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Uppers > Uppers Head and C Spine Injuries > Flashcards

Uppers Head and C Spine Injuries Flashcards

1
Q

skull bones

A 
frontal
parietal temporal
-protects 7 cranial nerves
sphenoid
-forms a portion of the orbit
-houses paranasal sinuses
occipital
ethmoid
-between orbits
-separates nasal cavity from brain
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2
Q

skull sutures

A 
coronal
-between frontal and parietal bones
lambdoidal
-between parietal and occipital
squamosal
-between parietal and temporal
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3
Q

function of skull

A

protecting of the brain

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4
Q

cerebrum function

A 
cognition (conscious thought)
memory torage
motor and sensory function
emotion
special senses
behavior
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5
Q

cerebellum

A

balance - coordination
involuntary motor
smooth muscle control information processing

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6
Q

diencephalon

A 
hypothalamus, thalamus
controls pituitary gland
-homeostasis
-hormone regulation
circadian rhythm
processes and routs sensory information
-everything but smell
memory
emotion control
regulates body temperature
-hypothalamus
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7
Q

brainstem

A 
pons, medulla oblongata, midbrain
basic life functions
-HR
-respiration
peripheral blood flow
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8
Q

meninges

  • function
  • layers
A 
buffer to brain and spinal cord
layers
-dura mater
-arachnoid mater
-pia mater
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9
Q

dura mater

A

hard mother
outermost, next to skull
contain meningeal arteries

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10
Q

arachnoid mater

A

spider mother

separated from dura mater by subdural space

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11
Q

pia mater

A

tender mother
separated from arachnoid mater by subarachnoid space
-location of CSF
brain stem

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12
Q

CSF

A

originates from choroid plexus

proves padding for brain and spinal cord

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13
Q

vascular anatomy

A 
vertebral artery
carotid artery
-external
-internal
Circle of Willis
-internal carotid and vertebral arteries work together to supply blood to the brain
brain uses 20% of oxygen at rest
usage increases 7% per one degree C
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14
Q

intracranial hemorrhage

-types

A

epidural hematoma

subdural hematoma

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15
Q

epidural hematoma

A 
between dura and skull
-dura peeled off skull
arterial bleed
may occur concomitant to a skull fracture
onset of Sx begins w/in hours
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16
Q

epidural hematoma progression of Sx

A

possible unconsciousness or concussion signs
period of lucid consciousness
patient becomes disoriented, confused, or drowsy
C/O headache with increasing intensity
S/S of cranial nerve disruption
onset of coma
if untreated, death or permanent brain damage occurs

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17
Q

subdural hematoma

A 
forms between brain and dura mater
venous bleed
Sx take longer to develop
Sx
-headache
-decreased LOC
18
Q

skull fracture

  • fact
  • types
A

skin increases the amount of pressure the skull can withstand from 40 psi to 440-490 psi
types
-linear - no displacement, pain
-comminuted - fragmented
-depressed - refer but check nerves as well

19
Q

cervical spinal cord trauma

  • mechanisms
  • death
  • cervical fracture or dislocation
A

mechanisms
-impingement - secondary to bony displacement
-compression - secondary to hemorrhage, edema, ischemia of the cord
trauma above C4 = high probability of death
cervical fracture or dislocation
-bony fragments lacerate the cord
-swelling compresses the cord
-vertebra shifts - narrowing the spinal cord

20
Q

arriving on the scene

  • best-case scenario
  • worst-case scenario
  • unconscious
  • number of responders
A 
best-case scenario
-athlete is alert and responsive
worst-case scenario
-prone athlete is unconscious and has no pulse
all unconscious athletes must be treated as if they have a C-spine injury until determined otherwise
2 responders is ideal
-first: hold inline stabilization
-second: performs assessment
21
Q

evaluation of athlete’s position

A 
supine
prone/side-lying
posturing
-decorticate rigidity
-decerebrate rigidity
22
Q

decorticate rigidity

A 
above brainstem
plantar flexed
internally rotated leg
elbows flexed
shoulders adducted
23
Q

decerebrate rigidity

A 
brainstem injury
a lot of extension
arms extended
plantarflexed
wrists flexed
forearm pronated
24
Q

eye opening scale

A

spontaneous - 4 - patient is conscious
to verbal command - 3 - opens eyes in response to verbal command
to pain - 2 - opens eyes in response to pain
none - 2 - does not open eyes to any stimuli

25
Q

verbal scale

A

oriented, converses - 5 - patient is aware of self and surroundings
disoriented, converses - 4 - patient is articulate, but disoriented
inappropriate words - 3 - random and exclamatory speech
incomprehensible - 2 - “blabbering”
no response - 1 - no audible sounds

26
Q

motor scale

A

obeys verbal commands - 6 - readily moves limbs as instructed
localizes painful stimuli - 5 - moves limb in an effort to avoid pain
flexion withdrawl - 4 - pulls away from pain with a flexion motion
abnormal flexion - 3 - decorticate rigidity
extension - 2 - decerebrate rigidity
no response - 1 - flaccid

27
Q

primary and secondary survey

A

circulation, airway, breathing

other trauma to the body

28
Q

C-spine history

A

location of Sx

mechanism of head injury

29
Q

location of Sx

A

cervical pain
head pain
radicular symptoms
pain elsewhere

30
Q

mechanism of head injuries

A 
coup
-occurs at the same side of contact
-stationary head, moving object
contrecoup
-occurs opposite to side of impact
-moving head, stationary object
repeated subconcussive forces
rotational or shear force
-whiplash
-injury without any external contact
C-spine MOI
31
Q

inspection

A

bony structures
Battle Sign
eyes
nose and ears

32
Q

bony structures

A

position of the head
cervical vertebrae
mastoid process
skull and scalp

33
Q

Battle Sign

A

basilar fracture

-fracture of a combination of the temporal, occipital, sphenoid, and ethmoid bone

34
Q

eyes

A 
general appearance
nystagmus
pupil size
pupil reaction to light
-PEARL
35
Q

nose and ears

A

bleeding
CSF - Halo test
-take a gauze pad, roll it up, place in ear
-if there is fluid, it will appear as a yellow halo on the gauze
ecchymosis - “raccoon eyes”

36
Q

palpation

A 
not over obvious deformity
bony structures
-spinous process
-transverse process
-skull
soft tissue
-musculature
-throat
37
Q

functional assessment

A

behavior
analytical skills
-Serial 7s: count backwards from 100 by 7
information processing

38
Q

memory

A 
retrograde amnesia
-events before the injury
-what happened? where are you? what quarter is it?
anterograde amnesia
-events after the injury
-remembering words
39
Q

balance tests

A

Romberg test
tandem walking
BESS test (balance error scoring system)

40
Q

cranial nerves

A

notes

Uppers (8 decks)

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