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Pt Care > Head Trauma > Flashcards

Head Trauma Flashcards

1
Q

what is the only opening in the skull

A

foramen magnum(floating surrounded by csf)

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2
Q

What is the anatomy of the head

A

1)scalp 2)skull 3)dura mater 4)archanoid 5)subarchanoid space 6) pia mater 7)brain

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3
Q

What do the ventricles produce and how much

A

CSF and 1 ml every 3 mins

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4
Q

what is coup contracoup

A

“4 collision concept” car strikes tree, head strikes the windshield, brain strikes inside skull, brain rebounds and hits inside of occipital skull

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5
Q

when does the max swelling in the brain occur

A

72 hours

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6
Q

what does DECEREBRATE mean

A

Abnormal Extension outwards

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7
Q

What does DECORTICATE mean

A

Abnormal Flexion inwards

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8
Q

when should we CT scan

A

GCS <13, Suspect basal skull fracture, head of c-spine injury suspected

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9
Q

what are signs of basal skull fracture

A

Racoon eyes and battle sign(bruising behind the ear)

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10
Q

what is a cerebral contusion

A

brusing/swelling of brain tissue, swelling can be rapid and severe, may present as CVA

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11
Q

what is a diffuse axonal injury

A

most common with severe blunt trauma, diffuse injury, generalized edema, subarchanoid bleeding, seizure activity, coma/vommiting, may develop into herniation syndrome

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12
Q

what is Anoxic brain injury

A

injury related to o2, poor outcome

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13
Q

where can an intracranial hemorrhage occur

A

1)skull and dura 2) dura and arcahnoid 3) directly into the brain tissue

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14
Q

What is an epidural hematoma?

A

bleeding within the epidural space between the bone and dura mater

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15
Q

what is the bleeding often caused by?

A

by a tear in the middle meniginal artery that runs along inside the skull in temporal/parietal region

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16
Q

what is a subdural hematoma?

A

bleeding between dura mater and archanoid mater(subdural space)

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17
Q

what is the bleeding

A

usually venous

18
Q

what is this common in

A

alcoholics

19
Q

what is a subarchanoid hemorrhage

A

subarachnoid space between arachnoid mater and pia mater, usually a result of aneurismal rupture or bleeding rom arteriovenous malformation

20
Q

common in what kind of people

A

cocaine abusers/ bleeding disorders

21
Q

what is intracerebral hemorrhage

A

bleeding within the brain tissue;cerebrum/white matter;may result from blunt/penetrating trauma

22
Q

What is the Tx?

A

supportive therapy and possible surgical intervention

23
Q

what is herniation syndrome”coning”

A

caused by increase in pressure in cranial vault

24
Q

what are symptoms of it?

A

increase in ICP, dilation of pupils, coma, cushings reflex

25
Q

what is cushings triad?

A

hypertension, bradycardia, irregular respirations

26
Q

what happens in herniation syndrome?

A

bruising/swelling towards the spinal cord and trying to push brain down on brainstem compressing it.

27
Q

what does the brainstem control

A

breathing, HR and temp

28
Q

what is the TX

A

The only time HYPERVENTILATION is indicated, want co2 in the 25-30 or 30-35 range

29
Q

other txs are?

A

mannitol, ICP drain, phenobarbital(last resort) will cause an induced coma

30
Q

what is ICP

A

insertion of a catherter into the lateral ventricle , used for measurement and drainage of CSF

31
Q

what is the usual number for CSF

A

<15 mmhg

32
Q

what is the formula for CPP?

A

CPP=MAP-ICP

33
Q

What happens if ICP goes up

A

then BP must go up as well to maintain CPP

34
Q

when should we ICP?

A

when GCS is <8 after resuscitation, when CT scan is abnormal(hematoma, contusion, edema)

35
Q

When do we ICP if CT normal

A

age >40, systolic bp <90, decerebrate or decoritcate

36
Q

what is the normal CPP in adults

A

70-90mmhg, minimum should be >50mmhg for adequate perfusion

37
Q

what Bp is preffered to keep CPP

A

hypertension

38
Q

if there is an decrease in CO2 in the brain what occurs

A

vasoconstriction

39
Q

what will happen if paco2 is low causing vasoconstriction

A

will decrease ICP

40
Q

where do we want to keep co2 levels

A

30-35 range

41
Q

where do we wanna keep peep and aw press

A

low side for both

42
Q

do we want to sx these patients

A

not usually, will usually sedate before sxing

Pt Care (4 decks)

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