Card Set Information

2014-06-02 21:12:50

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  1. What is MAP?
    Mean Arterial Pressure
  2. What is the formula used to determine MAP?
  3. What is CPP?
    Cerebral Perfusion Pressure
  4. What is the formula used to find CPP?
    MAP - ICP
  5. What is the normal CPP range?
    60 - 80 mmHg
  6. What is the normal MAP range?
    80 - 100 mmHg
  7. What is your normal ICP range?
    0 - 10 mmHg
  8. ICP greater than what has a high mortality?
    20 mmHg
  9. Where is ICP transducer placed?
    Foramen of Monro (level of the ear)
  10. What is posturing associated with?
    • Brainstem herniation
    • Decorticate "to the core"
  11. What are the 3 legs of Cushings Triad and what does it indicate?
    • Hypertension
    • Bradycardia
    • ↑ Pulse Pressure (Systolic & Diastolic values will be far apart)
  12. What breathing pattern is associated with increased ICP?
    Cheyne-Stoke's Respirations
  13. What is your treatment for brain stem herniation?
    • Paralyze                  (RSI)
    • Intubate                  (RSI)
    • Hyperventilate         (Goal PaCO30-35 mmHg)
    • Mannitol                  (1g/kv IV bolus over 5 min)
    • Hypertonic Saline     (Give slowly)
  14. What do you treat seizures from brainstem herniation with?
    • Benzos:
    • Phenytoin (Dilantin) 1G loading dose infused at 50mg/min
  15. Can Lasixs be used in the setting of brainstem herniation?
    Yes. After Mannitol. Will not work as well.
  16. Does hyperglycemia make brain injuries better or worse?
  17. Describe a Diastatic Fracture.
    Fracture along the suture line
  18. Describe Linear Fracture.
    Fracture that extends towards the base of the skull.
  19. Describe Linear Stellate Fracture.
    Spider Web appearance
  20. What can a depressed skull fracture lead to?
  21. What type of injuries are the leading cause of death in trauma patients?
    Head injuries
  22. What is the GCS injury scale?
    • Minor          13 - 15
    • Moderate      9 - 12
    • Severe         < 8
  23. Define a hypertensive crisis/emergency.
    • Headache
    • N/V
    • Visual Changes
  24. What do we use to lower a patient's BP?
    • Labetolol
    • Nitroprusside (Nipride)
  25. Describe an Epideral Hematoma.
    • Arterial Bleed
    • Vessel damaged is the Middle Meningeal Artery (MMA)
  26. Describe the patient's LOC while suffering from a Epidural Hematoma.
    • unconscious for a minute
    • wake up 
    • then goes unconscious 30 minutes later
  27. What pattern of respirations would you expect in a Epidural Hematoma patient?
  28. Is a subarachnoid hemorrhage life threatening? What is a common complaint?
    • Yes
    • "Worst headache of my life"
  29. What is our treatment for a SAH?
    • Keep SBP below 140 mmHg
    • Nimodepine

    Patients with elevated BP should be treated with Nitroprusside (Nipride)
  30. Where is the T4 dermatome?
  31. Where are the T10 dermatomes?
  32. C3, C4, C5 intervate what?
  33. What is Autonomic Dysreflexia?
    What is the treatment?
    • In a paralyzed/spinal cord injury pt bladder become distended
    • Treatment:
    • Insert Foley catheter slowly
  34. What is an important physical finding on spinal cord injuries?
    • Babinski's Sign (reflex)
    • When foot is stroked big toe goes up other toes fan out
  35. What is a Brown Sequard Lesion?
    • Same side motor & vibratory sense loss below level of injury
    • Opposite side pain & temp loss
  36. Describe Central Cord Injury.
    • Motor weakness in upper extremities more than lower.
    • They can walk to you but can't shake your hand.
  37. Describe Anterior Cord Syndrome.
    Loss of pain & temperature sensation everywhere below the level of injury
  38. What do we trat Spinal shock with?
    • IV fluids
    • Vasopressors
  39. What are the signs of Distributive shock?
    What is the treatment?
    • Warm red skin
    • No tacycardia
    • Treatment:
    • IV fluids & vasoressors
  40. What is the triad of nuchal rigidity (Meningitis)?
    • neck stiffness
    • photophobia
    • headache
  41. What is Brudzinki's Sign?
    Involuntary lifting of leg when lifting a pt's head while laying flat
  42. What is Kernig's Sign
    Kicking Kernigs
  43. What personal protective measures for Meningitis?
    • Mask
    • Gloves
    • Gown
  44. TPA =
    Ischemic Stroke
  45. What do you treat Herpes Simplex Encephalitis with?
    IV Acyclovir
  46. Define Status Epilepticus.
    • Seizure lasting longer than 30 min or
    • multiple seizures without regaining continuous for greater than 30 min