Synapses and Snoozes
These 3 letters of the alphabet represent the priority assessment for patients in PACU.
What is
A - airway
B - breathing
C - circulation
This is the earliest and most important assessment finding for a rising ICP.
What is decreased level of consciousness?
This type of spinal cord injury typically happens within minutes of the in initial impact and is characterized by inflammation, edema, hemorrhage, cytokine release and vascular injury.
What is secondary injury?
What is a quiet, non-stressful environment?
This sign, often associated with liver failure, involves the yellowing of the skin and eyes due to elevated bilirubin levels.
What is jaundice?
This cranial nerve influences the position of the eyelids and the size of the pupils.
What is cranial nerve III - Oculomotor nerve?
CN I - Olfactory nerve. Providing sense of smell.
CN II - Optic nerve. Providing vision.
CN IV - Trochlear nerve. Looking down and moving your eyes toward your nose or away from it.
CN V - Trigeminal nerve. Providing sensations in your eyes, most of your face and inside your mouth. It also allows you to chew food.
Manipulating this result on the patient's ABG, will help decrease the cerebral blood flow and intracranial hypertension.
What is PaCo2?
Often seen with hyperextension injuries, this injury is occurs by a twisting force that causes fractured vertebral body and ruptured posterior ligament complex.
What is a Rotational Injury?
This drug is often used post SAH as it has a dilatory effect on arterial smooth muscle.
What is the calcium channel blocker nimodipine?
These phagocytic cells help to destroy worn RBC's and detoxify drugs in the liver.
What are Kupffer cells?
This lobe of the brain is responsible for voluntary motor function, cognitive function, and expressive language.
What is the frontal lobe?
Increased systolic blood pressure, bradycardia, irregular respirations, and this other finding make up the Cushing's triad.
What is a widening pulse pressure?
Common in injuries above T6, this condition is characterized by low BP, low HR, peripheral vasodilation, and poikilothermia.
What is neurogenic shock?
Vasopressin, fluids, and DDAVP are used to treat this condition which is characterized by dilute urine and excessive thirst.
What is Diabetes Insipidus?
This enzyme, often elevated in liver failure, is indicative of hepatocellular injury and is commonly measured in liver function tests.
What is alanine aminotransferase (ALT)?
This part of the brain is separated from the cerebrum by the dural fold tentorium cerebelli.
What is the cerebellum?
This supratentorial herniation syndrome is characterized by one fixed or dilated pupil due to the temporal lone pressing on CN III and post cerebral artery.
What is an Uncal herniation?
Occurring after a SCI, this condition causes flaccid paralysis below the injury level and has no treatment options.
What is spinal shock?
This hematoma if formed between the inner skull and the outer layer of the dura mater and typically results in alteration between states of loss of consciousness, lucidity, and then back to LOC.
What is an Epidural Hematoma?
This syndrome, often associated with liver failure, is characterized by altered mental status and hepatic encephalopathy due to the accumulation of toxins in the bloodstream.
What is hepatic encephalopathy?
Toxins = ammonia and glutamine. Treat with lactulose.
These "outpouchings" within a layer of the brain absorb cerebral spinal fluid, which drains into the venous drainage system.
What are arachnoid villi?
Located in the arachnoid mater and are at risk for obstruction by blood.
This imaging modality is often used to assess for mass effects, midline shift, or hemorrhage in patients with suspected elevated ICP.
What is a CT scan?
This response causes profuse sweating and flushing above the injury site and cool skin and goosebumps below the injury site.
What is autonomic dysreflexia?
These 5 criteria must be met for the Neurological Determination of Death.
What are:
1. Capable cause
2. Coma - unresponsive
3. Absent of brain stem reflexes
4. Positive Apnea Test - no resp effort and increase CO2 >20 above baseline (and >60)
5. Absent cofounding factors - shock, irregular temp, metabolic disorders, drugs, or nerve blocks.
This complication of portal hypertension involves the formation of collateral veins, often seen in the esophagus, which can lead to life-threatening bleeding.
What are esophageal varices?