Trauma - Fremont-Smith

Question 1

skull fractures

Answer 1

linear
depressed

may create communication

Question 2

trauma to brain

Answer 2

impact injury

and movement of brain injury

Question 3

middle meningeal artery

Answer 3

in epidural space

branch of external carotid artery - does not go into brain parenchyma

Question 4

bridging veins

Answer 4

cross meningeal layer to skull

bleed into subdura between arachnoid and meningeal layer of dura

Question 5

cerebral arteries

Answer 5

to SA space

Question 6

lens shaped lesion on CT

Answer 6

epidural hematoma

because confined to dural sutures

Question 7

break bridging vessels

Answer 7

subdural hematoma

Question 8

crescent shaped lesion on CDT

Answer 8

subdural hematoma

Question 9

shaken baby syndrome

Answer 9

get subdural hematoma

Question 10

subdural space

Answer 10

not connected to arachnoid space - where CSF is

Question 11

blood over time on CT

Answer 11

bright white (hyperdense) and fades to gray (isodense)

Question 12

hematocrit effect

Answer 12

The hematocrit effect is a blood-plasma level seen with acute re-bleeding into an older subdural blood collection.

Question 13

hygroma

Answer 13

chronic subdural hematoma

-is liquefied inside

Question 14

subarachnoid hemorrhage

Answer 14

bleeding in sulci - in virchow robin space

Question 15

ruptured berry aneurysm

Answer 15

SA hemorrhage

Question 16

one punch to head death

Answer 16

traumatic SA hemorrhage

-vertebral artery rupture - at C1

Question 17

hypoxic ischemic encephalopathy

Answer 17

blood in SA space - toxic on vessels - get vasospasm

• decreased O2 to brain
• global ischemia
• cells die
• fluid to edema - bad cycle

Question 18

shaken baby syndrome triad

Answer 18

encephalopathy
subdural hematoma
retinal hemorrhage - vitreous moves rips retina

Question 19

hemorrhagic necrosis of brain tissue

Answer 19

contusion

Question 20

location of contusions

Answer 20

more frequent - orbital surfaces of frontal lobes and tips of temporal lobes

Question 21

traumatic axonal injury

Answer 21

DAI - diffuse axonal injury

stretching of axons

Question 22

wallerian degeneration

Answer 22

with moderate/severe axon degeneration

Question 23

CNS myelin

Answer 23

oligodendrocytes

Question 24

PNS myelin

Answer 24

schwann cells

Question 25

wallerian degeneration

Answer 25

process that results when a nerve fiber is cut or crushed, in which the part of the axon separated from the neuron's cell body degenerates distal to the injury

Question 26

marker for DAI

Answer 26

beta-amyloid precursor protein

Question 27

tau protein

Answer 27

in microtubule of axons

Question 28

anoxic neuron

Answer 28

red neuron | -injured neuron shrinks, becomes eisinophilic, mito condense, become pyknotic

Question 29

concussion

Answer 29

mild to severe DAI loss of consciousness - dysfunction of reticular activating substance - upper brainstem chronic cumulative effect - chronic traumatic encephalopathy

Question 30

chronic traumatic encephalopathy

Answer 30

CTE -repeated DAIs atrophy in cerebral cortex, white matter, deep nuclei, brainstem show tau deposits

Question 31

tau deposits

Answer 31

in CTE

Question 32

phosphorylation of tau

Answer 32

forms aggregates | -alzheimers disease

Question 33

high tau in CSF

Answer 33

slow recovery after head trauma

Question 34

subfalcine herniation

Answer 34

usually asymptomatic | -may compress anterior cerebral artery - infarction

Question 35

central herniation

Answer 35

CN VI compromised - lateral rectur palsy B/L - hemiparesis or full paresis and coma

Question 36

uncal transtentorial herniation

Answer 36

CN 3 palsy - blown pupil compress posterior cerebral a compress corticospinal tract

Question 37

blown pupil

Answer 37

with uncal transtentorial herniation ipsilateral

Question 38

tonsillar herniation

Answer 38

brainstem compromise - respiratory and cardiac effect death

Question 39

small intracranial mass

Answer 39

can compensate for increasing ICP -reduce CSF and blood volume

Question 40

irritable and depressed alertness and attention

Answer 40

symptom of elevated ICP

Question 41

duret hemorrhage

Answer 41

with herniation - get compression of vessels usually in pons

Question 42

hemiplegia with uncal herniation

Answer 42

is contralateral

Question 43

kernohans phenomenon

Answer 43

ipsilateral hemiplegia caused by contralateral corticospinal tract compression

Question 44

lumbar puncture on patient with inceased ICP

Answer 44

bad - herniation

Question 45

corticospinal tract

Answer 45

decussate below brain - cervical level so motor control is C/L