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N232-U2-HEAD INJURY
HEAD INJURIES
| Question | Answer |
|---|---|
| THE INNER PART OF THE BRAIN IS ASSOCIATED WITH CONTENT OR MOVEMENT | CONTENT |
| THE OUTER PART OF THE BRAIN IS ASSOCIATED WITH CONTENT OR MOVEMENT | MOVEMENT |
| INNER | CONTENT |
| OUTER | MOVEMENT |
| AROUSAL COMES FROM THE BRAIN STEM, SPECIFICALLY FROM THE | RETICULAR ACTIVATING SYSTEM |
| THE RETICULAR ACTIVATING SYSTEM IS RESPONSIBLE FOR | AROUSAL |
| IF A PATIENT IS IN A COMA WHAT SCORE/RANGE WOULD THEY HAVE ON A GLASGOW COMA SCALE | 3-8 |
| WHAT IS THE BEST SCORE YOU CAN GET ON A GLASGOW COMA SCALE | 15 |
| THE RETICULAR ACTIVATING SYSTEM IS LOCATED IN THE OUTER OR INNER BRAIN | OUTER |
| A BUMP TO THE HEAD COULD AFFECT AROUSAL BECAUSE OF DAMAGE TO THE | RETICULAR ACTIVATING SYSTEM |
| AROUSAL COMES FROM | OUTER |
| CONTENT COMES FROM | INNER |
| AROUSAL BUT NO COGNITION IS | PERSISTENT VEGETATIVE STATE |
| NO MOTOR BUT UNDERSTANDS THINGS | LOCKED-IN SYNDROME |
| HOW MIGHT A PATIENT WITH LOCKED-IN SYNDROME COMMUNICATE WITH OTHERS | THROUGHT THE EYES |
| BRAIN DEATH IS | LEGAL DEATH |
| IS AROUSAL PRESENT IN PERSISTENT VEGETATIVE STATE | YES |
| WHAT IS NOT PRESENT IN A PERSISTENT VEGETATIVE STATE | COGNITION |
| WHAT IS PRESENT IN LOCKED-IN SYNDROME | COGNITION |
| TRAUMA, STROKE/HEMORRHAGE, INFECTION AND NEOPLASMS ARE ALL WHAT TYPE OF CAUSE OF ALTERED LOC | STRUCTURAL |
| HYPOGLYCEMIA, HYPOXIA, CHEMICAL TOXINS, CHANGES IN BODY TEMP ARE ALL | METABOLIC CAUSES OF ALTERED LOC |
| THE OUTER BRAIN FUNCTION | CONTENT |
| THE INNER BRAIN FUNCTION | AROUSAL |
| INNER BRAIN---RAS--- | AROUSAL |
| OUTER BRAIN--- | CONTENT |
| THE PATIENT THAT RESPONDS TO STIMULI IS | ALERT |
| THE PATIENT THAT NEEDS CUES OR THEIR JUDGMENT IS OFF IS | CONFUSED |
| THE DROWSY PATIENT THAT NEEDS STIMULATION | LETHARGIC |
| RESPONDS | ALERT |
| NEEDS CUES | CONFUSED |
| DROWSY | LETHARGIC |
| VERY SLOW TO RESPOND TO STIMULI AND NEEDS CONSTANT STIMULATION TO MAINTAIN RESPONSE | OBTUNDED |
| A PERSON IS ‘OBTUNDED’ IF THEY NEED WHAT | CONSTANT STIMULATION TO MAINTAIN A RESPONSE |
| A PATIENT THAT ONLY MOANS OR GROANS TO STIMULI IS CONSIDERED TO BE | STUPOROUS |
| LOC ASSESSMENT INCLUDES | MENTAL STATUS, MOTOR, SENSORY AND GLASGOW COMA SCALE |
| MENTAL STATUS, MOTOR, SENSORY AND GLASGOW COMA SCALE ARE ALL PART OF | LOC ASSESSMENT |
| AN INCREASED SCORE ON THE GLASGOW CORRELATESWITH A | INCREASED STATE |
| A DECREASED SCORE ON THE GLASGOW CORRELATES WITH | A DECREASED STATE |
| RIGID EXTENSION OF ALL FOUR EXTREMETIES WITH HYPERPRONATION OF FOREARMS | DECEREBRATE POSTURE |
| DECEREBRATE POSTURE TURNS THE LEGS ___ AND THE ARMS/WRISTS ___ | LEGS IN, ARMS/WRISTS OUT |
