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Unit 3 Nervous System Disorders
Unit 3
111
Other
Graduate
01/17/2014

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Term
A traumatic injury to the brain that is capable of producing physical, intellectual, emotional, social and vocational changes
Definition
Traumatic Brain Injury
Term
One of the leading causes of disability and death in the U.S.
Definition
Traumatic Brain Injury
Term
Average client age with a TBI is between ___ and ___ years
Definition
15 and 30
Term
Injuries that occur when the head hits an immovable object
Definition
Deceleration Forces
Term
Injuries that occur when a moving object hits the head
Definition
Acceleration Forces
Term
Injuries that occur when the head is hit with a moving object and hits an immovable object, moving the brain within the cranium
Definition
Acceleration-Deceleration Forces
Term
Movement of the brain in a side to side twisting motion inside the cranium, which often occurs with aceleration- deceleration forces
Definition
Rotational Forces
Term
Injuries that occur due to direct blows to the head that change the shape of the head
Definition
deformation forces
Term
A focal cerebral injury directly under the area of impact
Definition
Coup
Term
A cerebral injury that occurs opposite the point of impact
Definition
countrecoup
Term
3 main types of hematomas that result from trauma
Definition
1. Epidural
2. Subdural
3. Intracerebral
Term
Hematoma that evolves from bleeding into the epidural space between the skull and the dura mater
Definition
Epidural hematoma
Term
Most common type of hematoma with the highest mortality rate
Definition
subdural hematoma
Term
Most common site of an epidural hematoma
Definition
Temporal bone, middle meningeal artery
Term
Hematoma located between the dura mater and the arachnoid meningeal layer
Definition
subdural hematoma
Term
Single or multiple lesions deep within brain tissue
Most commonly occur in the frontal and temporal lobes
Definition
Intracerebral hematoma
Term
Hematomas that are ___ or larger are considered mass lesions
Definition
25 ml
Term
Bleeding into the subarachnoid space

Associated with cerebral vasospasm and hydrocephalus
Definition
traumatic subarchnoid hemorrhage
Term
Bruising of the brain
Definition
contusion
Term
Temporary disruption of the brain without structural abnormality
Definition
concussion
Term
Complications of secondary brain injury
Definition
hypotension, hypoxia, hypercapnia, intracranial hypertension, acid-base imbalance, cerebral vasospasm, electrolyte abnormalities, hyperthermia, infection, cerebral ischemia, seizures, hypoglycemia and hyperglycemia
Term
Pathophysiology of secondary brain injury
Definition
Inflammation and apoptosis (cellular damage/death)
Term
ICP=
Definition
MAP- CPP

(mean arterial (cerebral perfusion
pressure) pressure)
Term
A skull fracture is classified 3 ways:
Definition
1. Linear (simple)
2. Comminuted and depressed
3. Basilar
Term
Most common type of skull fracture, 80% from point of impact toward base of the skull, hematomas may develop
Definition
Linear (simple)
Term
Type of skull fracture that increase the risk of damage to brain tissue, risk of infection if skin is lacerated or dura torn
Definition
comminuted and depressed
Term
Type of skull fracture at base of skull, often an extension of other fractures, CSF leakage, hemotympanum, racoon eyes
Definition
Basilar
Term
Medication for skull fracture
Definition
decadron ( to reduce cerebral edema)

Antibiotics prophylactic (if surgery delayed)
Term
______ ______ injuries usually result from vertebral injuries, which usually occur due to aceleration, deceleration, or deformation forces usually applied at a distance
Definition
Spinal cord
(SCI)
Term
_____ occurs when external force is applied in rear-end collision

