Trauma

Question 1

Epidural

Answer 1

Occurs between the dura and the skull

Epidural hematoma usually caused by a rupture of the bridging veins in this space

Question 2

Subdural

Answer 2

Occurs between the dura and the arachnoid membrane

Subdural hematoma usually caused by a rupture of the bridging veins in this space

Question 3

Subarachnoid

Answer 3

Occurs below the arachnoid membrane

Question 4

Epidural hematoma

Answer 4

When there is bleeding between the dura and skull.
Happens from a low-impact injury (fist, beer bottle) and a thin fracture happens in the temporal bone.

The most common sign and symptom is for the pt to go unconscious immediately after the injury then regain consciousness as the “Lucid interval” which can last anywhere between minutes to 24 hours

Question 5

Lucid interval

Answer 5

Lucid interval is when the pt regains consciousness and is fully coherent. This can be very dangerous since the pt can refuse care. This interval can also last anywhere from minutes to 24 hours but eventually the pt does loose consciousness again from increasing ICP

Question 6

ICP

Answer 6

Increased intracranial pressure

Question 7

Beck triad

Answer 7

Combination of a narrowed pulse pressure,
muffled heart tones,
JVD
are associated with cardiac tamponade;
usually caused by penetrating chest trauma

Question 8

Cushing reflex

Answer 8

Combination of slowing pulse,
rising BP,
erratic respiratory pattern;
a grave sign for pts with head trauma or cerebrovascular accident

Question 9

Types of blast injuries

Answer 9

Primary - due to the blast wave itself

Secondary - due to objects being propelled by the blast force

Tertiary - due to impact with another object

Quaternary - collateral injuries such as burns, crush injuries, toxic inhalation

Quinary - long term damage from biologic, chemical, or radioactive contaminants

Question 10

Cardiac Tamponade

Answer 10

Fluid in the pericardial sack around the heart which compresses the heart

signs and symptoms
Shortness of breath, Chest tightness/Dizziness,
Narrowed pulse pressure, Muffled heart sounds, Equal breath sounds, JVD, Shock, Loss of radial pulse on inspiration

Question 11

Decorticate posturing

Answer 11

Abnormal bending/flexing arms towards core of the body
Toes pointed
Wrists flexed
This posture may indicate damage to the area directly below the cerebral hemisphere

Question 12

Decerebrate posturing

Answer 12

Abnormal extension away from core
Toes pointed
Wrists flexed
More severe, may indicate damage within or near the brainstem