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MEDICAL SURGICAL NURSING 2 ,[object Object]
BRAIN  INJURIES
BRAIN INJURY an injury to the skull or brain that is severe enough to interfere with  normal functioning.
Closed/Blunt Brain Injury :  occurs when head accelerates and then rapidly or collides with another object and brain tissue is damaged, but there is no opening through the skull and dura. Open Brain Injury :  occurs when an object penetrates the skull, enters the brain, and damages the soft brain tissue in its path, or when blaunt trauma is so severe that it opens the scalp, skull and dura to expose the brain.
PATHOPHYSIOLOGY
Brain suffers traumatic injury  Brain swelling or bleeding increases intracranial volume Rigid cranium allows no room for expansion of contents so intracranial pressure increases Pressure on blood vessels within the brain causes blood flow to the brain to slow Cerebral hypoxia and ischemia occur Intracranial pressure continues to rise. Brain may herniate Cerebral blood flow ceases
- Signs and symptoms of increased intracranial pressure - Cerebrospinal fluid leakage from ears and nose - Battle’s Sign: ▪ altered level of conciousness ▪ confusion ▪ papillary abnormalities ▪ altered or absent gag reflex ▪ absent corneal reflex ▪ sudden onset of neurologic deficits ▪ changes in vital signs ( altered respiratory pattern,  widened pulse pressure, bradychardia, tachycardia,  hypothermia or hyperthermia) ▪ vision and hearing impairement ▪ sensory dysfunction ▪ headache and seizures ASSESSMENT OF BRAIN INJURIES Clinical Manifestations:
Types of Brain  Injury
A. Concussion -  a temporary loss of neurological function with no apparent  structural damage often a head injury. -  also referred as  MILD TRAUMATIC BRAIN INJURY. -  no known exact recovery time. -  involves a period of unconsciousness lasting from a few seconds to few minutes. - if frontal lobe is affected, patient may exhibit bizarre irrational behavior - if temporal lobe, it can produce amnesia or disorientation.
B. Contusion - brain is bruised w/ severe sub-dural hemorrhage - patient is unconscious for morethan several seconds - signs and symptoms depend on the size of contusion and amount of associated cerebral edema. - patient may lie motionless, with a faint pulse, shallow respirations - BP and temperature are sub-normal. - vertigo and residual headache are common. -seizures may occur. - Patients are conscious and easily disturbed from any form of stimulation, may become hyperactive at times. - pulse, respirations, temperature and other body functions return to normal but full recovery maybe delayed for months.
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HEAD INJURIES
CAUSES ,[object Object],[object Object],[object Object]
PATHOPHYSIOLOGY ,[object Object],[object Object],[object Object]
SCALP INJURIES
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SKULL FRUCTURE ,[object Object],[object Object]
Clinical Manifestation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment & diagnostic findings ,[object Object],[object Object],[object Object]
Nsg. Management: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preventing Head Injuries ,[object Object]
SPINAL CORD INJURY
 
 
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2 categories of spinal cord injury
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DIAGNOSTIC FINDINGS AND CLINICAL MANAGEMENT
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EFFECTS OF SPINAL CORD INJURY
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Brain & S Ci

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  • 3. BRAIN INJURY an injury to the skull or brain that is severe enough to interfere with normal functioning.
  • 4. Closed/Blunt Brain Injury : occurs when head accelerates and then rapidly or collides with another object and brain tissue is damaged, but there is no opening through the skull and dura. Open Brain Injury : occurs when an object penetrates the skull, enters the brain, and damages the soft brain tissue in its path, or when blaunt trauma is so severe that it opens the scalp, skull and dura to expose the brain.
  • 6. Brain suffers traumatic injury Brain swelling or bleeding increases intracranial volume Rigid cranium allows no room for expansion of contents so intracranial pressure increases Pressure on blood vessels within the brain causes blood flow to the brain to slow Cerebral hypoxia and ischemia occur Intracranial pressure continues to rise. Brain may herniate Cerebral blood flow ceases
  • 7. - Signs and symptoms of increased intracranial pressure - Cerebrospinal fluid leakage from ears and nose - Battle’s Sign: ▪ altered level of conciousness ▪ confusion ▪ papillary abnormalities ▪ altered or absent gag reflex ▪ absent corneal reflex ▪ sudden onset of neurologic deficits ▪ changes in vital signs ( altered respiratory pattern, widened pulse pressure, bradychardia, tachycardia, hypothermia or hyperthermia) ▪ vision and hearing impairement ▪ sensory dysfunction ▪ headache and seizures ASSESSMENT OF BRAIN INJURIES Clinical Manifestations:
  • 8. Types of Brain Injury
  • 9. A. Concussion - a temporary loss of neurological function with no apparent structural damage often a head injury. - also referred as MILD TRAUMATIC BRAIN INJURY. - no known exact recovery time. - involves a period of unconsciousness lasting from a few seconds to few minutes. - if frontal lobe is affected, patient may exhibit bizarre irrational behavior - if temporal lobe, it can produce amnesia or disorientation.
  • 10. B. Contusion - brain is bruised w/ severe sub-dural hemorrhage - patient is unconscious for morethan several seconds - signs and symptoms depend on the size of contusion and amount of associated cerebral edema. - patient may lie motionless, with a faint pulse, shallow respirations - BP and temperature are sub-normal. - vertigo and residual headache are common. -seizures may occur. - Patients are conscious and easily disturbed from any form of stimulation, may become hyperactive at times. - pulse, respirations, temperature and other body functions return to normal but full recovery maybe delayed for months.
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  • 35. 2 categories of spinal cord injury
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  • 38. DIAGNOSTIC FINDINGS AND CLINICAL MANAGEMENT
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  • 40. EFFECTS OF SPINAL CORD INJURY
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