Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Nursing Acutely Ill > Traumatic Brain Injury > Flashcards

Traumatic Brain Injury Flashcards

(84 cards)

Start Studying
1
Q

What does AVPU stand for

A

Alert
Responsive to verbal stimuli
Responsive to painful stimuli
Unconscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Actions to carry out when pt has altered level of consciousness

A

GCS
PEARL
FLP
Full neurological assessment by dr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 6 lobes of the brain?

A 
Frontal 
Parietal 
Occipital 
Temporal 
Limbic 
Lumbar cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal ICP value

A

<15mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cerebral perfusion pressure equation

A

CPP= mean arterial pressure -intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nausea and vomiting is caused by pressure in which area of the brain?

A

Vomit receptors in the 4th ventricle on the medulla oblongata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 factors that make up cushings triad

A

Decreased heart rate
Increased blood pressure
Wide pulse pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Definition of tonsillar herniation

A

Brain stem pushes down into the vertebral column aka coning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the early signs of tonsillar coning?

A

Pupil changes
Confusion
Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is meant by the term haematoma?

A

Solid swelling of clotted blood between tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Areas of the brain susceptible to haematoma formation

A

Subdura
Cerebral epidural
Spinal epidural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How quickly should a pt with suspected head injury be seen?

A

<15minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

4 tools of neurological assessment

A

GCS
Obs
Pupillary reaction
Limb powers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three aspects of response that GCS measures?

A

Eye opening
Best verbal response
Best motor response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In GCS what is eye opening scored out of?

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In GCS what is best verbal response scored out of?

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In GCS what is best motor response scored out of?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

With a diagnosis of traumatic brain injury what should the:
SaO2
PaCO2
CO2 be?

A

SaO2 normal 95-100%
PaCO2 normal 4.5-6
CO2 normal 23-29mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What degree should a pt with traumatic brain injury be nursed at?

A

30 degrees to reduce ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the function of the cerebrum?

A

Interpretation of sensory data.
Co-ordination of muscular movement
Intellectual and emotional processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the function of the cerebellum?

A

Co-ordination

Skilful movement, posture and balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the function of the brain stem?

A

Communication centre between spinal cord and brain.
Houses 10/12 cranial nerve pairs.
Reflex centres for respiration, cardiovascular system and consciousness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the function of the hypothalamus?

A

Controls autonomic nervous system.
Emotion and behaviour.
Temperature.
Maintaining circadian rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 4 functions of the frontal lobe?

