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91 Cards in this Set
- Front
- Back
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types of brain injury
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concussion
contusion |
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a concussion is a what
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symptom
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a contusion is a what
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physical problem
a bruise on the brain |
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coup injury
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injury underlying point of contact
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contra-coup injury
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brain injury on opposite side of brain from point of contact
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most susceptible areas to brain injury
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frontopolar
anterior temporal orbito-frontal area cribiform plate |
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what is the cause of inertial injuries
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lesion from rotational acceleration/deceleration
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inertial injuries are what type of injuries
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diffuse axonal injuries
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worst case inertial injuries may lead to what
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deep cerebral hemorrhage
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battles sign
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blood over mastoid process
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where is a epidural hematoma
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above the dura
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what is most common cause of epidural hematoma
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tear of middle meningeal artery in basal skull fracture
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epidural hematomas respect what
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suture line
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where are subdural hematomas located
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under the dura
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most common cause of subdural hematomas
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rupture of cerebral bridging vessels
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subdural hematomas do not respect what
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suture lines
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subdural hematomas are more common in what population
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older patients
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pneumocephaly
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gas in brain
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most common causes of pneumocephaly
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sinus fractures or open fractures
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nontraumatic causes of pneumocephaly
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post op
congenital skull defect infection with gas producing organism scuba(barotrauma) |
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systemic factors affecting TBI
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circulatory failure
pulmonary failure fat emboli |
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when do you most likely see fat emboli
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fracture of long bones
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presentation of fat emboli
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acute respiratory failure
global neurologic dysfunction petechial rash |
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coma
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unconsciousness with unresponsiveness
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categories for glasgow scale
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eye opening
verbal response motor response |
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when is glasgow scale best
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in intial phase of injury
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when can glasgow not be used
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children
shock hypoxia intoxication postictal state |
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glasgow scale for eye opening
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4=spontaneous
3=eyes open to speech 2=eyes open to pain 1=none |
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glasgow scale for verbal response
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5=oriented
4=confused 3=inappropriate 2=incomprehensible 1=none |
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glasgow scale for motor
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6=obeys commands
5=localizes to pain 4=withdraws to pain 3=flexor withdrawl 2=extensor withdrawl 1=none |
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max score for glasgow
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15
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min score for glasgow
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3
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signs of increased intracranial pressure
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altered mental status
dilated fixed pupil unilaterally papilledema |
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treatment for intracranial pressure
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osmotic agents
hyperventilation barbiturate coma |
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osmotic agents used for intracranial pressure
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mannitol and furosemide
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function of hyerventilation in reducing increased intracranial pressure
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decrease PCO2 pressure to induce cerebral vasoconstriction
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how long with hyperventilation last
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8-10min
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last resort for increased intracranial pressure
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barbiturate coma
short acting benzos like diprivan |
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poor prognostic factors for TBI
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older age
presistent ICP poor pupillary response hypotension hypercarbia mass lesion requiring surgery |
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signs of early behavioral syndrome
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attention defiict
confusion amnesia sleep disturbance confabulation denial of illness |
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signs of middle behavioral syndrome
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improved attention
improved memory lack of concern |
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signs of late behavioral syndrome
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imperfect attention
forgetfullness apathy/irritability poor insight, reasoning, problemsolving personality changes |
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post traumatic complications
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seizures
communicating hydrocephalus post concussion syndrome hypogonadotropic hypogonadism diabetes insipidus |
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when is post concussion syndrome more common
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in mild closed head injury
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what type of tract is the corticospinal tract
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descending motor
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where does the corticospinal tract cross
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in medulla
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what type of tract is spinothalmic
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ascending sensory
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what type of information does spinothalmic carry
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pain and temperature
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what type of tract is posterior column
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ascending sensory
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what type of information does posterior column carry
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vibration and joint position
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vasculature to the spinal column
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anterior spinal artery
posterior spinal artery |
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large thoracic radicular branch is also known as what
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artery adamkiewicz
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pathology following transection
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loss of all sensation and motor below lesion
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symptoms of central cord lesion
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dissociated sensory loss
flaccid paralysis, atrophy, fasciculations |
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what is classic distribution of central cord lesion
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cape like distribution
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other spinal cord syndromes
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anterior cord=pain and temp
brown-sequard |
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symptoms of brown sequard
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loss of ipsilateral vibration, joint position and power
contralateral loss of pain |
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sign of radiculopathy
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hypo or areflexive
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myelopathy
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loss of cns control
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signs of myelopathy
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hyperreflexive
fasiculations |
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things to look for on plain film radiographs
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subluxation and fractures
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MRI uses
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for soft tissue especially discs
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trauma affects what area of the spine most commonly
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cervical spine
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forces involved in spinal cord injury
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vertical compression
flexion extension rotational |
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types of spinal column injuries
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fracture
dislocation herniation |
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types of injury to spinal cord
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transection
compression contusion |
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primary treatment of spine injury
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immobilization
realignment stabilization |
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types of spinal infections
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osteomyelitis and epidureal abscesses
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most common bacteria
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s aureus
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presentation of bacterial infection
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back pain
wt loss radiculopathy myelopathy |
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viral spinal infections
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myelitis
meningitis |
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when might you see myelitis
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following systemic illness
or post-vaccination |
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causes of spinal infarction
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embolic or venous
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most common artery to be embolized and cause spinal infarction
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artery of adamciewicz
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what is presentation of spinal infarction
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acute paraplegia
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what is the treatment for spinal infarction
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supportive trying to prevent another episode
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what is the cause of spinal AVM
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congenital
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what is presentation of spinal AVM
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pain
weakness sensory change |
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what is the management of spinal AVM
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surgical resection
thrombosis |
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congenital spinal cord lesions
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myelomeningocele(spina bifida)
diastematomyelia(split cord) intraspinal cysts sacral lipoma tethered cord |
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cause of spina bifida
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failure of neural tube to close due to folic acid deficiency
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pregnant women on what drugs need extra folic acid
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anti-epileptics
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two types of diastematomyelia
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diastemateomyelia=two cords split by bone
diplomyelia=2 cords split by soft tissue |
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degenerative spine disease
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spondylosis
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presentation of spondylosis
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radiculopathy or paresthesias
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treatment for spondylosis
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NSAIDs
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spinal stenosis
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narrowing of the AP dimension of spinal canal
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treatment for spinal stenosis
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NSAIDs or surgery in severe cases
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causes of disc herniation
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trauma or degeneration
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presentation of disc herniation
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radiculopathy
myelopathy |
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management of disc herniation
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conservative
surgery for severe cases with weakness |
