Intracranial Disorders Flashcards
1
Q
Term referring to the person being aware of the self and environment and can respond appropriately to stimuli
A
Consciousness
2
Q
It requires normal arousal and full cognition
A
Consciousness
3
Q
A level of consciousness pertaining to a person being Alert, oriented to time, place, and person;
Comprehends spoken and written words well
A
Full Consciousness
4
Q
A level of consciousness pertaining to a person being unable to think rapidly and clearly;
A
Confusion
5
Q
A level of consciousness pertaining to a person being
Easily bewildered, with poor memory and short attention span;
A
Confusion
6
Q
A level of consciousness pertaining to a person who
Misinterprets stimuli; Judgment is impaired
A
Confusion
7
Q
A level of consciousness pertaining to a person who is Not aware or not oriented to time, place, or person
A
Disorientation
8
Q
A level of consciousness pertaining to a person who is Lethargic, Somnolent;
A
Obtundation
9
Q
A level of consciousness pertaining to a person who is Responsive to Verbal or Tactile Stimuli stimulation but Quickly drifts back to sleep
A
Obtundation
10
Q
A level of consciousness pertaining to a person who is Generally Unresponsive;
A
Stupor
11
Q
A level of consciousness pertaining to a person who may be Briefly aroused by vigorous, repeated, or painful stimuli, and may shrink away from or grab at the source of stimuli
A
Stupor
12
Q
A level of consciousness pertaining to a person who does not move spontaneously, unresponsive to stimuli although vigorous or painful stimuli may result in Stirring, Moaning, or Withdrawal from the Stimuli, Without Actual Arousal
A
Semi-Comatose
13
Q
A level of consciousness pertaining to a person who is Unarousable; Will not Stir or Moan in response to any stimuli;
A
Coma
14
Q
A level of consciousness pertaining to a person who may exhibit Non-Purposeful Response (Slight Movement) of Area Stimulated but does not attempt to withdraw
A
Coma
15
Q
A level of consciousness pertaining to a person who is Completely Unarousable and Unresponsive to any kind of Stimulus including pain;
A
Deep Coma
16
Q
A level of consciousness pertaining to a person who has an Absence of Brainstem Reflexes, Corneal, Papillary, and Pharyngeal Reflexes, and Tendon & Palmar Reflexes
A
Deep Coma
17
Q
1. Altered Level of Consciousness
2. Increased Intracranial Pressure (IICP)
3. Headache (Mild & Transient Pain within the Cranial Vault)
These may be indications of what Intracranial Disorder?
A
ALTERED CEREBRAL FUNCTION
18
Q
A major cause of Altered Level of Consciousness involving damage to the Cerebral Hemispheres Directly and Widely OR
That Compressor Destroy the _______
A
Lesions and/or Injuries that affect the Cerebral Hemispheres Directly and Widely
OR
That Compressor Destroy the Neurons
19
Q
A major cause of Altered Level of Consciousness involving the body’s metabolism
A
Metabolic Disorders
20
Q
Two (2) Identified Major Causes of Altered Level of Consciousness
A
- Lesions and/or Injuries that affect the Cerebral Hemisphere directly and widely OR that Compressor destroys the Neurons
- Metabolic Disorders
21
Q
Secondary causes of Altered Level of Consciousness (there are 3 identified)
A
- Accumulated Waste Products and Toxins from Liver or Renal Failure
- Drugs that Depress the CNS
- Seizure Activity
22
Q
Three (3) Identified Categories under Coma States and Brain Death
A
A. Persistent Vegetative State
B. Locked-In Syndrome
C. Brain Death
23
Q
A permanent condition of complete unawareness of self and the environment and Loss of Cognitive Functions
A
Persistent Vegetative State
24
Q
Usually the result of severe brain trauma or global ischemia, this condition results from the death of the Cerebral Hemispheres with the continued function of the Brainstem and Cerebellum
A
Persistent Vegetative State
25
A category of Coma State where the client has sleep-wake cycles and retains the ability to chew, swallow and cough BUT cannot interact with the environment
Persistent Vegetative State
26
In this category of Coma State: In a minimally conscious state, the client is aware of the environment and can follow simple commands, manipulate objects, gesture, and “yes or no” response
Persistent Vegetative State
27
In this category of Coma State, the client is alert and fully aware of the environment and has **Intact Cognitive Abilities**, but is unable to communicate through speech or movement because of blocked efferent pathways from the brain
Locked-In Syndrome
28
In this category of Coma State, there is the **Cessation and Irreversibility of all Brain Functions** including the **Brainstem**
Brain Death
29
QUICK NOTEEZ ONLY:
The phrase "cessation and irreversibility of all brain functions, including the brainstem," is a key concept in defining brain death.
