Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NURS 319: Injury
Chapter 35 Neuro Injury
| Question | Answer |
|---|---|
| acceleration- deceleration | brain occurs when the head is accelerated and then stopped suddenly |
| conus medullaris | terminal end of the spinal cord |
| neurogenic shock | organ tissue hypoperfusion resulting from the disruption of normal sympathetic control over vascular tone |
| tetraplegia | paralysis caused by an injury of the cervical spinal cord |
| cauda equina syndrome | occurs when the nerve roots in the lumbar spine are compressed, cutting off sensation and movement |
| cushing's triad | widened pulse pressure (increasing systolic, decreasing diastolic) bradycardia, and irregular respirations |
| postconcussion syndrome | occurs when symptoms of a mild traumatic brain injury last longer than expected after an injury |
| transtentorial herniation | the movement of brain tissue from one intracranial compartment to another. |
| areflexia | Absence of neurologic reflexes such as the knee-jerk reaction |
| cytotoxic cerebral edema | a type of cerebral edema, most commonly seen in cerebral ischemia, in which extracellular water passes into cells, resulting in their swelling |
| paraplegia | paralysis of the legs and lower body, typically caused by spinal injury or disease |
| traumatic brain injury (TBI) | happens when a sudden, external, physical assault damages the brain |
| cerebral perfusion pressure | the net pressure gradient that drives oxygen delivery to cerebral tissue |
| coup-contrecoup injury | A coup injury happens at the point of impact with an object, whereas a contrecoup injury takes place on the opposite side of the skull from the impact |
| quadriplegia | paralysis of all four limbs; tetraplegia. |
| uncal herniation | occurs when rising intracranial pressure causes portions of the brain to flow from one intracranial compartment to another |
| cauda equina | the sack of nerve roots (nerves that leave the spinal cord between spaces in the bones of the spine to connect to other parts of the body) at the lower end of the spinal cord |
| decerebrate posture | an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward. |
| spinal shock | altered physiologic state immediately after a spinal cord injury |
| vasogenic cerebral shock | inadequate tissue perfusion by oxygen-carrying blood |
| concussion | a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. |
| decorticate posture | a reflex pose that's a symptom of damage to or disruptions in brain activity. |
| how many tbi's in 2013 | 2.8 million |
| what was the most common cause of tbi? | falls |
| how many SCIs in 2013? | 174,000 |
| what were the most common causes of tbi/ sci? | sports related accidents and violence |
| who most often succumbs to these injuries? | males more than females |
| what age group succumbs to these injuries? | ages 16-30 for sca |
| frontal lobe | consciousness, judgment, emotional responses, impulse control |
| temporal lobe | hearing, memory, speech |
| parietal lobe | body awareness/ spacial awareness, sensory, perception of touch |
| occipital lobe | vision |
| brain stem | vital sign center, ANS, sleep/wake cycle and level of awareness |
| what is a normal pressure inside the brain? | 5 to 15 mmHg |
| what is the brain made up of? | 10% cerebral spinal fluid 80% brain tissue 10% blood volume |
| at what pressure does the brain start to not be able to compensate? | above 15 mmHg |
| at what pressure does the brain herniate? | 60 mmHg |
| what is the Monroe-Kellie Hypothesis | brain trying to maintain pressure in itself |
| level of consciousness is about | self awareness and our ability to interact with the environment; includes electrolyte disturbances, toxins, drugs, psychosis |
| how does the brain regulate consciousness? | interconnected neural pathways with all brain lobes- awake, alert oriented |
| what is meant by arousability? | awake, alert, oriented- ability to wake up |
| continuum of normal consciousness to severely abnormal | alert, lethargy, obtunded, coma |
| blunt trauma | object hits skull forcefully, causing fractures/ damage to underlying brain |
| acceleration-deceleration (coup-contracoup) | brain rotates within skull (MVA) forceful stop/impact |
| penetrating injury | something goes into skull/brain, causes damage |
