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brain injury Flashcards

1
Q

a life-threatening emergency in patients with spinal cord injury that causes a hypertensive emergency

A

autonomic dysreflexia

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2
Q

a condition that involves total loss of sensation and voluntary muscle control below the lesion

A

complete spinal cord lesion

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3
Q

a temporary loss of neurologic function with no apparent
structural damage to the brain

A

concussion

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4
Q

bruising of the brain surface

A

contusion

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5
Q

a condition in which there is preservation of the sensory or motor fibers, or both, below the lesion

A

incomplete spinal cord lesion

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6
Q

bladder dysfunction that results from a disorder or dysfunction of the nervous system; may result in either urinary retention or bladder overactivity

A

neurogenic bladder

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7
Q

paralysis of the lower extremities with dysfunction of the bowel and bladder from a lesion in the thoracic, lumbar, or sacral region of the spinal cord

A

paraplegia

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8
Q

initial damage to the brain that results from the traumatic
event

A

primary injury

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9
Q

an insult to the brain subsequent to the original traumatic event

A

secondary injury

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10
Q

an injury to the spinal cord, vertebral column, supporting soft tissue, or intervertebral discs caused by trauma

A

spinal cord injury (SCI)

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11
Q

varying degrees of paralysis of both arms and legs, with dysfunction of bowel and bladder from a lesion of the cervical segments of the spinal cord

A

tetraplegia

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12
Q

formerly called quadriplegia

A

tetraplegia

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13
Q

severing of the spinal cord

A

transection

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14
Q

severing all the way through the cord

A

complete transection

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15
Q

severing partially through the cord

A

incomplete transection

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16
Q

an injury to the skull or brain that is severe enough
to interfere with normal functioning

A

traumatic brain injury

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17
Q

another word for traumatic brain injury

A

craniocerebral trauma

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18
Q

occurs when the head accelerates and then rapidly decelerates or collides with another object and brain tissue is damaged, but there is no opening through the skull and dura

A

closed traumatic brain injury

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19
Q

occurs when an object penetrates the skull, enters the brain, and damages the soft brain tissue in its path (penetrating injury)

A

open traumatic brain injury

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20
Q

when blunt trauma to the head is so severe that it opens the scalp, skull, and dura to expose the brain

A

open traumatic brain injury

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21
Q

encompasses any damage to the head as a result of trauma

A

head injury

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22
Q

why would a scalp injury bleed profusely

A

because of the many blood vessels that constrict poorly

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23
Q

what are the locations of fractures

A

temporal, frontal, basal

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24
Q

a break in the continuity of the bone

A

linear fracture

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25
Q

splintered or multiple fracture line

A

comminuted fracture

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26
Q

a fracture where the skull is forcefully displaced downwards

A

depressed skull fracture

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27
Q

scalp laceration or tear in the dura

A

open fracture

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28
Q

dura is intact

A

closed fracture

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29
Q

what are clinical manifestations of head injury

A

persistent localized pain
swelling
hemorrhage from the nose
blood under the conjunctiva
battle sign
CSF otorrhea
CSF rhinorrhea

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30
Q

ecchymosis seen over the mastoid

A

battle sign

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31
Q

what are the diagnostic tests for head injury

A

computed tomography scan
magnetic resonance imaging scan

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32
Q

types of brain injuries

A

focal
diffuse

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33
Q

the brain is bruised and damaged in a specific area because of severe acceleration–deceleration force or blunt trauma.

A

contusion

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34
Q

characteristics of contusions

A

loss of consciousness
hemorrhage
edema

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35
Q

contusion effects of injury peak after what time

A

18 to 36 hours

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36
Q

types of hematoma

A

epidural (above the dura)
subdural (below the dura)
intracerebral (within the brain)

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37
Q

this subdural hematoma is caused some kind of head injury

A

acute subdural hematoma

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38
Q

brain damage that occurs directly under the point of impact

A

coup injury

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39
Q

occurs on the opposite side of the brain from where the head is stuck

A

countercoup injury

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40
Q

brain is bruised and damaged in a specific area

A

cerebral contusion

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41
Q

where is the origin of the epidural hematoma

A

middle meningeal artery

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42
Q

what is the cause of epidural hematoma

A

skull fracture

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43
Q

a period when patient is awake and conversant (time where compensator mechanism is working)

A

lucid interval

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44
Q

where is the origin of the bleeding of subdural hematoma

A

venous

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45
Q

types of subdural hematoma

A

chronic and acute

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46
Q

subdural hematoma associated with major head injuries

A

acute subdural hematoma

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47
Q

what are manifestations of acute subdural hematoma

A

rapidly developing symptoms
altered level of consciousness
pupillary signs
hemiparesis

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48
Q

what are the sighs of rapidly expanding mass

A

coma
cushing’s triad (hypertension, bradycardia, bradypnea)

