Week 2: Nervous system anatomy/disorders (Injuries, Hematomas, ICP)

Question 1

What is a mild brain injury

Answer 1

bruising of the tissue

Question 2

what is a severe brain injury

Answer 2

destruction of the brain tissue
swelling of the brain

Question 3

what is a concussion

Answer 3

mild traumatic brain injury result of mild blow to head
reversible interference with brain function
amnesia and headaches can follow
usually recover within 24h w/o perm. damage

Question 4

what occurs in brain when a concussion happens

Answer 4

sudden excessive movement in the brain disrupted neurologic function and a loss of conciousness

Question 5

whats a contusion

Answer 5

result from blunt blow in head
bruising of brain tissue and rupture of small blood vessels and edema
possible residual damage

Question 6

what causes residual damage when contusion occurs

Answer 6

regen of scar tissue

Question 7

whats a closed head injury

Answer 7

skull not fractured
brain tissue injured
blood vessels may rupture
extensive damage can occur when head roates

Question 8

whats an open head injury

Answer 8

fractures
penetration of brain
by sharp objects

Question 9

what are depressed skull fractures

Answer 9

displacement of piece of bone below level of skull

• compression of brain tissue
• blood supply to area imparied

Question 10

whats a basilar fracture

Answer 10

occur at base of skull
leaking of CSF through ears or nose

ex. when forehead hits winsheild car accident

Question 11

whats a contrecoup injury

Answer 11

area of brain contralateral to site of direct damage when brain bounces off skull

ex. acceleration/ deceleration injuries

Question 12

how can you tell the diff. btwn normal nasal discharge and CSF

Answer 12

consistency
CSF has glucose

Question 13

primary brain injuries

Answer 13

involve laceration/compression of brain tissue
unusual force can rotate/shift brain inside skull

ex. mvmt. of lobes against eachother
damage by rough/irregular inner surface of skull
piece of bone/foregin object
rupture or compression of cerebral bl.vess.

Question 14

secondary brain injuries

Answer 14

result from additional effects of
- cerebral edema
- hemorrhage
-hematoma
-cerebral vasospasm
-infection
-ischemia related to systemic issues

Question 15

what does trauma to brain tissue cause

Answer 15

loss of function in part of body controlled by that area of brain

Question 16

what does cell damage and bleeding lead to

Answer 16

inflammation, vasospasm around inury site
icp
ischemia
dysfunction

Question 17

what does vasospasm cause

Answer 17

lack o2
vessels shrink (constriction)

Question 18

what are hematomas

Answer 18

relation to meninges

Question 19

epidural hematoma

Answer 19

bleeding btween.
dura and skull

-signs arise within a few hrs of injury when a patient loses consciousness after period of responses

Question 20

whats a subdural hematoma

Answer 20

bleeding btwn.
dura and arachnoid

-acute 24h
-subacute 1wk
-tear in arachnoid

Question 21

what does tear in arachnoid allow

Answer 21

CSF to leak into subdural space
creating additional pressure

Question 22

whats a subarachnoid hemorrhage

Answer 22

bleeding btwn
arachnoid and pia

-traumatic bleeding from bl.vess. at base of brain
-blood mixes w CSF- not localized hematoma

Question 23

whats an intracerebral hematoma

Answer 23

results from contusions or shearing injuries
may develop several days after injury

Question 24

what do all types of hematomas lead to

Answer 24

local pressure on adjacent tissue
increase in icp

Question 25

what are signs and symproms of hematomas

Answer 25

focal & general signs of increased ICP seizures cranial nerve impariement otorrhea rhinorrhea fever

Question 26

whats a fever sign of in relation to hematomas

Answer 26

hypothalmic impairment or cranial systemic infection

Question 27

what can be used to determine the extent of brain injury

Answer 27

ct mri

Question 28

glucocorticoid agents

Answer 28

decrease edema

Question 29

antibiotics

Answer 29

reduce risks of infection

Question 30

surgery

Answer 30

reduce icp

Question 31

blood products and o2

Answer 31

used to protect remaining brain tissue

Question 32

what within the brain is not compressible

Answer 32

skull fluids blood CSF

Question 33

increase of fluid or additional mass causes what?

Answer 33

increase pressure in brain

Question 34

what happens when their is increased pressure in brain

Answer 34

ischemia and infarction of brain tissue

Question 35

what is the cycle of increased ICP

Answer 35

increased ICP vasoconstriction inflammatory response vasodilation increased blood supply to brain increased fluid in brain hematoma growth occurs

Question 36

whats the pathophysiology behind increased ICP

Answer 36

body first tries to shift CSF out of brain by increasing venous return hypoxia occurs, this causes vasodilation through autoregulation effect this increases fluid in skull

Question 37

what are early signs of increased ICP

Answer 37

decreased conciousness/responsiveness severe headache vomiting papilledema

Question 38

why does severe headaches occur when ICP increases

Answer 38

stretching of dura and walls of large vessels

Question 39

what is vomiting a result of when ICP increases

Answer 39

pressure stimulating emetic center in medulla

Question 40

why does papilledema occur

Answer 40

increased ICP and swelling of optic disc

Question 41

what affects size and response of pupils

Answer 41

pressure on oculomotor nerve

Question 42

whats ptosis

Answer 42

droppy eyelid

Question 43

what are visual signs of increased ICP

Answer 43

ipsilateral pupil ptosis

Question 44

what area the componenets of the cushings reflex of cushings triad

Answer 44

systolic hypertension decrease HR decrease RR

Question 45

why does systolic hypertension occur

Answer 45

systemic vasoconstric to pump more blood to brain to relieve ischemia

Question 46

why does HR decrease

Answer 46

by baroreceptor in carotid arteries in response to high BP

Question 47

why does RR decrease

Answer 47

by chemoreceptors bcz of low co2

Question 48

why does only systolic BP increase

Answer 48

bcz of slow HR and intermittent cushing triad

Question 49

what is significant in ppl w ICP

Answer 49

increase Pulse pressure

Question 50

what occurs if ICP is not relieved

Answer 50

drop in BP RR control destroyed cheyne strokes respiration

Question 51

why does bp drop if icp is not relieved

Answer 51

loss of circulatory control with severe ischemia and neruonal death

Question 52

why are respiratory controls destoryed when ICP is not releived

Answer 52

herniation pushes donw on brain stem

Question 53

what are cheyne stokes respiration

Answer 53

alternating apnea and periods of increased and decreasing respirations

Question 54

whats elevated when icp is increased

Answer 54

pressure of CSF

Question 55

whta does it mean when CSF is pink

Answer 55

contains erythrocytes RBC

Question 56

what does it mean when CSF is cloudy and yellow

Answer 56

contains WBC

Question 57

what may abnormal protein levels indicate

Answer 57

neoplasm

Question 58

contents moved from one place to another through a membrane

Answer 58

herniation