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Neuro Exam 2 > Trauma I > Flashcards

Trauma I Flashcards

1
Q

Cerebral Edema= excessive ____ in the brain

A

fluid

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2
Q

—Vasogenic Edema:

  • —Disrupted ____-____ _____
  • —Examples – around hemorrhages and tumors; infections
A

blood brain barrier

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3
Q

—Cytotoxic Edema:

  • —Increased _______ fluid
  • —Example – hypoxic/ischemic injury, osmotic disequilibrium – dialysis or _____, _____-osmotic states - SIADH
A

—Cytotoxic Edema:

  • —Increased intracellular fluid
  • —Example – hypoxic/ischemic injury, osmotic disequilibrium – dialysis or DKA, hypo-osmotic states - SIADH
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4
Q

—Interstitial Edema:

  • —Increased ______ (ventricular) pressure pushes fluid across _____layer
  • —Example – area adjacent to enlarged _____ in hydrocephalus
A

—Interstitial Edema:

  • —Increased intracranial (ventricular) pressure pushes fluid across ependymal layer
  • —Example – area adjacent to enlarged ventricles in hydrocephalus
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5
Q

With edema morphology, the brain is _____ and ____.

A

With edema morphology, the brain is enlarged and softened.

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6
Q

As a result of edema morphology, the following can occur:

  • —Increased intracranial pressure
  • —Flattening of ______
  • —Compression of ventricular cavities
  • —Herniation
  • —Neurologic symptoms
  • —Headaches
  • —Vomiting
  • —Papilledema
A

As a result of edema morphology, the following can occur:

  • —Increased intracranial pressure
  • —Flattening of gyri
  • —Compression of ventricular cavities
  • —Herniation
  • —Neurologic symptoms
  • —Headaches
  • —Vomiting
  • —Papilledema
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7
Q

What does this image show?

A

cerebral edema:

An acute stroke (left) is characterized by edema. The infarcted side is larger than the opposite hemisphere.

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8
Q

what does this image show?

A

Cerebral Edema:

cerebral abcesses surrounded by edema

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9
Q

What does this image show?

A

The edema appears as a dark rim around the central tumor on CT.

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10
Q

Mechanism of herniation: —_____brain pushes brain through ____

A

Mechanism of herniation: —expanding brain pushes brain through opening

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11
Q

What are the consequences of the mechanism of herniation?:

  • —_____ of structures/deficits
  • —Vascular compromise
  • —Ischemia
  • —Hemorrhage
A

What are the consequences of the mechanism of herniation?:

  • —Compression of structures/deficits
  • —Vascular compromise
  • —Ischemia
  • —Hemorrhage
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12
Q

—Transtentorial Herniation:

  • —Supratentorial lesion forces brain through ______ notch
  • —Compression of _____ nerve
  • —Duret hemorrhage in midbrain/upper ___ secondary to downward displacement of the______ (and fixed penetrating vessels)
  • —Compression of opposite cerebral _____ (Kernohan notch)
A

—Transtentorial Herniation:

  • —Supratentorial lesion forces brain through tentorial notch
  • —Compression of 3rd nerve
  • —Duret hemorrhage in midbrain/upper pons secondary to downward displacement of the brainstem (and fixed penetrating vessels)
  • —Compression of opposite cerebral peduncle (Kernohan notch)
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13
Q

—Subfalcian herniation:

  • —Lateral cerebral hemisphere lesion forces brain under ____
  • —Compression of _____ cerebral arteries possible
A

—Subfalcian herniation:

  • —Lateral cerebral hemisphere lesion forces brain under falx
  • —Compression of anterior cerebral arteries possible
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14
Q

—Cerebellar tonsillar herniation:

  • —Often secondary to ______ _____lesion
  • —Brain forced down through foramen _____
  • —_____centers compromised – Apnea and death
A

—Cerebellar tonsillar herniation:

  • —Often secondary to posterior fossa lesion
  • —Brain forced down through foramen magnum
  • —Respiratory centers compromised – Apnea and death
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15
Q

What does this image show?

A

Uncal herniation is seen with supratentorial masses forcing the uncal region down through the tentorial notch.

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16
Q

What does this image show?

A

Tonsillar herniation

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17
Q

What does this image show?

A

Duret Hemmorhage:

As the uncus and brainstem are pushed downward, penetrating vessels become stretched and break. This leads to hemorrhages in the upper pons, Duret hemorrhages, that can be fatal.

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18
Q

What does this image show?

A

Duret hemorrhage

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19
Q

What type of trauma is a gunshot through the brain?

A

penetrating

20
Q

What type of trauma is it when the head strikes the floor or a dashboard?

A

Blunt trauma

21
Q

What type of trauma is it when the skull is disrupted?

