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Emergency Medicine: Head Trauma

Instructions:
  • Answer 36 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Blunt trauma - Usually anterior temopral or posterior frontal lobe - CT may be initially normal - delayed bleed - Symptoms range from normal -> LOC






2. Blunt trauma - shaken baby syndrome - CT normal -> puncuate hemorrhagic injury along grey-white junction of cerebral cortex






3. Increased ICP -> Poor brain perfusion - Bilateral uncal herniation - drug effects - severe hypoxia






4. Intracranial hematoma with uncal herniation - requires rapid operative decompression






5. The most common site of brain herniation






6. Battle's sign (mastoid ecchymosis) - Raccoon eyes (periorbital ecchymosis) - CSF otorrhea / rhinorrhea - hemotympanum - vertigo - decreased hearing - 7th nerve palsy






7. GCS Motor (1-6)






8. Patients with ______ should be given immediate antibiotics (ceftriaxone 2 gm IV)






9. Uncal transtentorial herniation -> compression of parasympathetic fibers running with CN-III (Oculomotor) -> ________






10. Carefully ventilated to maintain PaCO2 levels 35-40 mm Hg - Adequate sedation -> keeps patients relaxed & inhibits gag reflex - Elevate head of bed to 30 degrees -> increases outflow of CSF from skull base - Give mannitol






11. Occurs @ site of impact with an object






12. CBF is maintained when the CPP is ______






13. GCS score of 9-13






14. The blood supply to the brain in a given time - Typically 15% of cardiac output - CBF = CPP / CVR






15. Athletes at highest risk - Recurrent concussions more likely after 1st






16. GCS - Verbal (1-5)






17. Occurs @ side opposite to the area that was impacted






18. Any alteration in the mental state at the time of the event or subsequent to the event - 'Getting your bell rung' or 'Seeing stars' - Subtle impairment of cognitive function






19. Blunt trauma - acceleration- deceleration - Brains with extensive atrophy (elderly and alcoholics) more susceptible to this - Acute: rapid LOC - lucid period possible - Chronic: Behavioral / AMS - gradual LOC






20. Most common type of brain injury - Head injury with a temporary loss of brain function - aka: mild brain injury - mild traumatic brain injury (MTBI) - mild head injury (MHI) - and minor head trauma






21. Net pressure gradient causing blood flow to the brain - Too little -> Ischemia - Too much -> Raised ICP






22. Set of symptoms a patient may experience for up to a year or more after a concussion - Causes: HA - difficulty concentrating - emotional/behavioral problems (irritability)






23. Neurologic or neurophysiologic dysfunction w/o overt hemorrhages or other gross lesions






24. Skull fracture causes - Immediate LOC with a 'lucid' period prior to deterioration (in 20%)






25. Caused by contusions - hematomas - diffuse axonal injury - direct cellular damage - tearing/shearing of tissues - loss of BBB - disruption of neurochemical homeostasis - loss of electrochemical function






26. The major caUse of Brian's herniations






27. Osmotic agent that can reduce ICP - Expands plasma volume (reduces hypotension) - Can improve oxygen-carrying capacity






28. 1. Prevent further secondary injury (managing hypoxemia - hypotension - anemia - hyperglycemia - hyperthermia - evacuating intracranial masses) 2. Identify treatable mass lesions 3. Identify other life-threatening injuries






29. GCS - Eye opening (1-4)






30. A - Allergies M - Medications P - Past medical history L - time of Last meal E - Events leading up to injury






31. An ICP level of _____ increases subsequent morbidity and mortality






32. The pressure inside the skull and thus in the brain tissue and CSF






33. The major caUse of brain herniations






34. GCS score of 3-8






35. GCS score of 14-15






36. Blunt trauma - acceleration-decelleration injury - Traumatic disruption parenchyma and ____ vessels - blood in CSF - Symptoms of HA - photophobia - meningeal signs - Traumatic ____ common in moderate-severe TBI - Early signs = higher mortality rate