1. Today’s Outline I.Skit: Part II II.Break into groups -Discuss the case III. Kavita’s INTERACTIVE review IV. Dayo’s Picture review V.Questions??? VI. Debriefing/Feedback

2. In a traumatic brain injury event, the ___________ injury is often more damaging than the ___________ head injury. A blow to the side of the head, like what happened to Jared in the football game, can fracture the ___________. This can cause ___________ inside the skull. SECONDARY PRIMARY TEMPORAL BONE BLEEDING

3. It is easier for a blow to the side of the head to fracture your ___________ if you are not wearing a helmet. (So ALWAYS wear a ___________ when playing contact sports or riding a bike, and make sure it is ___________!!) TEMPORAL BONE HELMET FASTENED

4. The three layers that envelop the brain are called ___________. In order from closest to the brain to farthest from the brain they are: 1. ___________ 2. ___________ 3. ___________ MENINGES PIA MATER ARACHNOID DURA MATER

5. Jared’s secondary injury is an ___________ hematoma. This means ___________ has accumulated between the ___________ mater and the ___________. Brain volume can increase with ___________, blood volume in the brain can increase with ___________. The brain can only swell up to a point, however, before it is stopped by the ___________. EPIDURAL BLOOD DURA SKULL SWELLING BLEEDING SKULL

6. A build up of ___________ can increase intra___________ pressure. This can cause the brain to ___________ and push through the ___________ ___________, which can damage the ___________ ___________. BLOOD CRANIAL HERNIATE FORAMENMAGNUM BRAINSTEM

7. The brain stem is responsible for things we do automatically, that we need to keep us alive, such as: 1. ___________ 2. ___________ 3. ___________ 4. ___________ So if ___________ pressure increases, and the brain ___________ through the foramen ___________, a person’s ___________, ___________, ___________, and ___________ will be affected. BREATHING HEART RATE BLOOD PRESSURE ADJUSTMENTS CONCIOUSNESS/AROUSAL MAGNUM BREATHING HEART RATEBLOOD PRESSURE CONCIOUSNESS INTRACRANIAL HERNIATES

8. A Neurological exam includes testing: 1.___________ ___________ 2.___________ 3.___________ 4.___________ 5.___________ CRANIALNERVES SENSATION STRENGTH GAIT (HOW A PERSON WALKS/BALANCE) REFLEXES

9. There are ___________ cranial nerves. Because the cranial nerves exit the brain near the ___________ ___________, testing them can give a doctor/nurse/paramedic valuable information about the status of the ___________ ___________. 12 BRAINSTEM BRAINSTEM

10. Jared has increased intra___________ pressure from a buildup of ___________ in his ___________ space. Increased ___________ pressure can cause something called a ___________ Response. A ___________ Response includes: 1. ___________ blood pressure 2. ___________ heart rate 3. ___________ breathing or respirations CUSHING’S BLOOD CRANIAL EPIDURALINTRACRANIAL DECREASED CUSHING’S INCREASED IRREGULAR