A patient was admitted to the emergency room after being in a motor vehicle acci

Question

A patient was admitted to the emergency room after being in a motor vehicle accident. He hit his forehead on the windshield and has a short loss of consciousness. The admitting diagnosis is a contusion of the frontal lobe.

1. Review the functions of the frontal lobe and describe what type of clinical manifestations the nurse might expect to monitor in this patient.

2. If the admitting CT scan showed a subdural hematoma, can you explain where this would be located thinking about the meninges and their function and location?

3. If the patient developed a dilated pupil, which cranial nerve can be involved?

Explanation / Answer

1. Functions of frontal lobe includes solving problems through reasoning; communication and interaction; movement of volunatary muscles and planning. Clinical manifestations expected in case of  a contusion of the frontal lobe are attention disorder; reduction in spontaneous activities; inability to develop a plan; no coordination in behavior and lack of concern.

2. Subdural hematoma is the accumulation of blood in between the outermost layer of tissue that surrounds the brain called dura and the subsequent layer called arachnoid.

3. The movement of eyes is controlled by muscles which are supplied with nerves by cranial nerves III, IV and VI. The oculomotor nerve controls the functioning of pupil which falls under the category of intrinsic ocular muscle and the dillation is due to the sympathetic nerves innervating the pupillary dilator muscles.

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