What are the meninges and what are their function? (In order) Answer - -Dura
matter(outer most layer)
-arachnoid(center layer)
-pia matter(thin innermost membrane)
(The meninges protect the cranial nerves and spinal cord)
What is the foramen magnum? Answer - The primary opening through which
pressure can be released; located at the base of the skull, it is a circular
opening which the spinal cord passes through
What are the brain hemispheres and what are their function? Answer - -
cerebrum: largest part of the brain; houses sensory functions, motor functions,
and higher intellectual functions such as intelligence and memory
-cerebellum: controls primitive functions, coordination and balance
-brain stem: controls vital body functions such as cardio-respiratory functions
What is cerebral spinal fluid? Answer - -A nutrient fluid that bathes and
protects the brain and spinal cord
-it is constantly produced within the ventricles of the brain and is reabsorbed
by the arachnoid membrane
-obstruction of CSF will create an accumulation of spinal fluid within the brain
which causes an increase in intracranial pressure
,What is decorticate posturing Answer - Flexion of the arm and legs pulled
toward the core of the body. Remember the core.
What is decerebrate posturing? Answer - Abnormal body posture involves the
arms and legs being extended straight out, the toes are being pointed
downward, and the head and neck being arched backwards.
-usually indicative of a more severe brain injury (brain stem)
What is the HALO test used to determine? Answer - If drainage from a head
injury contains cerebrospinal fluid
-using a clean piece of white gauze dip it into the drainage, the CSF will wick
faster into the fabric forming a "halo" around the bloody drainage spot
Battles signs and raccoon eyes may indicate what type of injury? Answer -
Basilar skull fracture (fracture of the floor of the cranium)
A difference in pupil size greater than what measurement is considered
abnormal? Answer - 1.0mm
What type of injury is probable if both pupils are dilated and are non reactive
to light? Answer - Brain stem injury
T/F- dilated pupils that may or may not react to light are strictly caused by brain
injury? Answer - False
What is cushing's triad? Answer - Hypertension, bradycardia, irregular
respirations
Hypotension caused by head injury is usually what type of event? Answer -
Terminal event
, What does MACE stand for and what is it designed for, what is the maximum
score possible? Answer - Military Acute Concussion Evaluation
What are the red flags for a head injury? Answer - -witnessed loss of
consciousness
-unusual behavior/combative
-unequal pupils
-seizures
-repeated vomiting
-double vision/loss of vision
-worsening headache
-weakness on one side of the body
-cannot recognize people or disoriented to place
-abnormal speech
You are working in a BAS at your FOB in Afghanistan when a patient is brought
in after having been exposed to an IED blast. You perform a MACE assessment
and his score is 26. As you assess the patient he complains that he feels like his
teeth don't fit together in his mouth. What possible injury may this patient
have? Answer - Mandible fracture
What is the definition of a traumatic brain injury? Answer - An injury to the
brain resulting from an external force and/or acceleration/deceleration
mechanism from an event
In what category do you place a patient with a head injury for evacuation?
Answer - Urgent surgical, and when possible the the fact the casualty is urgent
surgical due to a neurological issue should be relayed
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