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adult neuro test 3 > brain injury > Flashcards

brain injury Flashcards

1
Q

One approach that defines TBI into 3 categories… what are they?

A
  1. local(focal) Brain Damage
  2. Diffuse Brain Damage
  3. Secondary Brain Damage
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2
Q

what does local (focal) Brain damage consist of?

A

contusions
lacerations
hematomas
herniations

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3
Q

what does diffuse brain damage consist of?

A

axonal shearing

small hemorrhages

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4
Q

what does secondary brain damage consist of?

A 
edema
hypoxia
hypotension
infection
salkt/water imbalance
concussions 
post traumatic epilepsy
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5
Q

true or false

secondary brain damage can occur months or even years after sustaining an injury

A

true

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6
Q

name 6 other ways to categorize TBI

A 
scalp injuries
skull fractures
intracranial injuries
traumatic cerebro-vascular lesions
CN pathology
Prognosis (recovery stages)
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7
Q

scalp injuries include?

A

Abrasion/contusion
Hematoma/herniation
Scalp laceration

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8
Q

skull fractures include?

A

linear
comminuted
compound

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9
Q

intracranial injuries include?

A

Concussion
Epidural hematomas
Subdural hematomas
ICP monitoring

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10
Q

traumatic cerebro-vascular lesions include?

A

aneurysms

cartoid-cavernous fistulas

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11
Q

CN pathology consist of?

A

CN II
CN III
CN VII
CN VIII

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12
Q

Prognosis (recovery stages) include?

A

Glasgow Coma Scale

Rancho Los Amigos Cognitive Scale

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13
Q

when dealing with a CNS infectious disease, a PT should?

A

Self-protect from contagious diseases
Understand how etiology and prognosis affects treatment goals
Be able to communicate with other health care providers
Be able to provide patient and family education

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14
Q

CNS infections can be caused by?

A

bacterial
parasitic
fungal
viral

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15
Q

true or false

most microorganisms attack the CNS through the PNS

A

False

while rabies and herpes simplex attack the PNS, most infections are hematogenously born

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16
Q

Brain infection is categorized by ______ and _______

A

location and cause

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17
Q

the three categorize of brain infections include

A

Brain Abscess
Meningitis
Encephalitis

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18
Q

Leptomeninges =

A

pia + arachnoid mater

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19
Q

S/S of a brain abscess include?

A

headaches
convulsions
hemiparesis
incoordination

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20
Q

TRUE OR FALSE
Brain abscesses are usually a result to secondary inflammatory process elsewhere such as lungs, heart, sinuses, ear mastoiditis

A

true

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21
Q

generalized infection and increased ICP —>

A

specific neurological symptoms

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22
Q

What is Leptomeningitis?

A

Infection spread through CSF with inflammatory process of pia mater, arachnoid mater, and superficial CNS tissues, to include subarachnoid space`

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23
Q

TRUE or FALSE

CSF is self-contained with plenty of antibodies and cells to prevent an ideal growth medium for microorganisms

A

FALSE

CSF self-contained with no antibodies and few cells, so an ideal growth medium for microorganisms

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24
Q

Leptomeningitis is usually classified as ______ or _______

A

bacterial or viral (aseptic)

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25
Q

TRUE or FALSE

Untreated bacterial meningitis can lead to death

A

true

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26
Q

S/S of bacterial Meningitis are?

A 
headaches
vomiting
 fever
 altered consciousness
 convulsions
nuchal rigidity
 irritability
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27
Q

Inflamed congested pia-arachmoid mater with PMN exudate leads to?

A

obstructing ventricular formaina causing increased ICP

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28
Q

True or False

Bacterial Meningitis leads to increased blood sugar levels

A

False

decreased blood sugar levels

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29
Q

what is a positive Brudzinski Neck sign?

A

Neck flexion causes hip/knee flexion….sign of bacterial meningitis

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30
Q

True or False

Viral meningitis is similar to bacterial but not as life threatening

A

true

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31
Q

True or false

Viral Meningitis acts slow

A

False

Fulminating= suddenly with great intensity

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32
Q

Viral Meningitis affects ?

A

children and young adults

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33
Q

True or False

With viral meningitis, blood sugar levels are increased dramatically

A

False

levels are normal

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34
Q

Acute Viral Lymphocytic Meningitis occurs when=

A

Viral contamination of CSF with an increase in lymphocytes

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35
Q

True or False

Chronic Meningitis is a slowly evolving infection

A

True

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36
Q

Two agents that cause Chronic Meningitis are?

