SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Emergency Medicine: Head Trauma
Start Test
Study First
Subjects
:
health-sciences
,
emergency-medicine
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. 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
Increased risk of brain injury
Basilar skull fracture
Moderate - Severe TBI Causes
Concussion
2. Increased ICP -> Poor brain perfusion - Bilateral uncal herniation - drug effects - severe hypoxia
Subarachnoid hemorrhage
Moderate TBI
Bilateral fixed and dilated pupils
Intraparenchymal Hemorrhage
3. Occurs @ site of impact with an object
Uncal Herniation
Concussion
Moderate TBI
Coup Injury
4. GCS - Verbal (1-5)
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
Subarachnoid hemorrhage
Post-Concussive syndrome
1 - None 2 - To pain 3 - To command 4 - Spontaneous
5. 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
Single fixed and dilated pupil
ED steps to lower ICP
Intraparenchymal Hemorrhage
Concussion
6. Net pressure gradient causing blood flow to the brain - Too little -> Ischemia - Too much -> Raised ICP
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
ED steps to lower ICP
Uncal Herniation
Cerebral Perfusion Pressure
7. GCS score of 14-15
Intraparenchymal Hemorrhage
Severe TBI
Mild TBI
Mild TBI injury
8. 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
Subdural hematoma
ED steps to lower ICP
Mild TBI
Mannitol
9. Blunt trauma - shaken baby syndrome - CT normal -> puncuate hemorrhagic injury along grey-white junction of cerebral cortex
Moderate - Severe TBI Causes
Diffuse Axonal injury
Single fixed and dilated pupil
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
10. 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
> 60 mm Hg
Subarachnoid hemorrhage
ED steps to lower ICP
Mild TBI
11. The pressure inside the skull and thus in the brain tissue and CSF
Intracranial Pressure
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
Ipsilateral fixed and dilated pupil
Subdural hematoma
12. 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
Epidural Hematoma
Primary treatment/management priorities of TBIs
Diffuse Axonal injury
1 - None 2 - To pain 3 - To command 4 - Spontaneous
13. Skull fracture causes - Immediate LOC with a 'lucid' period prior to deterioration (in 20%)
Pharmacology
> 60 mm Hg
Epidural Hematoma
Cerebral Perfusion Pressure
14. GCS - Eye opening (1-4)
Subdural hematoma
AMPLE Acronym for HI hx
Subarachnoid hemorrhage
1 - None 2 - To pain 3 - To command 4 - Spontaneous
15. Battle's sign (mastoid ecchymosis) - Raccoon eyes (periorbital ecchymosis) - CSF otorrhea / rhinorrhea - hemotympanum - vertigo - decreased hearing - 7th nerve palsy
Basilar skull fracture
1 - None 2 - Extension 3 - Flexion 4 - Withdraws to pain 5 - Localizes pain 6 - Follows commands
AMPLE Acronym for HI hx
Single fixed and dilated pupil
16. The blood supply to the brain in a given time - Typically 15% of cardiac output - CBF = CPP / CVR
Mild TBI
Intracranial Pressure
Cerebral Blood Flow
Mild TBI injury
17. Patients with ______ should be given immediate antibiotics (ceftriaxone 2 gm IV)
Post-Concussive syndrome
Penetrating wounds
Bilateral fixed and dilated pupils
Pharmacology
18. The major caUse of brain herniations
Expanding lesions
Cerebral Blood Flow
Contra-coup Injury
Pharmacology
19. Uncal transtentorial herniation -> compression of parasympathetic fibers running with CN-III (Oculomotor) -> ________
Post-Concussive syndrome
Ipsilateral fixed and dilated pupil
AMPLE Acronym for HI hx
Cerebral Perfusion Pressure
20. Neurologic or neurophysiologic dysfunction w/o overt hemorrhages or other gross lesions
Mild TBI causes
Epidural Hematoma
1 - None 2 - To pain 3 - To command 4 - Spontaneous
Mild TBI
21. GCS score of 9-13
Basilar skull fracture
Moderate TBI
Mild TBI injury
Mild TBI
22. GCS Motor (1-6)
1 - None 2 - To pain 3 - To command 4 - Spontaneous
Mild TBI
1 - None 2 - Extension 3 - Flexion 4 - Withdraws to pain 5 - Localizes pain 6 - Follows commands
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
23. A - Allergies M - Medications P - Past medical history L - time of Last meal E - Events leading up to injury
Severe TBI
Moderate TBI
Mild TBI
AMPLE Acronym for HI hx
24. 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
Mild TBI injury
Diffuse Axonal injury
Epidural Hematoma
Ipsilateral fixed and dilated pupil
25. The most common site of brain herniation
Severe TBI
ED steps to lower ICP
1 - None 2 - Incomprehensible 3 - Inappropriate words 4 - Confused speech 5 - Oriented
Uncal Herniation
26. Blunt trauma - Usually anterior temopral or posterior frontal lobe - CT may be initially normal - delayed bleed - Symptoms range from normal -> LOC
Bilateral fixed and dilated pupils
Epidural Hematoma
Cerebral Perfusion Pressure
Intraparenchymal Hemorrhage
27. Intracranial hematoma with uncal herniation - requires rapid operative decompression
Moderate TBI
Penetrating wounds
Cerebral Blood Flow
Single fixed and dilated pupil
28. Occurs @ side opposite to the area that was impacted
Coup Injury
ED steps to lower ICP
Contra-coup Injury
Basilar skull fracture
29. An ICP level of _____ increases subsequent morbidity and mortality
> 20 mm Hg
Subdural hematoma
Penetrating wounds
Increased risk of brain injury
30. 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)
Mild TBI causes
Post-Concussive syndrome
Subdural hematoma
Increased risk of brain injury
31. The major caUse of Brian's herniations
Pharmacology
> 20 mm Hg
Mannitol
Uncal Herniation
32. 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
Mannitol
> 60 mm Hg
Intraparenchymal Hemorrhage
Subdural hematoma
33. Athletes at highest risk - Recurrent concussions more likely after 1st
Increased risk of brain injury
Moderate TBI
Mild TBI injury
Cerebral Blood Flow
34. GCS score of 3-8
Pharmacology
Coup Injury
Mild TBI causes
Severe TBI
35. Osmotic agent that can reduce ICP - Expands plasma volume (reduces hypotension) - Can improve oxygen-carrying capacity
ED steps to lower ICP
Moderate - Severe TBI Causes
Epidural Hematoma
Mannitol
36. CBF is maintained when the CPP is ______
Uncal Herniation
> 60 mm Hg
Mild TBI causes
Mild TBI injury