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Emergency Medicine: Head Trauma
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Avg score: 37% • Most missed: “Occurs @ side opposite to the area that was impacted”
Emergency Medicine: Head Trauma
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25 Questions

1. Occurs @ site of impact with an object

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

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

4. CBF is maintained when the CPP is ______

5. GCS - Eye opening (1-4)

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

7. 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

8. GCS - Verbal (1-5)

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

10. The most common site of brain herniation

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

12. The major caUse of brain herniations

13. GCS score of 3-8

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

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

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

17. 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

18. 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

19. GCS score of 14-15

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

22. GCS Motor (1-6)

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

24. Blunt trauma - Usually anterior temopral or posterior frontal lobe - CT may be initially normal - delayed bleed - Symptoms range from normal -> LOC

25. GCS score of 9-13

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