Traumatic Brain Injury Flashcards

1
Q

what are the common causes of TBI?

A
  • motor veichle accidents
  • cycling accidents
  • sports injuries
  • violence
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2
Q

name the three potential effects of head injury

A
  • behaviour and personality changes
  • cognitive impairment
  • motor and sensory deficits changes
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3
Q

what are the behaviour and personality changes that can occur after TBI?

A
  • anxiety
  • depression
  • loss of motivation
  • difficulty controlling anger
  • impulsivity
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4
Q

what are the cognitive impairments that can occur after TBI?

A
  • problems with memory, attention and concentration
  • low tolerance for noisy or stressful enviroments
  • loss of insight and initiative
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5
Q

what are the potential changes in motor and sensory systems after TBI?

A
  • loss of coordination
  • muscle rigidity
  • epilepsy
  • difficulty speaking
  • sight/ smell/ taste loss
  • fatigue
  • sexual problems
  • paralysis
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6
Q

how do they access TBI?

A

The Glasgow Coma Scale (GCS)

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7
Q

what does GCS do ?

A
  • monitors changes in conciousness
  • monitors motor response, verbal response and eye opening
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8
Q

what does GCS scores mean?

A
  • <8 is a severe head injury (coma)
  • 9-12 is a moderate head injury
  • > 12 is a mild head injury
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9
Q

what does GCS scores mean?

A
  • <8 is a severe head injury (coma)
  • 9-12 is a moderate head injury
  • > 12 is a mild head injury
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10
Q

what are the three things GCS check?

A
  • best motor response
  • best verbal response
  • eye opening
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11
Q

what is a closed head injury?

A

A trauma causes the brain to be violently shaken inside of the skull, such as a blast injury (no visible wound).

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12
Q

what is a crush injury?

A

when the head is sandwiched between two hard objects

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13
Q

what is an open/ penetrating injury?

A

when an object goes through the skull and enters the brain

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14
Q

What is a coup injury?

A

Primary injury caused when the head stops suddenly and the brain rushes forward. Brain incurs a primary impact injurt at the site of the skull strike as well as surrounding tissue

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15
Q

what is a contrecoup injury?

A

Secindary injury caused when the brain bounces off the primary surface of impact and goes on to impact the opposite side of the skull. The brain incurs a focal area of damage as well as damage to the nearby surrounding tissue.

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16
Q

what can contrecoup cause?

A
  • confusion
  • swelling
  • blood clots
17
Q

what is hyperflexion?

A

head recoils forward and stops. Occipital lobe strikes back of skull.

18
Q

what is hyperextension?

A

Sudden backwards acceleration of skull. Once skull stops moving, the frontal lobe strikes the front of skull.

19
Q

what is haematoma?

A

a localised pooling of blood

20
Q

what is concussion?

A

temporary neuronal dysfunction

21
Q

what is contusion?

A

bruising of brain on impact, damage to blood vessels

22
Q

what is DAI (Diffuse axonal injury)?

A

damage to axons throughout brain

23
Q

what is a haemorrhage?

A

bleeding from ruptured blood vessels

24
Q

what is a secondary injury (intacranial)?

A

evolves over hours, days, weeks after impact

25
Q

how does a secondary intractanial injury?

A

haematoma leading to increased intracranial pressure and shifting of brain tissue causes an increased pressure on brain tissue

26
Q

name the key features of a secondary intracranial injury?

A
  • brain swelling, cerebral oedema, hydrocephalus
  • increased intracranial pressure
  • intracranisl haemorrhages, traumatic haematomas, infections
  • blood flow changes and metabolic changes
  • epilepsy
  • hypoxia-ischaemia (reduced oxygen to brain)
27
Q

what is cerebral perfusion pressure

A

mean arterial pressure - intrcranial pressure

28
Q

what should CPP not fall below? and what does it increase the risk of?

A

70 mmHg otherwise risk of hypoxia and ischaemia

29
Q

what is the normal ICP (Intracranial pressure)?

A

7-15 mmHg

30
Q

If a patient is drowsy and confused what is there ICP and GCS likely to be?

A

20 mmHg
With a GCS of 13-15

31
Q

what does ICP stand for?

A

Intracranial Pressure

32
Q

if a GCS was <8 what would you expect there ICP to be?

A

30 mmHg

33
Q

what is intracranial pressure made up of ?

A

-Brain
-Blood
-CSF (cerebrospinal fluid)

34
Q

what percentage of the brain makes up ICP?

A

80% of total volume, tissues and interstitial fluid

35
Q

what percentage of the brain makes up blood?

A