| DECORTICATE POSTURE AND DECEREBRATE POSTURE BOTH INCLUDE | EXTENSION OF LOWER EXTREMITIES |
| THE ARMS ARE POSITIONED HOW IN DECORTICATE POSTURING | ADDUCTED, POINTED IN TO THE ‘CORE’ |
| THE ARMS ARE POSITIONED HOW IN DECEREBRATE POSTURING | RIGIDLY EXTENDED WITH HYPERPRONATION OF FOREARMS |
| WHICH POSTURING INDICATES A MORE SERIOUS CONDITION | DECEREBRATE |
| WITH DECEREBRATE YOU DON’T | CELEBRATE…WORSE CONDITION |
| DECEREBRATE POSTURING INDICATES DISRUPTION OF MOTOR FIBERS IN THEMI | D BRAIN AND BRAIN STEM |
| IN DECORTICATE POSTURING THE ARMS ARE | PULLED IN TO THE CORE |
| IN ASSESSING PUPIL ACCOMMODATION THE CLOSER THE OBJECT IS TO THE PUPIL THE | SMALLER THE PUPIL GETS |
| HANDS CURLED INTO AN E | DECEREBRATE |
| HANDS BROUGHT UP TO THE CHEST | DECORTICATE |
| WHICH POSITION OF THE HAND INDICATES A MORE SERIOUS CONDITION | CURLED INTO AN E |
| X-RAY STUDIES, CTS AND MRIS ARE USED TO DETERMINE WHAT TYPE OF LOC CAUSE | STRUCTURAL |
| AN EEG ANALYZES THE | CORTEX |
| IF AN EEG DOESN’T SEE ANY CONTENT WHAT TEST WILL BE PERFORMED NEXT | EP |
| EP STANDS FOR | EVOKED POTENTIAL |
| WHICH TEST CAN SEE THE BRAINSTEM | EP |
| AN EEG MEASURES | ELECTRICAL ACTIVITY OF THE CORTEX |
| AN EP IS USED TO | RULE OUT DRUGS AS A CAUSE OF COMA |
| DURING AN EP THE BRAIN IS STIMULATED WITH | LIGHTS, SOUND AND/OR PAINFUL STIMULI |
| WHICH TEST IS USED TO DETERMINE THE PRESENCE OR ABSENCE OF BRAIN STEM ACTIVITY | EP |
| EP GOES | DEEP |
| OUTER | MOVEMENT |
| INNER | CONTENT |
| WHICH TEST IS DONE INTERNALLY, AN EP OR AN EEG | EP |
| A DOPPLER ULTRASONOGRAPHY IS USED TO SEE WHAT | BLOOD SUPPLY |
| A CEREBRAL ANGIOGRAPHY IS USED TO SEE | ARTERIES IN THE BRAIN |
| WHAT IS USED DURING A CEREBRAL ANGIOGRAPHY | CATHETER WITH CONTRAST |
| WHAT TEST IS USED TO MEASURE ICP | LUMBAR PUNCTURE |
| WHAT TEST USES A NEEDLE AND CATHETER INSERTED IINTO THE SPINE TO TAKE PICTURES | MYELOGRAPHY |
| DOPPLER ULTRA SONOGRAPHY | TO SEE BLOOD SUPPLY |
| CEREBRAL ANGIOGRAPHY | CATHETER WITH CONTRAST TO SEE ARTERIES IN BRAIN |
| LUMBAR PUNCTURE | DRAW FLUID TO MEASURE ICP |
| MYELOGRAPHY | NEEDLE & CATHETER TO TAKE PICTURES |
| A LUMBAR PUNCTURE IS PERFORMED BETWEEN THE | 3RD AND 4TH LUMBAR |
| A NORMAL ICP IS | 8-18 OR 20 |
| AN ICP IN THE TEENS IS CONSIDERED TO BE | NORMAL |
| AN ICP CATHETER IS INSERTED TO | DETERMINE PRESSURE IN THE VENTRICLES |
| WHEN ASSESSING FOR THE ICP WE USE WHAT | THE AVERAGE SHOWN |
| HOW DOES THE BRAIN INITIALLY RESPOND TO INCREASED ICP | COMPLIANCE |
| COMPLIANCE MEANS THE BRAIN | ADAPTS TO THE PRESSURES |
| ICP PATHOPHYSIOLOGY INCLUDES | COMPLIANCE, AUTOREGULATION AND DISPLACEMENT OF BRAIN TISSUE |
| WHICH RESPONSE OCCURS FIRST WHEN ICP RISES | COMPLIANCE |
| WHICH RESPONSE WILL CONSTRICT BLOOD FLOW TO THE BRAIN | AUTOREGULATION |