| blast injury | explosion based on type/ material/distance; pressure wave/ sound/ heat |
| major causes of increased ICP? | cerebral edema, trauma, hemorrhage, stroke |
| vasogenic edema | pores of brain capillaries open |
| when does vasogenic edema happen? | disruption of the blood-brain barrier, allowing protein-rich fluid to accumulate in the extracellular space |
| cytotoxic edema | increased intracranial pressure and increased cerebrospinal fluid |
| when does cytotoxic edema happen? | after stroke |
| how can we lower ICP? | decrease brain tissue, decrease circulating blood and CSF, lower BP, cut hole in skull |
| what happens if we cannot lower ICP? | brain death |
| what is brain death? | irreversible end of all brain activity |
| who can pronounce someone brain dead? | neurologist or neurosurgeon |
| what diagnostic tools are used in declaring brain death? | EEG, cerebral angiogram |
| what are some important assessment findings in TBI (skull fracture)? | head trauma findings, glasgow coma scale, coma and posturing, cushing's triad |
| TBI assessment | level of consciousness, CSF leaking from eyes or ears, blood visible behind tympanic membrane, bruising in front of the mastoid process or under the eyes |
| what scale is used to determine LOC? | glasgow coma scale- shorthand neurological assessment |
| what does a glasgow score of 15 mean? what about 3? | very oriented and absence of all activity |
| what glasgow score is an indicator of severe brain injury? | 6 and below is comatose |
| which posture has a poorer prognosis? | decerebrate |
| imaging studies that help assess TBI? | CT, CT angiogram, MRI, EEG, ventriculostomy with ICP monitoring |
| why are CT scans sometimes done daily? | look for difference/ improvements |
| what is a ventriculostomy? | hole bore into brain, probe inserted to monitor pressure/ drain excessive CSF |
| epidural hematoma | collection of blood above the dura mater usually resulting from hematoma causing a tear in the middle meningeal artery |
| sub dural hematoma | a collection of venous blood beneath the dura mater usually associated with the elderly- even with minor head trauma |
| two types of sub arachnoid hemorrhage, which is more common | traumatic (more common) and aneurysmal |
| how does the brain react to blood in SA space? | brain tissue irritated, brain cells destroyed |
| what happens during cerebral vasospasm | arteries constrict because they are so irritated |
| sentinel leak symptoms | leaks down into meninges- headaches |
| aneurysm rupture symptoms | worse headache of life, deteriorating level of consciousness |
| primary injury | trauma (tear, stretch, cut) and loss of circulation (spinal stroke) |
| secondary injury | ischemia from primary injury and cytotoxic edema |
| what can a dermatome map tell us | sensory level testing; score based on sensation level |
| how do you assess for sensory function | light touch, spacial awareness, vibration, painful stimuli |
| how do you assess for motor function | maximum strength attained no matter the duration, 0-5 scale for each area |
| why is it important to determine the level of injury in SCI? | find where motor and sensory are intact |
| what is the ASIA impairment scale | ABCDE scale- sacral sparing test |
| what diagnostics are used to confirm the level of injury | X-ray, CT, MRI, myelography |
| how is the respiratory system affected by injuries above C4? | respiratory complications, respiratory rate, chest wall expansion, ABGs |
| what about t2-t4? | changes to how much air a person can breathe in and out and weaken cough reflex |
| what is areflexia eventually replaced with? | flaccid muscle replaced with spasticity |
| what level of injury do we worry about neurogenic shock? | injuries above t6 |
| what neurotransmitter is no longer released, leading to the development of neurogenic shock? | norepinephrine |
| spasicity | contraction of muscles that causes rigidity |
| autonomic dysreflexia | PNS/SNS dysfunction below area of injury, unregulation of ANS |
| cardiovascular complications | HR, BP, unregulated |
| respiratory complications | RR unregulated |
| bowel/ bladder dysfunction | incontinence |
| secondary immunodeficiency | fighting off infections more difficult |
| pressure injuries | loss of sensation |
| neuropathic pain | phantom pain, pins and needles, tingling |
Created by:
lcorlew1
Popular Pathology sets