NUR 2063 Module 7, 8, 9 Focused Review

• Brain abscess s/s (infection, pus)

Signs of infectious etiology, localized collection of pus

-Stiff neck, headache, intracranial pressure, change in LOC, vision/speech/behavior

changes

• Priority assessments

ABC’s (airway, breathing/respiratory, circulation/cardiovascular), level of consciousness

• Glascow coma scale

Used to assess LOC in acutely brain-injured patients, eye opening/arousal-directed

responses/motor reactions, under 8 is severe, over 12 is mild

• Mechanisms of spinal cord injuries

Hyperflexion (forward), hyperextension (backward), compression

• Decorticate vs decerebrate posturing

Decorticate=abnormal flexor (arms/hands up on chest), decerebrate=abnormal extension

(arms/hands at sides)

• Meningitis (S.P. bacteria in CNS)

-Bacteria usually reach the CNS via the bloodstream or extension from cranial structures

like sinuses or ears.

-Most common bacteria are Streptococcus pneumoniae.

-Bacteria invade leptomeninges; accumulation of inflammatory exudate can result in

obstructive hydrocephalus (excess fluid in head).

-Classic presentations: headache, fever, stiff neck (meningismus), and signs of cerebral

dysfunction (confusion, delirium)

• Types of traumatic brain injuries

LOCATION: Primary=focal (coup), polar (coup countercoup)(acceleration/deceleration,

injury to polar sides), diffuse (widespread)

MECHANISM: Concussion, contusion, intracranial hematomas=epidural, subdural,

subarachnoid

SEVERITY: Secondary Injury=ischemia (decreased blood flow), hypoxic events

(decreased blood oxygenation), vasogenic/neurogenic edema

• Focal (coup) brain injuries

-Localized to site of impact

-Decreased LOC, muscle weakness, cranial nerve dysfunction

• Difference between hemorrhagic stroke and thrombotic/embolic stroke (ischemic) as

well as diagnosis

-Ischemic strokes result from sudden occlusion of a cerebral artery secondary to

thrombus formation or embolization

-Thrombotic strokes associated with atherosclerosis and coagulopathies- clot traveled to

brain

-Hemorrhage within the brain parenchyma , usually occurs secondary to severe, chronic

hypertension (secondary injury, morbidity much higher)

-CT, MRI, LOC