TBI Flashcards
initial damage to the brain.
primary injury
hours or days after the primary injury. In adequate delivery of nutrients
secondary
simple abrasion, scalp bleeds profusely, hematoma beneath the layers of the tissue of the scalp
superficial injury
management of a superficial injury
determine degree, clean wound, apply antibiotic cream, ct to rule out fracture, TT may be needed
Lobe? Personality, behavior, emotion, intellectual functions, concentration, judement
frontal
brocas area is where? what is caused there
frontal, language production. (Expressive aphasia)
lobe: sensory area sensory discrimination
parietal
Lobe? Visual reception, visual interpretation
occipital (OH I SEE)
motor coordination equilibrium, balance
cereBELLum. Bella gets me home when I am drunk
hearing, taste smell (TSH), memory
temporal.
which speech area does the temporal lobe have
wernicke’s (receptive aphasia)
breathing, digestion, HR control, vessel control A/O
brain stem
low velocity impact, simple break in continuity, temporal bone meningeal artery tear,
simple or linear skull fracture
underneath what is CSF
dura mater
splinted or multiple line, fragmented interruptions, contaminated and open would debridement and surgical closure
open or comminuted skull fracture
tear to dura, CSF leakage
basal skull fracture
Halo sign
CSF leakage. Blood with yellow ring around it
when leaking blood from the nose, don’t do what?
blow it
battle sign
ecchymosis over the mastoid bone. bulging tempanic membrane, raccoon eyes or periorbital ecchymosis
battle sign is a sign of
basal skull fracture
halo sign is a sign of
basal skull fracture
displacement of communited skull fracture. frequently seen with contusions or lacerations
depressed skull fracture
halo sign, battle sign, otorrhea, rhinorrhea, R/F infection, persistent localized pain
depressed skull fracture
in a depressed skull fracture, elevation of the bone and debridement needs to happen within
24 hours
drainage of CSF is a major problem associated with
meningitis
skull fracture diagnostic tests
xray, CT, MRI, cerebral angiography
with is the safest and which is the most accurate diagnostic tests for skull fracture
CT scan - safe. MRI - accurate
types of hematomas
epidural, subdural, intracerebral
bleeding between het space of the skull and dura
epidural hematoma
most common in temperal bone area. laceration of and artery or vein. CLASSIC SYMPTOM: brief LOC followed by lucid interval lasting from min to hours
epidural hematoma
when lucid and awake, compensation is occuring. when no longer able to compensate?
rapid deterioration of LOC, restless, agitation, confusion, can progress to coma.
bleeding between the dura and the arachnoid layer
subdural hematoma
type of subdural hematoma where the symptoms last for 48 hours to three weeks. bleeding at a much slower rate
subacute subdural hematoma
subdural hematoma that lasts 3 weeks to several months. develops slowly from the repeated small venous bleed until a significant mass effect develops
chronic subdural hematoma
hematoma usually seen in the elderly due to brain shrinkage which weakens tissue and stretches blood vessels
chronic subdural hematoma
bleeding into the substance of the brain. head injuries. aneurysm rupture, intracranial tumors, bleeding disorders, anticoagulant therapy
intracerebral hematoma
a sudden change in the clients behavior is an indication of
ICP
a sudden change in behavior needs to be
reported stat
hematoma management
anti-seizure medication, CCB (nimodipine), mannitol
which CCB for hematoma management
nimodipine
shaking of the brain
concussion
LOC less than 30 min. self reported, memory lapse,
mild concussion
results in LOC, last less than six hourse, post traumatic amnesia
classic concussion
characterized by a second impact within several weeks before the brain recovers from the first concussion. massive cerebral edema and death can occur
second impact syndrome
bruising of the brain due to skull fracture or hematoma
contusion
frontal lobe and occipital lobe affected
coup/countercoup
causes: blunt trauma, penetrating wound, acceleration/deceleration injuries by MVA, falls, assaults
contusion
greater release of ADH, excessive retention of water, hyponatremia
SIADH
avoid what after TBI due to masking symptoms
opioids
injury to the white matter that results in tearing and shearing of axons and small blood vessels
diffuse axonal injury
coma, decrebrate, decorticate posture. long term disability is final outcome
diffuse axonal injury
score of less than 8? Score of less than 3?
vent, complete coma
patient is awake with no cognitive awareness. state of coma after severe brain injury.
persistent vegetative state
score of less than 3. sustained, severe head injury, compatible with life, coma, absence of brain stem reflexes and apnea
brain death
