Traumatic Head/Spinal Injury Flashcards Preview

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Flashcards in Traumatic Head/Spinal Injury Deck (33):
1

2 kinds of skull fractures

linear
depressed

2

concussion is defined as?

clinical term
instantaneous loss of consciousness
temp resp arrest
loss of reflexes

3

pathogenesis of concussion?

maybe brainstem?

4

percentage of CNS injury:
all deaths
deaths from trauma
deaths from MVAs?

1% all deaths
30% deaths from trauma
50% deaths from MVAs?

5

what is penetrating injury?

direct disruption of tissue

6

what is a closed injury?

movement and compression of brain within skull

7

2 acute secondary effects of traumatic head injury?

ischemia
hypoxia

8

3 delayed secondary effects of traumatic head injury?

increased ICP
infection
epilepsy

9

difference between open and closed fracture of skull?

open communicates with outside world, increase risk of infection

10

splintering of bone?

comminuted

11

when do you get blood/csf from nose/ears?

basal fracture

12

cause of epidural hematomas? more likely in what age group?

middle meningeal artery
younger age group

13

cause of subdural hematomas? more likely in what age group?

subdural veins, acute or chronic
older ppl more likely, brain shrinkage

14

what is brain contusion?

hemorrhagic necrosis bruising

15

what is coup?

site of impact

16

what is contrecoup?

opposite site of impact

17

where do sterotypic contusions occur?

base of brain, inferior frontal and temporal lobes

18

what does an old cerebral contusion look like macroscopically?

collapsed brain tissue
orange staining
scarring at tips of gyri

19

what is a vulnerable site if too much energy transfer?

ponto-medullary junction

20

What is particularly vulnerable to TAI/DAI?

corpus callosum

21

what is diffuse axonal injury?

diffuse vascular injury, usually secondary

22

what is a histological sign of diffuse axonal injury?

axonal spheroids: build up of proteins in broken axons

23

longterm effects of diffuse axonal injury includes?

brain atrophy
enlarged ventricles
thin corpus callosum
less white matter

24

what happens to spinal cord in vertebral # and dislocation?

cord compression, toothpaste effect

25

4 longer term sequelae of brain trauma?

infections
hydrocephalus ( blocked 4th ventricle exits)
epilepsy
chronic traumatic encephalopathy

26

chronic traumatic encephalopathy features? 3

brai atrophy
abnormal Tau protein deposition
A/B plaque deposition

27

how much blood and CSF in brain?

150ml each

28

how does blood and CSF react initially to trauma?

drainage of both as much as possible, then increase ICP (explains delay)

29

when do you get zero brain perfusion?

as ICP approaches arterial pressure

30

what happens to brain tissue close to dural openings?

herniations

31

big causes of raised ICP? 5 things

cerebral oedema
trauma
hemorrhage
infection
too much or blocked exit of CSF

32

2 subtypes of cerebral oedema

vasogenic: white matter BBB more permeable
cytotoxic: white and grey matter, increased INTRAcellular fluid.

33

which cerebral oedema is responsive to steroids?

vasogenic
NOT cytotoxic