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EMT > Head & Spine Injuries > Flashcards

Head & Spine Injuries Flashcards

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1
Q

Basilar skull fracture

A

Fractures to the floor of the cranium

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2
Q

Basilar skull fracture can lead to?

A
  • CSF drainage from nose and ears
  • Battle signs
  • Raccoon eyes
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3
Q

Dura mater

A

Outer most meninges “hard mother” composed of a double layer of tough, fibrous tissue.

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4
Q

Arachnoid

A

Next layer after the dura mater

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5
Q

Pia Mater

A

The next layer after arachnoid and in contact with the brain “soft mother”

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6
Q

3 layers of Meninges

A
  1. Dura Mater
  2. Arachnoid
  3. Pia Mater
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7
Q

Layers of the head

A
  1. Cranium
  2. Dura Mater
  3. Arachnoid
  4. Pia Mater
  5. Cerebral Cortex
  6. Cerebellum
  7. Medulla Oblongata
  8. Spinal Cord
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8
Q

Subarachnoid Space

A

A lattice of fibrous spongy tissue filled with cerebrospinal fluid that separates the arachnoid membrane and Pia Mater.

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9
Q

Epidural

A

Bleeding between the dura mater and the skull, usually involves the brain’s outermost arteries.

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10
Q

Subarachnoid Hemorrhage

A

Bleeding that occurs between the arachnoid membrane and the surface of the brain.

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11
Q

Cerebrum

A
  • Responsible for conscious and sensory functions, emotions, and personality.
  • Largest part of the brain, three-fourths of the brain’s volume.
  • Divided into two hemispheres (right and left)
  • Each hemisphere is made up of four distinct lobes: Frontal, parietal, occipital, and temporal lobe
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12
Q

Cerebellum

A

-“Little brain” controls equilibrium and coordinates muscle activity.

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13
Q

Brainstem

A
  • Made up of pons, midbrain, and Medulla Oblongata
  • Controls Automatic functions of the body including cardiac, respiratory, vasomotor (Blood Pressure), and other functions vital to life.
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14
Q

Medulla Oblongata

A
  • Responsible for involuntary or automatic functions of the body including cardiac, respiratory, and vasomotor
  • Connects brain to spinal cord
  • All messages between the brain and spinal cord passes through the medulla
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15
Q

Scalp Injuries

A
  • Has a heavy blood supply

- Can lead to difficulty detecting skull fractures

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16
Q

Linear skull fracture

A
  • Most common type
  • Resembles a line
  • Diagnosed only through a radiograph
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17
Q

Depressed Fracture

A

-Occurs when the bone ends are pushed inward toward the brain

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18
Q

Primary Brain Injury

A
  • The result of trauma to the brain that occurs at the time of accident.
  • EMT can’t do anything to reverse the damage done by primary brain Injury.
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19
Q

Coup-Countercoup Injury

A

Occurs when one side is hit and then bounces to the opposite side due to the force of the impact.

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20
Q

Brain Contusion

A
  • Bruising or Swelling of brain tissue

- May accompanied by concussion

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21
Q

Subdural hematoma

A

-Blood gathers between the inner layer of the dura mater and the Arachnoid mater.
-Bleeding due to tearing of blood vessels on the surface of the brain
-Generally venous Bleeding
•Bridging Veins
-Mortality Rate higher than epidural

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22
Q

Epidural Hematoma

A

-Bleeding between skull and protective covering of brain (Dura Mater)
-Usually arterial Bleeding
•Middle meningeal
-TBI S/Sx and lucid intervals of concussion

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23
Q

Secondary Brain Injury

A

-The pathophysiologic processes following primary brain injury, can continue for hours to days.

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24
Q

You must prevent these things from happening during secondary brain injury

A
  • Hypotension (Maintain 90 Systolic or above)

- Hypoxia (Maintain O2 sat 95% or above)

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25
Q

Brain Herniation

A

-Brain is squeezed across structures within the skull due to Herniation from a Hematoma

26
Q

Cushing’s Triad

A
  • Increased BP
  • Bradycardia
  • Cheyenne-Stokes respirations
27
Q

Inter Cranial Pressure (ICP) S/Sx

A

-Blown pupil on one side
-Weakness or paralysis
-Severe changes of mental status
-Non-purposeful movement
•Decorticate
•Decerebrate
-Cheyne-stokes
-Cushing Reflex