A

Behaviour
Intelligence
Memory
Movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the 4 functions of the parietal lobe?
Intelligence Language Reading Sensation
26
What are the function of the occipital lobe?
Vision
27
What are the 5 functions of the temporal lobe?
``` Behaviour Hearing Memory Speech Vision ```
28
What are the 5 functions of the brain stem?
``` BP Breathing Consciousness Heartbeat Swallowing ```
29
What are the 2 functions of the cerebellum?
Balance | Co-ordination
30
What are the two pairs of arteries that supply blood to the brain?
Carotid and spinal arteries.
31
Name 4 of the main arteries in the brain?
Internal carotid artery Middle cerebral artery Circle of Willis BAsilar artery
32
What are names of the 3 meninges of the brain? From outter to inner most.
Arachnoid membrane Dura mata Pia mata
33
What is the Monro-Kellie Hypothesis? What are the 3 compartments?
That the intercranial volume is fixed between three compartments within the brain: Brain/intracellular water Cerebral blood volue Cerebrospinal fluid
34
What does the Monro-Kellie hypothesis mean in terms of volumes within the brain changing?
If volume in one compartment increases or decreases the other compartments compensate.. If compensation doesn't occur ICP increases.
35
What are 4 examples of factors that influence ICP?
Cerebrospinal fluid displacement Cerebral blood displacement Brain volume displacement Vasoconstriction reducing cerebral blood volume
36
What is cerebral perfusion pressure?
Pressure required to maintain adequate cerebral blood flow.
37
What is the definition of cerebral perfusion pressure (CPP)? What is CPP equivalent to?
Blood pressure gradient across the brain. | Equal to the difference between mean cerebral arterial and venous blood flow.
38
What is the calculation for cerebral perfusion pressure (CPP)?
CCP= Mean arterial pressure (MAP) - Inter Cranial Pressure.
39
What is the acceptable value for cerebral perfusion pressure in mmHg?
>70mmHg
40
Cerebral perfusion pressure below ?mmHg may lead to reduced cerebral blood flow?
<30mmHg
41
What are the 5 stages of the cycle that increases ICP in traumatic brain injury?
``` Increased ICP. Reduced cerebral blood flow. Tissue hypoxia. Increased PaCO2, decreased pH. Vasodilation and oedema. Increased ICP. ```
42
What are the 5 common symptoms of increased ICP?
``` Headache Nausea and vomiting Pailloedema (swelling of optic disk) Reduced consciousness Cardiorespiratory signs ```
43
What is cushing reflex?
Rising BP Decreased HR Creating wide pulse pressure Compensatory response in an attempt to keep adequate CPP.
44
What causes Cushing reflex?
ICP >33mmHg reducing cerebral blood flow. Simulating vasomotor centre in brain stem.
45
What are the three components of Cushing's triad?
Hypertension Bradicardia Abnormal resp rhythm
46
What is Cushing's triad a imminent sign of?
Brain stem herniation known as tonsillar herniation aka coning
47
What is tonsillar herniation? What does it pass through?
Decent of brain through foramen magnum
48
What are the 5 early signs of tosillar herniation?
``` Pupil changes Confusion Motor weakness Nausea and vomiting Headache ```
49
What are the 5 late signs of tonsillar herniation?
``` Pupil changes Increased confusion/coma Increasing weakness/paralysis CVS changes/arrest Respiratory changes/arrest ```
50
What are the 4 different mechanisms of traumatic brain injury?
Stretching Shearing Contusion Haemorrhage
51
What is the mechanism of a shearing injury?
Pulling of nerve fibres causing damage
52
What is the mechanism of a shearing brain injury?
Damage due to nerve fibres rubbing over one another
53
What is the mechanism of a contusion brain injury?
Bruising on brain surface
54
What is the mechanism of a haemorrhage?
Bleeding.
55
What is a coup, contracoup injury?
Brain impacting on skull at point of impact (coup) then rebounding backwards to hit skull on opposite side (Contrecoup)
56
What are 3 examples of a diffuse traumatic brain injury?
Concussion Diffuse axonal injury Traumatic subarrachnoid haemorrhage
57
What are 3 examples of a focal traumatic brain injury?
Extradural haematoma Subdural haematoma Contusions/intracerebral haematoma
58
What is concussion?
Mild traumatic brain injury involving a temporary impairment of neurological function which quickly self-resolves. No structural brain damage occurs.
59
What occurs to cause diffusion axonal injury (DAI)? Examples of the accident in which it occurs
Result of shearing forces that occur due to the head rapidly accelerating and decelerating e.g. car accidents, falls, assaults.
60
What is commonly the outcome of DAI?
Coma
61
How many traumatic brain injuries are as a result of diffuse axonal injury?
50%
62
What is a subarrachnoid haemorrhage?
A bleed into the subarrachnoid space.
63
What are the 3 common symptoms of a subarrachnoid haemorrhage?
Rapid onset of a thunder clap headache Vomiting Altered consciousness
64
What are the 4 components of a neurological assessment?
Vital signs: temp, pulse, resp, BP and SpO2 GCS Limb powers Pupillary function
65
What are the three behavioural aspects of GCS?
Eye opening Best verbal response Best motor response
66
What are the highest and lowest scores for GCS?
Highest 15 | Lowest 3
67
What is the eye opening aspect of GCS scored out of?
4
68
What is the verbal response aspect of GCS scored out of?
5
69
What is the motor response aspect of GCS scored out of?
6
70
What GCS score requires intubation?
Equal or <8
71
From best to worst, what are the 4 options for GCS eye opening?
Spontaneous To speech To pressure None
72
From best to worst, what are the 5 options for GCS verbal response?
``` Orientated Confused Words only Sounds only None ```
73
From best to worst, what are the 6 options for GCS motor response?
``` Obeys commands Localises to pain Withdraws from pain Flexion to pain Extension to pain None ```
74
What is the system of decreasing frequency for GCS testing for a pt following traumatic brain injury with GCS 15/15?
Every half an hour for two hours Every hour for four Every two hours after
75
If GCS decreases in a traumatic brain injury patient what should be the frequency of neurological obs?
Every half an hour
76
How soon following a CT scan for traumatic brain injury should a interpretation by a neuro consultant be provided?
<1 hour
77
What is a primary injury?
Occurs at the time of injury or accident, is unable to be intervened with.
78
What is a secondary injury?
Physiological injury that can be managed to avoid exacerbation of primary injury.
79
What are 5 examples of secondary injuries?
``` Hypoxia Hypotension Raised ICP Infection Seizures ```
80
What are the 4 primary aims of management in traumatic brain injury?
Maintenance of cerebral perfusion. Adequate oxygenation Avoidance of hyper/hypocapnia Avoidance of hyper/hypoglycaemia
81
What is a neuromusular blockade?
Neuromuscular drugs used in anaesthesia known as muscle relaxants. Block the neuromuscular junction relaxing muscles of abdomen and diaphragm allowing for intubation.
82
What 4 factors need to be taken into account/done in the positioning of a traumatic brain injury patient?
Maintain neutral head and neck alignment by log rolling pt. Elevate head to 15-30 degrees. Avoid uncontrolled repositioning and hip flexion Observe and document all effects of repositioning on CPP, MAP and ICP
83
What is hemiparesis?
Weakness to one side of the body
84
What is hemiplegia?
Paralysis to one side of the body

Nursing Acutely Ill (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions