Neuro Trauma

Identify the stage of injury:

• Direct mechanical trauma to neural tissue occurring at the moment of impact. This damage is instantaneous and irreversible.

Primary injury

Identify the stage of injury:

• Cascade of biochemical and cellular events that occur minutes to days after initial trauma, potentially exacerbating damage. Secondary injury presents opportunities for therapeutic intervention.

secondary injury

Identify the category of TBI:

• Caused by acceleration-deceleration forces with no penetration of the skull

closed/blunt TBI

Identify the category of TBI:

• Direct breach of the skull and meninges

open/penetrating TBI

What is the first priority for RNs taking care of PTs with TBI?

airway management

The following are classified as which stage of spinal cord injury:

• compression

• contusion

• laceration

• shearing of axons

primary injury

The following are classified as which stage of spinal cord injury:

• vascular damage and ischemia

• excitotoxicity

• free radical production

• inflammatory response

secondary injury

At wh leichvel in the spine does injury cause complete diaphragm paralysis?

C1-C3

Many SCI PTs develop a ______________

neurogenic bladder (loss of voluntary control over urination)

_______________ — A potentially life-threatening condition characterized by exaggerated autonomic response to noxious stimuli (ie bladder distention) below the level of injury. Usually occurs with injuries at T6 or above.

autonomic dysreflexia

What are the clinical manifestations of autonomic dysreflexia?

above level of injury

• severe, pounding headache

• profuse sweating

• flushed skin

• nasal congestion

below level of injury

• pale, cool skin

• no sweating

___________ — A form of distributive shock resulting from disruption of sympathetic nervous system function below the injury level; a hemodynamic emergency requiring intervention; loss of sympathetic tone; circulatory; Characterized by:

• hypotension due to loss of vasomotor tone

• bradycardia

• warm, dry skin below injury level

• usually with injuries above T6

• treat with fluids, vasopressors

neurogenic shock

___________ — Temporary loss of all spinal cord function below the level of injury. neurologic; Characterized by:

• flaccid paralysis

• areflexia (loss of reflexes)

• loss of autonomic function

• can occur at any injury level

• days to weeks duration

• resolves with return of reflexes

spinal shock

Fever (high grade), nuchal rigidity (inability to flex neck) and headache (severe) are the classic triad of ______________

meningitis

____________ — medication that is used to treat spasticity from SCIs and works by enhancing GABA inhibitory effects, which relax muscles

Baclofen