28
Q

Cushing Reflex

A
  • Increased BP

- Slow Pulse

29
Q

Concussion

A
  • Mild head injury
  • No actual Damage to brain tissue
  • Will have traumatic brain injuries but will show immediately and will progressively improve
30
Q

Concussion S/Sx

A
  • Loss of consciousness
  • No recall of event
  • Repetitive questioning
31
Q

Laceration head injury

A
  • Usually Caused by penetrating injury
  • Permanent Injury
  • May cause nervous system disruption
32
Q

Assessing head injury pt

A 
-Primary focus on:
  •Spinal motion restriction
  •Mental status/AVPU
  •Purposeful or non purposeful movement 
  •ABC’s (Maintain adequate Oxygenation)
33
Q

Glasgow coma scale (GCS) score of 13-15

A

Mild

34
Q

GCS score of 9-12

A

Moderate

35
Q

GCS score of 3-8

A

Severe

36
Q

GCS eye scores

A

1= Eyes doesn’t open
2=Open eyes in response to pain
3=Open eyes in response to voice
4=Opens eyes spontaneously

37
Q

GCS Verbal score

A 
1=makes no sound
2=makes sounds
3=speak words
4=Confused, disoriented 
5=Oriented, converses normally
38
Q

GCS Motor score

A 
1=makes no movements 
2=Decerebrate
3=Decorticate
4=Flexion/Withdrawal to painful stimuli 
5=Localizes to painful stimuli
6=Obeys commands
39
Q

Glasgow coma scale (GCS)

A

A neurological scale to see a Pt’s conscious state

40
Q

Decorticate posturing

A
  • Abnormal posturing
  • Stiff bent arms towards the body
  • Clenched fists held on the chest
  • Legs held out straight
41
Q

Decerebrate posturing

A
  • Abnormal posturing
  • Arms extended at the sides
  • Wrist rotated internally with fist pointing outwards
  • Legs held out straight
42
Q

How many vertebrae do we have ?

A

33

43
Q

Name spinal columns in order

A
  • Cervical (7)
  • Thoracic (12)
  • Lumbar (5)
  • Sacrum (5)
  • Coccyx (4)
44
Q

Spinal Column injury

A
  • Bone injured
  • painful
  • May or may not include spinal cord injury
  • Rx Spinal motion restriction
45
Q

Spinal Cord injury

A
  • Nervous tissue damage
  • Disrupts motor or sensory pathways
  • Will have tingling or loss of sensation
  • Rx Spinal motion restriction
46
Q

Complete spinal injury

A
  • Complete severing of the spinal cord
  • Will have loss of pain and sensation below injury site
  • May lead to spinal shock (Neurogenic)
47
Q

Spinal shock

A
  • Shock due to injury to spinal cord
  • Vessels relax due to loss of impulses
  • May resolve itself or may never come back
48
Q

Assessing spinal injured pt

A

-Put em in Spinal motion restriction (SMR)
-Pay close attention to MOI and worsening or resolving S/Sx
•Respiratory Symptoms
•Paralysis or loss of sensation
•Priapism

49
Q

Put Pt’s in SMR if?

A
  • Suspected spinal injuries
  • GCS score less than 15
  • Has neurologic deficit
  • Pain or Tenderness along Spinal column
  • Deformity to spinal column
50
Q

Put pt in backboard if?

A

If they have complete paralysis, loss of sensation, or signs of complete spinal cord injury

51
Q

Don’t put pt in backboard if?

A

Pt have neck or spinal pain but no sign of complete spinal cord injury

52
Q

Rx for foreign objects or chemical burns in the eye

A
  • Flush with copious amounts of water for minimum of 20 min

- Cover both eyes

53
Q

Rx for impaled object in eye

A
  • Stabilize object
  • Cover both eyes
  • Do not remove
54
Q

Compression spinal injury

A
  • When the weight of the body is driven against the head

- Falling or hitting head first

55
Q

Flexion spinal injury

A

-When there is severe forward movement of the head where chin meets the chest

56
Q

Extension Spinal Injury

A
  • When there is severe backward movement of the head in which the neck is stretched
  • Most common with whiplash
57
Q

Rotation spinal Injury

A

-twisting movement of the head of spine beyond its normal rotation

58
Q

Lateral bending spinal injury

A

When the body or neck is bent severely from the side

59
Q

Distraction spinal injury

A
  • When vertebrae and spinal cord are stretched and pulled apart.
  • Common in hangings
60
Q

Penetration spinal injury

A

-Injury from gunshot, stabbing, or other penetrating trauma that involve the cranium or spinal column

EMT (26 decks)

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