Exam 3 Flashcards
Meninges
Dura Mater
Arachnoid
Pia Mater
Subarachnoid space
Dura Mater
Outer layer
Arachnoid
middle layer
Web-like
Avascular
Pia Mater
delicate adheres closely to brain
Very vascular
subacrachnoid space
filled with CSF
What assessment is most important/useful in detecting changes
Level of consciousness (LOC)
NEURO assessments
PERRLA V/S LOC Behavior Gait Speech
Neuro Status Red Flags
High-pitched cry
Ataxic breathing
Paradoxic chest movement
hyperventilation
Symptoms of increased ICP
altered LOC, behavior
Pupils sluggish
V/S alterations
Increased ICP in infants
Sun-setting tense bulging fontanel separated cranial sutures destended scalp veins poor feeding irritiability, high pitched cry
Symptoms of IC in children
Headache nausea projectile vomiting blurred vision seizures
LATE symptoms of ICP
bradycardia decreased motor response to command altered perrla decerbrate or decorticate posturing cheynes-strokes papilledema decreased conciousness coma
Primary head injury
Occurs at the moment of impact
Secondary head injury
Brain tissue destruction secondary to hypoxia, hemorrhage, edema, etc
Skull fracture - Linear
dura not involved
Skull fracture - Depressed
bone indented, several irregular fragments push inward
Surgical intervention necessary to elevate fracture
Fragments cause tear in dura, HUGE risk for infection
Skull fracture - Basilar
At base of skull; symptomes include Battle’s sign, raccoon eyes, rhinorrhea, otorrhea, hemotympanum
-usually involve dural tear
Skull fracture - comminuted
fragmentation
Types of head injuries
Concussion Intracranial hemorrhage (epidural & subdural)
Concussion
Transient, reversible neuronal dysfunction!
Posttraumatic amnesia
Post traumatic amnesia - retrograde
Period of time before injury
Post traumatic amnesia - Anterograde
period of memory loss after injury
Post-concussion syndrome
diffuse symptoms of brain dysfunction
- HA
- dizziness
- Impaired concentration
- variable duration
Post-concussion syndrome Infants
Pallor Sweating Irritability Sleepiness Vomiting
