Chapter 28- Head And Spine Injuries

Question 1

Central nervous system includes:

Answer 1

The brain and the spinal cord.

Question 2

The brain

Answer 2

The organ that controls the body; it is also the center of consciousness.

Question 3

The brain is divided into three major areas:

Answer 3

cerebrum
Cerebellum
Brainstem

Question 4

The cerebrum contains

Answer 4

75% of the brain’s total volume
Controls a wide variety of activities, including most voluntary motor function and conscious thought.

Divided into two hemispheres with four lobes

Question 5

The brainstem

Answer 5

Controls virtually all the functions that are necessary for life, including the cardiac and respiratory systems and nerve function transmissions

Best protected part of the CNS

Question 6

The spinal cord

Answer 6

Mostly made up of fibers that extend from the brain’s nerve cells.

Carries messages between the brain and the body via gray and white matter of the spinal cord.

Question 7

Gray matter

Answer 7

Composed of neural cell bodies and synapses which are connections between nerve cells.

Question 8

White matter

Answer 8

Consists of fiber pathways.

Question 9

Meninges

Answer 9

Three distinct layers of tissue that suspend the brain and the spina cord within the skull and spinal canal.

Question 10

Dura mater

Answer 10

A tough, fibrous layer that closely resembles leather.

Question 11

Inner two layers of the meninges

Answer 11

Arachnoid and pia mater

Question 12

Cerebral spinal fluid is produced..

Answer 12

In a chamber inside the brain, called the third ventricle.

Question 13

There is approximately how much CSF in the brain at any one time.

Answer 13

125-150 mL

Question 14

If a patient with a head injury has what looks like a runny nose or reports a salty taste at the back of the throat, you should assume that the fluid is….

Answer 14

Cerebrospinal fluid

Question 15

_____ pairs of spinal nerves conduct sensory impulses from the skin and other organs to the spinal cord

Answer 15

31

Question 16

Cranial nerves are the _____ pairs of nerves that emerge from the brainstem and transmit information directly to or from the brain

Answer 16

12

Question 17

If a sensory nerve in this arc detects an irritating stimulus, such as heat, it will…

Answer 17

Bypass the brain and send a message directly to a motor nerve, causing a response such as pulling away from heat.

Question 18

Voluntary activities

Answer 18

Actions that we consciously perform, in which sensory input determines the specific muscular activity.

Question 19

Involuntary activities

Answer 19

Actions that are not under our conscious control, such as breathing.

Question 20

The skull is composed of two groups of bones:

Answer 20

The cranium, which protects the brain

And the facial bones.

Question 21

The cranium is occupied by _____% brain tissue, ______% blood supply, and _____% CSF

Answer 21

80, 10, 10

Question 22

Intervertebral disk

Answer 22

The cushion that lies between two vertebrae.

Question 23

How may vertebrae in the cervical spine?

Answer 23

7

Question 24

How many vertebrae in thoracic spine?

Answer 24

12

Question 25

How many vertebrae in lumbar spine?

Answer 25

5

Question 26

How many vertebrae in sacrum?

Answer 26

5

Question 27

How many vertebrae in coccyx?

Answer 27

4

Question 28

The two general types of head injuries:

Answer 28

Closed head injuries | Open head injury

Question 29

Closed head injury

Answer 29

Those in which the brain has been injured but there is no opening into the brain

Question 30

Open head injury

Answer 30

One in which an opening from the brain to the outside world exists.

Question 31

Ecchymosis

Answer 31

Bruising

Question 32

Raccoon eyes

Answer 32

Bruising under the eyes that may indicate a skull fracture

Question 33

Battle sign

Answer 33

Bruising behind an ear over the mastoid process that may indicate a skull fracture.

Question 34

Linear skull fractures

Answer 34

Account for 80% of skull fractures; also referred to as a non displaced skull fractures; commonly occurs in the temporal-parietal region of the skull; not associated with deformities to the skull

Question 35

Depressed skull fractures

Answer 35

Result from high-energy direct trauma to the head with a blunt object

Question 36

Basilar skull fractures

Answer 36

Also associated with high energy trauma, but they usually occur following diffuse impact to the head.

Question 37

Open skull fractures

Answer 37

Is what the name implies; brain tissue may be exposed to the environment which significantly increases the risk of a bacterial infection.

Question 38

Traumatic brain injury (TBI)

Answer 38

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.

Question 39

Traumatic brain injuries are classified into two broad categories:

Answer 39

Primary (direct) injury | Secondary (indirect) injury

Question 40

Primary brain injury

Answer 40

Injury to the brain and its associated structures that result instantaneously from impact to the head.

Question 41

Secondary brain injury

Answer 41

Refers to a multitude of processes that increase the severity of a primary brain injury and, therefore, negatively impact the outcome.

Question 42

Coup-contrecoup injury

Answer 42

When the head falls back against the headrest and/or seat, and the brain slams into the rear of the skull.

Question 43

Cerebral edema

Answer 43

Swelling of the brain

Question 44

Intracranial pressure (ICP)

Answer 44

Pressure within the cranial vault.

Question 45

Cheyne stokes respiration’s

Answer 45

Respiration’s that are fast and then become slow, with intervening periods of apnea

Question 46

Ataxic (Biot) respiration’s

Answer 46

Characterized by irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Question 47

Signs and symptoms of ICP

Answer 47

``` Decreased pulse rate headache nausea vomiting decreased alertness bradycardia sluggish or non reactive pupils decerebrate posturing increased or widened blood pressure ```

Question 48

The triad of _______ ________ ________ signifies increased ICP

Answer 48

Increased systolic BP Decreased pulse rate Irregular respirations

Question 49

Epidural hematoma

Answer 49

An accumulation of blood between the skull and dura mater

Question 50

Subdural hematoma

Answer 50

An accumulation of blood beneath the dura matter but outside the brain.

Question 51

Intracerebral hematoma

Answer 51

Bleeding within the brain tissue itself

Question 52

Subarachnoid hemorrhage

Answer 52

Bleeding occurs into the subarachnoid space, where the CSF circulates

Question 53

Concussion

Answer 53

A temporary loss or alteration of part or all of the brain’s abilities to function without actual physical damage to the brain.

Question 54

Retrograde amnesia

Answer 54

When the patient can remember everything but the events leading up to the injury

Question 55

Anterograde (posttraumatic) amnesia

Answer 55

Inability to remember events after the injury

Question 56

Contusion (of the head)

Answer 56

Bruise to the brain. Far more serious than a concussion

Question 57

Hyper-extension

Answer 57

When the spine is pulled along its length Can cause fractures in the spine as well as ligament and muscle injuries.

Question 58

Axial loading injuries

Answer 58

Injuries where load is applied along the vertical or longitudinal axis of the spine; Ex: falling from a height and landing on the feet in an upright position.

Question 59

PMS

Answer 59

Pulse Motor Sensation

Question 60

Cushing triad

Answer 60

Increased blood pressure (hypertension) Decreased heart rate (bradycardia) Irregular respirations (cheyne-stokes and bigots) ICP indicators

Question 61

Eyes forward position

Answer 61

A head position in which the patient’s eyes are looking straight ahead and the head and torso are in line.

Question 62

Do not move the head any farther if the patient reports any of the following symptoms:

Answer 62

- muscle spasms in the neck - substantial increased pain - numbest, tingling, or weakness in the arms or legs - compromised airway or ventilations