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49
Q

this type of subdural hematoma develops from minor head injuries and are common among older adults

A

chronic subdural hematoma

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50
Q

what are the manifestations of chronic subdural hematoma

A

severe headache (on and off)
alternating focal neurologic signs
personality changes
mental deterioration
focal seizures

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51
Q

what is the location of intracerebral hematoma

A

cerebral parenchyma

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52
Q

what are the causes of intracerebral hematoma

A

head injuries involving severe force to the head over a small area
raptured aneurysm
hypertension
bleeding disorders

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53
Q

what are the manifestations of intracerebral hematoma

A

neurologic deficits - initial sign
headache

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54
Q

what are the medical management of intracerebral hematoma

A

supportive care
control of icp
fluid and electrolyte replacement
antihypertensive

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55
Q

what are the surgical management for intracerebral hematoma

A

craniotomy
craniectomy

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56
Q

what is a mild form of neurologic brain injury

A

concussion

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57
Q

what is the cause of a concussion

A

blunt trauma from

  • acceleration-deceleration force
  • direct blow
  • blast injury
58
Q

what are the clinical manifestations of frontal lobe involvement in concussions

A

bizarre, irrational behavior

59
Q

what are the clinical manifestations of temporal lobe involvement

A

temporary amnesia or disorientation

60
Q

why are narcotics avoided for concussion pain

A

it may alter the neurologic exam

61
Q

how many days til the patient can gradually return to nonsport activities

A

2-3 days

62
Q

a region in an organ or tissue which has suffered damage through injury or disease

A

lesion

63
Q

what are the parts of the spinal cord

A
  • 7 cervical spine
  • 12 thoracic spine
  • 5 lumbar spine
  • coccyx
64
Q

responsible for stimulating movement and feeling

A

spinal cord root

65
Q

what nerves supply the head, neck, shoulders, arms, and hands

A

cervical nerves (8 pairs)

66
Q

what cervical nerves control neck muscles

A

c1-c3

67
Q

what cervical nerves control the diaphragm

A

c4

68
Q

what cervical nerves control the deltoid

A

c5

69
Q

what cervical nerve controls the wrist

A

c6

70
Q

what cervical nerve controls the triceps

A

c7

71
Q

what cervical nerve controls the fingers

A

c7 - c8

72
Q

these spinal cord roots connects portions of the upper abdomen and muscles in the back and chest areas

A

thoracis nerves (12 pairs)

73
Q

what thoracic nerve controls the hand

A

t1

74
Q

what thoracic nerve controls the intercostals

A

t2-t12

75
Q

what nerve controls the abdominals

A

t7-L1

76
Q

what thoracic nerve controls ejaculation

A

t11-L2

77
Q

what spinal cord root feeds the lower back and legs

A

lumbar nerves (5 pairs)

78
Q

what lumbar nerve controls the hips

A

L2

79
Q

what lumbar nerve controls the quadriceps

A

L3

80
Q

what lumbar nerves control the hamstrings-knee

A

L4-L5

81
Q

what lumbar nerves control the foot

A

L4-S1

82
Q

what spinal cord root supplies the buttocks, legs, feet, anal and genital areas of the body

A

sacral nerves (5 pairs)

83
Q

what sacral nerve controls penile erection

A

S2

84
Q

what sacral nerve controls the bowel and bladder

A

S2-S3

85
Q

what are the risk factors of spinal cord injury

A

younger age
male gender
alcohol and drug use

86
Q

what are the major causes of death for people with spinal cord injury

A

pneumonia
pulmonary embolism
sepsis

87
Q

what are the mechanisms of sci

A

concussion - patient fully recovers
contusion
laceration
compression - due to slipped disk or tumor
transection - severed spinal cord

88
Q

what are the vertebrae commonly involved in spinal cord injury

A

C5-C7 - deltoid, wrist, fingers
T12 - intercostals, ejaculation
L1 - abdominals, intercostals

89
Q

what causes tetraplegia

A

C4 or C6 injury

90
Q

what causes paraplegia

A

T6-L1 injury

91
Q

what sci has this clinical manifestation
- injury at c2 and c3 are usually fatal

A

cervical sci

92
Q

what sci has this clinical manifestation
- tetraplegia

A

cervical sci

93
Q

what sci has this clinical manifestation
- respiratory muscle paralysis

A

cervical sci

94
Q

what sci has this clinical manifestation
- bowel and bladder retention

A

cervical sci/thoracic sci/lumbar sci

95
Q

what sci has this clinical manifestation
- paraplegia

A

thoracic sci/lumbar sci/sacral sci

96
Q

what sci has this clinical manifestation
- poor control of upper trunk

A

thoracic sci

97
Q

what sci has this clinical manifestation
- autonomic dysreflexia

A

thoracic sci (lesion above t6)