| THE SHEARING OF AXONS | DISPLACEMENT OF BRAIN TISSUE |
| DISPLACEMENT OF TISSUE INTO AN AREA IT’S NOT MEANT TO BE IS | HERNIATION |
| THE BLOOD SUPPLY TO THE OUTER PORTIONS | ARTERY |
| THE BLOOD SUPPLY TO THE INNER PORTIONS | VENOUS |
| WHICH IS AN EMERGENCY, A BLEED FROM THE OUTER OR THE INNER | OUTER, ARTERY |
| A BLEED IN THE INNER, VENOUS SYSTEM WILL PROGRESS SLOW OR FAST | SLOW, VENOUS |
| WHICH CONDITION IS MORE EMERGENT, AN ARTERIAL OR VENOUS BLEED | ARTERIAL |
| A LACERATION TO THE OUTER BLOOD SUPPLY IN THE HEAD IS A MEDICAL | EMERGENCY |
| VE’N’OUS | I’NN’ER |
| ‘A’RTERIAL | ’O’UTER |
| C02 IS A POTENT | VASODILATOR |
| WHY WOULD WE HYPERVENT A PATIENT WITH INCREASED ICP | HYPERVENTING INCREASES C02 AND THE CO2 WILL DILATE THE VESSELS AND LOWER THE ICP |
| CEREBRAL EDEMA IS | FLUID |
| BRAIN SWELLING IS | AN INCREASE IN BLOOD VOLUME |
| INCREASED ICP AND ALTERED LOC ARE EARLY OR LATE SIGNS OF INTRACRANIAL PRESSURE PROBLEMS | EARLY |
| CUSHING’S TRIAD, RESPIRATORY CHANGES AND POSTURING ARE EARLY OR LATE SIGNS | LATE |
| RESPIRATORY CHANGES INDICATE LATE OR EARLY SIGNS OF INCREASED ICP | LATE |
| WHAT IS CUSHING’S TRIAD | INCREASE IN SYSTOLIC, DECREASE IN DIASTOLIC AND DECREASE IN HR |
| A WIDE PULSE PRESSURE WITH SLOWING PULSE IS CALLED | CUSHINGS TRIAD |
| A WIDE PULSE PRESSURE AND DECREASED PULSE ARE EARLY OR LATE SIGNS OF INCREASED ICP | LATE |
| WHAT IS THE FIRST THING YOU WILL SEE WHEN ICP RISES | AN INCREASE ON THE MONITOR |
| WHAT WILL YOU SEE AFTER THE MONITOR ICP RISES | ALTERED LOC |
| WHAT ARE THE CARDIOVASCULAR SYMPTOMS OF INCREASED ICP | CUSHING’S TRIAD-WIDE PULSE PRESSURE AND DECREASED HR |
| IN WHAT ORDER WILL SIGNS OF INCREASED ICP OCCUR | NUMBER ON MONITOR WILL INCREASE, THEN LOC CHANGES AND THEN CV CHANGES |
| CV CHANGES WILL BE SEEN AFTER | LOC CHANGES |
| IS AN IRREGULAR RESPIRATORY PATTERN AN EARLY OR LATE SIGN OF INCREASED ICP | LATE |
| POSTURING, CUSHING’S AND RESPIRATORY CHANGES ARE ALL | LATE SIGNS OF INCREASED ICP |
| WHEN FLUID IS PRESENT IT IS CALLED | EDEMA |
| WHAT IS USED TO TREAT EDEMA | DIURETICS |
| WHAT IS THE MOTHER OF ALL DIURETICS | MANITOL |
| WHEN BLOOD VOLUME TO THE BRAIN IS INCREASED WE GIVE | VASOCONSTRICTORS |
| WHAT IS COMMONLY DONE WHEN WE GIVE VASOCONSTRICTORS | HYPERVENT TO BALANCE CONSTRICTION AND DILATION |
| COUGING, VOMITING, DEFECATION AND VALSALVA MANEUVER ARE ALL ACTIVITIES THAT WILL HAVE WHAT AFFECT ON ICP | INCREASE |
| WHEN THE FEET ARE HIGHER THAN THE HEAD WHAT WILL HAPPEN TO ICP | INCREASES |
| WHEN THE HEAD IS HIGHER THAN THE FEET WHAT WILL HAPPEN TO ICP | DECREASES |
| ACTIVITIES THAT DECREASE ICP INCLUDE HYPERVENTING, POSITIONING SO THAT THE HEAD IS HIGHER THAN THE FEET AND | CNS DEPRESSANTS/SEDATION |
