Head and Spine Trauma Flashcards
Learn the different interventions and causes of Head and Spine trauma
What are the layers of scalp?
- Hair and skin
- Subcutaneous tissue
- Galea Aponeurotica
- Loose connective tissue
- Periosteum: covers the surface of the bone
Define:
Foramen Magnum
A large opening at the base of the skull where the brain connects to the spinal cord.
It is the location where the brain can herniate.
What is the purpose of sutures on the skull?
It connects the different sections of bones on the skull.
What is the purpose of fontanelles?
It links the sutures together.
Define:
Crista Galli
A prominent bony ridge in the center of the anterior fossa and is the point of attachment for meninges.
Define:
Cribriform Plate
A passage for olfactory nerve filaments from the nasal cavity.
What is the function of the olfactory nerves?
smell
What are the major regions of the brain?
- Cerebellum
- Diencephelon
- Brainstem
- Cerebrum
What is the function of the Frontal lobe?
Voluntary motor actions and emotion.
What is the function of the Parietal lobe?
- voluntary sensory and motor functions
- memory and emotions
What is the function of the Occipital lobe?
vision
What is the function of the Temporal lobe?
speech
What is the function of the Limbic System?
- motivation
- emotions
- mood
- sensations of pain and pleasure
Define:
Meninges
A protective layer that surrounds the brain and spinal cords.
What are the layers of Meninges?
List from top to bottom.
- Dura
- Arachnoid
- Pai
Remember using the acronym “DAP”.
_______ ______ _____ is manufactured in the ventricles of the brain.
Cerebral spinal fluid
What is the function of Subarachnoid Space?
The space where the CSF flows.
What are the components of the vertebrae?
- Spinous Process
- Pericles
- Lamina
How many pairs of spinal nerves are there in the human body?
31
What is the function of facial and trigeminal nerve?
facial feeling and function
What are the MOI criteria that suggest a possible spinal injury?
- Greater than 40 mph crash.
- Unrestrained occupant.
- 12 inch intrusion to vehicle.
- Fall from three times the person’s height.
What happens to the brain during a coup contra coup injury?
- Brain hits front of head.
- Brain hits back of the head.
Fill in the blank.
You need at least ____ mmHg of Cerebral Perfusion Pressure to perfuse the brain.
60
Treatment:
Hypotension with head injury
IVF 20 ml/kg
Blood pressure must be sustained at >110-120 mmHg systolic.
Fill in the blank
Injury to ____ to ___ may stop breathing because it is innervated by the phrenic nerve.
Hint: cervical vertebrae
C3, C5
Fill in the blank.
Consider RSI in a head injury if GCS is < ___.
8
Treatment:
RSI with ICP
- Preoxygenate
- Administer a lidocaine bolus of 1 - 1.5 mg/kg.
- Use two-man intubation to stabilize the head.
What are the three ICP grades and its indications?
Mild:
- pupils reactive
- increased BP
- Cheyne-Stokes respirations
- headache
- vomiting
Moderate:
- widened pulse pressure
- pupils sluggish
- bradycardia
- Kussmaul respirations
- decerebrate posturing
Severe:
- irregular bradycardic pulse
- widened BP
- Biot respirations
- blown pupils unilaterally
- decorticate posturing
Define:
Babinski Reflex
The toes move upward in response to stimulation of the sole of the foot.
In normal circumstances, the toes move downward.
What are the indications of Basilar skull fracture?
- CSF drainage
- raccoon eyes
- battle signs
May show up 24 hours after injury.
What are the primary and secondary injuries of a TBI?
- Primary: injury from impact
- Secondary: edema, ICP, cerebral ischemia after the injury
What is the normal ICP?
0-15 mmHg
Define:
brain herniation
The brain is forced through the foramen magnum.
What are the indications of the Cushing’s triad?
- Hypertension (widening pulse pressures)
- Bradycardia
- Irregular respirations
What is a diffuse brain injury?
Injury that affects the entire brain.
What causes a cerebral concussion?
When the brain is jarred in the cranial vault.
Define:
Retrograde Amnesia
Inability to recall memories that were formed before the onset of amnesia.
Define
Anterograde Amnesia
Inability to recall memories that were formed after the onset of amnesia.
Define:
Diffuse Axonal Injury
DAI
Stretching of brain tissue from twisting motion at brainstem.
Typically caused from high-speed collision forces.
What are the signs/symptoms of epidural hematoma?
- LOC
- wakes up, passes back out
What are the signs/symptoms of subdural hematoma?
- Slurred speech
- Unilateral Hemiparesis
Venous bleed that takes longer to show signs/symptoms.
What are the signs/symptoms of subarachnoid hematoma?
- sudden severe headache
- posturing
- vomiting
- decrease LOC
- seizures
Treatment:
exposed brain tissue
Cover with moist, sterile dressings.
What are the complications of scalp lacerations?
serious blood loss
What is the cause of flexion injuries?
Forward movement of neck.
Define:
subluxation
Partial dislocation of the spinal column.
What is the cause of vertical compression?
Forces transmitted through the spine from feet or head.
What is the cause of hyperextension?
Head and neck extend backwards.
What are the primary and secondary injuries of a spinal cord injury?
- Primary: injury at impact
- Secondary: edema after impact
What are the signs/symptoms of Anterior Cord Syndrome?
- Decreased movement.
- Loss of sensation to touch, temperature, and pain.
What are the signs/symptoms of Central Cord Syndrome?
- Decreased sensation.
- Loss of sensation to pain and temperature.
What are the signs/symptoms of Posterior Cord Syndrome?
Loss of sensation to light, vibration, and perception of one’s body.
Define:
Cauda Equina Syndrome
Compression of distal nerve roots.
Horse’s Tail
Define:
Brown-Séquard Syndrome
Damage to hemisection of cord causing symptoms on one half of the lateral body.
How should rapid extrication with C-spine precautions be performed?
Hold C-spine and extract in one full motion quickly.
When do you remove a helmet with suspected spinal injury?
- Remove if chin strap and helmet fail to hold head in line.
- Prevents immobilization for transport.
- Prevents adequate airway control.
How do you treat C-Spine in the water?
Completely board and strap patient in water before moving to land.
What is the formula for cerebral perfusion pressure?
CPP
CPP= (MAP)−(ICP)
