Exam 3

Question 1

Meninges

Answer 1

Dura Mater
Arachnoid
Pia Mater
Subarachnoid space

Question 2

Dura Mater

Answer 2

Outer layer

Question 3

Arachnoid

Answer 3

middle layer
Web-like
Avascular

Question 4

Pia Mater

Answer 4

delicate adheres closely to brain

Very vascular

Question 5

subacrachnoid space

Answer 5

filled with CSF

Question 6

What assessment is most important/useful in detecting changes

Answer 6

Level of consciousness (LOC)

Question 7

NEURO assessments

Answer 7

PERRLA
V/S
LOC
Behavior 
Gait 
Speech

Question 8

Neuro Status Red Flags

Answer 8

High-pitched cry
Ataxic breathing
Paradoxic chest movement
hyperventilation

Question 9

Symptoms of increased ICP

Answer 9

altered LOC, behavior
Pupils sluggish
V/S alterations

Question 10

Increased ICP in infants

Answer 10

Sun-setting 
tense bulging fontanel
separated cranial sutures
destended scalp veins
poor feeding
irritiability, high pitched cry

Question 11

Symptoms of IC in children

Answer 11

Headache
nausea
projectile vomiting
blurred vision
seizures

Question 12

LATE symptoms of ICP

Answer 12

bradycardia
decreased motor response to command
altered perrla
decerbrate or decorticate posturing
cheynes-strokes
papilledema
decreased conciousness
coma

Question 13

Primary head injury

Answer 13

Occurs at the moment of impact

Question 14

Secondary head injury

Answer 14

Brain tissue destruction secondary to hypoxia, hemorrhage, edema, etc

Question 15

Skull fracture - Linear

Answer 15

dura not involved

Question 16

Skull fracture - Depressed

Answer 16

bone indented, several irregular fragments push inward
Surgical intervention necessary to elevate fracture
Fragments cause tear in dura, HUGE risk for infection

Question 17

Skull fracture - Basilar

Answer 17

At base of skull; symptomes include Battle’s sign, raccoon eyes, rhinorrhea, otorrhea, hemotympanum
-usually involve dural tear

Question 18

Skull fracture - comminuted

Answer 18

fragmentation

Question 19

Types of head injuries

Answer 19

Concussion
Intracranial hemorrhage (epidural & subdural)

Question 20

Concussion

Answer 20

Transient, reversible neuronal dysfunction!

Posttraumatic amnesia

Question 21

Post traumatic amnesia - retrograde

Answer 21

Period of time before injury

Question 22

Post traumatic amnesia - Anterograde

Answer 22

period of memory loss after injury

Question 23

Post-concussion syndrome

Answer 23

diffuse symptoms of brain dysfunction

• HA
• dizziness
• Impaired concentration
• variable duration

Question 24

Post-concussion syndrome Infants

Answer 24

Pallor
Sweating
Irritability
Sleepiness
Vomiting

Question 25

Post-Concussion syndrome Children

Answer 25

Behavioral disturbances
Sleep disturbances
Phobias
Emotional lability
Irritability
Seizures
Altered school performance

Question 26

Subdural Hemorrhage

Answer 26

Most Common
Bleeding between dura and cerebrum from birth trauma, falls, shaking, MVA
Usually VENOUS

Question 27

Epidural Hemorrhage

Answer 27

Most often occur with skull fracture
ARTERIAL pressure
fixation of ipsilateral pupil

Question 28

Head Injury- Call Physician if:

Answer 28

• Bleeding lasts longer than 10min
• Needs sutures
• Child younger than 12mo
• Seizures, loss of consciousness
• Confusion, N/V, severe HA
• Slurred speech, blurred vision
• Blood or watery fluid from nose or ears
• Unequal pupil size, crossed eyes
• Difficulty walking, weakness