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Neuro- Roos P2 > 4] Treating The Patient With Brain Injury > Flashcards

4] Treating The Patient With Brain Injury Flashcards

1
Q

4 main types of brain injury

A

1] external forces
2] accelerate/decelerate
3] blast injuries
4] [penetrating objects

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2
Q

Gender more likely to have TBI related deaths and injuries

A

Men (3x more for death)

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3
Q

0-4 years get TBI by

A

Assault

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4
Q

5-24 years get TBI by

A

MVA

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5
Q

65 and older get TBI by

A

Falls

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6
Q

What are the deficits seen with damage to the frontal lobe

A

Deficits in: reasoning, planning, parts of speech, movement, emotions, problem solving

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7
Q

Deficits seen with damage to the parietal lobe

A

Movement
Orientation
Recognition
Perception of stimuli

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8
Q

Deficits associated with damage to the temporal lobe

A

Perception and recognition of auditory stimuli, memory and speech

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9
Q

Wandering hand syndrome seen with damage to whcih lobe

A

Temporal lobe

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10
Q

Deficits seen with damage to the occipital love

A

Visual processing deficit

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11
Q

Deficits seen with damage to the cerebellum

A 
Incoordination of voluntary movements resulting in problems with: 
Posture
Balance
Coordination
Speech
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12
Q

Damage to what results in difficulty learning motor behaviors?

A

Cerebellum

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13
Q

Delicate and rapid sequence of sensory and motor events requiring the coordination activity of several parts of the body

A

Communication

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14
Q

Listeners do not tell on

A

Info delivered from speech waves

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15
Q

Listeners depend on ?

A

Cues- CONTEXT

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16
Q

Which population has the most amount of language disorders?

A

Children - 43.7%

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17
Q

Vocal tract includes

A

Lungs, trachea, larynx, pharynx, nose and mouth

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18
Q

3 primary functions of speech production

A

Breathing
Swallowing
Speech

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19
Q

When we speak, what do we control?

A

Rate of breathing

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20
Q

Impaired auditory comprehension, speech is often a normal rate and melody

A

Fluent aphasia

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21
Q

Fluent aphasia is lesion where

A

Posterior temporal gyrus of L hemisphere

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22
Q

Non-fluent aphasia is characterized by

A

Limited vocab
Hesitant speech
Awkward articulation
Restricted use of grammar

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23
Q

Where is non-fluent aphasia located

A

Anterior lesion- frontal convolution in L hemisphere

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24
Q

Global aphasia is not a type but

A

A designation of severity

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25
Q

Wernickes aphasia is AKA

A

Fluent, sensory, receptive aphasia

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26
Q

Wernickes aphasia is located?

A

Lesion in posterior portion- temporal gyrus L hemisphere

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27
Q

Characterized by impaired auditory comprehension

A

Wernickes aphasia

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28
Q

Wernickes aphasia is?

A

Fluent speech with word subs and nonsense words

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29
Q

Reading and writing for wernickes

A

Severely impaired

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30
Q

Define anomic aphasia

A

Can’t find the right words in context of fluent, grammatically well-formed speech

31
Q

Wernickes aphasia may evolve into ?

A

Anomic aphasia

32
Q

Brocas aphasia is aka

A

Nonfluent
Expressive
Motor
Verbal aphasia

33
Q

Brocas aphasia is a lesion in ?

A

Frontal convolution of L hemisphere in subcortical white matter and extends posteriorly to precentral gyrus

34
Q

Broca’s aphasia is characterized by (4)

A

Awkward articulation
Restricted vocab
Writing skills mirror speech pattern
Reading is less impaired than speech and writing

35
Q

Conduction aphasia is a lesion in?

A

Parietal lobe or posterior superior temporal lobe

36
Q

Can be fluent or non-fluent

A

Conduction aphasia

37
Q

What’s good and poor in conduction aphasia

A

Good comprehension

Poor repetition, naming, writing

38
Q

Transcortical motor aphasia is a lesion in

A

Anterior superior frontal lobe

39
Q

What type of aphasia is transcortical motor aphasia?

