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NeuroMedical-Surgical Nursing-7th edition

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Injury to the base of the skull; about immediately below eyes...
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Basilar skull fracture
In a coup/contrecoup injury, the coup represents _______ and the contrecoup is injury sustained when _______.
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coup = initial injury; injury against object - direct trauma. contrecoup = impact from the brain hitting the opposite side of the skull after initial injury. Whiplash/MVA
Acceleration/deceleration injury...
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Coup and contrecoup head injury
What injury usually causes death in an MVA?
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Coup/Contrecoup (*fast edema and increase ICP)
Trauma where the dura remains intact and brain tissues aren't exposed to the environment. Internal damage; cranial vault OK.
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Blunt (closed) trauma
Break or penetration of the dura that exposes brain contents to the environment...
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Open (penetrating) trauma
The severity of a diffuse axonal injury (DAI) depends on...
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the amount of shearing force on the brain and brain stem.
Shearing, tearing or stretching of nerve fibers are common signs of a _______ injury.
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Diffuse axonal injury *MVA *system symptoms
What causes interstitial edema?
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Transependymal movement of CSF from the ventricles into the extracellular spaces of brain tissues (subarachnoid to meninges)
What causes ischemic edema?
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A cerebral infarction.
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Ischemic edema is a combo of _______ and _______. Initially, the edema is intracellular; necrosis leads to autodigestion, increased BBB permeability.
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vasogenic and cytotoxic edema
What causes cytotoxic (metabolic) edema?
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Toxic factors directly affect the cellular elements of the brain parenchyma causing failure of the active transport pump (Na+ and K+).
What is the pathology of cytotoxic/metabolic edema?
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Toxin affects neuronal, glial and endothelial cells. Pump failure. Cells lose K+ and gain Na+. H2O follows Na+, causing cells to swell. Gray matter is disrupted.
What is the pathology of vasogenic edema?
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Injury to vascular structure. Disruption of BBB; proteins leak out of the tissue, fluid follows. Fluid accumulates in the white matter on the same side (ipsilateral) of the injury. High ICP. *process happens quickly.
What are signs and symptoms of vasogenic edema?
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Focal neurologic deficits, decreased LOC, severe ICP. *Resolves by slow diffusion.
What causes vasogenic edema?
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Increased permeability of the capillary endothelium of the brain after an injury to the vascular structure.
Interstitial edema is seen most often with _______.
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noncommunicating hydrocephalus
Which form of cerebral edema is the most important type clinically?
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Vasogenic Edema
What is cerebral death?
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Loss of cognitive function; awareness of self and surroundings that's present more than a month.
In oculomotor nerve compression, you will normally see dilation in _______.
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one side (one eye)
What tests are done to measure/determine brain death?
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Oculomotor reflex (Doll's eyes), Oculovestibular reflex (caloric test)
  
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