Brain death is a **legal and medical determination of death**, distinct from other states like a coma or vegetative state.
Here’s what it means:
1. Cessation: This refers to the **complete and total stopping of all activities in the brain**, including both the cerebral hemispheres (responsible for higher brain functions like thought, memory, and awareness) and the brainstem (which controls critical life-sustaining functions like breathing, heart rate, and reflexes). There is no electrical activity or blood flow within the brain.
2. Irreversibility: This means that the **loss of brain functions cannot be recovered**. Even with medical interventions, the brain’s functions will not resume. This is determined through rigorous medical testing, ensuring that the cessation is not due to reversible causes like severe hypothermia or drug overdose.
3. Brainstem: The inclusion of the brainstem is critical because, **while higher brain functions might cease in certain conditions (like a coma), the brainstem may still sustain basic life functions**. Brain death occurs only when the brainstem itself has ceased to function and will not recover.
30
Give three (3) Criterions indicating Brain Death (1-3; there are a total of five identified criterions)
1. **Unresponsive Coma** with *Absent Motor and Reflex Movements*
2. **No Spontaneous Respirations**
3. **Pupils Fixed and Dilated**
31
Give two (2) Criterions indicating Brain Death (4-5; there are a total of five identified criterions)
4. Absent Ocular Responses to Head-Turning and Caloric Stimulation
5. **Flat Electroencephalogram (EEG)** and **No Cerebral Blood Circulation** present on Angiography
32
The Area of Cerebral Damage indicated by **Cheyne-Stokes Respirations** - Alternating Regular Periods of Deep, Rapid Breathing followed by Apnea
Area of Cerebral Damage:
*Diencephalon*
33
The Area of Cerebral Damage indicated by **Neurogenic Hyperventilation** - may exceed 40 RR per minute, the result of *Uninhibited Stimulation of the Respiratory Centers*
Area of Cerebral Damage:
*Midbrain*
34
The Area of Cerebral Damage indicated by **Apneustic Respirations** - characterized by sighing on mid inspiration or prolonged inhalation and exhalation; Results from excessive stimulation of the Respiratory Centers*
Area of Cerebral Damage:
*Pons*
35
The Area of Cerebral Damage indicated by **Ataxic/Apneic Respirations** - Uncoordinated and Irregular, probably as a result of the Loss of Responsiveness to Carbon Dioxide
Area of Cerebral Damage:
*Medulla*
36
What is the Pattern of Respiration if the area of cerebral damage involves the *Diencephalon*?
*Cheyne-Stokes Respiration*;
Alternating Regular Periods of Deep, Rapid Breathing followed by Apnea
37
What is the Pattern of Respiration if the area of cerebral damage involves the *Midbrain*?
*Neurogenic Hyperventilation*;
may exceed 40 RR per minute, the result of *Uninhibited Stimulation of the Respiratory Centers*
38
What is the Pattern of Respiration if the area of cerebral damage involves the *Pons*?
*Apneustic Respirations*;
Characterized by sighing on mid inspiration or prolonged inhalation and exhalation; Results from excessive stimulation if the Respiratory Centers
39
What is the Pattern of Respiration if the area of cerebral damage involves the *Medulla*
*Ataxic/Apneic Respirations*;
Uncoordinated and Irregular, probably as a result of the Loss of Responsiveness to Carbon Dioxide
40
Under **Pupillary and Oculomotor Responses**;
If the Lesions or Process affecting the Neurologic Function is *Localized*, the Effects may be seen in what Pupil?
*Ipsilateral Pupil*
41
Under **Pupillary and Oculomotor Responses**;
With *Generalized or Systemic Processes*, The Pupils are affected in what way?
*Pupils are Affected EQUALLY*
42
Under **Pupillary and Oculomotor Responses**;
As the Level of Functional Impairment Progresses, the Pupils become what?
