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Questions and Answers
What is a common sign of a basilar skull fracture?
What does a GCS score of 10 indicate regarding traumatic brain injury severity?
Which of the following is NOT a method to test for CSF leakage?
Which condition is categorized as a type of diffuse brain injury?
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Which demographic is most likely to experience head injuries from car accidents?
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What is the role of mannitol in the treatment of traumatic brain injury?
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Which of the following conditions would render the Glasgow Coma Scale invalid for assessment?
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What is the ideal time frame to initiate nutritional therapy after a traumatic brain injury to improve patient outcomes?
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What does abnormal flexion of the extremities indicate in a patient with a brain injury?
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Which of the following best describes the Glasgow Coma Scale's indicators?
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What is the primary cause of an intracerebral hemorrhage?
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Which clinical manifestation is most commonly associated with right-brain stroke damage?
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What imaging technique is commonly preferred for rapid access and diagnosis of a stroke?
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Which of the following is a risk factor for stroke?
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How does impaired comprehension manifest in left-brain stroke damage?
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What is a common effect of increased intracranial pressure (ICP) in hemorrhagic strokes?
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What characterizes the performance of a patient with right-brain damage?
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Which of the following would NOT typically be a sign of hemiparesis?
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What is the normal range for intracranial pressure (ICP)?
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Which factor can cause an increase in intracranial pressure?
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What mechanism is responsible for maintaining stable ICP when the volume of one cranial component increases?
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How does hyperthermia affect intracranial pressure?
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What occurs when compensatory mechanisms to regulate ICP fail?
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What is the role of autoregulation in cerebral blood flow?
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Which condition would most likely impair the brain's ability to autoregulate blood flow?
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What happens to cerebral blood vessels in response to increased levels of CO2?
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Which of the following is a potential consequence of high intracranial pressure?
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How does the brain primarily obtain oxygen and glucose for metabolic functions?
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What is the GCS score for a patient who opens their eyes only in response to pain, makes incomprehensible sounds, and withdraws from pain?
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Which of the following symptoms is NOT commonly associated with post concussion syndrome (PCS)?
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What type of hematoma is most likely if a patient presents with a head injury followed by a period of lucidity and then a rapid decline in consciousness?
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Which type of brain injury is characterized by widespread damage to the brain's white matter, particularly the axons?
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In a patient suspected of having a transient ischemic attack (TIA), which symptom should the nurse expect to find?
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In assessing a patient with right-brain damage following a stroke, which finding is most likely?
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Which statement by a patient prescribed Clopidogrel (Plavix) indicates a need for further teaching?
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Which option best describes a transient ischemic attack (TIA)?
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Study Notes
Increased Intracranial Pressure (ICP)
- Cranium contains three components: brain tissue, blood, and cerebrospinal fluid (CSF).
- Normal ICP ranges from 3-15 mmHg; significant increases above 20 mmHg indicate raised ICP.
- Modified Monro-Kellie doctrine posits that if one component increases, another must decrease to maintain ICP.
- ICP regulation can be affected by blood pressure, cardiac function, body position, temperature, and CO2 levels.
- Children exhibit more resilience to ICP increases due to flexible skulls and sutures.
Factors Influencing ICP
- Compliance is the brain's ability to adjust to changes in ICP through mechanisms like CSF displacement and blood volume reduction.
- Failure of compensatory mechanisms leads to neuronal compression and ischemia, with herniation being a critical emergency.
Cerebral Blood Flow (CBF)
- The brain requires 25% of the body’s oxygen and glucose, necessitating consistent CBF.
- Autoregulation maintains adequate CBF despite fluctuations in blood pressure, ineffective under extreme hypotension or hypertension.
- Increased CO2 levels cause vasodilation to boost CBF, while low O2 triggers cerebrodilation.
Nutritional Therapy and Management
- Early nutritional support after TBI is crucial; initiated ideally within 5 days via tube feeds or TPN.
- Mannitol, an osmotic diuretic, is used to manage ICP while monitoring fluids and electrolytes.
Glasgow Coma Scale (GCS)
- GCS assesses level of consciousness through eye opening, verbal response, and motor response, scoring ranges from 3 to 15.
- Conditions affecting GCS interpretation include nonverbal patients, infants, and language barriers.
- Abnormal responses: A = flexion (better prognosis), B = extension (poorer prognosis) linked to brainstem damage.
Traumatic Brain Injury (TBI)
- Scalp lacerations and skull fractures can lead to significant injury; car accidents are a leading cause.
- Basilar skull fractures exhibit key signs like raccoon eyes, Battle’s sign, and CSF leaks from nose/ears.
- TBI types: diffuse (generalized) or focal (localized); categorized by GCS score: mild (13-15), moderate (9-12), severe (3-8).
Concussion and Brain Injuries
- Concussion represents a mild TBI with symptoms like headache and confusion; risks include cumulative injuries.
- Diffuse axonal injury results from rapid acceleration forces, damaging axons and leading to severe outcomes.
Hemorrhagic Strokes
- Chronic hypertension typically causes intracerebral hemorrhages through blood vessel weakening, among other factors.
- Subarachnoid hemorrhages generally arise from ruptured aneurysms or arteriovenous malformations.
- Stroke symptoms include hemiparesis, dysphagia, dizziness, ataxia, and sensory deficits, with increased ICP and edema common in hemorrhagic types.
Stroke Evaluation and Prevention
- CT and MRI are key diagnostic tools for stroke; CT scans are faster and more accessible.
- Stroke prevention focuses on managing hypertension, diabetes, and underlying cardiac conditions.
Key Clinical Characteristics of Stroke Types
- Left-brain damage tends to impair speech and comprehension with slow performance; right-brain damage causes spatial deficits and impulsivity.
- Symptoms of TIA (Transient Ischemic Attack) include unilateral weakness and transient neurological deficits; these resolve quickly.
Patient Education on Medication
- Clopidogrel for stroke prevention requires patient education on its purpose, duration, and the importance of adherence, especially avoiding unsupervised cessation.
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Description
This quiz covers key concepts from Week 3 regarding increased intracranial pressure, traumatic brain injury (TBI), and strokes. Explore the fundamentals of the cranium's components and how changes in volume affect intracranial pressure. Test your understanding of these critical neurology topics.
