Ch. 34 Head and Spinal trauma

Which of the following is the correct method for rapid extrication of a patient from a motor vehicle?

Extrication collar, slide a long board under the buttocks, remove pt. from car

How should you move an injured patient from the ground to a backboard?

Four-person log roll

Cerebrum

Largest portion of the brain, responsible for higher functions of the brain.

Cerebral cortex

Largest portion of the cerebrum regulates skeletal movement, level of awareness injury results in: paresthesia, weakness, and paralysis of extremities.

coup-contrecoup injury

Dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds.

depressed skull fracture

Inward indentation of the skull with possible pressure on brain due to high energy direct trauma

A rise of 20 mm Hg above the patient's normal resting blood pressure along with a history of SCI and associated signs and symptoms indicate the patient is experiencing what?

autonomic dysreflexia

You are assessing a young woman who fell and hit her head. She is conscious but can't remember the circumstances that led up to the injury. What is this patient experiencing?

retrograde amnesia

Most reliable sign of a head injury

Decreased level of consciousness

When applying a short spine board, what part of the body do you need to secure first?

Torso

When to use a KED

Sitting patient that is stable

cerebellum

A large structure of the hindbrain that controls fine motor skills, equilibrium, skilled movements. Injury test: finger to nose then walking in a straight line

Flexion injuries

A type of injury that results from forward movement of the head, typically as the result of rapid deceleration, such as in a motor vehicle crash, or with a direct blow to the occiput.

locations of meningeal hemorrhage

An epidural hematoma occurs between the dura mater and the skull and is usually caused by a rupture of the middle meningeal artery. A subdural hematoma occurs between the dura mater and the arachnoid membrane and is usually caused by a rupture of the bridging veins in this space. A subarachnoid hemorrhage occurs below the arachnoid membrane.

When immobilizing a child younger than the age of 6 on a long backboard, where do you need to place padding?

Between the shoulder blades

intracerebral hematoma

Bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchymal hematoma.

You are responding to an older woman who slipped and struck her forehead on the bathtub. She is complaining of having trouble "making her arms work." Which syndrome is this patient exhibiting?

Central cord syndrome

Ventilation in head or spine injury

Cerebral edema and ICP are aggravated by hypoxia and hypercapnia so you must be vigilant in oxygenation.

Neurogenic shock clues

Skin will still be WPD signs of shock present without bleeding hypotension and bradycardia

Base of the skull

The base of the skull consists of parts of the ethmoid, sphenoid, occipital, frontal, and temporal bones. It is divided into the anterior fossa, middle fossa, and posterior fossa.

The brain

The brain accounts for only 2% of total body weight, but it is the most metabolically active and perfusion-sensitive organ in the body. Because the brain has no mechanism for storing oxygen or glucose, it is completely reliant on cerebral blood flow provided by the carotid and vertebral arteries. Maintaining perfusion to the brain is paramount in the treatment of a patient with a TBI or other head trauma

Subdural hematoma

a hematoma located beneath the dura

epidural hematoma symptoms

an accumulation of blood between the skull and dura mater severe headache, dizziness, vomiting, increased size of one pupil or sudden weakness in an arm or leg

subarachnoid hemorrhage symptoms

bleeding into the subarachnoid space. common causes: trauma, aneurysm rupture, and ateriovenous malformation young people-WORST headache of your life→ sudden!!! vomiting, neural defictis

Brain stem

consists of midbrain, pons, and medulla oblongata reticular activating system(RAS): maintains consciousness (the book says this....) controls basic vitals functions and regulations

dermatones

cutaneous area (skin) that sends sensory info to a specific spinal nerve/spinal cord level

Meninges

dura mater, arachnoid mater, pia mater

second impact syndrome

exponential increase in symptoms from a concussion following the immature return of an athlete back into competition prior to symptoms being resolved

Floor of the cranial vault

has several ridges and depression and has openings allowing nerves ot exit the skull

Head injury

is a traumatic insult to the head that may result in injury to the soft tissues of the scalp or bony structures of the head and skull, not including the face.

Traumatic brain injury (TBI)

is an impairment of brain function caused by an external force that may involve physical, intellectual, emotional, social, and vocational changes.

post concussion syndrome

lingering symptoms from a concussion that last for an extended period of time

parietal lobe

processes information from sensory receptors in the skin and joints. governs perception of pain, temp., and vibration. also involved in proprioception (book says this....) and mathematical calculations.

temporal lobe

speech center on the left side, long term memory, hearing, taste, and smell

cerebral contusion

the bruising of brain tissue as the result of a head injury that causes the brain to bounce against the rigid bone of the skull

Subluxation (flexion injury)

the partial displacement of a bone from its joint.

Cushings triad

three classic signs—bradycardia, hypertension, and irregular respirations—seen with pressure on the medulla as a result of brain stem herniation

occipital lobe

visual processing injury results in: visual disturbances

Frontal lobe

voluntary motor functions, personality, judgement, filters raw emotion from limbic system injury results in: seizures, placid reactions (flat affect), personality changes