*The Pupils become FIXED and Eventually DILATED*
43
Under **Pupillary and Oculomotor Responses**;
Are Reflexive Movements of the Eyes in the *Opposite Direction of Head Rotation*;
*Doll’s Eye Reflex Movements*
> Indicator of **Brainstem Function**
44
Brisk Rotation of Head with Eyes held open;
Watch for Contraversive Movement
Doll’s Eye Reflex Movement;
45
Regarding Doll’s Eye Reflex Movement, this is indicated by the Eyes Deviating Up and Eyelids Open (Doll’s Head Phenomenon)
*Flexion*
46
Regarding Doll’s Eye Reflex Movement, this is indicated by the Eyes Deviating Downward
*Extension*
47
Regarding Doll’s Eye Reflex Movement, Abnormalities are caused by _____ of the Inner Ear or _____, especially the ____ and ____
*Lesions* of the Inner Ear or *Brainstem*, especially the *Pons and Midbrain*
48
These responses are the most accurate identifier of changes in mental status; In Altered LOC, the _____ response to stimuli ranges from an *Appropriate Response* to a *Command to Flaccidity*
*Motor Response/s*
49
In Altered LOC, Motor Response to Stimuli may range from _____ to _____
*Appropriate Response* to *A Command to Flaccidity*
50
In Altered LOC, ______ Motor Responses may occur, including ____ and ____ Posturing
*Reflexive Motor Responses* including *Decorticate* or *Decerebrate* **Posturing**
51
In Altered LOC, without intervention, the client eventually becomes ______, with little or no _______ to Stimuli
In Altered LOC, *Without Intervention*, the client eventually becomes **Flaccid**, with *Little or No* **Motor Response to Stimuli**
52
Under Altered LOC, it is performed by Irrigating the Ear with Ice-Cold Water to test the *Oculovestibular Reflex* (A Reflex controlled by the **Brainstem**)
*Caloric Stimulation*
53
Under *Caloric Stimulation*, normally, the ____ causes the Eyes to first move toward the _____ Side, followed by a return to the _____
Under *Caloric Stimulation*, normally, the **COLD** causes the Eyes to first move toward the **IRRIGATED** Side, followed by a return to the **MIDLINE**
54
Under Altered LOC, In this test, the *Ventilator is removed* while *maintaining oxygenation* by **Tracheal Cannula** allowing the PCO2 to increase to _____ mmHg or Higher.
This level of Carbon Dioxide us high enough to *Stimulate Respiration if the Brainstem is Functional*
*Apnea Test*
Level of PCO2 is increased to *60 mmHg or Higher*
> **Stimulated Respiration if the Brainstem is Functional**
55
Two (2) Diagnostic Tests of Altered LOC under Altered Cerebral Function that are done to detect neurological damage due to:
1. Hemorrhage
2. Tumor
3. Cyst
4. Edema
5. Myocardial Infarction
6. Brain Atrophy
; May also identify Displacement of Brain Structures by Large or Expanding Lesions
EXTRA NOTEEZ ONLY:
*Recall Doc’s explanation*
1. The White expansive/spreading presentation on the Brain Scan Results - May indicate the severity of Hemorrhage;
2. The Black segments of a Segment of the Golgi or Sulci of the Brain - May indicate the size and/or severity of a Tumor
1. *CT (Computed Tomography) Scan*
and
2. *MRI (Magnetic Resonance Imaging)* Scanning
56
A Diagnostic Test of Altered LOC under Altered Cerebral Function that allows Radiographic Visualization of the *Cerebral Vascular System*.
