T3-Head Injuries in Infants

Question 1

The head of infants and younger children is proportionately ____ and ____ in relation to other body parts, therefor it is ____ likely to be injured

Answer 1

Large and heavy head= MORE likely to be injured!

Question 2

What contributes to falls at young ages?

Answer 2

Incomplete motor development

Question 3

What are head injuries major causes?

Answer 3

Falls
MVA
Bicycle injuries

Question 4

Are infants heads more or less vascular than infants? What does this mean?

Answer 4

More vascular–head injuries can cause them to bleed to death

Question 5

Acceleration forces: bruising at point of impact (___) and rebound bruising (___)

Answer 5

Impact: Coup

Rebound bruising: Contre coup

Question 6

Brain mass movement rips across structure, breaks small filaments holding it together (shearing forces)–this results in what 2 things?

Answer 6

Cerebral edema

Compression of brain mass

Question 7

Assessment: Head injury. What are the steps?

Answer 7

1. ABC
2. Spinal cord injury
3. Evaluate for shock
4. Neuro exam

Question 8

Hypoxic-ischemic brain injury: Near drowning

Where do infants drown?
Where do toddlers drown?

Answer 8

Infants: bathtub
Toddlers: Toilet bowel

Question 9

Hypoxic-ischemic brain injury near drowning–what is the definition of this?

Answer 9

Survival 24 hours after incident

Question 10

What is prevention for hypoxic-ischemic brain injury near drowning?

Answer 10

TEACH

Question 11

What head problem:

• Coup injury from initial impact
• Subdural vessels torn
• Bruising bc brain moves over skull floor
• Countercoup injury from secondary impact as brain moves forward and backward within skull

Answer 11

Shaken baby syndrome

Question 12

What is the most common head injury?

Answer 12

Concussion

Question 13

What are hallmark signs of concussion?

Answer 13

Amnesia

Confusion

Question 14

Cranial injury: trauma must be extreme to ____

Answer 14

Fracture

Question 15

T/F: Basal skull is relatively easier to fracture

Answer 15

True

Question 16

Is basal skull protected or unprotected?

Answer 16

Unprotected

Question 17

What fracture: Skin laceration and fracture

Answer 17

Compound

Question 18

Meds for compound fracture?

Answer 18

Antibiotics and surgery

Question 19

What fracture: Results in dural tear, hemorrhage into nose and middle ear

Answer 19

Basilar fracture

Question 20

What type of fracture: Traumatic separations of cranial sutures

Answer 20

Diastatic

Question 21

What type of fracture has racoon eyes ?

Answer 21

Anterior basal fractures

Question 22

What type of fractures has battle sign? What does this mean?

Answer 22

Basilar–effusion of blood under ear

Question 23

What are two characteristics of cranial injury—basal skull fracture?

Answer 23

Battle’s Signs

Raccoon Eyes

Question 24

Is this battle sign or raccoon eyes?

-Bilateral periorbital ecchymosis; associated with orbital fractures

Answer 24

Raccoon eyes

Question 25

Is this battle signs or raccoon eyes? - Retroauricuar ecchymosis - Associated with fracture of auditory canal and lower areas of skull

Answer 25

Battle sign

Question 26

Basilar skull fracture may tear dura..What does this mean?

Answer 26

Permit CSF to drain through an external passageway

Question 27

Hematomas: Physical characteristics What kind of support of the head? Who is particularly vurnuable? What kind of brain? What does this result in?

Answer 27

- Insufficient musculoskeletal support of head - Very young particularly vulnerable - Thinner and softer brain - Results in greater, long term damage

Question 28

Hematomas: Physical characteristics Thinner and compliant skull of younger children allow for?

Answer 28

Increased tolerance to ICP and blunt force that causes fractures

Question 29

Management of head injuries in children: Observation? (2)

Answer 29

- Neuro checks | - Changes in VS

Question 30

Management of head injuries in children: Surgical interventions? (3)?

Answer 30

- Craniotomy - Craniectomy - Repair of lacerations

Question 31

Unilateral dilated and reactive pupil is accounted with?

Answer 31

Intracranial mass

Question 32

A fixed and dilated pupil may be a sing of ?

Answer 32

Impending brainstem herniation

Question 33

Bilateral fixed and dilated pupils are associated with?

Answer 33

Brainstem herniation from increased ICP

Question 34

How is decorticate posturing characterized?

Answer 34

Rigid flexion --associated with lesions above the brainstorm in the corticospinal tracts

Question 35

How is decerebrate posturing distinguished? Associated with?

Answer 35

Distinguished by rigid extension; associated with lesions of the brainstem

Question 36

What kind of meds for head injuries?

Answer 36

Antiinflammatory and pain management

Question 37

What kind of long term problems may be associated with head injuries in children?

Answer 37

Physical problems and cognitive impairments