N202 Unit 6 Part 2 TBI

Question 1

periorbital bruising

Answer 1

raccoon eyes

Question 2

halo sign

Answer 2

clear draining that separates from bloody drainage (presence of CSF)

Question 3

bruising of the peri-auricular (behind the ear) area

Answer 3

battle signs

Question 4

Tx of Communicated & Compound Skull Fx

Answer 4

debride, abx, and crainioplasty prn

Question 5

linear fx at base of skull, frequently crosses the sinus & tears the dura → leakage of the blood &/or CSF

Answer 5

Basilar skull fxu

Question 6

With Basilar skull fx do NOT

Answer 6

pack the nose or the ear
blow nose
suction drainage

Question 7

tearing of the brain tissue

Answer 7

Laceration

Question 8

bruising of brain tissue

Answer 8

Contusion

Question 9

Contusion of the brain stem–>

Answer 9

coma

Question 10

Bleeding btwn dura mater & arachnoid layer

Answer 10

Subdural hematoma

Question 11

3 types of Subdural hematomas

Answer 11

acute
subacute
chronic

Question 12

Leading cause of TBI

Answer 12

Falls

Question 13

moving object hits a stationary head.

Answer 13

Acceleration

only pt of contact that is injured

Question 14

moving head strikes a stationary object

Answer 14

Deceleration

Question 15

most common w/ MVA

Answer 15

Acceleration-deceleration

Question 16

70% of all Skull Fx

Answer 16

Linear

Question 17

Straight ln/ crack in the skull.

Answer 17

Linear

Question 18

Tx for Linear Skull Fx

Answer 18

often bedrest

Question 19

hematoma btwn skull & upper surface of dura

Answer 19

Epidural hematoma

Question 20

Epidural hematoma

Answer 20

neurologic emergency

Can cause Death

Question 21

Bleeding btwn dura mater & arachnoid layer

Answer 21

Subdural hematoma

Question 22

3 Types of Subdural Hematoma

Answer 22

Acute
Subacute
Chronic

Question 23

Acute Subdural Hematoma

Answer 23

S/S w/in 48h
drowsy & confused
Ipsilateral pupil dilates/ fixed.

Question 24

Subdural Hematoma occurs w/in 2-14d; may have failure to regain conciseness

Answer 24

Subacute

Question 25

Subacute Subdural Hematoma

Answer 25

2-14d | Failure to regain consciousness may be an indicator.

Question 26

Late sign hypoglycemia

Answer 26

seizure, EKG changes

Question 27

prevent alcohol S&S of W/D

Answer 27

Benzodiazepines

Question 28

Dilantin, Phenobarb

Answer 28

Anticonvulsants

Question 29

Seizures increase

Answer 29

cerebral metabolic rate, CBF, CBV (cerebral blood volume)

Question 30

Tx of acute hypoglycemic episode in Unconscious Pt

Answer 30

Assess airway Glucagon SQ, Amp D50 IV Always follow institutional policy

Question 31

Tx acute hypoglycemic episode in conscious its

Answer 31

PO Glucagon | Always follow institutional policy

Question 32

``` rapid onset Polydipsia, polyuria, polyphagia Kussmaul Respirations ketones present metabolic acidosis BS (~600mg/dl) ```

Answer 32

DKA

Question 33

Goal of tx of DKA

Answer 33

Decrease BS by 50 mg/dl/hr

Question 34

Epidural hematomas most frequently occur

Answer 34

in the area of the temporal bone d/t the presence of the middle meningeal artery

Question 35

s/s w/in 48h | Ipsilateral pupil dilates & becomes fixed.

Answer 35

acute subdural hematoma

Question 36

Cluster Breathing

Answer 36

Upper Medulla

Question 37

Biots breathing, depressed respirations, or gasping breaths

Answer 37

Medulla lesions

Question 38

Apneustic breathing

Answer 38

lesions of lower pons

Question 39

Central neurogenic hyperventilation

Answer 39

lesions in lower midbrain to midpons area

Question 40

Cheyne-stokes

Answer 40

lesions deep inside the cerebral hemispheres & basal ganglia

Question 41

Tracrium, Pavulon, Succinylcholine

Answer 41

Neuromuscular blockades

Question 42

Ativan, Versed, Propofol (Diprivan), Morphine, Haldol

Answer 42

Analgesia

Question 43

Pressure/Volume

Answer 43

Elastance | brain’s ability to accommodate changes in volume

Question 44

Volume/Pressure

Answer 44

Compliance

Question 45

amt of bld passing through brain tissue in one minute

Answer 45

CBF | ~750ml blood/min

Question 46

talk and die

Answer 46

epidural hematoma

Question 47

bleeding btwn the skull and dura

Answer 47

epidural hematoma

Question 48

Sudden transient mechanical head injury with disruption of neural activity & change in LOC. (NO STRUCTURAL DAMAGE)

Answer 48

Concussion

Question 49

Widespread axonal damage--> axons are broken, attempt to repair, massive proliferation, → scaring.

Answer 49

dai

Question 50

``` Cerebral Blood Flow (CBF) Cerebral Blood Volume (CBV) Intraabdominal & intrathoracic pressure Posture Blood gases (CO2 levels)- affect CBF ```

Answer 50

influence ICP