*It can Identify Lesions* such as:
1. Aneurysms
2. Occluded Blood Vessels
3. Tumors
*May also be used to Determine*:
4. Cessation of Cerebral Blood Flow and Brain Death
*Cerebral Angiography*
57
A Diagnostic Test of Altered LOC under Altered Cerebral Function, that Use an *Ultrasound Velocity Detector* that Records Sound Waves reflected from RBCs in Blood Vessels to assess Cerebral Blood Flow
*Transcranial Doppler Studies*
58
A Diagnostic Test of Altered LOC under Altered Cerebral Function that is used to Evaluate the *Electrical Activity* of the *Brain*
*Electroencephalogram (EEG)*
59
A Laboratory Test of Altered LOC under Altered Cerebral Function, that is measured immediately when a Coma is of Unknown Origin and *Hypoglycemia* is Suspected or Possible
*Blood Glucose*
60
A Laboratory Test of Altered LOC under Altered Cerebral Function, that are measured to assess for *Metabolic Disturbances* and *Guide Intravenous Therapy*
*Serum Electrolytes*
(Sodium, Potassium, Bicarbonate, Chloride, Calcium)
61
A Laboratory Test of Altered LOC under Altered Cerebral Function, that involve the concepts of:
Both Hyperosmolar and Hypo-Osmolar States may be associated with Coma
*Serum Osmolality*
62
A Laboratory Test of Altered LOC under Altered Cerebral Function, that are drawn to *Evaluate Arterial Oxygen and Carbon Dioxide Levels* as well as *Acid-Base Balance*
*Arterial Blood Gases (ABG)*
63
A Laboratory Test of Altered LOC under Altered Cerebral Function, that are determined to *Evaluate Hepatic Function*
*Liver Function Tests*
(Bilirubin, AST, ALT, LDH, Serum Albumin, Serum Ammonia Levels)
64
A Laboratory Test of Altered LOC under Altered Cerebral Function, that is done to determine if altered LOC is the result of *Acute Drug or Alcohol Toxicity*
*Toxicology*
(**Screening of Blood & Urine**)
65
Give 3 Medications for Altered LOC under Altered Cerebral Function (there are a total of seven Meds; 1-3)
1. IV Therapy (NSS or Lactated Ringer’s Solution)
2. Hypoglycemia Medications
3. Hyperglycemia Medications
66
Give 4 Medications for Altered LOC under Altered Cerebral Function (there are a total of seven Meds; 4-7)
4. Narcotic Overdose
5. Thiamine
6. Furosemide (Lasix) and/or Mannitol
7. Antibiotics
67
A Nursing Diagnosis of Altered LOC due to Altered Cerebral Function, that is Related to Loss of the Cough Reflex and Inability to Expectorate; this is regarding the patient’s airway
*Ineffective Airway Clearance*
68
A Nursing Diagnosis of Altered LOC due to Altered Cerebral Function, where there is an Unconscious Client with *Depressed or Absent Gag and Swallowing Reflex*
*Risk for Aspiration*
69
A Nursing Diagnosis of Altered LOC due to Altered Cerebral Function, that is a *Result of Immobility and Inability to Provide Self-Care*
*Risk for Impaired Skin Integrity*
70
A Nursing Diagnosis of Altered LOC due to Altered Cerebral Function, where the Unconscious Client are *Unable to Maintain Normal Musculoskeletal Movement* and at **High Risk for Contractures (*permanent shortening of muscles, tendons, or other soft tissues*)**
*Impaired Physical Mobility*
71
Give four (4) Nursing Diagnoses of Altered LOC due to Altered Cerebral Function:
1. *Ineffective Airway Clearance*
2. *Risk for Aspiration*
3. *The Risk for Impaired Skin Integrity*
4. *Impaired Mobility*
72
This condition manifests as *Sustained Elevated Pressure* (**10 mmHg or Higher**) *Within the Cranial Cavity* due to Altered Cerebral Function
*Increased Intracranial Pressure*
(**IICP**)
73
Normal Range of Pressure within the Cranial Cavity (Intracranial Pressure)
5-10 mmHg
74
How is ICP Measured?
ICP is measured with Pressure Transducer
75
How do we position our patients during ICP Monitoring?
While measuring ICP with *Pressure Transducer*, the Patient’s *Head is Elevated at 30-60 Degrees or 60-80 cm H2O-measured with Water Manometer* while the patient **Lies in a Lateral Recumbent Position**
76
The Cranial Cavity is normally filled with three (3) essentially non-compressible elements. What are these?
1. The Brain (80%)
2. Cerebrospinal Fluid (8% CSF)
3. Blood (12%)
77
States that because of the *Limited Space for Expansion within the Skull*, an increase in any one of the components in the cranial vault causes a **change** in the *Volume of the Others*, then there will be an *Increase in ICP*
*The Monro-Kellie Hypothesis/Theory*
78
Causes of IICP due to Altered Cerebral Function (there are seven identified causes)
1. Head Injury
2. Tumor
3. Localized Abscess
4. Hemorrhage (Stroke)
5. Cerebral Edema
6. Hydrocephalus
7. Inflammatory Conditions (e.g.M Meningitis, Encephalitis)
79
Because brain tissue has limited space to expand (*Skull is Non-Expendable Cavity*), the Body can *Compensate for Increasing ICP* by what three (3) identified Mechanisms?