A 
Mycobacterium tuberculosis (lung TB)
Treponema pallidum (syphilis)
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37
Q

If Chronic Meningitis is in the SAS, it may lead to?

A

hydrocephalus

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38
Q

S/S of chronic meningitis include?

A 
headaches
vomiting
mental confusion
weight loss
 fatigue
night sweats
chest pain
 general malaise
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39
Q

Medical management for Meningitis for bacteria? viral?

A

antimicrobial antibiotics for bacteria

treat viral infections symptomatically - antivirals if caught soon enough

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40
Q

In chronic meningitis, _______ ______ is found in the meninges with increased number of what 4 cells?

A

gelatinous exudate

lymphocytes/plasma cells/macrophages/fibroblasts

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41
Q

Encephalitis is a viral infection of?

A

brain and spinal cord cells (neurons and glia)

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42
Q

With encephalitis, _____ and ______ of the brain and spinal cord destroys the ____matter

A

edema and inflammation

white

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43
Q

With encephalitis, increased ICP leads to?

A

transtentorial herniation

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44
Q

True or False

With encephalitis, the viral latency period can be months to years

A

true

45
Q

With encephalitis, the mononuclear cell infiltrate increases with?

A

Patients who are immunosuppressed

46
Q

S/S of encephalitis include?

A

headaches, fever, nuchal rigidity, vomiting, general malaise, coma, CN palsies, hemiplegia

47
Q

Encephalitis

A

inflammation of the brain

48
Q

Encephalomeningitis

A

inflammation of the brain and spinal cord

49
Q

Encephalomyeloneuropathy

A

inflammation of the brain, spinal cord, and PNS

50
Q

Acute Viral Encephalitis affects

A

frontal/temporal lobe gray

51
Q

True or False

Acute Viral Encephalitis is most fatal with those who survive having sever dementia

A

true

52
Q

Acute Toxic Encephalitis come about how?

A

Arbovirus arthropod-borne systemic infections

Vertebrate host, mosquito vectors, tick-borne

53
Q

S/S of “slow virus” encephalitis are?

A

first personality abnormalities, visual and spatial orientation/coordination problems leading to severe dementia with myoclonus

54
Q

“Slow Virus” Encephalitis has a ______ latent incubation; however it is fatal within _______ and progresses to ________

A

slow
month
dementia

55
Q

“Slow Virus” Encephalitis resembles?

A

“Spongiform” bubbles and holes in brain cortex; resembles degenerative disease

56
Q

Creutzfeldt-Jacob Disease Etiology? (3)

A
  1. Familial
  2. Sporadic
  3. Iatrogenic
57
Q

True or False

Creutzfeldt-Jacob Disease ( CFD) can decades to show symptoms?

A

True

58
Q

Creutzfeldt-Jacob Disease should be considered when a patient develops ___________ and _________?

A

rapid dementia

myoclonus

59
Q

S/S of Creutzfeldt-Jacob Disease include?

A

Initial symptoms are subtle and ambiguous: depression, confusion, personality and behavioral changes, strange physical sensations, and memory, coordination and visual problems. Language, sight, muscle weakness and coordination problems worsen.

60
Q

what test is 95% effective for diagnosing CFD?

A

14-3-3 protein spinal fluid test

61
Q

True or False

A pathologically benign tumor may be “clinically” malignant

A

True

62
Q

________ and _______ of tumor determines the clinical picture

A

location and size

63
Q

true or false

Brain tumors can spread via the CSF to produce carcinomatous meningitis

A

true

64
Q

With Brain Tumors, survival time is _____ in older persons with a prognosis of _______

A

shorter

poor

65
Q

what two groups are afflicted the most with Brain Tumors?

A

0-15 yo

adult 50-70 yo

66
Q

what are some theories of cause of brain tumors?

A 
Heredity
Familial incidence by toxic or infectious exposure
Petrochemicals, organic solvents, rubber
Electromagnetic field exposure
Ionizing radiation, high dose
67
Q

what is the Intra-cranial pressure triad?

A

headaches
nausea, vomiting
Papilledema ( optic disc edema)

68
Q

Cerebellar S/S include?

