Brainscape's Knowledge GenomeTM

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


See full index

Module 7 > Traumatic Brain Injury > Flashcards

Traumatic Brain Injury Flashcards

1
Q

Skull has 3 essential components

A

Brain tissue, blood and cerebrospinal fluid

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

Primary injury

A

Injury from car crash or impact
Happens then and there

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

Secondary injury

A

Will come from swelling , hypoxia , hypotension , etc

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

Monro-Kellie doctrine

A

When the volume of something in our head goes up .. the volume of something else has to go down

The head stays at 100 %

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

Which volume in the skull goes down first

A

CSF
It can be displaced into one of the cisterns in the head and even stop manufacturing

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

Next thing in the skull that would go down

A

Blood supply in the brain
It can’t be pushed anywhere and then the vessels will be compressed and the blood is not going to circulate
Once this happens then the pt starts becoming hypoxic leading to ischemia

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

Last thing that goes up in the skull

A

The brain tissue swells up leading to herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cerebral blood flow is

A

Amount of blood in mL passing through 100 g brain tissue in 1 minute

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

Autoregulation of cerebral blood flow

A

So we can have a consistent amount of blood in the brain

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

MAP goal

A

At least 65 preferably 70

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

Map of greater than or equal to 150

A

Causes all of the autoregulation to shut down in the brain
Vessels lose their elasticity

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

Normal ICP

A

5-15 mmhg

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

Sustained intracranial of 20 or greater

A

Considered abnormal and must be treated

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

What happens when the brain loses its autoregulation

A

We can drain the pt head

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

CPP

A

Map- ICP

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

MAP formula

A

Systolic +diastolic x2 / 3

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

Why is diastolic pressure multiplied by two

A

The diastolic pressure last longer than my systolic

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

Normal ICP

A

5-15 mmhg

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

When do people posture?

A

If we go in and mess with them but they may be posturing the whole time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ICP increase .. Cushing triad

A

Systolic BP increase
Decrease pulshe
Altered resp pattern (kussmauhs , Cheyenne strokes, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indicated increased intracranial pressure (question in class)

A

Headache
Vomiting
Posturing
Pupillary changes’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cushing triad ICP

A

Increased systolic BP
Decrease pulse
Decrease resp

Neuro issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do we support brain function in increased ICP

A

providing o2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is nutritional support important during increase ICP

A

The body needs more calories becuase it uses so many to heal .. we also do not want the gi to release endotoxins..

Even if it is just a trickle feed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Death occurs at three point in time after injury. When is this?

A

Immediately after injury
Within 2 hours after injury
3 weeks after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

People who have multiple concussions such as football players and boxers..what do they lose?

A

Their language skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Skull fractures

A

Linear or depressed
Simple , communituted or compound
Closed or open

28
Q

Diffuse injury

A

Concussion
Diffuse atonal injury

29
Q

Focal injury

A

Lacerations
Contusion
Coup -contrecoup

30
Q

Contusion

A

Bruise

31
Q

Diffuse axonal injury

A

Widespread damage of brain
Unconscious and unresponsive
Jello consistency

32
Q

A pt falls 10 ft and has a basilar skull fracture.. what is our major concern?

A

If this break tore the dura and have a meningeal leak (CSF) which could set them up for a big infection

33
Q

Epidural hematoma

A

Medical emergency bleeding inbetween the dura and the skull
Typically an arterial bleed ( fast)
Comes from the middle meningeal artery
O.R ASAPPPPPPP!!!!!!!!
Faster in the O.R it dramatically changes their outcome

34
Q

Classic signs of epidural hematoma

A

Walking dead
Brief onset of unconsciousness at the scene
Immediately after it happen
Followed by a lucid period of consciousness then knocked out again

35
Q

Acute Subdural hematoma

A

Similar signs and symptoms to compression in increased ICP

Don’t go to the OR .. they wait a moment to see if they’ll seal them selves up and reabsorb