1. *Displacing/Shifting CSF*
2. *Increasing the Absorption or Diminishing the Production of CSF*
3. *Decreasing Cerebral Blood Volume*
80
When the body can no longer compensate, the following sequelae occur; What are the four (4) identified Sequelae?
A. *Cerebral Flow is Increased*
B. *Hypoxia Develops as PCO2 Increases and PO2 Decrease*
C. *Cerebral Edema Increases*
D. *ICP Increases*
81
As the ICP rises, the Brain may _____, leading to eventual _____
As the ICP rises, the Brain may *HERNIATE*, leading to *EVENTUAL DEATH*
82
An increase in the Volume of Brain Tissue due to *Abnormal Accumulation of Fluid*
*Cerebral Edema*
83
Often associated with IICP; it may occur as a *Local Process in the area of Tumor or Injury,* or it *may affect the entire brain*
Cerebral Edema
84
Two (2) Types of Cerebral Edema
1. Vasogenic Edema
2. Cytotoxic Edema
85
A type of Cerebral Edema where there is an increase in the Capillary Permeability of Cerebral Vessels;
Occurs with *Impairment of the Blood-Brain Barrier*, allowing diffusion of water and protein into the interstitial spaces of the brain
*Vasogenic Edema*
86
A type of Cerebral Edema manifested by *Focal (Localized) Neurologic Deficits*, **Altered LOC,** and *Severe Intracranial Hypertension*
*Vasogenic Edema*
87
A type of Cerebral Edema where there is an Actual Swelling of the brain cells from an *Increase in the Intracellular Fluid* due to Pathologies such as:
1. **Water Intoxication** (*SIADH*)
2. **Severe Ischemia**
3. **Intracranial Hypoxia**
4. **Acidosis**
5. **Brain Trauma**
*Cytotoxic Edema*
88
Refers to *Progressive Dilatation of the Ventricular System*, which becomes Dilated as the *Production of CSF **EXCEEDS** Absorption*
*Hydrocephalus*
89
A classification of Hydrocephalus that Occurs when CSF Drainage from the Ventricular System is Obstructed
*Non-Communicating Hydrocephalus*
90
A classification of Hydrocephalus that may develop when:
1. a mass or tumor,
2. inflammation, or
3. hemorrhage, or
4. congenital malformation
> *obstructs* the ventricular system
*Non-Communicating Hydrocephalus*
91
A classification of Hydrocephalus in which CSF is not effectively reabsorbed through the *Arachnoid Villi* and may occur secondarily to *Subarachnoid Hemorrhage* or *Scarring from Infection*
*Communicating Hydrocephalus*
92
If IICP is not treated, Cerebral Tissue is *displaced toward a more compliant area*, **Displacement of Brain Tissue from its Normal Compartment** under Dural Folds of the Falx Cerebri or through the Tentorial Notch on Incisura of the Tentorium Cerebelli
*Brain Herniation*
93
Identify the *Location* of Brain Herniation due to untreated IICP
*Supratentorial Herniation*
94
Local Blood Supply and Cerebral Tissue are *Compressed*, resulting in *Ischemia* and further increases ICP; Occurs when the Cingulated Gyrus is displaced; A type of Brain Herniation
*Cingulate Herniation*
95
Downward displacement of the brain structures, including the Cerebral Hemispheres, Basal Ganglia, Diencephalon, and Midbrain through the tentorial incisura
*Central / Transtentorial Herniation*
96
Occurs when a lateral mass displaces cerebral tissues Centrally, forcing the Medial Aspect of the Temporal Love *under the edge of the tentorial incisura*
*Uncal / Lateral Transtentorial Herniation*
97
Results from increased pressure within the *Infratentorial Compartment*
*Infratentorial Herniation*
98
What arterial pressure increases in IICP
*Mean Arterial Pressure (MAP)*
99
Is the average pressure in a patient’s arteries during *One Cardiac Cycle*;
*Mean Arterial Pressure*
100
As a Vital Sign, It is considered a better indicator of *Perfusion to Vital Organs*
*Mean Arterial Pressure*
101
How do we calculate for MAP
[ Diastolic x 2 + Systolic ] / 3
102
