Cns Trauma

Front 1

Loss of the sense of smell.

Back 1

Anosmic (Bad sign after a head injury b/c means head was shaken very badly)

Front 2

Focal areas of necrosis in gyral crests, usually with overlying SAH.

Back 2

contusions

Front 3

Lesions found directly underneath the site of trauma.

Back 3

coup lesions

Front 4

Lesions found diametrically opposed to the traumatic impact.

Back 4

contrecoup lesions

Front 5

What is a common complaint of patient's with a concussion?

Back 5

lack of concentration

Front 6

What is the first thing performed if head injury is suspected?

Back 6

Glascow Coma Scale

Front 7

Brain starts to die after ___ minutes w/o oxygen.

Back 7

three

Front 8

Epidural hematomas result from a tear in which vessel?

Back 8

Middle meningeal artery

Front 9

Epidural is often associated with a _____.

Back 9

lucid interval in which the patient is alert, but w/ headache and confusion "still drunk"

Front 10

Subdural hemorrhages arise from tears in what?

Back 10

Bridging veins, occurs slowly

Front 11

SD hematomas are more common in what populations?

Back 11

elderly due to cerebral atrophy and susceptibility to falls, Alzheimer patients, and children (due to activity)

Front 12

SD hematomas can organize and form _____ tissue.

Back 12

granulation

Front 13

Cerebral edema is characterize by?

Back 13

blunting of gyra and narrowing of sulci

Front 14

Name the type of herniation: symmetrical swelling of both hemispheres. Swelling forces brainstem downward closing off 3rd ventricle leading to hydrecephalus.

Back 14

Central

Front 15

Central herniations are common in _____ events.

Back 15

global (e.g. anoxia)

Front 16

Name the herniation: Cingulate gyrus is pushed underneath the the falx cerebri.

Back 16

Sub-falcine

Front 17

Sub-falcine herniations are seen in ______ lesions.

Back 17

unilateral

Front 18

Sub-falcine herniations can damage what?

Back 18

corpus callosum

Front 19

Name the herniation: Uncus is pushed downward into posterior fossa, compressing the brain stem.

Back 19

Uncal

Front 20

What are some complications of an uncal herniation?

Back 20

alterations of consciousness, CN III palsies, hemiparesis

Front 21

Uncal herniations can lead to compression of which artery?

Back 21

PCA

Front 22

Midline hemorrhages seen in a uncal herniation.

Back 22

Duret hemorrhages

Front 23

Names the herniation: increase in intercranial pressure pushes tonils of cerbellum through the foramen magnum.

Back 23

Tonsillar

Front 24

Name the injury: Blunt trauma to the head causes stretching of fibers, breaking them. Numerous broken, clubbed axons throughout white matter. No gross evidence of damage.

Back 24

Diffuse Axonal Injury

Front 25

What type of embolism often follows a fracture of a long bone?

Back 25

fat embolism

Front 26

In a GSW which matters more the size of the bullet or the speed?

Back 26

Speed, E = 1/2MV^2

Front 27

What is the major blood supply to the spinal cord?

Back 27

anterior spinal artery

Front 28

Superficial gastric ulcers that can follow many types of systemic stress including head trauma.

Back 28

Cushing's ulcers

Front 29

A syndrome of chronic brain damage.

Back 29

dementia pugilistica or "punch drunk syndrome"

Front 30

What are the three phases of a spinal cord injury?

Back 30

acute phase, latent period, and late phase

Front 31

Complex sequence of events following axonal severage.

Back 31

Wallerian degeneration

Front 32

First step in distal axonal degeneration.

Back 32

Develops irregular swelling (varicosities) and then fragments

Front 33

What changes occur in the cell body when an axon is severed?

Back 33

Nissl substance disappears, cell body swells, and nucleus is pushed to the periphery

Front 34

Series of events that occur in cell body after axon is severed.

Back 34

Central chromalysis

Front 35

Subarachnoid hemorrhages are usually due to rupture of what vessels?

Back 35

small cortical vessels

Front 36

Transient neurological deficit w/ no anatomic correlate.

Back 36

Concussion

Front 37

Major TBI is defined by:

Back 37

GCS less than 8 with a positive CT

Front 38

ABCDE's of initial assesment of TBI

Back 38

A - Airway
B - Breathing
C - Circulation
D - Disability
E - Evaluate

Front 39

Three components of Glasgow Coma Scale

Back 39

Motor, Eye Opening, Verbal

Front 40

Raccoon eyes are often seen with this fracture

Back 40

frontal sinus

Front 41

Rupture of a blood vessel and then a fibrous reaction around vessel to repair defect.

Back 41

Pseudoaneurysm

Front 42

ASIA classification of a SCI

Back 42

A - complete
B - incomplete sensory
C - incomplete motor less than 3
D - incomplete motor greater than 3
E - normal

Front 43

3 Column model of stability

Back 43

Anterior - Anterior half of vertebral body and ALL
Middle - posterior half of vertebral body and PLL
Posterior - pedicles, facets, laminae w/ ligamentum flavum, interspinous ligament, facet capsules

Front 44

Where are the most vulnerable areas of spine stablity?

Back 44

C5-C6 and L1

Front 45

Cervical Flexion Injury

Back 45

compression w/ flexion, teardrop fracture, severe SCI, instability in 3 columns

Front 46

Cervical Extension Injury

Back 46

posterior element fractures, often w/o fracture esp. in elderly, associated w/ "central cord syndrome"

Front 47

Central hemorrhage may damage the medial portion of the lateral corticospinal tract resulting in paralysis of upper limbs w/ lower limbs intact.

Back 47

Central Cord Syndrome

Front 48

Cervical Distraction Injury

Back 48

ligamentous injury, posterior element fracture, disc disruption, associate w/ severe SCI

Front 49

Thoracolumbar Burst Fracture

Back 49

Instability at thoracolumbar junction, injury to conus medullaris and cauda equina

Front 50

Late sequela of SCI. Associated w/ ascending weakness, loss of pain/temperature, scoliosis.

Back 50

Traumatic Syringomyelia