Exam (elaborations)
NSB 236 WEEK 2 TEST
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NSB 236 WEEK 2 TEST...
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NSB 236 WEEK 2 TESTTBI (traumatic brain injury): ANSWER Traumatically produced structural
injury or physiological disruption of brain function due to an external impact.
(Dynamic loading - vehicle crash organs back and fro; angular loads - punch.)
TBI symptoms include amnesia, neurological deficit, intracranial lesion (organ
damage), penetrating or closed head traumas, and GCS <8. Those aged 15-44
and 75+ are at higher risk due to falls, hypertension, and medications.
Mechanism of injury: ANSWER Transfer of energy from the environment to
tissue over what can be adsorbed without malfunction (dynamic loading -
automobile crash organs back and forth, and angular loads - punch).
Types of traumatic brain injuries: ANSWER 1. Acceleration (whiplash damage)
2. Deceleration (a strike to the head-hit)
3. Acceleration-deceleration (the brain rebounds within the skull coup-
contrecoup)
4. Rotational Forces
What happens after a traumatic brain injury? - ANSWER 1: Haematoma
2. Skull fracture.
3. Traumatic shearing.
Diffuse axonal head damage (traumatic shearing) (coup-contracoup) -
ANSWER 1. Tensile forces related to trauma, such as shaken baby syndrome.
2. Axonal shearing, which causes axonal separation.
3. Neurotransmitters are leaking and in contact with brain tissue.
Poor outcomes—90% remain in a persistent vegetative state.
, Primary injury from intracranial hemorrhage - ANSWER The first insult causes
neuropathological alterations, which lead to:
1. Ischemia (decreased blood flow).
2. Cerebral edema
3. Neurodeath
4. Inflammation
ANSWER 1: Brain injury (secondary injury) develops as a result of
autoregulation.
2. Autoregulation is the brain's ability to maintain cerebral blood flow in
ANSWER to changes in blood pressure and cerebral perfusion pressure.
Result: 1. Reduced oxygen levels indicate brain ischemia.
2. Changes in brain metabolism as a result of reduced cerebral blood flow.
3. Transition from aerobic to anaerobic metabolism.
How does secondary damage occur? Injuries come from poor autoregulation.
1. Hypotension. 2. Hypoxia, 3. changed BGLs. 4.anaemia, 5. Hyperthermia 6.
Hypercarbia.
Intracranial pressure (ICP) refers to the pressure exerted by the cerebrospinal
fluid (CSF) within the ventricles of the brain.
▪ Normal ICP: 5-15mmHg | 20 < intervention in pediatrics. 1.5-6 (infants) or
3.5-7 (children)
Clinical factors that elevate intracranial pressure in head injured patients: body
and resp. - ANSWER Body posture: severe hip flexion and neck angulation.
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