©Jason MacConnell 2025 ALL RIGHTS RESERVED.
Second Exam for CHSO 404 Questions With
Correct Answers A+
Brain injury causes - Answer✔direct trauma or vascular changes that result in lack of perfusion
or hemorrhage of brain tissue
-can give rise to hypoxia and edema
-can increase ICP and result in herniation
Brain injury manifestations - Answer✔loss of consciousness, altered motor and respiratory
responses, change in the pupils
Traumatic brain injury - Answer✔varying impairments depending on cause, severity, and brain
region involved
-may be reversible or self resolving depending on the severity of injury
-head injury and subsequent damage to brain, possibly cranial nerves as well
-head injury usually refers to a TBI, though it may involve damage to other structures (i.e. scalp
& skull)
-TBI is major cause of death and disability
-common causes - falls, vehicle accidents, violence
-head injuries can be closed (intact skull) or open (skull fracture)
-brain trauma occurs from the injury itself but can often lead to secondary injury from altered
blood flow and intracranial pressure
-symptoms - dependent on whether TBI is diffuse or local, the severity, and part of brain
involved
Cerebrovascular disease - Answer✔vascular injuries such as stroke that may present with similar
manifestations as TBI
-cerebrovascular brain injury and neurological dysfunction caused by disruption of blood flow to
the brain
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-includes disorders of cerebral vessels, TIAs, stroke
-causes - HTN, HLD
-compromised profusion gives rise to CVD, with underlying causes of thrombosis (40% of
cases), embolism (30%), and aneurysm (20%)
Circle of Willis - Answer✔-a protective circulation system that facilitates blood flow to the brain
and allows collateral flow to compromised regions
Spinal cord injuries (SCIs) - Answer✔the result of injuries to cranial nerves that often
accompany TBIs
Seizures - Answer✔accompany many neurological conditions, including TBIs and
cerebrovascular disease
Consciousness - Answer✔-a state of awareness and orientation to surroundings, and the ability to
respond to stimuli
-determined by the reticular activating system (runs through brain stem to both hemispheres)
-a continuum - including confusion, delirium obtundation, stupor and coma
-coma refers to the disruption of the conscious state, resulting in a lack of wakefulness and
awareness
-evaluated with the GCS (assesses opening of eyes and verbal/ motor responses
-varying degrees of changes in pupillary response, motor function, and respiratory response
-changes depend upon the extent and location of damage
-loss of consciousness implies diffuse brain injury
-focal neurological deficit does not usually disrupt consciousness
Concussion - Answer✔-caused by sudden movement of brain as during a sports injury, car
accident, or fall
-most common form of TBI
-diffuse, but not transient and reversible
-associated with temporary loss of consciousness, changes in respirations, hypotension,
bradycardia, and amnesia (depending on length of consciousness loss)
Cerebral contusion - Answer✔-bruising of brain tissue
-associated with small petechial hemorrhages that leak into brain tissue
-present on 20-30% of severe head injuries
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-associated with blunt trauma in closed head injuries
-partially reversible, depending on severity
Hematoma - Answer✔focal injury involving collection of blood in or around the brain, often
caused by hemorrhage
Primary brain injury - Answer✔-refers to structural damage at the moment of trauma to neurons,
glial cells, and blood vessels
Secondary brain injury - Answer✔-occurs as body responds to primary injury
-includes changes to blood flow (ischemia, hypoxia)
-includes edema and subsequent intracranial pressure, which can lead to brain cell death or
herniation
-can significantly worsen the damage from primary injury, leading to a large number of TBI
deaths
Types of secondary brain injury - Answer✔-hypoxic and ischemia injury - result from decreased
oxygen availability in brain tissue - ischemia reduces availability of glucose and removal of
waste products
-cerebral edema - from accumulation of fluids - causes include damage to BBB or swelling of
brain cells due to inadequate waste removal
-ICP - results from fluid accumulation due to inflammatory or edematous processes - resultant
reduction in tissue perfusion can lead to hypoxia and. neuronal death - ICP can also lead to
herniation (brain pushed out of confined area into area of lower pressure)