A

disorder of equilibrium, gait, coordination; ataxia

69
Q

Bitemporal hemianopia

A

Temporal ½ visual field loss in both eyes

70
Q

Common manifestations of brain tumor include

A

Intra-cranial pressure triad
Cerebellar S/S
Bitemporal hemianopia
Disorders of cognitive ability, speech, personality
Dysfunction of the long motor tracts: weakness, head tilt
Sensory disturbances: hypesthesia (decreased sensation)
Symptoms of increased ICP: seizures
Abnormal reflexes (ex.: + Babinski)

71
Q

Most primary brain tumors are ______ followed ______

A

Glioblastoma (50%)

Meningioma (17%)

72
Q

Secondary Neoplasms are ______ tumors usually from ______

A

metastatic

carcinomas

73
Q

secondary neoplasms originate from?

A 
lungs
breast
skin
kidney
GI tract
74
Q

Diagnosis of Neoplasms

A

Clinical S/S

Radiology + Computer Tomography + MRIs

Tissue Biopsy

Laboratory findings

75
Q

Medical/Surgical Management of neoplasm include?

A

Chemotherapy

Radiation

Surgery

Stereotactic Radiosurgery

Combination of all of the above

76
Q

What are common complications of a Brain Injury?

A

Raised Intracranial Pressure

Heterotopic Ossification

Decubiti

DVT

Autonomic Dysfunction

Infections and Pulmonary Problems

Amnesia

77
Q

normal intracranial pressure is?

A

up to 15 mmHg

78
Q

____-______ of patients with BI or SCI develop heterotropic ossification

A

5-20%

79
Q

what is heterotrophic ossification ?

A

formation of bone in abnormal anatomical locations

80
Q

S/S of heterotrophic ossification include?

A 
sudden loss of ROM
Swelling
local heat
Erythema
non-septic fever
81
Q

true or false

Vigorous stretching should be avoided with heterotrophic ossification

A

true

82
Q

what is retrograde amnesia?

A

partial or total loss of the ability to recall events that have occurred during the period immediately preceding BI

83
Q

postraumatic amnesia is?

A

the time lapse between the accident and the point at which the functions concerned with memory are restored

84
Q

anterograde amnesia is?

A

decreased attention or inaccurate perception; inability to develop ongoing short-term memory

85
Q

Levels of alertness are?

A 
comatose
stuporous
obtunded
lethargic 
alert
86
Q

what does comatose mean?

A

unconscious and unresponsive

87
Q

Stuporous means?

A

near unconscious with apparent mental inactivity and reduced ability to respond to stimulation

88
Q

obtunded is?

A

opens their eyes, responds slowly to questions, somewhat confused, decreased interest in the environment

89
Q

lethargic means?

A

dull, sluggish and appears half asleep

90
Q

Coma: what is the Rancho level?

A

1

91
Q

Coma: what is the level of arousal?

A

eyes do not open

92
Q

Coma: Awareness of Auditory and Visual Stimuli

A

No evidence of

93
Q

Coma: communication and emotion?

A

no evidence of

94
Q

Coma: Motor Response?

A

no purposeful movement

95
Q

Vegetative State: Rancho Level?

A

I or II

96
Q

Vegetative State: Level of arousal?

A

Eyes open spontaneously
Sleep-Wake cycle resumes
Arousal sluggish and poorly sustained

97
Q

Vegetative State: Awareness of Auditory and Visual Stimuli?

A

May move eyes to person or objects

May orient to sound (startle)

98
Q

Vegetative State: Communication and Emotion?

A

May moan make sounds

Cry or smile without apparent cause

99
Q

Vegetative State: Motor Response?

A

Withdrawals from noxious stimuli

Non-purposeful repetitive movement

100
Q

Minimally Conscious State: Rancho Level?

A

II or III

101
Q

Minimally Conscious State: Levels of Arousal?

A

Eyes open spontaneously
Normal to abnormal sleep-wake cycle
Arousal obtunded to normal

102
Q

Minimally Conscious State: Awareness of Auditory and Visual Stimuli?

A

Tracks objects

Localizes sound

103
Q

Minimally Conscious State: Communication and Emotion

A

Communication ability

Inconsistent (Yes/no, Gestures, Basic emotions)

104
Q

Minimally Conscious State: Motor Response?

A

Localizes noxious stimuli
Reaches for objects
Automatic behaviors (scratching)

105
Q

Confusional State: Rancho Level

A

IV, V, and VI

106
Q

Confusional State: Level of Arousal?

A

Fluctuation in level of responsiveness

may be excessively drowsy

107
Q

Confusional State: Awareness of Auditory and Visual Stimuli

A

Response to external stimuli may be accentuated

108
Q

Confusional State: Communication and Emotion?

A

Able to communicate but disoriented

Impaired attention and memory

109
Q

Confusional State: Motor Response

A

Purposeful motor responses

adult neuro test 3 (7 decks)

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