Head Injury Flashcards
A traumatic brain injury is any injury to the head. There are 2 types of traumatic head injury, open and closed. What is a closed head injury?
1 - damage to the head but no penetration of skull
2 - damage to the skull and membranes of skull and brain are compromised
3 - skull damaged leading to PTSD
4 - skull damaged and infection follows
1 - damage to the head but no penetration of skull
- range form toddler bumping head to a severe car accident
A traumatic brain injury is any injury to the head. There are 2 types of traumatic head injury, open and closed. What is a open head injury?
1 - damage to the head but no penetration of skull
2 - damage to the skull and membranes of skull and brain are compromised
3 - skull damaged leading to PTSD
4 - skull damaged and infection follows
2 - damage to the skull and membranes of skull and brain are compromised
- more common in the military settings
A traumatic brain injury is any injury to the head. There are 2 types of traumatic head injury, open and closed. Which one is more common?
- closed
During a closed loop traumatic injury we can hurt our heads from the initial impact (coup) followed by the rebound to the back of the head (contrecoup). During the initial head trauma there are three things that are damaged in the brain, what are they?
1 - neuronal, vascular and/or hearing injury
2 - neuronal, cardiac and/or axonal injury
3 - neuronal, vascular and/or axonal injury
4 - vision, vascular and/or axonal injury
3 - neuronal, vascular and/or axonal injury
During a closed loop traumatic injury we can hurt our heads from the initial impact (coup) followed by the rebound to the back of the head (contrecoup). During the initial head trauma there may be injury to neuronal, vascular and/or axons. What generally follows this?
1 - metabolic and inflammatory process (oedema)
2 - metabolic and cardiac changes
3 - vision and cardiac changes
4 - inflammatory process and blood clot formation
1 - metabolic and inflammatory process (oedema)
During a closed loop traumatic injury we can hurt our heads from the initial impact (coup) followed by the rebound to the back of the head (contrecoup). During the initial head trauma there may be injury to neuronal, vascular and/or axons, followed by metabolic and inflammatory process (oedema). What does this then cause in the CSF?
1 - increased amounts
2 - decreased amounts
3 - impaired regulation in CSF flow
4 - blocked CSF flow
3 - impaired regulation in CSF flow
Following a traumatic brain injury we can damage the brain which can lead to hypo-perfusion. Which of the following does NOT occur due to the hypo-perfusion?
1 - insufficient oxygen
2 - anaerobic glycolysis
3 - aerobic glycolysis
4 - build up of lactic acid
3 - aerobic glycolysis
Following a traumatic brain injury we can damage the brain which can lead to cytotoxic & inflammatory processes, altered cerebral microcirculation and hypoperfusion and failure to deliver vital metabolites. Does this lead to a decrease or increase in excitatory neurotransmitters?
- increase excitatory neurotransmitters
NMDA receptors are now understood to critically regulate a physiologic substrate for memory function in the brain. Following a traumatic brain injury we can damage the brain which can lead to cytotoxic & inflammatory processes, altered cerebral microcirculation and hypoperfusion and failure to deliver vital metabolites. Are the NMDA levels and pathways affected?
- yes
Following a traumatic brain injury we can damage the brain which can lead to cytotoxic & inflammatory processes, altered cerebral microcirculation and hypoperfusion and failure to deliver vital metabolites. What happens to Ca2+ and Na+ levels and what does this lead to?
1 - both increase increasing neuronal excitation
2 - both increase leading to neuronal and axon destruction
3 - both decrease leading to neuronal and axon destruction
4 - both decrease increasing neuronal excitation
2 - both increase leading to neuronal and axon destruction
Following a traumatic brain injury we can damage the brain which can lead to cytotoxic & inflammatory processes, altered microcirculation and hypoperfusion and failure to deliver vital metabolites. This can lead to different types of oedema, vasogenic and cytotoxic oedema. What is vasogenic oedema?
1 - fluid collects inside brain stopping transport across blood brain barrier
2 - fluid collects in space between the brain and skull stopping transport across blood brain barrier
3 - fluid collects inside brain stopping increasing across blood brain barrier
4 - fluid collects extracellularly between the brain and skull increasing permeability of the blood brain barrier
4 - fluid collects extracellularly between the brain and skull increasing permeability of the blood brain barrier
Following a traumatic brain injury we can damage the brain which can lead to cytotoxic & inflammatory processes, altered cerebral microcirculation and hypoperfusion and failure to deliver vital metabolites. This can lead to different types of oedema, vasogenic and cytotoxic oedema. What is cytotoxic oedema?
1 - injured cells leak osmotic solutes that are taken up by other cells in the brain causing oedema
2 - injured cells absorb osmotic solutes that are released from healthy cells in the brain causing oedema
3 - blood brain barrier leaks allowing solutes into brain and causing oedema
1 - injured cells leak osmotic solutes that are taken up by other cells in the brain causing oedema
- generally Na+ and Cl-
What is the most common cause of death and disability in those aged 1-40?
1 - stroke
2 - heart attack
3 - traumatic brain injury
4 - infection
3 - traumatic brain injury
- 40% have a skull fracture
- <1% arriving at ED die
How would we assess a patient with suspected brain trauma?
1 - Mini mental state examination
2 - Glasgow comma scale
3 - Addenbrooke’s Cognitive Examination
4 - Montreal Cognitive Assessment
2 - Glasgow comma scale
Which of the following is not a category of the GCS?
1 - verbal response
2 - eye opening
3 - reflex response
4 - motor response
3 - reflex response
The GCS has 3 sections: verbal response, eye opening and motor response. What is the range of the scores?
1 - 0-15
2 - 1-15
3 - 3-15
4 - 5-15
3 - 3-15
- patients get a 1 for failure to complete a task
What is defined as a mild GCS score?
1 - >14
2 - >13
3 - >12
4 - >8
3 - >12
What is defined as a moderate GCS score?
1 - 12-14
2 - 10-13
3 - >10
4 - 9-12
4 - 9-12
What is defined as a severe GCS score?
1 - <12
2 - <10
3 - >8
4 - <8
4 - <8
- patients are determined as unable to breathe independently
- major fatality patients have moderate or severe GCS