Exam 3: Head Injuries Flashcards

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1
Q

scalp

A
hair
skin
superficial fascia layer
epicranius muscle
deep fascia layer
periosteum
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2
Q

cranium

A

supports and protects brain

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3
Q

meninges

A

three membranes that envelop brain and spinal cord:

  1. dura mater - outer
  2. arachnoid - middle
  3. pia mater - inner
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4
Q

subarachnoid space

A

between arachnoid and pia mater - contains csf

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5
Q

contrecoup injury

A

opposite hit injury - i.e. frontal hit with damage to cerebellum

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6
Q

major brain arteries

A
  1. internal carotid arteries - anterior brain
  2. vertebral arteries - posterior brain
  3. circle of willis - formed by connection of internal carotid and vertebral - ensures continuous blood supply if one or other is damaged
  4. external carotid arteries - scalp and neck
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7
Q

circle of willis

A

formed by connection of internal carotid and vertebral arteries
- ensures continuous blood supply if one is damaged

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8
Q

major veins

A
  1. internal jugular vein - anterior
  2. vertebral veins - posterior
  3. external jugular - scalp and cranium
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9
Q

3 major brain injury classifications

A
  1. skull fracture
  2. focal injuries
  3. diffuse injury
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10
Q

brain injury - skull fracture

A

with or without damage to intracranial structures:

brain, meninges, arteries, veins

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11
Q

brain injury - focal injury

A

localized area of the brain has been contused - internal bleeding - 50% of all injuries - most deaths

  1. epidural/extradural hematoma
  2. subdural hematoma
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12
Q

brain injury - diffuse injury

A

causes wide spread disruption of neural activity - 40% of all hospitalizations - 35% of all head injury deaths
1. cerebral concussion

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13
Q

epidural/extradural hematoma (focal)

A
  • results in arterial bleeding
  • occurs fast
  • occurs under high pressure
  • can cause serious brain injury quickly (minutes)
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14
Q

pathology of epidural/extradural hematoma

A
  1. injury to one or more of the meningeal arteries
  2. meningeal arteries supply blood to the dura mater and brain
  3. meningeal arteries are located in boy grooves in the skull
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15
Q

What area of the brain is damaged in an epidural/extradural hematoma?

A

meningeal arteries - supply blood to dura mater and brain

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16
Q

What is the MOI for an epidural/extradural hematoma?

A
  1. blow to the head
  2. head hits an object
  3. indirect force
17
Q

Diagnostic tests for epi/extradural hematoma

A
  • X-rays
  • mri
  • ct scan
18
Q

signs and symptoms of hematoma

A
  1. loss of consciousness at time of injury
  2. recovery of consciousness in variable period of time
  3. patient is lucid
  4. onset of increasingly severe headache - ER IMMEDIATELY
  5. decreased level of consciousness
  6. dilation of pupil - usually same side as clot
  7. weakness - usually on opposite side of clot
  8. decerebrate posturing
19
Q

Hematoma

A

localized collection of blood outside the blood vessel

20
Q

Subdural hematoma (focal)

A
  1. frequently involves damage to a subdural vein
  2. collection of blood in subdural space
  3. often associated with swelling of brain
  4. occurs more frequently (3:1) than epidural hematomas
21
Q

signs and symptoms of subdural hematoma

A
  1. same as epidural/extradural with one exception:

- symptoms may appear rapidly as in an epidural or may take hours, days, or weeks

22
Q

ipsilateral

A

occurring on same side

23
Q

signs and symptoms of expanding lesion

A
  1. severe headache - increases - most important
  2. visual disturbance
  3. nausea or vomiting
  4. increase in dizziness
  5. inability to concentrate
  6. tinnitis
  7. weakness
  8. pupil change in size
  9. convulsions
  10. blood or csf drainage from ears or nose
  11. slurred speech
  12. increased drowsiness
  13. difficulty in rousing patient
  14. marked slowness of pulse
  15. stiff neck
  16. pulsating pain in eye
  17. unconsciousness
24
Q

What is a concussion?

A

severe shaking or violent jarring of the brain

25
Q

MOI for concussions - Knock-out state

A
  1. disruption in the electrochemical activity of the brain
  2. possibly from anoxia
  3. caused by constriction of blood vessels
26
Q

Concussion scenarios

A
  1. conscious & ambulatory
  2. conscious & non-ambulatory
  3. unconscious
27
Q

concussion severity

A
  1. length of unconsciousness

2. length signs and symptoms persist

28
Q

amnesia

A
  1. anterograde (post traumatic) - inability to recall events that have occurred from the moment of injury
  2. retrograde - inability to recall events prior to injury
29
Q

Second impact syndrome

A
  1. may occur if the athlete is returned to competition before all cerebral functions have cleared
  2. re-injury - chance of death or vegetative state is approx 50% with almost a sure chance of permanent injury
  3. most commonly occurs in football