A

open trauma

22
Q

What type of trauma is it when the skull is intact and you have internal lesions?

A

closed trauma

23
Q

A concussion is what type of injury?

A

Parenchymal

24
Q

Contusion is what type of injury?

A

parenchymal

25
Q

Laceration is what type of injury?

A

parenchymal

26
Q

Diffuse axonal damage is what type of injury?

A

Parenchymal

27
Q

Hematomas are what type of injury?

A

vascular damage injury

28
Q

Do concussions have physical damage?

A

no

29
Q

What is contusion?

A

bruising

30
Q

Types of contusion:

—Coup –____ lesion

—Contrecoup – on _____side of brain

A

Types of contusion:

—Coup – under lesion

—Contrecoup – on opposite side of brain

31
Q

Shearing of axons can occur through ____ or ___

A

acceleration or deceleration

32
Q

What areas are most at risk for axonal damage?

A

midline white matter areas (around corpus callosum)

33
Q

Diastatic fractures occur across ____

A

sutures

34
Q

—Basilar fractures – At ____ of brain; can lead to ____ eyes (pooling of blood around eyes/orbit) or _____hematomas; ____ cranial nerves can be compromised

A

—Basilar fractures – At base of brain; can lead to raccoon eyes (pooling of blood around eyes/orbit) or mastoid hematomas; lower cranial nerves can be compromised

35
Q

—Concussion

  • Follows trauma with no _____ physical damage
  • —Damage/changes may be _______
  • —Associated with brief loss of consciousness and transient amnesia
  • —Severity varies from very mild to severe
  • —Much attention with sports injuries
  • —Repeated concussions increase chance of permanent brain damage.
A

—Consussion

  • Follows trauma with no observable physical damage
  • —Damage/changes may be biochemical
  • —Associated with brief loss of consciousness and transient amnesia
  • —Severity varies from very mild to severe
  • —Much attention with sports injuries
  • —Repeated concussions increase chance of permanent brain damage.
36
Q

—Contusion

  • —Bruise with local vascular damage and resultant ischemia; worse at _____ of gyri
  • —Occurs at area of injury (coup) or opposite to area of injury (contrecoup) often opposite areas of rough/irregular skull (e.g. base of ____ and ____lobes)
  • —Coup (at site of injury) often occur when head is _____ and receives a blow
  • —Contrecoup (opposite site of injury) often occur when head is _____ and collides with surface.
  • Often ____ lesions are often present.
A

—Contusion

  • —Bruise with local vascular damage and resultant ischemia; worse at crests of gyri
  • —Occurs at area of injury (coup) or opposite to area of injury (contrecoup) often opposite areas of rough/irregular skull (e.g. base of temporal and frontal lobes)
  • —Coup (at site of injury) often occur when head is immobile and receives a blow
  • —Contrecoup (opposite site of injury) often occur when head is mobile and collides with surface. Often coup lesions are often present.
37
Q

What do these images show?

A

contusions

38
Q

What does this image show?

A

Acute contusions show evidence of the hemorrhages. Contrecoup lesions are often located on the temporal horns or inferior frontal lobes (i.e. opposite rough and irregular skull).

39
Q

—

Epidural vascular injury/hemorrhage:

  • Tear of middle meningeal artery by _____skull fracture
  • —Increase in volume and possible herniation and death more ____than other forms; often following _____ interval
A

Epidural vascular injury/hemorrhage:

  • Tear of middle meningeal artery by temporal skull fracture
  • —Increase in volume and possible herniation and death more rapid than other forms; often following lucid interval
40
Q

—Subdural vascular injury/hemorrhage

  • —Tear of_______veins (cortex to sagittal sinus)
  • —More common in _____ (greater distance between brain and sinus)
  • —Accumulation of blood _____ than epidural
  • —Bilateral chronic subdurals can be associated with _____
A

—Subdural vascular injury/hemorrhage

  • —Tear of bridging veins (cortex to sagittal sinus)
  • —More common in elderly (greater distance between brain and sinus)
  • —Accumulation of blood slower than epidural
  • —Bilateral chronic subdurals can be associated with dementia
41
Q

—Subarachnoid/Intraparenchymal vascular injury/hemorrhage

  • —With contusions and lacerations
  • —Secondary to tearing of _____ blood vessels
A

—Subarachnoid/Intraparenchymal vascular injury/hemorrhage

  • —With contusions and lacerations
  • —Secondary to tearing of small blood vessels
42
Q

What does this image show?

A

epidural hemorrhage

43
Q

What does this image show?

A

Subdural Hemorrhage

44
Q

What does this image show?

A

Subarachnoid Hemorrhage

45
Q
A

Neuro Exam 2 (18 decks)

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