Volume 4 Chapter 8

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Volume 4 Chapter 8
2011-03-02 17:05:58
Volume Chapter

Volume 4 Chapter 8
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  1. Galea Aponeurotica
    Connective tissue sheet covering the superior aspect of the cranium
  2. Cranium
    Vaultlike portion of the skull encasing the brain
  3. Sutures
    Pseudojoints that join the various bones of the skull to form the cranium
  4. Intracranial Pressure (ICP)
    Pressure exerted on the brain by the blood and cerebrocpinal fluid
  5. Meninges
    Three membranes that surround and protect the brain and spinal cord. They are the dura mater, pia mater, and arachnoid mater
  6. Dura Mater
    Tough layer of the meninges firmly attached to the interior of the skull and interior of the spinal column
  7. Pia Mater
    Inner and most delicate layer of the meninges. Covers the convolutions of the brain and spinal cord.
  8. Arachnoid Membrane
    Middle layer of the meninges
  9. Cerebrospinal Fluid
    Fluid surrounding and bathing the brain and spinal cord.
  10. Cerebrum
    Largest part of the brain. Consists of two hemispheres seperated by a deep longitudinal fissure. It is the seat of conciousness and the center of the higher mental functions such as memory, learning, reasoning, judgment, intelligence and emotions.
  11. Cerebellum
    Portion of the brain located dorsally to the pons and medulla oblangata. It plays an important role in the fine controls of voluntary muscular movements
  12. Brainstem
    The part of the brain connecting the central hemispheres with the spinal cord. Comprised of the medulla, oblangata, pons and midbrain.
  13. Midbrain
    Portion of the brain connecting the pons and cerebellum within the cerebral hemispheres
  14. Hypothalmus
    Portion of the brain important for controlling certain metabolic activities, including temperature regulation
  15. Thalamus
    Switching station between the pons and the cerebrum in the brain
  16. Ascending Reticular Activating System
    A series of nervous tissues keeping the human system in a state of conciousness
  17. Pons
    Process of tissue responsible for the communication interchange between the cerebellum, cerebrum, midbrain and spinal cord
  18. Medulla Oblangata
    Lower portion of the brainstem containing respiratory, cardiac and vasomotor centers
  19. Cerebral Perfusion Pressure
    Pressure moving blood through the brain. CPP=MAP-ICP
  20. Autoregulation
    Process that controls blood flow to brain tissue by causing alterations in blood pressure
  21. Monroe Kelly Doctrine
    Intracranial volume = Brain volume + CSF volume + blood volume + Mass/lesion volume
  22. Cranial Nerves
    Olfactory - sense of smell

    Optic- image from retina to brain

    Oculomotor- controls four of 6 occular muscles. most eye motion and eyelid motion

    Trochlear - results in coordinated gaze

    Trigeminal - innervates and receives sensation from mouth. controls muscles of chewing

    Abducens - Responsible for downward eye motion

    Facial - facial expression and sensation of anterior tongue

    Acoustic - innervates cochlea and vestibule of ear and hearing. Positional sense, motion sensation and balance

    Glossopharyngeal - posterior tongue, pharynx, swallowing. baro and chemo receptors

    Vagus - Major nerve of parasympathetic system that monitors and controls the heart, respiration, and much of abdominal viscera