Diagnostic Tests when IICP happens r/t Cerebral Dysfunction (there are 5, give 3)
1. CT Scan
2. MRI
3. Lumbar Puncture
4. Serum Osmolality (lab test)
5. ABG Analyses (lab test)
103
One of the most frequent manifestations of a Health Problem people experience is *Pain Within the Cranial Vault*
*Headache*
104
105
Occur as a result of Benign or Pathologic Conditions, Intracranial or Extracranial Conditions, and Diseases of other Body Systems, Stress, Musculoskeletal Tension, or a Combination of these Factors
*Headache*
106
Give 3 causes (there are a total of 5) of Headache r/t Altered Cerebral Function
1. General
2. Allergic and Toxic
3. Cranial (Intra & Extra)
4. Systemic
5. *Cranial Arteritis*
107
The cause of headache in the *Older Population*, reaching the greatest incidence in those older than ____ years of age
*Cranial Arteritis*
(Above 70 yrs of age)
108
4 Identified types of Headaches according to area perceived to have pain
1. Sinus
2. Tension
3. Migraine
4. Cluster
109
A recurring vascular headache lasting from **4-72 Hours**, often initiated by a triggering event and usually accompanied by a neurologic dysfunction
*Migraine Headache*
110
This pertains to *Early Neurologic Symptoms and Later Symptoms*
*The Vascular Theory*
111
Refers to clients that are aware only that a headache is imminent, develops gradually, lasting hours to days, and may occur in women during a period of premenstrual tension and fluid retention; Type of Membrane Headache
*Common Migraine*
112
A type of Migraine Headache characterized by three Stages;
1. AURA stage
2. HEADACHE stage
3. PODT-HEADACHE
*Classic Migraine*
113
An extremely severe, unilateral, burning pain located *Behind or Around the Eyes*
*Cluster Headache (Histamine Headache)*
114
Characterized by Bilateral Pain, with a sensation of a hand of tightness or pressure around the Head
*Tension Headache*
115
Two (2) Identified Managements for Headaches
1. Abortive Therapy (Symptomatic Tx)
2. Preventive Approach
116
Also called seizure disorder, sometimes called Convulsions
*Epilepsy*
117
We stop giving Anticonvulsants if Seizure does not occur within ____ Years
**3 Years**
118
The clonic-tonic (Jerky, Contract-Relax) movement is associated with some seizures
*Convulsions*
119
Stroke that involves the Cerebral Cortex; or even Tumors, can cause a chronic disorder of abnormal recurring, excessive, and self-terminating electrical discharge from neurons
*Epilepsy*
120
Composed of *Paroxysmal Neurologic Dysfunction* causing a recurrent episode of one or more of the following:
A. Loss of Consciousness
B. Convulsive Movements on other Motor Activity
C. Sensory Phenomena
D. Behavioral Abnormalities
*Epileptic Syndrome*
121
A classification of Seizure that affect only part of the brain / activation of only a part of the cerebral hemisphere; involves the primary motor area / primary sensory area of the *PARIETAL LOBE*
*Partial Seizures*
122
A type of Partial Seizure that typically involves the Motor Portion of the Cortex causing Recurrent Muscle Contractions of the Face or a Contralateral part of the body, such as a finger or hand
*Simple Partial Seizure*
123
A type of Partial Seizure that is one in which consciousness is impaired may engage in repetitive, non-purposeful activity
*Complex Partial Seizure*
124
A type of Partial Seizure that is characterized by *AUTOMATISM*
*Complex Partial Seizure*
125
A classification of Seizure that presumably involves the **Entire Cerebral Cortex and Diencephalon* or Deeper Brain Structures, such as the Thalamus, Basal Ganglia, and Upper Brainstem
*Generalized Seizures / Complete Seizures*
126
A type of Generalized Seizure that usually occurs in children after the age of 4 and before puberty
*Absence Seizure*
127
Absence Seizure is also known as what?
