Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuroscience > Traumatic head and spinal injury > Flashcards

Traumatic head and spinal injury Flashcards

1
Q

Which structures may the direct effects of trauma be seen in? Which types of trauma affect each structure?

A

Scalp - lacerations
Skull - fractures
Meninges - vascular injury, lacerations
Brain/spinal cord - contusions, lacerations, diffuse axonal injury, diffuse vascular injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is concussion?

A

A clinical term to describe instantaneous loss of consciousness, temporary respiratory arrest and loss of reflexes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes concussion?

A 
Sudden change in the momentum of the head
Pathology unknown (maybe RAS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is a head injury assessed clinically?

A

Glasgow coma scale
13 or above: mild brain injury
9-12: moderate brain injury
8 or less: severe brain injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is the bony casing around the brain and spinal cord both a blessing and a curse?

A

Blessing: high energy transfer required to breach layer
Curse: Soft tissue against hard bone can cause problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is damage caused in penetrating injuries and in closed injuries?

A

Penetrating: direct disruption of tissue
Closed: movement and compression of neural and vascular structures within bony casing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the secondary effects of traumatic head injury?

A 
Ischaemia
Hypoxia
Cerebral swelling
Infection
Epilepsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do skull fractures generally behave?

A

Radiate from point of impact

May be depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the different classes of skull fractures?

A

Open: communicate with surface
Closed: do not communicate with surface
Comminuted: splintering of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does blood or CSF coming from the nose and/or ears indicate?

A

Basal skull fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is it important to diagnose skull fractures?

A

They are an indicator of high energy transfer energy

Therefore, potential for direct brain sequelae is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why are extradural haematomas less common in elderly people?

A

Dura becomes more adherent to the skull with age, so that blood cannot track through it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are subdural haematomas more common in elderly people?

A

Brain shrinks > veins stretched> more susceptible to rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why can subdural haematomas be acute or chronic?

A

Can be self-limiting, as it is very low pressure blood

Can continue to accumulate unnoticed until it causes raised ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are contusions?

A

Haemorrhagic necrosis or bruising of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are coup injuries?

A

Those that occur at the site of impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are contrecoup injuries?

A

Injuries that occur on the opposite side of the brain when the head is not immobilised at the time of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why do contusions often occur at the base of the brain?

A

Many irregularities in the cranial floor which the brain may rub against

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some common sites for contusions at the base of the brain?

A

Inferior frontal lobes

Inferolateral temporal lobes

20
Q

Describe the appearance of old cerebral contusions?

A

Abnormal gyri
Collapsed brain tissue
Yellowish

21
Q

Why do old cerebral contusions appear yellowish?

A

Macrophages have removed necrotic tissue and blood

Leave behind haemosidirin

22
Q

What causes a traumatic cerebral haematoma?

A

Intra-cerebral haemorrhage when a large blood vessel is ruptured

23
Q

Define a laceration?

A

Penetration by foreign body or skull fragments

24
Q

Describe the damage caused by missile injuries?

A

Brain at either side of bullet path has shockwave effect

So, actual injury to brain can be much greater in diameter than the bullet itself

25
Q

What is required for cerebral tissue to tear?

A

Severe enough impact with sufficient energy transfer

26
Q

What is the most vulnerable site for cerebral tissue tearing?

A

Ponto-medullary junction

27
Q

Which part of the brain is most susceptible to diffuse axonal injury?

A

Corpus callosum

28
Q

Describe the microscopic appearance of diffuse axonal injury lesions in the corpus callosum?

A

Silver stain > axonal spheroids (area of swelling in axon, marker of transection)

29
Q

Describe the macroscopic appearance of diffuse vascular injury?

A

Spotty haemorrhages

30
Q

Describe the longterm effects of diffuse axonal injury?

A

Brain atrophy
Enlarged ventricles
Thin corpus callosum
Thin white matter

31
Q

Describe the toothpaste effect in cord-compressive acute traumatic injuries?

A

Spinal cord squashed by bone and cartilage > cord tissue squeezed both proximally and distally

32
Q

List some of the longer term sequelae after brain trauma?

A

Infections
Hydrocephalus
Epilepsy
Chronic traumatic encephalopathy

33
Q

What is hydrocephalus?

A

Ventricles become dilated and brain tissue is compressed as a consequence

34
Q

Why may hydrocephalus occur in the long term after brain trauma?

A

Exit for CSF may be blocked off by scar tissue

35
Q

What are the three major components of the cranium?

A

Brain tissue
CSF
Blood

36
Q

How much blood and CSF usually exists in the cranium

A

150mL each

37
Q

How does the brain initially respond to an expanding brain lesion?

A

Expulsion of as much venous blood and CSF as possible

38
Q

Where can herniations of brain tissue occur due to raised ICP?

A

Through dural openings

39
Q

What happens as ICP approaches arterial pressure?

A

Brain perfusion ceases

CPP=MAP-ICP

40
Q

What is a major structural sequelae of raised ICP?

A

Herniation of brain tissue

41
Q

What are the causes of raised ICP?

A 
Trauma
Tumor
Infarction
Haemorrhage
Infection
Cerebral oedema
Increased CSF
42
Q

What are the two main types of cerebral oedema?

A

Vasogenic

Cytotoxic

43
Q

Describe vasogenic cerebral oedema?

A

Due to BBB disruption with increased vascular permeability
Predominantly involves white matter
Responds to normal treatment

44
Q

Describe cytotoxic oedema?

A

Increased intracellular fluid to cell membrane injury
Involves grey and white matter
Non-steroid responsive

45
Q

Which three brain areas are prone to herniation with raised ICP?

A

Medial temporal lobe
Cingulate gyrus
Cerebellar tonsil

Neuroscience (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions