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Flashcards in Head Trauma Deck (42):
1

what is the only opening in the skull

foramen magnum(floating surrounded by csf)

2

What is the anatomy of the head

1)scalp 2)skull 3)dura mater 4)archanoid 5)subarchanoid space 6) pia mater 7)brain

3

What do the ventricles produce and how much

CSF and 1 ml every 3 mins

4

what is coup contracoup

"4 collision concept" car strikes tree, head strikes the windshield, brain strikes inside skull, brain rebounds and hits inside of occipital skull

5

when does the max swelling in the brain occur

72 hours

6

what does DECEREBRATE mean

Abnormal Extension outwards

7

What does DECORTICATE mean

Abnormal Flexion inwards

8

when should we CT scan

GCS <13, Suspect basal skull fracture, head of c-spine injury suspected

9

what are signs of basal skull fracture

Racoon eyes and battle sign(bruising behind the ear)

10

what is a cerebral contusion

brusing/swelling of brain tissue, swelling can be rapid and severe, may present as CVA

11

what is a diffuse axonal injury

most common with severe blunt trauma, diffuse injury, generalized edema, subarchanoid bleeding, seizure activity, coma/vommiting, may develop into herniation syndrome

12

what is Anoxic brain injury

injury related to o2, poor outcome

13

where can an intracranial hemorrhage occur

1)skull and dura 2) dura and arcahnoid 3) directly into the brain tissue

14

What is an epidural hematoma?

bleeding within the epidural space between the bone and dura mater

15

what is the bleeding often caused by?

by a tear in the middle meniginal artery that runs along inside the skull in temporal/parietal region

16

what is a subdural hematoma?

bleeding between dura mater and archanoid mater(subdural space)

17

what is the bleeding

usually venous

18

what is this common in

alcoholics

19

what is a subarchanoid hemorrhage

subarachnoid space between arachnoid mater and pia mater, usually a result of aneurismal rupture or bleeding rom arteriovenous malformation

20

common in what kind of people

cocaine abusers/ bleeding disorders

21

what is intracerebral hemorrhage

bleeding within the brain tissue;cerebrum/white matter;may result from blunt/penetrating trauma

22

What is the Tx?

supportive therapy and possible surgical intervention

23

what is herniation syndrome"coning"

caused by increase in pressure in cranial vault

24

what are symptoms of it?

increase in ICP, dilation of pupils, coma, cushings reflex

25

what is cushings triad?

hypertension, bradycardia, irregular respirations

26

what happens in herniation syndrome?

bruising/swelling towards the spinal cord and trying to push brain down on brainstem compressing it.

27

what does the brainstem control

breathing, HR and temp

28

what is the TX

The only time HYPERVENTILATION is indicated, want co2 in the 25-30 or 30-35 range

29

other txs are?

mannitol, ICP drain, phenobarbital(last resort) will cause an induced coma

30

what is ICP

insertion of a catherter into the lateral ventricle , used for measurement and drainage of CSF

31

what is the usual number for CSF

<15 mmhg

32

what is the formula for CPP?

CPP=MAP-ICP

33

What happens if ICP goes up

then BP must go up as well to maintain CPP

34

when should we ICP?

when GCS is <8 after resuscitation, when CT scan is abnormal(hematoma, contusion, edema)

35

When do we ICP if CT normal

age >40, systolic bp <90, decerebrate or decoritcate

36

what is the normal CPP in adults

70-90mmhg, minimum should be >50mmhg for adequate perfusion

37

what Bp is preffered to keep CPP

hypertension

38

if there is an decrease in CO2 in the brain what occurs

vasoconstriction

39

what will happen if paco2 is low causing vasoconstriction

will decrease ICP

40

where do we want to keep co2 levels

30-35 range

41

where do we wanna keep peep and aw press

low side for both

42

do we want to sx these patients

not usually, will usually sedate before sxing