Trauma Flashcards
(40 cards)
Stem Cells?
Have potential to develop into every type of body cell. Currently studying how to use stem cells to repair defective cells in CF (could restore lung tissue).
Pros and cons of stem cells?
Pros- possibility to treat many incurable disease that deal with undividing nerve cells (SCI). Adult stem cells have low rejection rate (treatment more effective). Many learning opportunities about cells/development.
Cons- research depends on embryonic stem cells (which requires destruction of embryo- immoral). Some people believe stem cell research can lead to cloning humans, Stem cells are difficult to obtain/methods are painful
Complete spinal cord injury?
Total loss of all motor/sensory function below level of injury (account for almost half of all SCI) but SC is rarely cut/transected
Incomplete spinal cord injury?
Some sensory and motor functioning below level of injury. So may be able to move one limb more than other, feel parts of body that can’t be moved, or have more functioning on one side of the body
How to diagnose SCI?
Dx based on level of injury. It will predict what parts of the body may be affected by paralysis and loss of function
Parts of the spinal cord?
Cervical spine 1-8 (upper extremities, fingers), T1-T12 (nipple line, sternum, abdomen, pubic bone), L1-L5 (spinal cord ends at L1, sensation of legs), S1-S5 (perineal area, sacrum, tail bone)
Injury prognosis at cervical neck, C5, C6/C7?
Cervical neck- result in quadriplegia, injuries at C3 and above require ventilator support
C5- shoulder/bicep control but no control of hands/wrists, diaphragm function present
C6/7- quadriplegia, some function of upper extremities
Sensory loss below sternum
Prognosis of T1-8, T9-12, and L/S injuries?
All injuries at thoracic level/below=paraplegia (hands not affected)
T1-8: control of hands but poor trunk control (lack of abdominal muscle support)
T9-12: good trunk control/good abdominal muscle control, sitting balance is very good
L/S- decreasing control of hip flexors and legs
Changes d/t SCI?
Bowel and bladder dysfunction, men may have their fertility affected (women generally not), low BP, inability to regulate BP, reduced control of body temp, inability to sweat below injury level, chronic pain
How to dx SCI?
Neurological exam indicates location of injury if not evident, spine x-ray, CT scan or MRI, and reflexes may be abnormal or absent in affected areas of body
What is autonomic dysreflexia? and S+S
Complication r/t SCI that causes HTN, severe headaches, pallor/flushing above injury and seizures. Can be triggered by full bladder
5 types of Treatment for SCI?
- Meds- corticosteroids (dexamethasone or methyl prednisone to reduce swelling that may damage SC)
- Surgery- remove fluid/tissue that presses on SC (decompression laminectomy), or remove bone fragments/foreign objects or stabilize vertebrae by inserting hardware
- Bedrest- allow bones of spine to heal
- Treatment to address muscle spasms, skin care, B+B dysfunction
- Extensive PT, OT, and other rehab after injury is healed
What is a concussion?
Most common head injury that cause mild injuries to brain by rapid movement of head so brain is injured by hitting the inside of the skull. Causes instant loss of awareness/responsiveness and Persist for min to hrs followed by amnesia (memory is disturbed)
S+S of concussion?
General confusion, amnesia, N/V, dizzy (see stars), strange behaviour and unusual emotions, slurred speech, headache, slow to respond, lack of coordination, LOC
What is postconcussive syndrome of childhood and symptoms?
Causes delayed lethargy, irritability, behavioural changes, headache, dizziness, depression/anxiety (late symptoms) and these symptoms persist after 3 months
What is second impact syndrome?
Rare condition in which brain swells rapidly after person suffers second concussion before S+S from an earlier one have subsided. The second blow may occur days or weeks after the initial concussion
What is increased intracranial pressure? what can it lead to patho wise?
Increase in the normal brain pressure b/c of increase in CSF pressure (exerts force within cranial vault). Can lead to decreased cerebral perfusion pressure (amount of pressure to ensure O2 and nutrients are delivered to brain). increased ICP=reduced blood flow to brain
S+S of increased ICP? early vs late
Early- headache, vomit, vision disturbances, slight vital sign changes, slight LOC change, seizures
Late- significant decreased LOC, decreased motor/sensory response, bradycardia, irregular resp, posturing, fix/dilated pupils
How to dx ICP?
MRI/CT scan to determine cause/confirm dx, ICP pressure over 15 (1-10mmHg normal), subarachnoid screw can be drilled into skull to measure pressure on brain surface
What to assess for ICP?
LOC, coma scale, head circumference under 2 yrs, vital signs (bradycardia, widening pulse pressure- difference between systolic and diastolic over time, irregular resp)
Dx of TBI?
Glasgow coma scale score of 8 or less, coma, increased ICP, post-traumatic amnesia lasts >24 hrs
What does LOC describe?
Alertness (ability to react) and cognition (processing of data and their response)
TBI? most common causes
Head trauma that leads to brain injury. Common causes are falls, sport related injury, being hit on head, injuries with bicycles or motor vehicles
S+S of TBI?
Changes/impaired LOC, headache, amnesia, confusion, disoriented, vomit, blurry vision, seizures