Hemorrhage - Answer✔-TBI may result in hemorrhage into the cranial vault from epidural,
subdural, or intracerebral sources leading to accumulation of blood and increased ICP
-epidural - material blood (middle meningeal artery) into extradural space between skull and
outermost brain layer
-subdural - most common meningeal hemorrhage where blood accumulates between dura mater
and arachnoid mater - caused by trauma, coagulopathy, alcoholism - often found in the
connecting veins in the cerebral cortex
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-intracerebral - disruption of the cerebral vessels within the brain parenchyma, resulting in
neurological deficits - commonly found in frontal and temporal lobes
Stroke - Answer✔-sudden focal neurological deficit from a vascular disease
-non traumatic disruption of the blood supply to an area of the brain
-causes - occlusion of cerebral arteries by ischemia (87% of time) or hemorrhage (13%)
-ischemic stroke - results from obstructed blood flow; can lead to ischemia, potentially
irreversible necrosis and cerebral infarction; may also be caused by poor perfusion (shock)
-hemorrhagic stroke - results from intracranial hemorrhage; occurs deep in the parenchyma or
near the surface of brain; often has HTN as an underlying cause
*stroke is a medical emergency that can cause permanent brain damage or death
Aneurysm - Answer✔-refers to localized dilation in a blood vessel wall that can rupture and lead
to hemorrhage
-most ruptures are due to developmental defects (95%)
-a defect in the tunica media (middle layer) can for a protruding sac (saccular or berry aneurysm)
-often go undetected through life
-can result in aneurysmal subarachnoid hemorrhage
-has clinical manifestations that range from mild headache to coma and death
Encephalitis - Answer✔-infection and inflammation of brain tissue or spinal cord
-caused by viruses - equine encephalitis, west nile, herpes, HIV, cytomegalovirus, rabies, and
possibly prion virus
Meningitis - Answer✔-infection of meninges (membranes that cover brain)
-caused by bacterial infection - streptococcus pneumonia, neisseria meningitidis, haempphilus
influenzae
-also caused by viruses - enteroviruses, coxsackie virus, adenovirus, herpes, HIV, Epstein Barr
virus, CMV
Parkinson's disease - Answer✔-degenerative disease of the CNS characterized by movement
disorder
Second Exam for CHSO 404 Questions With
Correct Answers A+
Brain injury causes - Answer✔direct trauma or vascular changes that result in lack of perfusion
or hemorrhage of brain tissue
-can give rise to hypoxia and edema
-can increase ICP and result in herniation
Brain injury manifestations - Answer✔loss of consciousness, altered motor and respiratory
responses, change in the pupils
Traumatic brain injury - Answer✔varying impairments depending on cause, severity, and brain
region involved
-may be reversible or self resolving depending on the severity of injury
-head injury and subsequent damage to brain, possibly cranial nerves as well
-head injury usually refers to a TBI, though it may involve damage to other structures (i.e. scalp
& skull)
-TBI is major cause of death and disability
-common causes - falls, vehicle accidents, violence
-head injuries can be closed (intact skull) or open (skull fracture)
-brain trauma occurs from the injury itself but can often lead to secondary injury from altered
blood flow and intracranial pressure
-symptoms - dependent on whether TBI is diffuse or local, the severity, and part of brain
involved
Cerebrovascular disease - Answer✔vascular injuries such as stroke that may present with similar
manifestations as TBI
-cerebrovascular brain injury and neurological dysfunction caused by disruption of blood flow to
the brain
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-includes disorders of cerebral vessels, TIAs, stroke
-causes - HTN, HLD
-compromised profusion gives rise to CVD, with underlying causes of thrombosis (40% of
cases), embolism (30%), and aneurysm (20%)
Circle of Willis - Answer✔-a protective circulation system that facilitates blood flow to the brain
and allows collateral flow to compromised regions
Spinal cord injuries (SCIs) - Answer✔the result of injuries to cranial nerves that often
accompany TBIs
Seizures - Answer✔accompany many neurological conditions, including TBIs and
cerebrovascular disease
Consciousness - Answer✔-a state of awareness and orientation to surroundings, and the ability to
respond to stimuli
-determined by the reticular activating system (runs through brain stem to both hemispheres)
-a continuum - including confusion, delirium obtundation, stupor and coma
