trauma Flashcards
pathophysiology of a concussion
a rapid acceleration applied to the cranium results in a force which needs to be dissipated
physical signs and symptoms of a concussion
headache, dizziness, tinnitus, N+V, fatigue, blurred vision, amnesia
sign suggesting basal skull fracture and its name
battle’s sign
bruising over the mastoid process
name some delayed symptoms of a concussion
difficulty concentrating, irritability, personality changes, photosensitivity, depression, sleep disturbance
how might a concussion present in children
dazed, irritable, unsteady, crying, change in eating and sleeping patterns, vomiting, seizures
what is a complication of a second injury before recovering from a concussion
second impact syndrome
who gets second impact syndrome
usually younger players who have a second event before recovering from the initial concussion
pathophysiology of second impact syndrome
the brains ability to regulate blood volume to the brain is damaged causing increased cerebral blood volume -> brain herniation and death
who is high risk for a TBI
young men and elderly
alcohol and drug abuse
name some mechanisms of injury for a TBI
assault, falls, RTCs
what principle is used to explain maintaining and managing ICP
monro kellie principle = the sum of volumes of brain, CSF and intracerebral blood is constant
what causes a diffuse axonal injury
shearing forces
where in the brain does a diffuse axonal injury occur
where density difference is the greatest - grey/white interface
corpus callosum and the brainstem in more severe cases
what investigation is needed in a suspected TBI
CT scan
how can we confirm brainstem death in a patient (6)
- No pupil response (II, III)
- No corneal reflex (V, VII)
- No motor response (CN distribution, V, VII)
- No vestibulo-ocular reflex (III, VI, VIII)
- No gag/cough reflex (IX, X)
- No respiration (apnoea test)
name some risk factors for mechanical back pain
heavy lifting, frequent bending, repetitive work
when do we become concerned about mechanical back pain
failure to improve after 4-6 weeks of therapy
pain at night or on rest
progressive motor or sensory deficit
what investigation is done in young men with persistent back pain and why
x-ray to rule out ankylosing spondylitis