| HEAD INJURIES HAVE WHAT EFFECT ON OXYGEN AND GLUCOSE | INCREASED NEED |
| WHAT IS THE MAIN GOAL OF CARE IN THE INITIAL MANAGEMENT OF HEAD INJURIES | ABC’S, IMMOBILIZE HEAD & NECK |
| WHAT IS THE ONGOING MANAGEMENT PRINCIPLE OF BRAIN INJURY CARE | MAINTAIN CEREBRAL PERFUSION, PREVENT INCREASE IN ICP |
| WHAT IS THE PROGNOSTIC PRINCIPLE OF HEAD INJURY | DURATION OF COMA |
| WHAT IS THE PRIMARY GOAL OF BRAIN INJURY CARE | SELF CARE IS THE PRIMARY GOAL |
| MANNITOL IS USED FOR | MOVING FLUID OUT OF THE BODY |
| MANNITOL WILL HAVE WHAT EFFECT ON ICP | LOWER IT BY LOWERING VOLUME |
| WHAT SHOULD BE MONITORED CLOSELY WHEN USING MANNITOL | OUTPUT AND ELECTROLYTES |
| DECREASED POTASSIUM RESULTS IN WHAT CHANGE ON AN EKG | DEPRESSED T WAVE |
| WHAT ARE THE S/S OF DECREASED POTASSIUM | CONFUSION, IRREG RHYTHM, RESPIRATORY PARALYSIS, ILEUS, NAUSEA AND WEAKNESS |
| WHAT ARE THE S/S OF INCREASED POTASSIUM | FACIAL NUMBNESS, DIARHEA, ASYSTOLE, RESPIRATORY ARREST |
| DIABETES INSIPIDUS AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE RELEASE ARE THE RESULT OF DAMAGE TO | THE PITUITARY GLAND |
| DIABETES INSIPIDUS IS THE DECREASE OF ____ THAT LEADS TO THE LOSS OF ______ | ADH, H20 |
| ADH IS INCREASED OR DECREASED IN DIABETES INSIPIDUS | DECREASED |
| HOW ARE DIABETES INSIPIDUS AND SIADH ALIKE | ADH IMBALANCE |
| INCREASED ADH RESULTS IN | RETENTION OF WATER |
| DECREASED ADH RESULTS IN | LOSS OF WATER |
| A PATIENT WITH DI WILL LIKELY BE HYPER OR HYPO-VOLEMIC | HYPOVOLEMIC |
| REMEMBER THAT WITH’ DI’ YOU HAVE | ’DEHY’-DRATION |
| TOO MUCH ADH WILL CAUSE | WATER RETENTION |
| ‘SI’ADH RESULTS IN | ’HI’ RETENTION |
| POTASSIUM AND THE T WAVE HAVE A | DIRECT RELATIONSHIP |
| WHEN POTASSIUM IS HIGH THE T WAVE IS | HIGH |
| WHEN POTASSIUM IS LOW THE T WAVE IS | LOW |
| WHEN POTASSIUM IS HIGH THE BOWELS ARE | HIGHLY ACTIVE |
| WHEN POTASSIUM IS LOW THE BOWELS ARE | SLOW |
| PULLING INTRACRANIAL FLUID OUT THRU VENTRICULOSTOMY IS CONSIDERED A | EXTREME MEASURE |
| BEFORE VENTRICULOSTOMY IS PERFORMED WHAT MEASURES SHOULD BE TRIED FIRST | HOB UP, HYPERVENT |
| A CONTUSION OF THE BRAIN STEM WILL RESULT IN THE LOSS OF WHAT | VITAL REGULATION |
| AN IMPACT TO THE HEAD WILL RESULT IN WHAT TYPE OF BRAIN INJURY | PRIMARY |
| THE PRIMARY HEAD INJURY WILL RESULT IN | THE SECONDARY INJURIES |
| AN EPIDURAL HEMATOMA IS EASY TO FIX BUT A | LIFE-THREATENING BLEED |
| IS AN EPIDURAL HEMATOMA VENOUS OR ARTERIAL | ARTERIAL |
| SUBDURAL HEMATOMAS ARE WHAT TYPE OF BLEED | SLOW, VENOUS |
| WHICH IS A DEEPER BLEED, EPIDURAL OR SUBDURAL | SUBDURAL |
| ARTERIES ARE IN THE | EPIDURAL |
| VEINS ARE IN THE | SUBDURAL |
Created by:
Lori Dobrisky
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