ICD & PACEMAKERS/ BRAIN TRAUMA Flashcards
What is a ICD
Implantable cardioversion defibrillator
What does the ICD do
It is multi programmed to deliver cardioversion, pacing, or defibrillation
When is ICD used
In patients who are in at risk for sudden cardiac death due to VF and those who have experienced one or more episodes of VF or VT unrelated to a MI
When will the ICD kick into pace mode
If severe bradycardia occurs
What is a demand pacer
A demand pacemaker Is synchronized with the patients HR, Meaning that it fires only when the patients HR goes below a set point
What is a fixed rate pacer
Fixed rate pacing is a synchronized with the patients HR meaning that it fires continuously at a preset rate regardless of the patients intrinsic HR
What is TBI
A traumatic insult to the brain possibly producing physical, intellectual, emotional, social, and vocational changes
What is blunt trauma to the head
The skull is closed ( not compromised) the dura remains intact, brain tissues are not exposed to the environment
What is open trauma
The injury breaks the dura and exposes the cranial contents to the environment
What is the hallmark sign of severe brain injury
Loss of consciousness for 6 hrs or more
What is a focal brain injury
An observable brain lesion
Cerebral edema. Coupe or counter coupe injury
The force of the impact causes contusions
What can contusions cause
Extradural ( epidural) hemmorhage or hematoma
Subdural hematomas
Intracerebral hematomas
Clinical manifestations of a contusion
What is the most common site for a extradural hematoma
The temporal fossa is the most common site of extradural hematoma caused by injury to the middle meninges artery or vein
What is the most common cause of a subdural hematoma
MVA
What are the 2 types of subdural hematomas
- Acute
3. Chronic
What is a acute subdural hematoma
Develops within 48 hrs
Often located at the top of the skull
What is a chronic subdural hematoma
Develops over weeks to months
Older adults
Alcohol abuse
80% complain of chronic headaches and tenderness at the site of injury
What is intracerebral hemmorhage
It is assoc with MVA and falls, resulting in intracerebral hemmorhage amd a resultant hematoma acting as an expanding mass
Increased ICP and compression of brain tissues with resultant edema
What is DAI
Diffuse axonal injury
What is a DAI
Shaking, acceleration/ deceleration, axonal damage ( shearing, tearing or stretching of nerve fibers)
A lot of nerves are damaged, the extent of injury isn’t seen on a MRI
What does severity of DAIs correspond to
Severity corresponds to the amount of shearing force applied to the brain and brain stem ( mild, moderate, severe)
What is a mild concussion
TEMPORARY axonal disturbances causing attention and memory deficits but no loss of consciousness
What is level 1 of a mild concussion
Confusion
Disorientation
Amnesia
What is level 2 of a mild concussion
Momentary confusion and retrograde amnesia
What is stage 3 of a mild concussion
Confusion with retrograde and anterograde amnesia
What are the most common sites for spinal cord injuries
Cervical 1,2,4-7
T1-L2
What is spinal shock
Normal activity of the spinal cord ceases below the level of injury, the site lacks continuous nervous discharges from the brain
Complete loss of reflex function ( skeletal, bladder, bowel, sexual, thermal control, autonomic control)
What is neurogenic shock
Develops from spinal cord trauma
It is loss of sympathetic outflow… ( vasodilation, hypotension, bradycardia, hypothermia)
What is autonomic dysreflexia
Massive uncompensated cardiovascular response to stimulation of the sympathetic nervous system
Stimulation of the sensory receptors below the level of the cord lesion
What is DDD
Degenerative disk disease…. Spondylolysis, spondylolisthesis, spinal stenosis,
Low back pain
Herniated intervertebral disk
Name 2 types of CVA’s
Thrombotic
Embolic
What is a thrombotic stroke
Arterial occlusions caused by thrombi formed in arteries supplying the brain or intracranial vessels
TIA’s
What is a embolic stroke
Fragments that break from a thrombus formed outside the brain
What is a subarachnoid hemmorhage
Blood escapes from defective or injured vasculature into the subarachnoid space
What are manifestations of a subarachnoid hemorrhage
Kernig sign
Brudziniski sign
