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NURS 3000 > Traumatic Brain Injury > Flashcards

Traumatic Brain Injury Flashcards

1
Q

Intracranial Fluid

A

10% CSF, 12% blood and 78% brain tissue that makes up 1.9L and does not alter the volume

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2
Q

Cerebral Blood Flow

A

requires 750-1000mL of blood due to the inability to store glucose and O2 but high demands for them.

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3
Q

Deficits in Cerebral Blood FLow Markers

A

<50 cerebral ischemia and >1500 is max constriction and intracranial hypertension occurs

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4
Q

Mean Arterial Pressure MAP

A

systolic BP + 2(diastolic BP)/3

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5
Q

ABG Levels in the Brain

A 
High CO2 (>45mmHG) or low O2 (<50mmHG) relaxes smooth muscles, dilated cerebral arteries, and decreased cerebral vascular resistance
Low O2 severe (<35mmHG) leads to anaerobic metabolism, lactic acid accumulation, high H+ concentration, low pH, increased cerebral vascular resistance,  and vasodilation when autoregulation is lost
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6
Q

Cerebral Perfusion Pressure

A

the pressure needed to ensure brain functioning, MAP + ICP

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7
Q

Intracranial Pressure ICP

A

balance of components in the brain, one goes screwy, the rest compensate. typical levels are 5-15mmHG, >20mmHG is brain damage

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8
Q

Factors that Influence ICP

A 
cardiovascular diseases
BP
intra-ab and intrathoracic pressure
body position
temp
ABGs, mostly CO2
intrinsic mechanisms that control ICP
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9
Q

Monro-Kellie Doctrine

A

state of dynamic equilibrium where the one component goes screwy, the rest compensate and fix their mess

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10
Q

Pressure-Volume Curve/Relationship

A

Stage I is intracranial compartments increase in volume, throwing off the others, autoregulation is intact
Stage II is compliance beginning to be exhausted, increased of high ICP if there are no changes
Stage III comp mechanisms are exhausted and start to exhibit the mild S&S
Stage IV we be fucked, at risk for hypoperfusion, herniation, and death, where there is a stroke occurring

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11
Q

Herniation

A

brain tissue is forcibly shifted from the compartment of greater pressure to = the pressure gradient

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12
Q

Brain Injury

A

any trauma to the skull, scalp and brain that includes an alteration in LOC, no matter how brief

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13
Q

Primary Brain Injury

A

the initial time of injury that results in displacement, bruising and damage of the three components of the skull

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14
Q

Secondary Brain Injury

A

hypoxia, ischemia, hypotension, hypertension, edema or increased OCP that occurs from a primary injury later on

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15
Q

Scalp Lacerations

A

minor brain injury. Don’t be alarmed if it bleeds a lot, that is just how it be

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16
Q

Linear Skull Fracture

A

break in the continuity of bone without alteration of the relationship of parts and not in little pieces

17
Q

Depressed Skull Fracture

A

dent in skull inward

18
Q

Simple Skull Fracture

A

linear or depressed without fragmentation or communicating lacerations

19
Q

Compound Skull Fracture

A

depressed and scalp laceration that has a communicating pathway to the intracranial cavity

20
Q

Commuted Skull Fracture

A

linear or depressed fractures with the fragmentation of bone

21
Q

Cerebral Edema

A

increase of fluid in the brain that can have many causes

22
Q

Cytotoxic Cerebral Edema

A

local disruption of the function and or makeup of the cell membranes within the brain that comes from the destructive lesions or trauma to the brain resulting in cerebral hypoxia or anoxia, Na+ depletion. Impairs sodium-potassium pump

23
Q

Vasogenic Cerebral Edema

A

changes in the endothelial lining of cerebral capillaries that cause macromolecules to leak from capillaries to the surrounding ECF space. Osmotic gradient off and increases the permeability of the blood-brain barrier

24
Q

Interstitial Cerebral Edema

A

result of periventricular diffusion of ventricular CSF in a pt with uncontrolled hydrocephalus

25
Q

S&S of Cerebral Edema

A 
altered LOC
confusion
restlessness
unilateral pupil change
altered resp pattern or resp depression
unilateral hemiparesis
stupor
abnormal motor response
bilaterally fixed and dilated pupils are terminal stage
coma
resp arrest
focal findings
papilledema
equilibrium be gone or diminished
seizures
headaches
hypertension with widened pulse pressure
hyperthermia
poor and stiff posture
26
Q

TX of Cerebral Edema

A 
neuro exam
ABCs
suction to remove excess fluids
O2
mannitol or hyeprtonic saline IV push or bolus
electrolyte balancing
corticosteroids, sedatives, and hypothermic therapy
NG tube to prevent ab distension and NPO
body positioning
slow ambulating
implementing falls safety procedures and seizure precautions
nutritional support
27
Q

Complications of Cerebral Edema

A 
inadequate cerebral perfusion
cerebral herniation
cingulate herniation or lateral displacement of brain tissues beneath the falx cerbri
tentorial herniation
herniation of cerebral tonsils
death
coma
28
Q

Diagnostic for Cerebral Edema

A 
MRI
CT 
MRA
ECG
ICP measurement
conventional cerebral angiography
brain tissue oxygenation
transcranial doppler studies
29
Q

Concussion

A

we been know, banging the brian around the skull, post-concussion is 2 weeks to 2 months post initial injury permitting that no symptoms occur

30
Q

Chronic Traumatic Encephalopathy

A

term for degeneration in the brain due to repeated concussions or traumatic brain injury need more research about the effects

31
Q

Diffuse Axonal Injury

A

axonal damage after traumatic brain injury mostly around the white matter decreased LOC, increased OCP, decerebration and global cerebral edema that can cause a vegetative state

32
Q

Focal Injury

A

a localized area of injury that consists of laceration, contusions, hematoma, and cranial nerve injuries with serious nerve damage, may require surgery to correct the necrotic brain tissue

33
Q

Contusion

A

bruising of brain tissues within a focal area

34
Q

Epidural Hematoma

A

collection of blood resulting from the bleeding between the dura and inner surface of the skull that compresses the brain that is a neuro emergency

35
Q

Subdural Hematoma

A

Collection of blood that results from bleeding between the dura and the arachnoid layer of the meningeal covering the brain

36
Q

Intraparenchymal Hematoma

A

collection of the blood within the parenchyma that results in bleeding within the brain tissue that makes up 16% of brain injuries

37
Q

Traumatic Subarachnoid Hemorrhage

A

traumatic injury forces damage to the superficial vascular structure in the subarachnoid space that causes vasospasm and diminished CBF that causes bleeding

38
Q

Brain Tumour

A

occurs in the brain and spinal cord that can be primary or secondary, resulting from metastasis from a malignant neoplasm somewhere else in the body

39
Q

Glasgow Coma Scale

A

useful in brian injuries, assess LOC through eye openings, reflexes, responsiveness to commands, ability to speak, verbal responses, reflexes to painful stimuli and motor funciton

NURS 3000 (11 decks)

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