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NUR 212 EXAM 3

QuestionAnswer
most common cause of head trauma and subdural hematoma mva
falls are associated with... subdural hematomas
trauma with sharp projectiles penetrating trauma
VS change late in neuro
vs with loss of autoregulation w IICP body responds to IICP by raising BP, in BP moves blood into brain, further IICP, HR falls in response to rising BP
Cushings triad inc in IPC, BP (S inc, D stays same "widening", diff between gets larger), dec P, altered breathing
narrowing between S & D BP values equals shock, inc P
widening between S & D BP values (S=inc and D=stays same) equals neuro, dec P
VS with IICP inc BP, dec P, Resp, Cushings Triad
VS with shock dec BP, Inc P, Resp
Glasgow Coma Scale= Eye opening response 4=spontaneous, 3=to voice, 2=to pain, 1=none
glasgow coma scale=best verbal response 5=converses oriented, 4=converses disoriented, 3=inappropriate words, 2=incomprehensible words, 1=no verbalization
glascow coma scale=best motor response 6=obeys and follows commands, 5=localizes byt clearly pushed away from pain, 4=withdraws only to painful stimuli, 3=decoraticate, 2= decerebrate, 1=flaccid-no response to noxious stimuli
decoraticate abnormal flexion of arms and extension of legs, to noxious stimuli (problem with cervical spinal tract or cerebral hemisphere. flexor posturing "to the core"
decerebrate abnormal extension of all extremities to noxious stimuli (prob w mid brain or pons) exterior posturing
caloric test ice H2O in ear to jerky eyes-nystagmus CN VIII
pupil response with ICP raised ICP and temporal (Uncal) hermiation can press on occulomotor cranial nerve III, pupil dilates on side of brain w ICP first. Initially reacts briskly to light later sluggish
rapid, rhythmic constriction and dilation of pupil, may indicate IICP. pupil doesnt stay constricted with light hippus
reflex activity superficial, deep tendon (ankle, knee, biceps, triceps), corneal, oculocephalic (dolls eye reflex), oculovestibular (caloric test)
abnormal reflex assessment..babinski dorsiflexion of the great toe with fanning of other toes. not good in adult
abnormal reflex assessment..clonus rapid alternating flexion/extention of a stretch muscle
abn reflex ass..battles sign fx of middle cranial fossa
abn reflex ass..raccoon eyes fx of frontal portion of skull base
dx tests for head trauma.lumbar punctures should not be done with IICP due to pressure will be decreased to fast
dx tests for head trauma. cerebral angiography looks at vessels in head. painful
EEG looks at electrical activity of the brain
mechanism of injury to head blunt, penetrating, coup-contrecoup=deceleration injury
type of injury skull fracture cerebral concussion, cerebral contusion, hematoma (epidural, subdural, intracrebral)
Created by: vstein