-coma refers to the disruption of the conscious state, resulting in a lack of wakefulness and
awareness
-evaluated with the GCS (assesses opening of eyes and verbal/ motor responses
-varying degrees of changes in pupillary response, motor function, and respiratory response
-changes depend upon the extent and location of damage
-loss of consciousness implies diffuse brain injury
-focal neurological deficit does not usually disrupt consciousness
Concussion - Answer✔-caused by sudden movement of brain as during a sports injury, car
accident, or fall
-most common form of TBI
-diffuse, but not transient and reversible
-associated with temporary loss of consciousness, changes in respirations, hypotension,
bradycardia, and amnesia (depending on length of consciousness loss)
Cerebral contusion - Answer✔-bruising of brain tissue
-associated with small petechial hemorrhages that leak into brain tissue
-present on 20-30% of severe head injuries
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-associated with blunt trauma in closed head injuries
-partially reversible, depending on severity
Hematoma - Answer✔focal injury involving collection of blood in or around the brain, often
caused by hemorrhage
Primary brain injury - Answer✔-refers to structural damage at the moment of trauma to neurons,
glial cells, and blood vessels
Secondary brain injury - Answer✔-occurs as body responds to primary injury
-includes changes to blood flow (ischemia, hypoxia)
-includes edema and subsequent intracranial pressure, which can lead to brain cell death or
herniation
-can significantly worsen the damage from primary injury, leading to a large number of TBI
deaths
Types of secondary brain injury - Answer✔-hypoxic and ischemia injury - result from decreased
oxygen availability in brain tissue - ischemia reduces availability of glucose and removal of
waste products
-cerebral edema - from accumulation of fluids - causes include damage to BBB or swelling of
brain cells due to inadequate waste removal
-ICP - results from fluid accumulation due to inflammatory or edematous processes - resultant
reduction in tissue perfusion can lead to hypoxia and. neuronal death - ICP can also lead to
herniation (brain pushed out of confined area into area of lower pressure)
Hemorrhage - Answer✔-TBI may result in hemorrhage into the cranial vault from epidural,
subdural, or intracerebral sources leading to accumulation of blood and increased ICP
-epidural - material blood (middle meningeal artery) into extradural space between skull and
outermost brain layer
-subdural - most common meningeal hemorrhage where blood accumulates between dura mater
and arachnoid mater - caused by trauma, coagulopathy, alcoholism - often found in the
connecting veins in the cerebral cortex
, ©Jason MacConnell 2025 ALL RIGHTS RESERVED.
-intracerebral - disruption of the cerebral vessels within the brain parenchyma, resulting in
neurological deficits - commonly found in frontal and temporal lobes
Stroke - Answer✔-sudden focal neurological deficit from a vascular disease
-non traumatic disruption of the blood supply to an area of the brain
-causes - occlusion of cerebral arteries by ischemia (87% of time) or hemorrhage (13%)
-ischemic stroke - results from obstructed blood flow; can lead to ischemia, potentially
irreversible necrosis and cerebral infarction; may also be caused by poor perfusion (shock)
-hemorrhagic stroke - results from intracranial hemorrhage; occurs deep in the parenchyma or
near the surface of brain; often has HTN as an underlying cause
*stroke is a medical emergency that can cause permanent brain damage or death
Aneurysm - Answer✔-refers to localized dilation in a blood vessel wall that can rupture and lead
to hemorrhage
-most ruptures are due to developmental defects (95%)
-a defect in the tunica media (middle layer) can for a protruding sac (saccular or berry aneurysm)
-often go undetected through life
-can result in aneurysmal subarachnoid hemorrhage
-has clinical manifestations that range from mild headache to coma and death
Encephalitis - Answer✔-infection and inflammation of brain tissue or spinal cord
-caused by viruses - equine encephalitis, west nile, herpes, HIV, cytomegalovirus, rabies, and
possibly prion virus
Meningitis - Answer✔-infection of meninges (membranes that cover brain)
-caused by bacterial infection - streptococcus pneumonia, neisseria meningitidis, haempphilus
influenzae
-also caused by viruses - enteroviruses, coxsackie virus, adenovirus, herpes, HIV, Epstein Barr
virus, CMV
Parkinson's disease - Answer✔-degenerative disease of the CNS characterized by movement
disorder
