Head injuries, brain trauma, stroke Flashcards Preview

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Flashcards in Head injuries, brain trauma, stroke Deck (27)
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1
Q

primary and secondary headaches

A

primary - first start between 20 and 40 years old including migraines and tension headaches
secondary - caused by problems elsewhere in the head or neck e.g. meds, meningitis, tumour

2
Q

neuro emergencies can effect CBF because of:

A

structural changes or damage
circulatory changes
alteration in ICP

3
Q

CPP =

A

MAP - ICP

4
Q

MAP =

A

SBP + (2 x DBP)

over 3

5
Q

Abnormal CPP

A

lower than 30mmHg

6
Q

raised ICP

A

greater than 20mmHg

7
Q

glucose metabolism

A

glucose is broken down through glycolysis to produce pyruvic arid which is broken down to produce ATP, H2o and Co2

8
Q

categories of brain injury

A

mild diffuse injury
moderate diffuse injury
diffuse axonal injury
focal injury

9
Q

RAS

A

a network of nerve fibers in the thalamus, hypothalamus, brain stem and cerebral cortex
essential for wakefulness, attention, concentration and introspection - GCS

10
Q

signs and symptoms of concussion

A
vomiting
combativeness
transient visual disturbances 
defect in equilibrium and coordination 
changes in BP, HR and resps (rare)
11
Q

moderate diffuse injury

A

results in small petechial bruising of brain tissue

involves the brain stem and RAS leading to unconsciousness

12
Q

diffuse axonal injury

A

results from movemennt of the brain within the skull secondary to acceleration or decceleration forces

13
Q

focal injury

A

lesions that result from skull fracture, contusion, oedema with increased ICP, ischaemic, haemorrhage, penetrating injury y

14
Q

cerebral ischaemia can result from

A

vascular injuries
secondary vascular spasm
increased ICP

15
Q

types of haemorrahge

A

epidural.extradural
subdural
subarachnoid
intracerebral haematoma

16
Q

Epidural haematoma

A

blood between the cranium and dura in the epidural space

17
Q

subdural haematoma

A

blood between the dura and the surface of the brain in the subdural space

18
Q

subarachnoid haemaorrhage

A

bleeding into the CSF

meningeal irritation

19
Q

intracerebral haemorrhage

A

blood of more than 5ml somewhere within the substance of the brain

20
Q

signs of severe brain trauma

A

abnormal posturing - flexor spasms, extensor spasms, flaccidity
pupillary changes
relaxation of the sphincter tone of the bowels and bladder
altered resps

21
Q

Cushing’s triad

A

increased SBP and widened pulse pressure
bradycardia
irregular or abnormal resps

22
Q

5th and 7th nerves

A

5th trigeminal - sensory innervation to the skin of the face
7th facial - innervates muscles of facial expression and supplies the anterior 2/3 of the tongue with taste fibers

23
Q

le forte 1 fractures

A

horizontal fractures crossing the lateral wall of the maxillary sinus up to the level of the nasal sinnus

24
Q

le forte II fractures

A

include the bony nasal skeleton and the middle third of the face including the medial orbits

25
Q

le forte III fractures

A

craniofacial dislocation involving all bones of the face and creating a mobile mid face

26
Q

signs of le forte fractures

A
mid facial oedema
unstable maxilla
lengthening of the face
epistaxis
numb upper teeth
nasal flattening 
nasal CSF leakage
27
Q

acute treatment of ischaemic stroke

A

thrombolytics - tPA
anticoagulants - warfarin, heparin
antiplatelet - aspirin
osmotic agents - mannitol