A

Non-fluent aphasia

40
Q

What’s good and poor in transcortical motor aphasia?

A

Good comprehension, excellent repetition.

Poor naming and writing.

41
Q

Pure word deafness is a lesion in

A

Heschl’s gyrus or b/w that and temporal gyrus

42
Q

Is pure word deafness fluent or nonfluent aphasia?

A

Fluent aphasia

43
Q

What’s good and poor with pure word deafness?

A

Good writing, naming, reading comprehension.

Poor comprehension and repetition.

44
Q

Rancho-

Purposeful, appropriate, stand-by assistance on request

A

Level 9

45
Q

Rancho-

Confused, appropriate, mod A

A

Level 6

46
Q

Rancho-

Purposeful, appropriate; modified independent

A

Level 10

47
Q

Rancho-

Confused, inappropriate non-agitated, max A

A

Level 5 rancho

48
Q

Rancho-

Purposeful, appropriate; stand by assistance

A

Rancho level 8

49
Q

Rancho- automatic, appropriate; min A for daily living skills

A

Rancho- level 7

50
Q

Rancho-

No response, total assistance

A

Rancho level 1

51
Q

Rancho-

Generalized response, total assistance

A

Level 2 rancho

52
Q

Rancho-

No response, total assistance

A

Level 1 rancho

53
Q

Rancho-

Localized response; total assistance

A

Rancho level 3

54
Q

Rancho-

Confused/agitated: max A

A

Level 4 rancho

55
Q

Rancho-

Confused, inappropriate, non-agitated: max A

A

Level 5 rancho

56
Q

Rancho-

Confused, appropriate: mod A

A

Level 6 rancho

57
Q

3 parts if treatment of individuals with TBI

A

Physical
Cognitive
Behavioral

58
Q

What other factors affect cognition? (3)

A

Depression
Meds
Not enough sleep

59
Q

One way to maximize performance and learning

A

Memory book

60
Q

5 things you can put in a memory book

A 
Photos
Calendar
Therapy schedule
Activity log 
HEP
61
Q

What’s the first thing you do with a patient?

A

CHECK alertness!!

62
Q

Criteria for cessation of physical rehab session (12)

A 
1- Sx drop in MAP (dizzy, lighthead, syncope)
2- HR less than 40 or more than 130 
3- RR less than 5 or more than 40 
4- SBP more than 180
5- new arrhythmia 
6- possible MI
7- pulse ox more than 88%
8- marked vent dysynchrony
9- patient distress 
10- concern for airway device integrity 
11- fall to knees 
12- endotracheal tube removal
63
Q

4 stages of treating a patient with increased agitation

A

1- anxiety
2- defensive
3- increased tension
4- acting out

64
Q

Patients behavior for anxiety

A

Can see undirected energy

65
Q

 Offer empathy
 Ask pt what may make them feel better & comply if able
 Make sure person knows thatyou have heard/understand
the concerns

A

Staff response to anxiety

66
Q 
 Rational thought is lost
 Self-protection primary goal of pt
 See verbal belligerence & 
hostility
 See power struggles/ “button pushing”
A

Patients behavior- defensive

67
Q

Most critical step in treating a patient with increased agitation

A

DEFENSIVE STEP

68
Q
  • identify what situations are primarily responsible
  • remain professional and in control
  • set structural limits that are clear to person,s imple and enforceable
  • deliver in non-threatening manner
  • make individual aware of appropriate response
  • practice response
A

Staff response to defensive

69
Q

See loss of physical and emotional control

A

Patient behavior- acting out

70
Q
  • Use LEAST restrictive form of crisis intervention

- verbal management of situation is exhausted

A

Staff response to acting out

71
Q

Most important stage of treating pt with increased agitation

A

Tension reduction

72
Q

Happens after person acts out, pt starts gaining physical and emotional control, may not remember anything of event

A

Tension reduction

73
Q 
• Re-establish channel of 
communication
• Have pt take deep breaths 
(proves he is able to follow 
commands & will help personrelax)
• Provide pt with information 
about what is going to occur 
next
A

Staff response to tension reduction

Neuro- Roos P2 (4 decks)

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