Pathology Flashcards
(93 cards)
Which structures of the brain can suffer traumatic damage? What kind of damage is common?
scalp, skull, meninges and brain/cord
scalp - laceration
skull - fractures
meninges - vascular injury, laceration
brain - contusion, laceration, diffuse axonal injury, diffuse vascular injury
what kind of fractures can occur at the skull
linear fracture
depressed fracture
what is contusion?
bruising and haemorrhagic necrosis of the brain
how can the brain tissue be lacerated?
from a depressed fracture, where bone gets pushed in and tears the tissue
What is a concussion?
a clinical consequence of head injury, involving instantaneous loss of consciousness, temporary resp arrest, and loss of reflexes
What is a concussion caused by?
a sudden change in the momentum of the head and the brain develops areas of undetectable injuries
What does a glasgow coma scale do?
It helps assess severity of brain injury
the lower the score, the higher the chance of severe brain injury
How is the brain and cord protected?
they are enclosed in protective bony cases, and a lot of energy will be needed to breach the bony layer
What is the downside of having bony protection around the brain?
Penetrating injury and closed injury can occur
Penetrating = direct disruption of tissue (depressed fracture) Closed = movement and compression of neurovascularture within confined space
What is secondary traumatic injury?
further damage to the brain following primary injury in certain circumstances
can be delayed or immediate
List 5 possible secondary injuries
ischaemia, hypoxia (generally acute)
raised ICP, infection, epilepsy (delayed)
T/F skull fracture tends to damage only the point of impact
False, skull fractures are able to radiate from primary site of impact
What is the term given to skull fracture with splinter
comminuted fracture
Why is a skull fracture “open”
If the fracture communicates with the surface (bone can be seen superficially)
What can result from a basal fracture?
blood and CSF come out from the nose and/or ear. This is a bad sign
Why is it important to diagnose bone fracture (think how a bone injury occurs) ?
bone fractures are a result of high energy transfer injury and may have severe secondary effects
The tearing of which artery can lead to epi-dural haematoma?
middle meningeal artery
Why is epi-dural haematoma less common for older people
because the dura mater adheres more tightly to the skull with increasing age
What is the cause of subdural haematoma?
tearing of sub-dural vein or sinuses
Why does subdural haematoma happen more frequently in older people?
shrinking of the brain + increased tension on veins
Contusions can occur at two locations upon traumatic injury, what is the name given for the 1) impact site 2) opposite to impact site
1) coup
2) countercoup
When can a contusion occur at the countercoup?
When the brain is not immobilised at the time of injury, so the sudden change of momentum freely moves the brain, causing injury on both sides
Why do contusions occur usually at the base of brain?
because of the irregular lining on the skull floor
what are two stereotypical locations for contusion?
inferior frontal lobe
inferolateral temporal lobe