NSG 3280 EXAM 3 QUESTIONS AND CORRECT ANSWERS
100% VERIFIED SOLUTIONS 100% VERIFIED!!
Primary injury
Initial damage to the brain that results from the traumatic event
not reversible
Secondary injury
An insult to the brain subsequent to the original traumatic event
progressive with delayed cell death
The more time that the injury effects the brain
The more tissue that is affected/gone (Time is tissue)
The three types of mechanisms of brain injury
Ischemia, hypoxia, increased ICP
The three compartments of the cranium include:
Brain tissue, CSF, and blood
The normal range of ICP is
0-15mm Hg
If one of the compartments in the cranium increases, what happen to the other
two parts?
They decrease
If all three of the compartments of the cranium while one of the compartments is
increased, what can happen?
Possible brain herniation
What could happen if there is a sudden decrease in CSF fluid?
Brain herniation
If the patient has increased ICP, should you do a lumbar puncture?
Hell no
Delirious
,In an acutely disturbed state of mind resulting from illness or intoxication and
characterized by restlessness, illusions, and incoherence of thought and speech.
Obtunded
Less than full alertness (altered level of consciousness), typically as a result of a
medical condition or trauma.
Falls asleep unless stimulated
Stuporous
Deep states of sleep: vigorous stimulation is required but pt cannot stay awake
Comatose
Unable to be aroused, even with vigorous painful stimuli; motor responses,such
as withdrawal or posturing, may occur
Decorticate posturing
Contractures toward their core
Decerebrate posturing
Posturing in which the neck is extended with jaw clenched; arms are pronated,
extended, and close to the sides; legs are extended straight out; more ominous
sign of brain stem damage. Most Severe.
Dysconjugate gaze
Paralysis of gaze or lack of coordination between the movements of the two eyes
Ocular palsies
One or more cranial nerves dysfunctional such that motor paralysis of the eye
impairs movements in one or more directions
Doll's eye reflex
When you move the head, the eyes should move, then return to a central
position; in some brain injuries, the eyes will be fixed centrally
Cold calorics test
Tests for brain stem function with cold water. Eyes should divert to side where
cold water is being put on
Coup injury
Brain injury at the site of impact
, Contracoup injury
Brain injury on the opposite side of impact
GCS is taken first________ hours after a TBI
48
The primary injury after a TBI is a
Hematoma:
epidural
Subdural
Subarachnoid
WHICH CAN CAUSE INCREASE OF ICP
Collection of blood between the dura and skull
LOC can be normal and then rapidly decreases
Epidural hematoma
Collection of blood between the dura and outer layer of arachnoid membrane:
typically involves bridging veins
Slower onset / prone to rebreeding
Subdural hematoma
Collection of blood between the arachnoid membrane and the Pia mater
Meningeal irritation
Subarachnoid hematoma
CSF should have high amounts of
Glucose
If there is a blockage of CSF to the brain,
Swelling could occur
Stroke Sequelae
Effects on body after the stroke
Thrombolitic strokes comes from
100% VERIFIED SOLUTIONS 100% VERIFIED!!
Primary injury
Initial damage to the brain that results from the traumatic event
not reversible
Secondary injury
An insult to the brain subsequent to the original traumatic event
progressive with delayed cell death
The more time that the injury effects the brain
The more tissue that is affected/gone (Time is tissue)
The three types of mechanisms of brain injury
Ischemia, hypoxia, increased ICP
The three compartments of the cranium include:
Brain tissue, CSF, and blood
The normal range of ICP is
0-15mm Hg
If one of the compartments in the cranium increases, what happen to the other
two parts?
They decrease
If all three of the compartments of the cranium while one of the compartments is
increased, what can happen?
Possible brain herniation
What could happen if there is a sudden decrease in CSF fluid?
Brain herniation
If the patient has increased ICP, should you do a lumbar puncture?
Hell no
Delirious
,In an acutely disturbed state of mind resulting from illness or intoxication and
characterized by restlessness, illusions, and incoherence of thought and speech.
Obtunded
Less than full alertness (altered level of consciousness), typically as a result of a
medical condition or trauma.
Falls asleep unless stimulated
Stuporous
Deep states of sleep: vigorous stimulation is required but pt cannot stay awake
Comatose
Unable to be aroused, even with vigorous painful stimuli; motor responses,such
as withdrawal or posturing, may occur
Decorticate posturing
Contractures toward their core
Decerebrate posturing
Posturing in which the neck is extended with jaw clenched; arms are pronated,
extended, and close to the sides; legs are extended straight out; more ominous
sign of brain stem damage. Most Severe.
Dysconjugate gaze
Paralysis of gaze or lack of coordination between the movements of the two eyes
Ocular palsies
One or more cranial nerves dysfunctional such that motor paralysis of the eye
impairs movements in one or more directions
Doll's eye reflex
When you move the head, the eyes should move, then return to a central
position; in some brain injuries, the eyes will be fixed centrally
Cold calorics test
Tests for brain stem function with cold water. Eyes should divert to side where
cold water is being put on
Coup injury
Brain injury at the site of impact
, Contracoup injury
Brain injury on the opposite side of impact
GCS is taken first________ hours after a TBI
48
The primary injury after a TBI is a
Hematoma:
epidural
Subdural
Subarachnoid
WHICH CAN CAUSE INCREASE OF ICP
Collection of blood between the dura and skull
LOC can be normal and then rapidly decreases
Epidural hematoma
Collection of blood between the dura and outer layer of arachnoid membrane:
typically involves bridging veins
Slower onset / prone to rebreeding
Subdural hematoma
Collection of blood between the arachnoid membrane and the Pia mater
Meningeal irritation
Subarachnoid hematoma
CSF should have high amounts of
Glucose
If there is a blockage of CSF to the brain,
Swelling could occur
Stroke Sequelae
Effects on body after the stroke
Thrombolitic strokes comes from