____ is a head on collision
Definition
acceleration

deceleration
Term
SCI injuries most commonly occur in the:
Definition
cervical and lumbar areas
Term
First manifestations of SCI
Definition
microscopic hemorrhages and edema
Term
Damage to spinal cord is classified as
Definition
complete or incomplete
Term
Spinal cord injury where motor and sensory pathways completely interupted (transected); total loss of motor and sensory function below injury
Definition
complete
Term
Type of spinal cord injury where pathways only partially intterupted; variable loss of function, further classified into syndroms
Definition
incomplete
Term
Paralysis of the lower part of the body as a result of damage done at the thoracic level
Definition
paraplegia
Term
paralysis of the arms trunk legs and pelvic organs due to high cervical injuries
Definition
tetraplegia (quadraplegia)
Term
Temporary loss of reflex activity below the level of spinal cord injury, usually occurs within 30-60 mins of a complete SCI
Definition
spinal shock
Term
An exaggerated sympathetic response in SCI's at or above the T6 level
Definition
Autonomic dysreflexia
Term
Kind of meds given for autonomic dysreflexia
Definition
antihypertussives
Term
Common causes of Autonomic dysreflexia
Definition
Full bladder, abdominal distension
Imopacted feces,skin pressure/breakdown
overstretched muscles, sexual intercourse
labor and delivery
infected ingrown toenail
exposure to hot/cold temps
over the counter decongestants
Term
herniated intervertebral disk common in ages ___ to ___
Definition
30-50
Term
Majority of herniated intervertebral disks common in ____ region
Definition
lumbar
Term
removal of part of the vertebral lamina: done to relieve pressure on nerves
Definition
laminectomy
Term
removal of nucleus polposus of an intervertebral disk (done alone or with laminectomy)
Definition
diskectomy
Term
insertion of a wedge shaped piece of bone or bone chips between vertebrae to stabilize them
Definition
spinal fusion
Term
enlargement of the opening between the disk and the facet joint
Definition
foraminotomy
Term
injection of enzyme chymopapain into nucleus pulposus: decreases size of herniation
Definition
chemonucleolysis
Term
Growths within the cranium, including tumors in the brain tissue, meninges, pituitary glands or blood vesssels
Definition
brain tumor
Term
highest incidence of brain tumors occur
Definition
young children and adults 50-70
Term
lab and diagnostic tests for brain tumor
Definition
Ct scan or MRI, EEG, pneumoencephalogram, endocrine studies, PET scans
Term
traditional chemo therapy for brain tumors has little or no values because of
Definition
blood brain barrier
Term
most common manifestations for brain tumors
Definition
changes in cognition or conciousness, headache usually worse in am, seizures, vomitting
Term
intracranial surgery that may facilitate evacuation of clot, series for craniotomy
Definition
burr hole
Term
surgical opening into cranial cavity, cranitome used to cut between holes, tumor excised and bone flap turned down, supratentorial, infratentional
Definition
craniotomy
Term
excision of portion of skull and complete removal of bone flap: may be done to provide decompression after cerebral edema
Definition
craniectomy
Term
plastic repair to skull in which synthetic material is inserted to replace cranial bone
Definition
cranioplasty
Term
A traumatic injury to the brain that is capable of producing physical, intellectual, emotional, social, and vocational changes
Definition
traumatic brain injury
Term
3 main types of hematomas that result from trauma
Definition
1. Epidural
2. Subdural
3. Intracerebral
Term
hematoma that evolves from bleeding into the epidural space between the skull and the dura mater
Definition
epidural hematoma
Term
most common type of hematoma with the highest mortality rate
Definition
subdural hematoma
Term
most common site of an epidural hematoma
Definition
temporal bone, middle meningeal artery
Term
hematoma located between the dura mater and the arachnoid meningeal layer
Definition
subdural hematoma
Term
single or multiple lesions deep within brain tissue
most commonly occur in the frontal and temporal lobes
Definition
intracerebral hematoma
Term
hematomas that are ____ or larger are considered mass lesions
Definition
25 ml
Term
spinal tumors classified by atomic location as either__________ or _____________
Definition
intra-medullary
or
extra medullary
Term
type of spinal cord tumor that arise from within neural tissue of the spinal cord (10 % of spinal tumors)
Definition
intra-medullary
Term
type of spinal tumor that arise from tissues outside the spinal cord
(intra-dural or extra-dural)
Definition
extra medullary
Term
diagnostic tests for spinal cord tumors
Definition
x ray film, ct scan or mri study, myelogram, electromyography, lumbar puncture
Term
_____ and _____ are the first manifestations of spinal cord injuries and are greatest at the level of injury and for two segments above and below it
Definition
microscopic hemorrhages and edema
Term
medication for skull fracture
Definition
decadron ( to reduce cerebral edema)
Antibiotics prophylactic( if surgery delayed)
Term
type of
Definition
Term
type of skull fracture at base of skull, often an extension of other fractures. CSF leakage, racoon eyes
Definition
basilar
Term
bleeding into the subarachnoid space
Associated with cerebral vasospasm and hydrocephalus
Definition
traumatic subarachnoid hemorrhage
Term
complications of secondary brain injury
Definition
hypotension, hypoxia, hypercapnia, intracranial hypertension, acid-base imbalance, cerebral vasospasm, electrolyte abnormalities, hyperthermia, infection, cerebral ischemia, seizures, hyper and hypo glycemia
Term
pathophysiology of secondary brain injury
Definition
inflammation and apoptosis (cellular damage/death)
Term
type of skull fracture that increase risk of damage to brain tissus, risk of infection if skin is lacerated or dura torn
Definition
comminuted and depressed
Term
most common type of skull fracture, 80 % from point of impact toward base of the skull, hematomas may develop
Definition
linear (simple)
Term
A skull fracture is classified 3 ways
Definition
1. Linear (simple)
2. Comminuted and depressed
3. basilar
Term
temporary loss of reflex function
Definition
areflexia
Term
concern of spinal shock
Definition
bradycardia and hypotension
Term
signs of autonomic dysreflexia
Definition
pounding headache, bradycardia, HTN, flushed skin above and pale skin below level of injury
Term
Glioma is an _______ tumor
Definition
intracerebral
Term
Most common type of brain tumor