*Petit Mal / Little Sickness*
128
Identify the four (4) Types of Generalized Seizures:
1. Absence Seizure
2. Myoclonic Seizures
3. Atonic/Akinetic Seizure (Drop Attack)
4. Tonic-Clonic (Grand Mal Seizure)
129
Phases of Seizure (there are four identified)
1. Aura phase (*Vauge Sense of Uneasiness*)
2. Tonic phase (*Falls; Stiffens; Opisthotonus; Shrill Cry*)
3. Clonic phase (*UROE*)
4. Post-Ictal phase (*Deep Sleep; No Recollection of the Attack*)
130
It is a condition developed during Seizure Activity, the seizure activity becomes *Continuous*, with only *Very Short Periods of Calm between Intense and Persistent Seizures*
*STATUS EPILEPTICUS*
131
Give 4 Identified Diagnostic Tests for *Epilepsy/Seizures* (there are a total of 6 Dx Tests)
1. Complete Hx & Physical Examination
2. Blood Works
3. CT Scan / MRI
4. EEG
5. Skull X-Rays
6. Lumbar Puncture
132
Refers to any injury of the scalp, skull (cranium or facial bones), or brain
*Traumatic Brain Injury*
133
Two (2) Classifications of TBI
1. *Penetrating (OPEN) Trauma*
2. *Blunt (CLOSED) Trauma*
134
Mechanisms of Head Injury; there are four (4) identified
1. Acceleration
2. Deceleration
3. Acceleration-Deceleration
4. Deformation Injuries
135
The damage is in the *Affective Side* — Primary Impact
*Coup*
136
The damage is in the *Opposite Side* — Secondary Impact
*Countercoup*
137
A break in the continuity of the Skull is caused by Forceful Trauma
*Skull Fracture*
138
Two identified Classifications of *Skull Fracture*
1. Open
2. Closed
139
Four (4) identified types of *Skull Fracture*
1. Depression Fracture
2. Compound Fracture
3. Hairline Fracture
4. Subdural Hematoma
140
**Classifications** according to Type of Fracture (there are three identified)
1. Linear
2. Comminuted/Depressed
3. Basilar Fracture
141
142
Signs and Sx of *CSF Leak* (there are too that can be observed on the face)
1. Battle’s Sign
2. Raccoon Eyes
143
Three identified types of Craniocerebral Trauma/Injury
1. Skull Fracture
2. Focal Brain Injury
3. CNS Infection
144
This is usually caused by Car Accidents; Falls or Assaults;
*Focal Brain Injury*
145
Are specific, grossly observable Brain Lesions confined to One Area of The Brain
*Focal Brain Injury*
146
Give the five (5) types of Focal Brain Injury;
1. Concussion - A-D Force
2. Contusion - Severe A-D Force / Blunt Trauma
3. Epidural Hematoma; r/t Meningeal Artery - Extradural Hematoma
4. Subdural Hematoma; r/t Veins on the Surface of the Cerebral Cortex / Subarachnoid Space
5. Intracerebral Hematoma; r/t Contusions
147
Two (2) Identified Types of *Subdural Hematoma*
1. Acute Subdural Hematoma
2. Chronic Subdural Hematoma
148
Give 3 Assessment and Diagnostic Findings for *Traumatic Brain Injury*
1. Rapid P.E. and Evaluation Status (Detect Obvious Brain Injuries)
2. Skull X-Rays (Detect Skull Fractures and assess Penetrating Objects)
3. CT Scan or MRI (Detect Contusions and Lesions)
4. ABG (Monitoring O2 and CO2)
5. EEG and Lumbar Puncture (Bleeding Assessment)
149
What is involved in *CUSHING’s TRIAD*
1. Bradycardia
2. Increased Systolic Pressure
3. Increased Pulse Pressure (20-40mmHg)
150
An Intracranial Disorder that is characterized by
1. Meningitis
2. Encephalitis
3. Brain Abscess
*Central Nervous System Infection*
151
Pathognomonic Signs in Meningitis; remember B - Batok
Brudzinki’s Sign
152
Pathognomonic Signs in Meningitis; remember K - Knee
Kernig’s Sign
153
Best preferred Diagnostic Test of Meningitis
*Lumbar Puncture*
154
Identified common cause of Meningitis
Bacterial (e.g. TB infection)
155
Identified common cause of Encephalitis
Viral Infection
156
Two (2) Identified Diagnostic Tests for Encephalitis
1. Lumbar Puncture (CSF)
2. EEG (extent of the brain damage)
157
Most common cause of Brain Abscess
Bacterial (e.g. Amoebic Abscess, Sinusitis)
158
An infection with a collection of *Purulent Material within the Brain Tissue*
*Brain Abscess*
159
In Brain Abscess; ____ percent is found in the Cerebrum, and ____ percent are Cerebellar
Cerebrum - 80% approx
Cerebellum - 20% approx
160
Diagnostic Tests for Brain Abscess
1. Gram Stain and Culture of CSF
2. Counterimmunoelectrophoresis (CIE)
3. Polymerase Chain Reaction Technique
4. CT Scan
5. Lumbar Puncture