Venous blood (much slower) ( breaching veins in the head)

36
Q

Subacute subdural

A

After initial bleeding, may appear to enlarge over time

When they go in for 2nd CT or MRI it will look bigger than what they came in then we will have to do something
S/s of increase ICP

37
Q

Chronic subdural

A

Peak incidence in sixth and seventh decades of life

( alcoholics at risk, elderly people)

38
Q

Intracerebral hemorrhage

A

Bleeding in the parechyma
Treat pt symptomatically and let the blood reabsorb
The outcome depends on how bad the bleed was

39
Q

Subarachoid hemorrhage

A

Present in the ER with a headache
Sometimes mistaken as a migraine
So dont shew off s/s because it “might “ be a migraine..

Bleeding into the subarachnoid space

40
Q

What causes a subarachnoid hemorrhage

A

Uncontrolled hypertension , trauma, uncontrolled BP

41
Q

Vasospasm

A

In about 3-14 days is when a pt can have a vasospasm in head after original bleed
Dangerous and can cause hypoxia leading to ischemia leading to permanent damage =cell death

42
Q

Treatment for vasospasm

A

Make them hypervolemic
Let them be permissibly hypertensive
Nimodipine(calcium channel blocker )

43
Q

Battle signs from head injury

A

Periorbital edema and ecchymoisis
Rhinorrhea
Ottorhea
Postaurcular ecchymosis

44
Q

CSF

A

Very sticky and sweet

45
Q

If CSF if dripping from nose and ears

A

Grab a gauze pad and let it drip on .. change it when needed

Never pack ears or nose because we dont want it trapped anywhere besides the dura and we run the risk of it becoming infected

46
Q

Why do we question an NG tube with head injury

A

Because it scoots up and down the nose and runs the risk of meningitis

And document that you questioned the order

47
Q

GCS

A

Best eye response
Best verbal response
Best motor response

48
Q

When we need to do a neuro assessment and the pt is sedated .. what do we do

A

Let the physician tell you to bring them up from sedation to do neuro assessment

49
Q

What is important to remember in GCS

A

To quantify what the pt can do in their limit like if they can only squeeze your hand they obey command but quantify it

50
Q

If a person is intubated but can write you notes

A

Oriented ..but writes note

Non verbal but wrote a note

QUANTIFY

51
Q

When giving report what is important to keep in mind when going over GCS

A

Do it at bed side with new nurse so she knows what ur looking at

Take into consideration what the pt family saw when you weren’t in the room

52
Q

Nerve I

A

Olfaction
Test using an alcohol pad

53
Q

Nerve II

A

Vision
Test with a vision chart

54
Q

Nerve III

A

Most eye muscles
“Follow the moving finger”

Some ICP can’t .. have odd eye movement

55
Q

What if someone can’t see

A

Verbalize where things are.. put them in the same spot .. tell them when you move something

56
Q

How we monitor ICP

A

Epidural
Intraparenchymal
Subarachnoid
Ventricular

57
Q

Gold standard monitoring for ICP

A

Ventricular
Goes in into the drainage pressure into the brain

58
Q

How are we going to monitor drainage system with ICP

A

Maintain temp control and watch for infection- watch labs, hot , flushed , running fever , maintain sterility

59
Q

How to keep sterility safe with drainage system

A

Biopatch and dressing over

60
Q

How can we support brain oxygenation w increase ICP

A

Oxygenation pao2 100%

61
Q

Interprofessional care increase ICP

A

Identify and treat the underlying cause
Support brain function
Drug therapy
Nutrition therapy

62
Q

What can someone with a concussion tell us

A

Everything but not about the accident

63
Q

Biggest concern of basilar skull fracture

A

Leak in meningeal , CSF leak, leading to a major infection

64
Q

What vessel bled for pt to have a subdurral

A

Bridging veins

65
Q

What. Is a GCS looking at

A

The best a pt can do

Module 7 (24 decks)

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