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Trauma and Injury (Nervous System) Flashcards

1
Q

brain trauma

A

alteration of brain function caused by an external force

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2
Q

what is the primary casues of death and disability in individuals under the age of 40

A

brain trauma

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3
Q

brain injury is more common in

A

men (2x)

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4
Q

brain trauma prevention

A
  • helmet in sports, seatbelts, air bags, decreased transport times to hospital
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5
Q

traumatic brain injury

A
  • some force was excerted outside of the skull
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6
Q

non traumatic brain injury

A

disease process occuring within the body casues the injury

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7
Q

non traumatic brain injuries examples

A
  • anoxia, infections, strokes, tumours, metabolic disorders
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8
Q

open brain injury examples

A

penetrating injuries
- assaults, falls, accidents, abuse, surgery

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9
Q

close brain injury example

A

internal pressure and shearing
- assualts, falls, accidents, abuse

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10
Q

closed brain trauma

A
  • brain dura intact; no external exposure
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11
Q

focal injury

A
  • observable precise location; hit in the forehead or back of the head
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12
Q

Coup

A

damage at the site of impact

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13
Q

contercoup

A
  • bounce back injury
  • front head is initial head, bounce back on the back in the contracoup injury
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14
Q

contusions

A
  • coup injury
  • compression at the point of impact, ozzing from blood vessel damage at point of impact
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15
Q

smaller the point of impact =

A

larger damage

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16
Q

signs and symptoms of major contusions in the frontal lobe

A

loss of conciousness, reflexes,

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17
Q

first stage of contusions

A

decreased HR, RR, BP
- lasts 30 seconds to a few minutes
- may have a gradual return to consciousness, but quick return of reflexes

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18
Q

diagnosis of contusions

A

GCS scale, CT scan, MRA

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19
Q

treatment of contusions

A

control inter cranial pressure and managing symptoms

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20
Q

epidural hematoma

A
  • artery is the source of the bleeed
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21
Q

80% of epidural hematoma is usually casued by

A

scull fracture

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22
Q

where is the most common location of epidural hematoma

A

temporal fossa

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23
Q

epidural hematoma signs and symptoms

A
  • loss of consciousness at time of injury, 1/3 lucid in a few minutes to days; 2/3 bleeding will continue to grow
  • headache, vomiting, confusion, drowsiness, hemiparesis may develop LOC, ipsilateral pupil dilation (same side of trauma)
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24
Q

