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ACP - Columbia > Week 34 Neuro Trauma Peds > Flashcards

Week 34 Neuro Trauma Peds Flashcards

(52 cards)

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1
Q

What is a the target BP in a patient with ICP?

A

Above 110-120

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2
Q

What is CPP?

A

MAP-ICP

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3
Q

What is herniation?

A

Brain being pressed down through foramen magnum due increased pressures in brain. (swelling)

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4
Q

Do you hyperventilate a ICP patient? T/F

A

FALSE YOU DUMMY

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5
Q

What is important factor to note regarding perfusion to the brain in regard to ICP

A

Increased ICP results in decreased blood availability to the brain

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6
Q

What are extra axial TBI’s?

A

Epidural hematoma, subdural hematoma, subarachnoid hemorrhage

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7
Q

What does extra axial mean?

A

Swelling is inside the skull and not involving brain parenchyma

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8
Q

What does intra axial mean?

A

involves the brain parenchyma

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9
Q

What is an example of a intra axial TBI

A

DIA

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10
Q

What is a primary head injury?

A

Impact

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11
Q

What is a secondary head injury?

A

Swelling (can persist for hours or days)

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12
Q

What is an epidural hematoma?

A

Blood collection between dura mater and inner aspect of periosteum

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13
Q

How does an EDH present? Symptoms?

A

LOC with a period of lucidness and regain of consciousness followed by a rapid deterioration, increased ICP. Symptoms of H/A, N/V, Focal neuro deficits ie weak, numb, vision, hearing.

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14
Q

How does an SDH present?

A

blood collection between the dura mater and arachnoid mater, bleeding source is commonly the bridging veins that connect cerebral venous sinuses (vulnerable to massive accel and decel)

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15
Q

What is important to remember with regards to head injuries in the elderly or chronic ETOH?

A

They have stretched out bridging veins, minor head trauma can cause acute SDH

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16
Q

Why are SDH considered to be “dangerous”

A

It is a venous bleed therefore it is slow and build it over time and not be caught until it is to late sometimes

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17
Q

Symptoms of SDH?

A

History of trauma, increased ICP, bad h/a, n/v, unsteady gait, confusion, cognitive problems, visual problems, slurred speech, dizzy, seizures, hemiparesis.

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18
Q

What is the brain parenchyma?

A

Functional tissues of the brain.

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19
Q

What is a SAH?

A

Subarachnoid hemorrhage, bleeding between the arachnoid mater and pia mater.

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20
Q

Common causes of SAH?

A

Head trauma, or spontaneous aneurysm rupture ie berry aneursym (AVM, genetic)

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21
Q

Symptoms of SAH?

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A

Thunderclap H/A, rapid progression, nuchal rigidity, seizures and increasing signs of ICP (N/V, vision disturb, confusion)

22
Q

How does a diffuse axonal injury occur?

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A

result from shearing forces that stretch and tear white mater axons in the brain disrupting communication of nerves leading to nerve cells dying and brain swelling due to this

23
Q

What is central herniation?

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A

downward displacement of brain stem

24
Q

Signs of increased ICP

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A

cushings triad, focal neuro signs

25
What is cushings triad?
HTN, bradycardia, IRR RR
26
3 layers of the meninges?
dura mater, arachnoid mater, pia mater
27
Causes of spinal cord injury
Trauma, infection, ischemia, tumors
28
What is the cervical spine responsible for?
sensory to neck, shoulder. and upper arms
29
What is the thoracic spine responsible for?
motor movement and sensory to thorax and abdomen
30
What is the lumbar spine responsible for?
low back, hips, legs, motor and sensory
31
sacral spine responsible for?
lowers legs, pelvis motor and sensory
32
What is important to note about a SCI?
injury to effected region impacts anything below it as brain signals can not reach that part of the body
33
What is the cause of SCI?
direct trauma or compression from fx vertebrae or masses
34
What could a leak of CSF indicate?
Head injury, tear in dura allowing csf to leak out
35
What can a high cervical injury manifest as?
hypotension, bradycardia, loss of sympathetic tone (neurogenic shock)
36
What is neurogenic shock? How does it manifest?
results from upper cervical injuries affecting cervical ganglia leading to loss of sympathetic tone. loss of sympathetic tone results in a shock state manifesting as hypotension and bradycardia
37
How does EDH manifest? History and Physical?
arterial: bleeding from branch of middle meningeal artery, anterior meningeal artery or dural arteriovenous fistula. venous: lac of dural venous sinus. LOC following trauma followed by a lucid interval then a rapid neuro deterioration. Physical: increased ICP, pupil changes, cushings vomiting, drowsy, confusion, seizures, weakness.
38
Patho of SDH? Hx? Physical?
accel-deecel causing trauma and rupture of bridging veins within the meninges causing them to bleed into the subdural space. Hx: trauma, or SIDS, (retinal bleeding a sign of SIDS), Physical: H/A. LOC, neuro deficits, posturing, cheyne stokes
39
Patho of SAH, Hx? Physical?
ruptured cerebral aneurysm or trauma, (AVM). Symptoms: thunderclap headache, lateral h/a, pupil asymmetry, brief loc, n/v, seizure. increased ICP, nuchal rigidity, photophobia, focal deficits.
40
How do ruptures occur?
hemodynamic stress to vessel wall due to HTN promotes formation and rupture of aneurysms.
41
What is downsyndrome?
A genetic condition where the person has 47 chromosomes and not the normal 46
42
What is important to note about down syndrome?
It effects almost every organ in the body
43
What is hydrocephalus?
symptomatic accumulation of CSF inside the cerebral ventricles
44
What are the ventricles?
Cavities of the brain that produce CSF
45
3 causes of hydrocephalus>?
Excess production of CSF, impaired reabsorption of sf into blood stream, blockage that causes accumulation.
46
4 types of hydrocephalus?
communicating, obstructive, hypersecretory, normal pressure
47
what is communicating hydrocephalus?
impaired absorption of csf due to past hemorrhagic or post inflammatory changes, SAH
48
What is obstructive hydrocephalus?
block in csf pathways
49
What is hypersecretory hydrocephalus?
overproduction of csf due to tumours
50
what is normal pressure hydro
not well understood, no icp, impaired csf dynamics
51
What is the monroe kelly doctrine?
total volume of brain, blood, csf within skull is constant. an increase in one compartment must accompany a decrease in volume in another otherwise pressure in head will increase
52
What is spina bifida?
neuro condition from failure of neural tube closure of varying degrees during fetal development can be either closed or open

ACP - Columbia (19 decks)

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