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Patho chap 35
brain & spinal injury
| Question | Answer |
|---|---|
| what was the most common cause of TBI's | falling |
| what were the most common causes of SCI's | motor vehicles, falls, sports injuries, violence |
| frontal lobe | conscious, judgement, emotional response, impulse control area |
| temporal lobe | hearing, memory, speech |
| parietal lobe | sensory perception, touch |
| occipital lobe | vision center |
| brain stem | vital sign center, sleep wake cycle, levle of alertness |
| what is a normal pressure inside the brain | 5 to 15 mmHg |
| what is the brain made up of | 10% - blood volume 80% - brain tissue 10% - cerebral spinal fluid |
| at what pressure does the brain start to not be able to compensate? | 15 mmHg |
| at what pressure does the brain herniate? | 60 mmHg |
| level of consciousness | self awareness and our ability to interact with the environment |
| how does the brain regulate consciousness? | through interconnected pathways |
| what is meant by arousability | level of alertness |
| use words to describe a continuum from normal consciousness to severely abnormal | alert lethargy obtunded coma |
| blunt trauma | object hits the skull forcefully causing fracture |
| acceleration - deceleration (coup- contra coup) | shearing of brain tissue due to fast movement bouncing back & forth |
| penetrating injury | foreign object penetrates skull |
| blast injury | explosion |
| what are some major causes of increased ICP | blood pressure changes brain tissue cerebral spinal fluid |
| when does vasogenic edema occur | after a stroke |
| how can we lower ICP | externally drain cerebral spinal fluid, decrease BP by fluids |
| what happens if we don't lower ICP if it's too high | brain death |
| what is brain death | irreversible end of all brain activity |
| what diagnostic tests are used in declaring brain death? | repeated EEG's for at least 30 min |
| important assessment findings in TBI | level of consciousness CSF leaking from the eyes or ears bruising in front of the mastoid process or under the eyes |
| what scale is used to determine LOC | glasgow coma scale |
| what does a score of 15 indicate on LOC | spontaneous & oriented |
| what does a score of 3 indicate on LOC | absence of actions |
| what score is considered an indication of severe brain injury on LOC | 6 or lower |
| cushing's triad | high blood pressure, widened pulse pressure and slowing of heart rate & respirations |
| decorticate posture | Bringing their arms to their core |
| decerebrate posture | arms are flexed outward, back is arched |
| what is a ventriculostomy | hole in the brain and proble put in it to help with the pressure |
| concussion | a mild TBI that may or may not involve a loss of consciousness as well as temporary memory loss and alteration of mental state |
| epidural hematoma | a collection of blood above the dura mater usually resulting from rupture causing a tear in the middle meningeal artery while a sub dural hematoma is a collection of venous blood beneath the dura mater |
| epidural hematoma associated with who | elderly - even with minor head trauma |
| two types of sub arachnoid hemorrhage | traumatic and aneurismal - traumatic is more common |
| how does the brain react to blood in the SA space during a SAH | irritates the brain meninges |
| what happens during cerebral vasospasm | brain is so irritated, arteries will constrict |
| sentinel leak symptoms | headache, dizziness, eye & neck pain |
| aneurysm rupture symptoms | thunder clap headache |
| primary injury in spinal cord injury | trauma, loss of circulation |
| secondary injury in spinal cord injury | ischemia or cytotoxic edema |
| what can a dermatome map tell us | 0 - sensation 1- impaired 2- normal |
| how do you assess for sensory function | whisper, touch, vibration |
| how do you assess for motor function | pull against arm, muscle strength |
| what is the ASIA impairment scale? | american spinal injury accessory tool |
| how is the respiratory system affect by injuries above C4 | phrenic nerve innervates diaphragm - can't breath on their own |
| how is the respiratory system affected by injuries near T2-T4 | can't move diaphragm as well and can get pneumonia |
| what is spinal shock | the altered physiologic state immediately after a spinal cord injury |
| how do you know spinal shock is resolved | indeterminable until spinal injury goes away, hours or weeks after injury |
| what is areflexia eventually replaced with for spinal shock | hyperflexia |
| what is neurogenic shock | condition that affects spinal injury at T6 or above: lack of norepinephrine |
| autonomic dysreflexia | over reaction of your autonomic nervous system |
| cardiovascular complications of SCI | orthostatic hypotension, venous stasis, vasodilation |
| respiratory complications of SCI | pneumonia, pulmonary embolism, atelectasis |
| bowel disorder for complications of SCI | neurogenic bladder |
| pressure injuries of SCI | muscle paralysis |
| neuropathic pain of SCI | burning, squeezing, aching, or tight pain |
Created by:
sammy.e7
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