    Spinal Accessory - Major muscles of neck, some swallowing, vocal cords

    Hypoglossal - Voluntary muscle control over tongue
  23. Zygoma
    Cheek bone
  24. Maxilla
    Upper part of jaw
  25. Mandible
  26. Nares
    Openings of nostrils
  27. Pinna
    Outer, visible portion of ear
  28. Semicircular Canals
    Three rings of inner ear. Sense motion of head and provide positional sense for body
  29. Orbit
    Eye socket
  30. Vitreous Humor
    Clear, watery fluid filling posterior chamber of eye. Responsible for giving eye spherical shape
  31. Retina
    Light and color sensing tissue lining the posterior chamber of the eye
  32. Aqueous Humor
    Clear fluid filling the anterior chamber of the eye
  33. Iris
    Pigmented portion of the eye. Muscular are that contricts of dilates to change pupil size
  34. Pupil
    Dark opening in the center of the iris through which light enters the eye
  35. Sclera
    White of the eye
  36. Cornea
    Thing, delicate layer covering the pupil and iris
  37. Conjuctiva
    Mucous membrane the that lines the eyelids
  38. Lacrimal Fluid
    Liquid that lubricates the eye
  39. Hematoma
    Blow disrupts blood vessels resulting in accumulation of blood under the skin
  40. Depression
    Blod may tear fascial layers under the scalp and result in a depression with our without skull fracture
  41. Normal Scalp Contour
    Blood can fill the space normally occupied by tissue
  42. Depressed Fracture
    Blood may fill the area vacated by a depressed skull fracture
  43. Retroauricular Ecchymosis
    Black and blue discoloration over the mastoid process (just behind the ear) that is characteristic of a basilar skull fracture. AKA battle's sign
  44. Bilateral Periorbital Ecchymosis
    Black and blue discoloration of the area surrounding the eyes.Usually associated with basilar skull fracture. AKA raccoon eyes
  45. Coup Injury
    An injury to the brain occuring on the same side as impact
  46. Contrecoup Injury
    Injury to the brain occuring on the opposite side of injury.
  47. Types of Direct Brain Injury
    • -Focal
    • Cerebral contusion
    • Intracranial hemorrhage
    • Epidural hematoma
    • Subdural hematoma
    • Intracerebral hemorrhage

    • -Diffuse
    • Concussion (mild to moderate diffuse axonal injury)
    • Moderate diffuse axonal injury
    • Severe diffuse axonal injury (brainstem injury)
  48. Subdural Hematoma
    Collection of blood directly beneath the dura mater
  49. Epidural Hematoma
    Accumulation of blood between the dura mater and the cranium
  50. Intracerabral Hemorrhage
    Bleeding directly into the tissue of brain
  51. Diffuse Axonal Injury
    Type of brain injury characterized by shearing, stretching or tearing of nerve fibers with subsequent axonal damage
  52. Conussion
    Transient period of unconciousness. In most cases unconciousness followed by complete return of function
  53. Moderate Diffuse Axonal Injury
    Concussion with minute bruising of brain tissue. Possible confusion, amnesia, disorientation after unconscious period
  54. Severe Diffuse Axonal Injury
    Significant disruption of axons in both hemispheres and brainstem. Most patients do not survive or have severe deficits. Unresponsive for long periods and may display signs of increased ICP.
  55. S/S of Brain Injury
    • AMS
    • Altered level of orientation
    • Alterations in personality
    • Amnesia (retrograde or anterograde)
    • Cushing's triad (increased BP, slow pulse, irregular respirations)
    • Vomiting (with or without nausea)
    • Body temperature changes
    • Changes in reactivity of pupils
    • Decorticate or decerebrate posturing
  56. Retrograde Amnesia
    Inability to remember events that occurred before the trauma
  57. Anterograde Amnesia
    Inability to remember events that occur after the trauma
  58. Cushing's Reflex
    Response due to ischemia that causes an increase in systemic BP which mainains cerebral perfusion during increased intracranial pressure
  59. Cheyne-Stoke's Respiration
    Respiratory pattern of alternating periods of apnea and tachypnea
  60. Cushing's Triad
    Increased BP, slow pulse, irregular respirations in response to increased ICP
  61. Glasgow Coma Scale
    Scoring system for monitoring patients with head injuries
  62. Le Fort Criteria
    Classification system for fractures involving maxilla
  63. Le Forte Facial Fracture
    I. Slight instability to maxilla, no displacement

    II. Fracture of both maxilla and nasal bones

    III. Fracture involving entire face below brow ridge (zygoma, nasal bone, maxilla)
  64. Diplopia
    Double vision
  65. Hyphema
    Blood in anterior chamber of the eye in front of iris
  66. Acute Retinal Artery Occlusion
    A nontraumatic occulusion of the retinal artery resulting in a sudden painless loss of vision in one eye
  67. Retinal Detachment
    Condition that may be traumatic in origin and presents with patient complaint of dark curtain obstructing a portion of the field of view
  68. Consensual Reactivity
    Response of both eyes to changes in light intensity that only affect on eye
  69. Fasciculations
    Involuntary contractions of twitching of muscle fibers