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NUR 212 EXAM 3
| Question | Answer |
|---|---|
| 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
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