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Pathophysiology > Trauma and Injury (Nervous System) > Flashcards

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
Q

epidural hematoma prognosis

A
  • if only one pupil is dialted: better
  • if both pupils dilate: severe brain damage
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26
Q

subdural hematoma

A
  • within the dura matter and brain
  • develops quickly
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27
Q

subdural hematoma sings and symptoms

A

headache, tenderness, progressing dementia, generalized rigidity

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28
Q

bilateral hematomas

A
  • not as common (25%)
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29
Q

chronic hematoma

A
  • develop slowly
  • alcoholics
  • brain atrophy
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30
Q

subdural hematoma treatment

A
  • craniotomy to remove congealed blood
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31
Q

intercerebral hematoma

A
  • bleeding within the tissues of the brain
  • spontanous leakage of blood into brain tissue
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32
Q

what are the causes of intercerebral hematoma

A

Aneurysm (main cause)
- birth defects, hypertension, tumour

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33
Q

primary blast injuries

A
  • from blast wave
  • damage at air fluid interfaces
  • significant mortality
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34
Q

secondary blast injuries

A
  • from objects propelled by the blast
  • significant source of casualties
  • high risk of infection
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35
Q

tertiary blast injuries

A
  • person propelled into solid objects
  • crush injuries common
36
Q

shock waves

A
  • causing overpressure followed by an under-pressure phase occuring milliseconds apart
37
Q

open brain injury

A
  • traumatic injury occurs with penetrating trauma or with skull fracture
  • cranial contents exposed to environment
38
Q

signs of basal skull fracture

A
  • raccoon eyes or battle sign
  • blackened eyes
  • clear drainage from ears or nose (halo sign characteristics)
39
Q

skull fracture signs and symptoms

A
  • loss of consciousness
  • other symptoms depend on location
40
Q

skull fracture diagnosis

A

physical exam
- skull x-rays
** hard to see basal skull fracture on x-ray

41
Q

open skull injury treatment

A
  • frequently require some form of debridement to prevent infection and blood clots
  • broad spectrum antibiotics, bed rest, close observation
42
Q

concussion

A
  • mild traumatic brain injury
43
Q

shaken baby injury

A
  • 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
Q

shaken baby syndrome signs and symptoms

A
  • 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
Q

shaken baby syndrome treatment

A
  • stop damage from progressing
  • cant repair damage
  • can remove hematoma
  • prevent chocking
  • ventilate initially
  • wait for swelling to decrease
46
Q

first insult

A
  • inflammation
  • cerebral edema
  • increased intercranial pressure
  • compromises blood vessels
  • decreases cerebral blood flow
  • cerebral hypoxia and ischemia
47
Q

second insult

A
  • start the circle over (ends up spiralling downward)
  • will lead to herniation of the brain
48
Q

secondary brain injury mainfestations

A

Systemic: stroke, hypotension, anemia, hypoxia, hypercapnia, or hypocapnia
Cerebral: inflammation, edema, increased intercranial pressure, ischemia, herniation

49
Q

secondary brain injury treatment

A
  • prevention, remove hematoma, manage blood pressure and hypoxemia, anemia, control intercranial pressure
50
Q

what is the main difference between primary and secondary injury

A

lenght of time is considered

51
Q

primary injury developes

A

-immediately up to a few minutes to fully develop

52
Q

secondary phase

A
  • can start in minutes but can continue for days
53
Q

post concussion syndrome symptoms

A
  • headache, dizziness, nervousness, not normal feeling, anxious, irritable, sleep disrupted, depression, inability to concentration, forgetfulness
54
Q

post concussion syndrome treatment

A
  • reassure regarding the stages of recovery
  • manage symptoms, anxiety, insomnia, headache
55
Q

how long can post concussion syndrome last

A

5-10 years

56
Q

post traumatic seizures

A
  • highest risk in open brain injuries
  • will develop seizures
  • can last 2-5 years
57
Q

post traumatic seizures treatment

A
  • prophylactic treatments
  • use anti-seizure medications
58
Q

chronic traumatic encephalopathy

A
  • recurrent traumatic brain injury
  • presents as progressive amnesia
  • strongly related to sports, blast injuries in soldiers, in work related head trauma
59
Q

long term complications of chronic traumatic encephalopathy

A
  • decreased cognitive abilities
  • pneumonia, recurrent infections, inability to ambulate
60
Q

Spinal cord injury results from

A

stretching or edema which can cause altered axonal transport
- myelin degeneration or degeneration of axons distal to injuries

61
Q

primary spinal cord injury

A
  • initial mechanism that cause trauma
  • immediate tissue destruction
  • contusion or concussion
62
Q

primary spinal cord injury results in

A

temporary loss of function
- bruising within the neural tissue

63
Q

bleeding/bruising of the neural tissue occurs in

A

contusion

64
Q

compression spinal injury

A
  • pressure can cause ischemia
65
Q

compression spinal injury treatment

A
  • decompress quickly to prevent damage
66
Q

laceration spinal injury

A
  • tearing of the neural tissue may be reversable dependent on what part of the spinal column is affected
67
Q

transection spinal injury

A
  • severing of spinal cord
  • most common
  • total loss of function below injury
68
Q

partial transection spinal injury

A

may preserve some motor or sensory function below injury

69
Q

simple fracture

A
  • no discoloration
  • no other damage
  • stable
70
Q

compression vertebral fracture

A
  • spine is pushed down on itself
  • no displacement
  • no other damage
  • loss of sensation or fucntion
71
Q

burst fracture

A
  • one vertebrae
  • disintegration of vertebrae
  • damage to spinal column
  • loss of protection for spinal column
72
Q

C1, C2 (high)

A

“hangman” fracture

73
Q

C4-C7, T10-T12

A
  • most mobile parts of your spine
  • most often seen in spinal trauma
74
Q

spinal shock

A
  • immediately after injury
  • normal activity at or below the level of injury is gone
75
Q

spinal shock manifestations

A
  • complete loss of reflex, flaccid paralysis, loss of sensation, bowel and bladder control
  • may experience hypertension, poor venous circulation, poikilothermic
76
Q

c4 injury

A

tetraplegia

77
Q

c6 injury

A

tetraplegia

78
Q

t6 injury

A

paraplegia

79
Q

L1 injury

A

paraplegia

80
Q

complete cord transection symptoms

A

flaccid muscles, loss of reflexes, no sensation of pain temperature touch or pressure, no bowel function, pale dry skin

81
Q

partial cord transection

A
  • may see asymmetrical loss (may see partial but not complete)
82
Q

neurogenic shock

A
  • absense of sympathetic activity (parasympathetic is unopposed)
  • vasodilation, hypotension, bradycardia, poiklethermia
83
Q

neurogenic treatment

A
  • immobilize spine to stabilize and prevent further injury
  • may require surgical fixation of burst fracture or dislocation
  • corticosteroids to decrease secondary injuries
84
Q

autonomic dysreflexia

A
  • someone with a spinal injury T6 or higher
  • emergent situation
  • pushed into fight or flight response
85
Q

autonomic dysreflexia signs and symptoms

A
  • 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
Q

autonomic dysreflexia treatment

A
  • most common: distended bladder (make sure catheter is functioning)
  • vasodilators

Pathophysiology (22 decks)

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