Trauma Prt 3 Flashcards
What is Cerebral Perfusion Pressure (CPP)?
Pressure required for perfusion to take place across vessels in the brain
CPP is dependent upon mean arterial pressure (MAP) and intracranial pressure (ICP).
What is the minimum CPP required to avoid hypoxia and neuronal death?
> 60 mmHg
Maintaining a CPP above this threshold is critical for brain perfusion.
What role does vasoconstriction play in cerebral perfusion?
Allows brain to maintain consistent perfusion pressure
This mechanism helps regulate blood flow despite changes in systemic blood pressure.
What are the signs and symptoms of increased ICP?
Decreased LOC, headache, vomiting, visual and speech disturbance, pupillary abnormalities
LOC stands for level of consciousness.
What is a traumatic brain injury (TBI)?
Classical coup-contrecoup injuries; brain moves through CSF and hits skull
TBIs can present with a Glasgow Coma Scale (GCS) score of less than 8.
What is an extradural hematoma (EDH)?
Blood in space between outer protective layers of the brain (dura) and the skull
EDH normally occurs under arterial pressure and can grow quickly.
What characterizes a subdural hematoma (SDH)?
Bleeding that occurs between dura and arachnoid mater
Increased dural space occurs as the brain shrinks, and anticoagulants increase the risk.
What is a subarachnoid hemorrhage (SAH)?
Occurs below arachnoid mater, associated with aneurysmal bleeds
SAH is often associated with a ‘thunderclap’ headache.
What are the components of Cushing’s triad?
Hypertension, bradycardia, decreased respiratory effect
This triad indicates impending brain herniation due to increased ICP.
What is a skull fracture?
Break in continuity of skull
Types include linear, depressed, and basilar fractures.
What is the risk associated with basilar skull fractures?
High risk of CSF leak
Basilar fractures occur at the base of the skull and can lead to serious complications.
What should be avoided in the case of a base of skull (BOS) fracture?
Do not insert NGT (nasogastric tube)
CSF leaks from the ears and nose can indicate a risk of infection.
How can body temperature management help in ICP control?
Cool body to 35 degrees reduces ICP
Other interventions include reducing noise, administering sedation, and minimizing stimuli.
What is hyperosmolar therapy?
Uses hypertonic solutions to remove excess fluid from the brain
Mannitol and 3-10% NaCl are common hyperosmolar therapies.
Fill in the blank: The Glasgow Coma Scale (GCS) score indicating severe TBI is _______.
<8
A GCS score below 8 indicates a severe level of consciousness impairment.
