ANSWERS MARKED A+
✔✔Generally, what is the cause of spinal cord injuries? - ✔✔Indirect trauma (i.e. MVA's,
vertebral compression from blows to head or butt)
Can also be caused by traciton force on spinal cord during breech delivery
✔✔What nerve does a high cervical cord injury affect? - ✔✔Phrenic nerve --> paralyzes
diaphragm, thus pt requires ventilation
✔✔What procedure can be done for spinal cord injuries? - ✔✔FES (functional electrical
sitimulation)
✔✔Are muscular dystrophies genetic? - ✔✔Yes, they have genetic origin --> Duchenne
Muscular Dystrophy has an X-linked pattern thus they affect males more than females
✔✔Will patients with muscular dystropy reach developmental milestones? - ✔✔Yes,
however they may regress (crawl, then walk, then crawl years later)
✔✔When age group does Duchenne muscular dystrophy normally affect? - ✔✔3-7
years old
*** most important cause of muscular dysfunction in childhood ***
✔✔What are characteristics of Duchenne muscular dystrophy? - ✔✔Calf muscle
hypertrophy
Progressive weakness
Gower sign, waddling when walking
Lordosis
Enlarged muscles (esp. thighs & upper arms)
Mental deficiency common
Death from respiratory or cardiac failure
✔✔How is Duchenne muscular dystrophy diagnosed? - ✔✔blood PCR
then confirmed by muscle biopsy, electromyelogram, and serum enzyme measurement
✔✔How is Duchenne muscular dystorphy treated? - ✔✔NO treatment
goal: maintain function of muscles as long as possible
genetic counseling for family
✔✔What are early signs of increased intracranial pressure? - ✔✔distended scalp veins,
vomiting, seizures, poor feeding, irritability, separated cranial sutures, lethargy,
drowsiness, less physical activity
✔✔What are late signs of increased intracranial pressure? - ✔✔Decreased LOC and
motor response
, Lack of response to painful stimuli
Altered pupil size and reactivity
Papilledema
Decerebrate or decorticate posturing
Cheyne-Stokes respirations
✔✔What are the 3 parts to Glasgow's Coma Scale? - ✔✔Eyes
Verbal response
Motor response
✔✔What does it mean to get a score of 15? 3? - ✔✔15- unchanged LOC
3- extremely decreased LOC
✔✔Where in the CNS is the brain damage if patient is constantly flexed? - ✔✔cerebral
cortex or lesions above brain stem
✔✔Where in the CNS is the brain damage is patient is constantly extended? -
✔✔midbrain damage or brain lesions (reversible)
✔✔What is the nursing care of an unconscious child? - ✔✔Pupillary reaction, LOC, VS
✔✔True of false? head size does not matter in terms of head injuries - ✔✔FALSE: head
size and msk support both determine child's response to injury
✔✔Are concussions permanent in children? - ✔✔No, they are transient and reversible
✔✔What are complications of head trauma? - ✔✔Herniation
Epidural hemorrhage
Subdural hemorrhage
Cerebral edema
✔✔How do you diagnose head traumas? - ✔✔assessing ABCs, evaluating shock, vital
signs, neurological exam, special tests: CT scan and MRI
✔✔True or false: tumors are difficult to treat and result in poor survival rates - ✔✔True
✔✔Explain infratentorial brain tumors. Where do they primarily occur? - ✔✔60%
infratentorial (posterior 1/3 of brain) in cerebellum or brainstem
✔✔Explain supratentorial brain tumors. Where do they primarily occur? - ✔✔40%
supratentorial (anterior 2/3 of brain) in cerebrum
✔✔How do you diagnose brain tumors? - ✔✔spinal tap (lumbar puncture), MRI, CT,
EEG