Originates from neuroglia and invades brain tissue
Definition
intracerebral tumors
Term
Which brain tumor causes:

endocrine dysfunction, visual deficits, and headache
Definition
pituitary tumors
Term
Which brain tumor causes:

Disturbances in coordination and equilibrium
Definition
cerebellum tumors
Term
Which brain tumor causes:

visual disturbances
Definition
occipital lobe tumors
Term
Which brain tumor causes:

Sensory deficits, paresthesia, loss of two point discrimination, visual field deficits
Definition
parietal lobe tumors
Term
Which brain tumor causes:

Innapropriate behavior, recent memory loss, personality changes, headache, inability to concentrate, expressive aphasia, impaired judgement, motor dysfunctions
Definition
frontal lobe tumors
Term
Which brain tumor causes:

pyschomotor seizures
Definition
temporal lobe tumors
Term
congenital tumor that is vascular and slow growing
Definition
hemangioblastoma
Term
slow growing extracerebral tumor that develops in meninges and is firm and encapsulated
Definition
meningioma
Term
fast growing and malignant extracerebral tumor found in cerebellum
Definition
medullablastoma
Term
Glioma tumor that is slow growing, may be encapsulated, denign
Definition
astroblastoma
Term
Extracerebral tumor that is slow gorwing and benign, originates from schwann cells of cranial nerve XIII, may also affect cranial nerves V, VII, IX and X

Firm encapsulated lesions attached to nerve
Definition
acoustic neuroma
Term
glioma tumor that develops from lining or ventricles
Definition
oligodendroglioma
Term
fast growing glioma
Definition
ependymoma
Term
most malignant form of glioma
Definition
glioblastoma multiforme
Term
most common glioma
Definition
astrocytoma
Term
types of glioma
Definition
astrocytoma
glioblastoma multiforme
ependymoma
oligodendroglioma
astroblastoma
Term
Most common source of neurologic tumors
Definition
Neuroglia (aka astrocytes)
Term
When performing a complete neurologic assessment, it is best to collect data by:
Definition
In phases
Term
A cleint is expieriencing increased intracranial pressure. Which prodedure would be performed in order to reduce the pressure?
Definition
craniotomy
Term
Digoxin
Definition
0.5-2
Term
Blood ph
Definition
7.35-7.45
Term
Sodium Na+
Definition
134-145
Term
Potassium k+
Definition
3.5-5.3
Term
Chloride
Definition
100-106
Term
creatinine
Definition
0.6-1.6
Term
BUN
Definition
10-20
Term
calcium Ca+
Definition
8.5-10.5
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