Head Injury (Gas #14)

Question 1

Concussion

Answer 1

momentary interruption of brain function with or without LOC

Question 2

s/s of a concussion

Answer 2

Photophobia (sensitivity to light), Amnesia, HA, N/V, blurry vision

Question 3

Discharge planning for a concussion

Answer 3

once home, monitor for 24 hrs, wake them up q 2 hrs to monitor mental status, competent caretaker

Question 4

How long does kid have to wait until he/she can play sport again after Sports related concussion

Answer 4

1 week WITH medical clearance

Question 5

Second Impact Syndrome

Answer 5

rapid swelling after injury

Question 6

Mild severity of concussion

Answer 6

transient loss or altered state of consciousness

Question 7

Moderate severity of concussion

Answer 7

loss of consciousness more than 30 minutes

Question 8

Severe severity of concussion

Answer 8

loss of consciousness lasting longer than 2 hours

Question 9

Very severe severity of concussion

Answer 9

loss of consciousness lasting longer than seven days

Question 10

<14 years of age when will deficits from a concussion resolve?

Answer 10

within 3 months; severe deficits within 5 years

Question 11

Mild head injury Glascow Coma rating

Answer 11

13-15

Question 12

Moderate head injury Glascow Coma rating

Answer 12

9-12

Question 13

Severe head injury Glascow Coma rating

Answer 13

8 or less

Question 14

Glascow Coma Scale

Answer 14

rating on eye opening, verbal response, best motor response; greater the # the better

Question 15

FOUR scale stands for?

Answer 15

Full Outline of Unresponsiveness score

Question 16

FOUR scale

Answer 16

motor and eye opening responses (pupil rxns, respiratory pattern

Question 17

Balance Error Scoring

Answer 17

Can be used on the side-line to determine sports related head injuries; determines ability to play, checks for balance problems

Question 18

Immediate head injury treatment

Answer 18

ABC’s, control bleeding-surgery intervention, Monitoring & controlling intracranial pressure, treat other injuries

Question 19

Primary Injury

Answer 19

inital damage to the brain resulting from a traumatic event ex. contusions, lacerations, torn vessels

Question 20

Secondary Injury

Answer 20

hrs & days after the initial injury. due to lack of 02 & nutrients to cells. Due to cerebral edema, ischemia, seizures, infection, hyperthermia, hypovolemia & hypoxia

Question 21

Contusions/bleeds

Answer 21

intracranial hemorrhage; bruise on brain

Question 22

How to get a contusion/bleed

Answer 22

direct trauma, shearing forces on arteries/veins,

Question 23

what determines s/s & time when symptoms occur with a contusion/bleed

Answer 23

site & rate of bleeding determines s/s & time when symptoms occur

Question 24

Epidural Intracranial bleed

Answer 24

bleed between dura & skull (burr holes are commonly used with this)

Question 25

Subdural intracranial bleed

Answer 25

between dura & arachnoid mater (brain); may be slow or fast

Question 26

Intracerebral intracranial bleed

Answer 26

in actual brain tissue ex. bullets or stab injury

Question 27

Burr holes are commonly used with which intracranial bleed?

Answer 27

Epidural and large acute subdural hematomas

Question 28

4 things you assess with Intracranial Bleed

Answer 28

1.)altered LOC 2.) changes in sensory or motor function 3.) pupil change 4.) vs changes

Question 29

Acceleration injury

Answer 29

The head is struck by a moving object

Question 30

Deceleration injury

Answer 30

when the head hits a stationary object

Question 31

Acceleration-deceleration (coup-countercoup phenomenon)

Answer 31

occurs when the head hits an object & the brain "rebounds" within the skull

Question 32

Penetrating Head injury

Answer 32

open brain injury; broken bones-youll see gray matter

Question 33

Closed head concussion (blunt)

Answer 33

a momentary interruption of brain function with or without loss of consciousness due to the blow to the head or a acceleration-deceleration injury

Question 34

Intracranial hemorrhage examples

Answer 34

Epidural, subdural, Intracerebral

Question 35

Skull fractures are classified as

Answer 35

open (dura is torn); closed (dura isnt torn) & 1)Liner 2)Comminuted/Depressed 3)Basilar

Question 36

Linear (Simple) Fractures, is dura intact? what can cause this?

Answer 36

most common, dura usually intact, subdural or epidural hematoma frequently underly the fracture

Question 37

Communited fractures

Answer 37

the bone is crushed into small fragmented pieces

Question 38

Depressed fractures

Answer 38

there is an inward depression of bone fragments

Question 39

with Communited/Depressed fractures is dura intact? what may be in brain tissue?

Answer 39

dura may or may not be intact, bone fragments may penetrate into the brain tissue

Question 40

Where do basilar fractures occur?

Answer 40

usually at the base of the skull, may involve the frontal sinus or temporal bone

Question 41

Manifestations of CSF leakage with Basilar fractures include

Answer 41

Rhinorrhea or otorrhea (test for glucose), "Halo" sign

Question 42

"Halo sign with basilar fractures

Answer 42

observe for blood tinged fluid, CSF dries in concentric rings on gauze or tissues

Question 43

Basilar fractures

Answer 43

if dura is disrupted, CSF may leak through tear; "Halo" & Battles sign may appear

Question 44

Battles sign with basilar fractures

Answer 44

seen several days after basilar fracture. there may be bloody drainage from ear right after fracture occured

Question 45

Craniotomy

Answer 45

part of skull is removed in order to evacuate chronic subdural hematomas

Question 46

Cushings response

Answer 46

when cerebral blood flow decreases significantly when brain is ischemic, it triggers an increase in arterial pressure to overcome the ICP

Question 47

Cushings Triad

Answer 47

brain trying to stabilize and fails; bradycardia, HTN, bradypnea

Question 48

3 s/s of cushings response

Answer 48

1)increase in systolic pressure 2)increase widing pulse pressure (S&D #s getting farther away) 3)bradycardia, bradyonea

Question 49

Brain stem function

Answer 49

automatic functions- heart rate,, breathing, swallowing, motor & sensory pathways

Question 50

Brain Stem consists of?

Answer 50

Mid-brain, Pons, Medulla oblongata

Question 51

Decorticate posturing & location

Answer 51

abnormal flexion of upper extremities; indicates damage to upper midbrain

Question 52

Decerebrate posturing & location

Answer 52

extreme extension of upper & lower extremities & indicates severe damage to brain @ lower midbrain & upper pons

Question 53

Locked in syndrome

Answer 53

a lesion affecting the pons or mid brain that causes tetraplegia & inability to speak