12% Medical and Physical Issues (EBIG chapters 5, 6, 7, and 9) Flashcards
What is autonomic storming?
Dysautonomia- autonomic functions such as heart, blood pressure, temp, etc are disrupted
also can present as muscle over activity (dystonia)
DVT/PE
Deep vein thrombosis causes a pulmonary embolism when the clots break off, travel up to the lungs and get stuck in the arteries, creating a blockage
What are some physical issues?
Spasticity, hyperreflexia, contractures, HO
Describe contractures
Abnormal usually permanent contracted joints (flexed position) due to shortening of muscle fibers and loss of skin elasticity
Describe hyperrflexia
Involuntary exaggerated deep tendon reflexes
Describe spasticity (city = city)
involuntary abnormal motoric patterns due to velocity-dependent increase in muscle tone
Describe HO
O= ossification
Abnormal growth of bone in soft tissues adjacent to the joints
Characterize bladder issues with brain injury (BI)
When injured, the regulatory systems in eliminating (using the bathroom) may be disturbed resulting in inconsistence or accidents.
How to help: bladder training (timed breaks), maintaining adequate hydration
Describe aspiration
When food/drink enters the airway. Swallowing is a difficult process and dysfunction can lead to aspiration in phase 1 of swallowing (oral stage)
Describe pressure sores
Pressure sores develop when a person lies on a bed or sits in a wheelchair for long periods of time without repositioning. Usually form at bony areas.
What are some risk factors for pressure sores?
Incontinence, poor nutrition, contractures, use of casts/splints.
Describe seizures
Seizures are caused by an abnormal discharge of electrical activity in the nerve cells of the brain.
What are some complications of seizures?
Early post-traumatic seizures (EPTS)
Late post-traumatic seizures (LPTS)
What is the mortality rate for seizures & TBI
After TBI individuals are 37x more likely to die of a seizure disorder as compared to the general population.
Status epilepticus also carries a high mortality risk (seizures lasting longer than 5 minutes)
Describe pain after brain injury
Pain can be subjective and can be acute or chronic. Pain can disrupt the rehabilitation process. Over time neuropathic pain like nerve injuries, and tendinitis may emerge due to spasticity.
The most common pain pathways for non-headache pain?
Nociceptive and Neuropathic
Nocioceptive
Pain related to the peripheral nerve fibers
Treatment: opioids, acetaminophen
Neuropathic
Pain asssociatied with primary lesion of dysfunction of the nervous system
Treatment: trigger point injections, antidepressants
Types of headaches
Tension type headache (TTH)- Tight pressing (like a clamp)
Cervicogenic- head pain generated from the cervical spine
Cranio-mandibular- headache associated with temporal mandibular joint
Migraine- Usually located on one side of the head
Migraine phases
Prodrome–> Aura –> Headache –> Postdrome
TBI & spinal cord overlap
TBI is present in 60% of individuals with spinal cord injury
What are some symptoms of cranial nerve damage?
Visual disturbance
Facial drooping
Postural instability
Dysphagia
Autonomic dysregulation
What are some perceptual (hint: perception how you view yourself) deficits?
Body scheme/Body image disorders
Spatial relation disorders
Agnosia
Apraxia
What are the three types of apraxia?
Ideomotor apraxia- cannot perform tasks on command
Ideational apraxia- cannot perform tasks automatically
What are the three types of apraxia?
Ideomotor apraxia- cannot perform tasks on command
Ideational apraxia- cannot perform tasks automatically and on command
Buccofacial apraxia- limitations on movements of the lips, cheeks, tongue, larynx, & pharynx
What is the prevalence and types of disorders of consciousness (DOC)
3 levels of DOC- coma, vegetative state, minimally conscious.
Vegetative state= 4,200 per year
DOC= 315,000 persons living with
Prognosis of DOC (disorders of consciousness)
Neuroimaging has lead to
better understanding of
DOC
Arousal, Awareness, Prevalence
Medical management of DOC
Keep skin healthy- watch for skin irritation
Keep lungs and airway clear- trach tube
Keep bladder and bowel healthy- Infection
Why is the autonomic nervous system important?
it controls the bodies automatic body processes such as blood pressure & breathing
Causes of sleep and fatigue disorders?
imbalance in the availability, utilization, and or/ restoration of resources needed to perform activity.
How do you measure sleep and fatigue disorders?
Visual analogue scale (VAS-F)
Fatigue severity scale (FSS)
Barrow Neurological fatigue scale (BNI Fatigue scale)
Global fatigue index (GFI)
Causes of fatigue questionnaire (COF)
Epworth Sleepiness Scale
Pittsburgh Sleep Quality Index
Polysomnography
Multiple Sleep Latency Test
What is the persistence of fatigue and sleep disorders?
Persists for years after a
moderate to severe injury
Treatments of sleep and fatigue disorders?
No well-established treatments for fatigue.
Lifestyle modifications, relaxation training, OTC medication, and CPAP devices for sleep disorders.
Fatigue vs sleep disturbances?
Sleep disorders are diagnosed through sleep history. Fatigue is the awareness of a decreased capacity for physical and or/mental activity.
What is psychological fatigue?
Is a state of weariness related to reduced motivation, prolonged, mental activity, or boredom that occurs with chronic stress, anxiety, or depression.