epidural hematoma diagnisis

A

MRI, CT scan

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25
epidural hematoma prognosis
- if only one pupil is dialted: better - if both pupils dilate: severe brain damage
26
subdural hematoma
- within the dura matter and brain - develops quickly
27
subdural hematoma sings and symptoms
headache, tenderness, progressing dementia, generalized rigidity
28
bilateral hematomas
- not as common (25%)
29
chronic hematoma
- develop slowly - alcoholics - brain atrophy
30
subdural hematoma treatment
- craniotomy to remove congealed blood
31
intercerebral hematoma
- bleeding within the tissues of the brain - spontanous leakage of blood into brain tissue
32
what are the causes of intercerebral hematoma
Aneurysm (main cause) - birth defects, hypertension, tumour
33
primary blast injuries
- from blast wave - damage at air fluid interfaces - significant mortality
34
secondary blast injuries
- from objects propelled by the blast - significant source of casualties - high risk of infection
35
tertiary blast injuries
- person propelled into solid objects - crush injuries common
36
shock waves
- causing overpressure followed by an under-pressure phase occuring milliseconds apart
37
open brain injury
- traumatic injury occurs with penetrating trauma or with skull fracture - cranial contents exposed to environment
38
signs of basal skull fracture
- raccoon eyes or battle sign - blackened eyes - clear drainage from ears or nose (halo sign characteristics)
39
skull fracture signs and symptoms
- loss of consciousness - other symptoms depend on location
40
skull fracture diagnosis
physical exam - skull x-rays ** hard to see basal skull fracture on x-ray
41
open skull injury treatment
- frequently require some form of debridement to prevent infection and blood clots - broad spectrum antibiotics, bed rest, close observation
42
concussion
- mild traumatic brain injury
43
shaken baby injury
- brain injury caused by forceful shaking - occurs quick within 5 seconds - repeated coup injury as brain comes in contain with skull - caused dissuse axonal injury
44
shaken baby syndrome signs and symptoms
- difficultly staying awake, tremors, abnormal resps, poor eating, vomiting, discoloured skin, seizures, coma, paralysis - permanent vision and hearing loss, sezuire disorder, developmental delays, cerebral palsy, subdural hematoma
45
shaken baby syndrome treatment
- stop damage from progressing - cant repair damage - can remove hematoma - prevent chocking - ventilate initially - wait for swelling to decrease
46
first insult
- inflammation - cerebral edema - increased intercranial pressure - compromises blood vessels - decreases cerebral blood flow - cerebral hypoxia and ischemia
47
second insult
- start the circle over (ends up spiralling downward) - will lead to herniation of the brain
48
secondary brain injury mainfestations
Systemic: stroke, hypotension, anemia, hypoxia, hypercapnia, or hypocapnia Cerebral: inflammation, edema, increased intercranial pressure, ischemia, herniation
49
secondary brain injury treatment
- prevention, remove hematoma, manage blood pressure and hypoxemia, anemia, control intercranial pressure
50
what is the main difference between primary and secondary injury
lenght of time is considered
51
primary injury developes
-immediately up to a few minutes to fully develop
52
secondary phase
- can start in minutes but can continue for days
53
post concussion syndrome symptoms
- headache, dizziness, nervousness, not normal feeling, anxious, irritable, sleep disrupted, depression, inability to concentration, forgetfulness
54
post concussion syndrome treatment
- reassure regarding the stages of recovery - manage symptoms, anxiety, insomnia, headache
55
how long can post concussion syndrome last
5-10 years
56
post traumatic seizures
- highest risk in open brain injuries - will develop seizures - can last 2-5 years
57
post traumatic seizures treatment
- prophylactic treatments - use anti-seizure medications
58
chronic traumatic encephalopathy
- recurrent traumatic brain injury - presents as progressive amnesia - strongly related to sports, blast injuries in soldiers, in work related head trauma
59
long term complications of chronic traumatic encephalopathy
- decreased cognitive abilities - pneumonia, recurrent infections, inability to ambulate
60
Spinal cord injury results from
stretching or edema which can cause altered axonal transport - myelin degeneration or degeneration of axons distal to injuries
61
primary spinal cord injury
- initial mechanism that cause trauma - immediate tissue destruction - contusion or concussion
62
primary spinal cord injury results in
temporary loss of function - bruising within the neural tissue
63
bleeding/bruising of the neural tissue occurs in
contusion
64
compression spinal injury
- pressure can cause ischemia
65
compression spinal injury treatment
- decompress quickly to prevent damage
66
laceration spinal injury
- tearing of the neural tissue may be reversable dependent on what part of the spinal column is affected
67
transection spinal injury
- severing of spinal cord - most common - total loss of function below injury
68
partial transection spinal injury
may preserve some motor or sensory function below injury
69
simple fracture
- no discoloration - no other damage - stable
70
compression vertebral fracture
- spine is pushed down on itself - no displacement - no other damage - loss of sensation or fucntion
71
burst fracture
- one vertebrae - disintegration of vertebrae - damage to spinal column - loss of protection for spinal column
72
C1, C2 (high)
"hangman" fracture
73
C4-C7, T10-T12
- most mobile parts of your spine - most often seen in spinal trauma
74
spinal shock
- immediately after injury - normal activity at or below the level of injury is gone
75
spinal shock manifestations
- complete loss of reflex, flaccid paralysis, loss of sensation, bowel and bladder control - may experience hypertension, poor venous circulation, poikilothermic
76
c4 injury
tetraplegia
77
c6 injury
tetraplegia
78
t6 injury
paraplegia
79
L1 injury
paraplegia
80
complete cord transection symptoms
flaccid muscles, loss of reflexes, no sensation of pain temperature touch or pressure, no bowel function, pale dry skin
81
partial cord transection
- may see asymmetrical loss (may see partial but not complete)
82
neurogenic shock
- absense of sympathetic activity (parasympathetic is unopposed) - vasodilation, hypotension, bradycardia, poiklethermia
83
neurogenic treatment
- immobilize spine to stabilize and prevent further injury - may require surgical fixation of burst fracture or dislocation - corticosteroids to decrease secondary injuries
84
autonomic dysreflexia
- someone with a spinal injury T6 or higher - emergent situation - pushed into fight or flight response
85
autonomic dysreflexia signs and symptoms
- anxiety, bowel or bladder tissues, blurry vision, dizzy, lightheaded, fever, diaphoretic above the point of injury - profound hypertension (hallmark sign) - seizures, pulmonary edema, renal insufficiency, myocardial infraction, cerebral edema
86
autonomic dysreflexia treatment
- most common: distended bladder (make sure catheter is functioning) - vasodilators

Pathophysiology (22 decks)

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