal injuries or a diffuse axonal injury throughout
hematoma
accumulation of clotted blood within the tissues
which are affected in epidural hematomas: arteries or veins?
mostly arteries
which hematoma will accumulate faster?
epidural because arteries are affected
which are affected in subdural hematomas: arteries or veins?
veins
which type of hematoma involves a brief loss of consciousness?
epidural
which hematoma has has a slower onset of symptoms?
subdural
which type of hematoma is more common?
subdural
Intracerebral hematoma
accumulation of blood in the parenchyma of brain tissue rather than the meninges
what are they 2 types of diffuse brain injury?
concussion and diffuse axonal injury
Concussion
transient neurological dysfunction do to a traumatic impact
Classic cerebral concussion
may include a loss of consciousness up to 6 hours but no longer than that
Mild concussion
has no loss of consciousness
manifestations of concussion
headache, confusion, disorientation, dizziness, visual disturbances and memory deficits
retrograde amnesia
lost memory of past events
anterograde amnesia
difficulty forming new memories
post concussive syndrome
persistent headache, anxiety, irritability, insomnia, difficulty concentrating, depression.
Chronic traumatic encephalopathy
- occurs post concussion
- progressive degeneration of brain tissue
- accumulation of tau (abnormal protein)
Where does a diffuse axonal injury occur
where grey matter meets white matter, this is where axons are the weakest
Why are infants more at risk for a diffuse axonal brain injury?
they have proportionally large heads and weak neck muscles
Aphasia
absense or inability to create speech
dysphasia
abnormal speech
agnosia
difficulty understanding speech or written words
Flexion spinal cord injury
chin snaps down to chest. Occurs in blows to back of head and front impact collisions
extension spinal cord injuries occur with?
falls and rear impact collisions
where will edema be in a spinal cord injury?
at the level of injury and 2 cord segments above and below
Spinal shock
flaccid paralysis and loss of reflexes below the injury. Lasts 7 days to 3 months
where would a spinal cord injury have to be for respiratory failure to occur?
C4 and above
What is an important complication of spinal cord injuries?
autonomic dysreflexia
Where must a spinal cord injury be located for autonomic dysreflexia to occur?
T6 or above
What is a complication of autonomic disreflexia?
stroke, due to extreme hypertension in upper extremities
What would a person with autonomic dysreflexia look like?
Pale below the injury and red above it
Would a person with autonomic dysreflexia have tachycardia or bradycardia?
they would have bradycardia
