N202 Unit 6 Part 2 TBI Flashcards Preview

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Flashcards in N202 Unit 6 Part 2 TBI Deck (50):
1

periorbital bruising

raccoon eyes

2

halo sign

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

3

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

battle signs

4

Tx of Communicated & Compound Skull Fx

debride, abx, and crainioplasty prn

5

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

Basilar skull fxu

6

With Basilar skull fx do NOT

pack the nose or the ear
blow nose
suction drainage

7

tearing of the brain tissue

Laceration

8

bruising of brain tissue

Contusion

9

Contusion of the brain stem-->

coma

10

Bleeding btwn dura mater & arachnoid layer

Subdural hematoma

11

3 types of Subdural hematomas

acute
subacute
chronic

12

Leading cause of TBI

Falls

13

moving object hits a stationary head.

Acceleration
only pt of contact that is injured

14

moving head strikes a stationary object

Deceleration

15

most common w/ MVA

Acceleration-deceleration

16

70% of all Skull Fx

Linear

17

Straight ln/ crack in the skull.

Linear

18

Tx for Linear Skull Fx

often bedrest

19

hematoma btwn skull & upper surface of dura

Epidural hematoma

20

Epidural hematoma

neurologic emergency
Can cause Death

21

Bleeding btwn dura mater & arachnoid layer

Subdural hematoma

22

3 Types of Subdural Hematoma

Acute
Subacute
Chronic

23

Acute Subdural Hematoma

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

24

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

Subacute

25

Subacute Subdural Hematoma

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

26

Late sign hypoglycemia

seizure, EKG changes

27

prevent alcohol S&S of W/D

Benzodiazepines

28

Dilantin, Phenobarb

Anticonvulsants

29

Seizures increase

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

30

Tx of acute hypoglycemic episode in Unconscious Pt

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

31

Tx acute hypoglycemic episode in conscious its

PO Glucagon
Always follow institutional policy

32

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

DKA

33

Goal of tx of DKA

Decrease BS by 50 mg/dl/hr

34

Epidural hematomas most frequently occur

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

35

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

acute subdural hematoma

36

Cluster Breathing

Upper Medulla

37

Biots breathing, depressed respirations, or gasping breaths

Medulla lesions

38

Apneustic breathing

lesions of lower pons

39

Central neurogenic hyperventilation

lesions in lower midbrain to midpons area

40

Cheyne-stokes

lesions deep inside the cerebral hemispheres & basal ganglia

41

Tracrium, Pavulon, Succinylcholine

Neuromuscular blockades

42

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

Analgesia

43

Pressure/Volume

Elastance
brain’s ability to accommodate changes in volume

44

Volume/Pressure

Compliance

45

amt of bld passing through brain tissue in one minute

CBF
~750ml blood/min

46

talk and die

epidural hematoma

47

bleeding btwn the skull and dura

epidural hematoma

48

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

Concussion

49

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

dai

50

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

influence ICP