Summary
samenvatting neurochirurgie VRHv6
- Course
- Institution
samenvatting van het onderdeel neurochirurgie binnen de module verpleegkundig redeneren en handelen verdiepend 6 in de opleiding verpleegkunde aan de Arteveldehogeschool.
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By: marievanhyfte • 2 year ago
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Samenvatting neurochirurgieSCHEDELTRAUMATA
- Inleiding:
1ste maatregel:
Airway
Breathing
Circulation
Belang: voldoende perfusie en oxygenatie van hersenen
2de maatregel: onderzoek:
GCS: Glasgow Coma Scale
Pupillen controleren
Mobiliteit van ledematen
3de maatregel: (hetero-) anamnese
4de maatregel: technische onderzoeken
CT-scan
Radiografieën
1
, - Schedelletsel: fracturen (belangrijke symptomen en aandachtspunten)
Gesloten: geen huidwonde
Open wonde: met huidwonde:
Soms hevig bloedend:
Arterie afklemmen
Drukverband
Halfzittende houding
Bij durabeschadiging (net boven hersenen): risico op meningitis
Fracturen schedeldak:
Linear: verhoogd risico op intercraniële bloeding, extraduraal >subduraal
Impressiefracturen (indeuking): risico op beschadiging cortex:
Bloeding
Epilepsie
Fracturen schedelbasis:
Voorste schedelbasis:
Rhinorrhee: liquorverlies uit neus
Brillhematoom
Middelste schedelbasis:
Otorrhee: liquorverlies uit oor
Mastiïdhematoom (achter oor)
- Hersenletsel:
Primair: opgelopen bij impact
Commotio cerebri: hersenschudding
Enkel functioneel zichtbaar
Evt bewustzijnsverlies
Amnesie:
Retrograad: voorafgaand aan ongeval
Anterograad: volgend op ongeval
Contusio cerebri: hersenkneuzing:
Anatomisch letsel
Evt focale uitval (indien in functionele zone)
Secundair: cascade die eventueel na impact kan komen
Algemene factoren:
Onvoldoende perfusie: hypovolemie
Onvoldoende oxygenatie: hypoxie
Intracraniële factoren: cascade effect
Beschadiging hersencellen
Vrijkomen zuurstofradicalen
Lipide peroxydatieve beschadiging
ICP: intercraniële druk
2
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