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Flashcards in Head and Spinal Trauma Deck (37)
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1

Protective layers of the brain

Dura mater
Arachnoid mater
Pia mater

2

Cerebral perfusion pressure

determined by: MAP - ICP
when ICP increases, CPP decreases

3

MAP

= DP + 1/3PP

4

Pulse pressure

SBP-DBP

5

Cushing's reflex

widening pulse pressure
bradycardia
hypertension

6

Cushing's Triad

widening pulse pressure
bradycardia
irregular resp pattern

7

Skull fracture

ecchymosis, CSF leak, depressed skull, open vault

8

Diffuse Axonal Injury

shearing and rotational forces result in major structural and functional disturbances
mild: coma 6-12 hrs
mod: over 24 hrs
severe: brainstem injury, prolonged unconsciousness

9

Concussion

subtle pulling, tugging or shearing of brain cells without causing obvious structural damage
effects: brief alteration of consciousness, LOC followed by periods of drowsiness, restlessness, and confusion, amnesia

10

Signs and Symptoms of Concussion

headache, vomiting, combativeness, transient visual disturbances, defect in equilibrium and coordination

11

Contusion

force applied to one sidde of head causing the brain to slam into the side of the skull and rupture blood vessels in pia mater, then rebound on other side of the skull

12

Signs and Symptoms of Contusion

seizures, hemiparesis, aphasia, personality changes, LOC

13

Compression

haemorrhage or oedema within the brain leads to structures being compressed or pressurized

14

Secondary Head injuries

bruised brain leads to dilation of blood vessels, cerebral oedema - increase ICP, reduced CPP, O2 and glucose, increased arterial pressure and BP

15

Causes of secondary head injuries

hypoxia
hypotension
hypoglycaemia
hyercapnia

16

Epidural/Extradural haemorrhage

haemorrhage in space between cranium and dura
caused by: low velocity blows to head, deceleration injuries

17

Presentation of pts with epidural haemorrhage

50% will have transient LOC, EDH enlarges and ICP increases, pt will develop a headache, contra-lateral hemiparesis, lethargy, reduced consciousness

18

Subdural Haemorrhage

collection of blood between dura and surface of brain bleeding from torn bridging veins
classified based on time between injury and symptom presentation

19

Subarachnoid Haemorrhage

intracranial bleeding into CSF resulting in bloody SCF and meningeal irriation
caused by: trauma, aneurysm, arteriovenous malformation

20

Symptoms of subsrachnoid haemorrhage

sudden and severe headache, dull and throbbing, dizziness, neck stiffness, unequal pupils, vomiting, seizures, LOC

21

Intracerebral Haematoma

collection of blood greater than 5ml somewhere in the brain
commonly frontal and temporal lobes
results from: multiple lacerations produced by penetrating head trauma, high velocity deceleration injury

22

Pre-Hospital Management

aim to control airway, stabilise cardiovascular system, interupt ongoing cerebral injury, protection from further harm, transport
History:
5 - greater than 5 mins LOC
H - skull fracture
E - emesis more than once
D - neuro deficit
S - seizure

23

Spinal Cord Tumours

Benign or malignant
Presentation: acute onset, compressive syndrome, irritative syndrome, inflammation

24

Vertebral injury results from:

hyperflexion, hyper extension, flexion rotation, vertebral compression, lateral flexion, distraction

25

Transverse Spinal Cord Damage

no info passed, total paralysis, total anaesthesia and analgesia

26

Acute Central Cervical Cord Syndrome

central part of spinal cord damaged while external remains intact
Caused by hyperextension
Motor and sensory function reduced in upper limbs

27

Brown Sequard Syndrome

Penetrating injury to one side of the spine
Ipsilateral paralysis

28

Anterior Spinal Artery Syndrome

Artery supplies 2/3 of spinal cord
Reduced cord perfusion inferior to lesion

29

Posterior Column Syndrome

All motor and sensory functions preserved except proprioception - touch and temp

30

Spinal Cord Concussion

Temporary cessation of spinal cord function
Recovery in 48 hours