chap 15 - 5 Chapter 15 ALTERATIONS OF PNS-involves nerve...

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Unformatted text preview: 5 Chapter 15 ALTERATIONS OF PNS:-involves nerve roots (radiculopathies); a nerve plexus, or the nerves themselves (neuropathies)… disorders of the neuromuscular junction can also occur ALTERATIONS OF CNS:-caused by traumatic injury; vascular disorders; tumor growth; infectious and inflammatory processes; metabolic disarrangement (nutritional deficiencies, drugs, chemicals); degenerative processes Brain Trauma o Risks for traumatic brain injury (TBI) Persons 15-24 years of age; infants 6 months to two years; young school age children; elderly Male: female ratio= 2:1 Highest among blacks, low/median income and areas with high crime rate o Major head trauma A traumatic insult to the brain possibly producing physical, intellectual, emotional, social, and vocational changes Transportation accidents Experience emotional changes. Falls Sports-related event Violence o Closed (blunt, nonmissile) trauma More common Head strikes hard surface or a rapidly moving object strikes the head The dura remains intact and brain tissues are not exposed to the environment Causes focal (local) or diffuse (general-axonal) brain injuries Ex: hit by a bat, clubs o Open (penetrating, missile) trauma 6 Injury breaks the dura and exposes the cranial contents to the environment Causes primarily focal injuries Missiles include bullets, rocks, shell fragments, knives, and blunt instruments. Mechanisms of injury: ▫ crush injury: laceration and crushing of whatever the m issile touches ▫ stretch injury: blood vessels and nerves damaged w/o direct contact as a result of stretching Ex: shot by a gun, stabbed Coup Injury ▫ Injury directly below the point of impact (impact against object) ▫ Shearing forces of subdural veins; trauma to base of brain Contrecoup ▫ Injury on the pole opposite the impact (impact within skull) ▫ Shearing forces through brain Example: slam on the breaks and your head hits the dash (coup injury) and the goes back and hits the seat (contrecoup), like a orange in bowl (get shuffled around) Coup and contrecoup happen in one continuous motion Compound fractures: object strikes head forcefully or head strikes object ▫ Diagnosed with xray ▫ Basilar skull fracture – down on the bottom, near the brain stem; upper impact of cervical vertebrae (bedrest and close watch for meningitis) • Focal Brain Injury o Observable brain lesion o 2/3 of death from brain injury o Force of impact typically produces contusions (bruises) that are superficial and just involve gyri; the contusions in turn produce hemorrhage and hematoma o Hematoma – blood clot (usually from hemorrhage) 7 o Severity Depends on energy amount t ransm itted Smaller area of impact leads to greater injury because force is more concentrated o Leads to: brain edema (increased int racranial pressure); infarction; necrosis; multiple hemmorages o Common in temporal and frontal lobes; less common in parietal and occipital...
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chap 15 - 5 Chapter 15 ALTERATIONS OF PNS-involves nerve...

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