98
Q

what sci has this clinical manifestation
- allows erection but no ejaculation

A

sacral sci (injury above s2)

99
Q

what sci has this clinical manifestation
- prevents erection and ejaculation

A

sacral sci (injury between s2-s4)

100
Q

what sci has this clinical manifestation
- bowel and bladder incontinence

A

sacral sci

101
Q

this is moving the patient as one unit. it maintains spinal alignment

A

logrolling

102
Q

this is given within the first 24-48 hours

A

high dose of methylprednisolone Iv

103
Q

why is high dose of methyprednisolone IV a controversial method

A

it only offers slight benefit for sci

104
Q

this prevents hypoxemia which can worsen neurologic deficits

A

oxygenation

105
Q

what should be taken care of if endotracheal intubation is needed

A

neck flexion and extension

106
Q

this is the restoration of preinjury position

A

reduction

107
Q

this provides immobilization of the c spine while allowing early ambulation

A

halo and vest

108
Q

this provides immobilization of the c spine while allowing early ambulation

A

halo and vest

109
Q

this reflects a sudden depression of reflex activity in the spinal cord below level of injury

A

spinal shock

110
Q

what are the clinical manifestations of spinal cord shock

A

paralysis
absent reflexes
hypotension
bradycardia
bowel and bladder retention

111
Q

this develops as a result of the loss of autonomic nervous system function below the level of the lesion

A

neurogenic shock

112
Q

what are the clinical manifestations of neurogenic shock

A

hypotension
bradycardia
decreased cardiac output
venous pooling in extremities
peripheral vasodilation
absence of perspiration in paralyzed areas of body

113
Q

a complication resulting from immobility

A

venous thromboembolism

114
Q

places the patient at risk to develop deep vein thrombosis and/or pulmonary embolism

A

venous thromboembolism

115
Q

what is the clinical manifestation of deep vein thrombosis

A

positive homan’s sign

116
Q

what are the clinical manifestations of pulmonary embolism

A

pleuritic chest pain
anxiety
shortness of breath
abnormal arterial blood gas (increased PaCO2 and decreased PaO2)

117
Q

what are the preventive management for venous thromboembolism

A

low dose anticoagulation using warfarin
sequential pneumatic compression device

118
Q

why should you never massage the calves or thighs of a patient who is immobile

A

because it might dislodge an undetected thromboembolus

119
Q

this causes hyperstimulation of the SNS

A

autonomic dysreflexia

120
Q

what are the triggers of autonomic dyreflexia

A

bladder distention
fecal impaction
skin stimulation (pressure sore above level of lesion)

121
Q

what are the clinical manifestations of autonomic dyreflexia

A

severe headache
blurring of vision
nasal congestion
hypertension
bradycardia
sweating above lesion
goose flesh below lesion

122
Q

what should u do to lower the bp of a patient suffering autonomic dysreflexia

A

place them in a sitting position to lower bp by gravity

123
Q

what should u do to a patient suffering autonomic dysreflexia to prevent bladder distention

A

catheterize as indicated

124
Q

what should u do to a patient suffering autonomic dysreflexia to prevent fecal impaction

A

perform manual extraction as indicated

125
Q

what should u do to prevent skin stimulation in a person suffering from autonomic dysreflexia

A

facilitate turning to sides to prevent pressure sores

126
Q

this is a ganglionic blocking agent for the treatment of autonomy dysreflexia

A

hexamethonium chloride

127
Q

this is a vasodilator for the treatment of autonomy dysreflexia

A

sodium nitroprusside

128
Q

what should u use to wash wounded area at home and in hospital

A

soap and water/sterile nss

129
Q

how many minutes should u apply pressure for scalp abrasion

A

10 minutes

130
Q

what should u use to remain sterility during application of pressure on bleeding site

A

clean gloves/gauze

131
Q

what should u do to reduce swelling and pain

A

apply ice compress for 20 minutes

132
Q

how many minutes should you apply ice compress for a scalp abrasion

A

20 minutes

133
Q

hat are the signs and symptoms for increased icp

A

restlessness
anisocoria
headache
projectile vomiting

134
Q

what is another word for controling bleeding

A

hemostasis

135
Q

how many hours should u delay the closure for scalp laceration

A

24 hours

136
Q

when should you administer tetanus toxoid for a patient with scalp laceration

A

if the last known dosage was >5 years ago

137
Q

this is the ecchymosis on the periorbital area

A

raccoon eyes

138
Q

this is the CSF leak from the ears

A

CSF otorrhea

139
Q

this is the CSF leak from the nose

A

CSF rhinorrhea

140
Q

what is the management for acute subdural hematoma

A

emergency craniotomy

141
Q

what is the management for chronic subdural hematoma

A

burr hole (multiple)
craniotomy

brain injury (3 decks)

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