CH 1 Brain Injury Overview

Question 1

What is acquired brain injury (ABI)?

Answer 1

occurs after birth and includes injury caused by external physical forces and internal insults to the brain
can be traumatic, traumatic inertial or non traumatic

Question 2

How does TBI differ from ABI?

Answer 2

TBI is a type of ABI, TBI is due to contact or non contact injury specifically

Question 3

What are 4 causes of ABI?

Answer 3

1. Traumatic Impact Closed
2. Traumatic Impact Open
3. Traumatic Inertial
4. Non-traumatic

Question 4

What happens in a coup-contrecoup injury?

Answer 4

Brain contact inside of skull and then bouncing back to hit on other side of skull resulting in focal injuries on both sides (brain moving in skull)

Question 5

Why is brain injury called a silent epidemic?

Answer 5

-underreporting
-fewer ppl are aware of cognitive changes
-fewer seek medical tx
-decreased access to rehab

Question 6

What is most common cause of BI according to CDC?

Answer 6

Stroke

Question 7

ABI is the second most prevalent disability in US affecting how many?

Answer 7

13.5 million

Question 8

What are primary injuries?

Answer 8

initial mechanism or etiology

Question 9

What are secondary injuries?

Answer 9

Pathophysiological response or delayed non-mechanical response to primary injury

Question 10

List 4 secondary injuries

Answer 10

-hydrocephalus
-edema
-hypoxia
-metabolic abnormalities

Question 11

LOC varies according to injury severity; list severities and durations

Answer 11

Mild-brief or no LOC
Moderate- any LOC up to 24 hours
Severe-24 hours or greater

Question 12

Which BI severity levels may show neurological signs such as fractures and bleeding?

Answer 12

moderate and severe

Question 13

What are 5 risk factors for brain injury?

Answer 13

-age
-alcohol
-domestic violence
-military action
-prisoner/inmate

Question 14

What age group has the highest rate of death from brain injury?

Answer 14

75 years+

Question 15

What age groups have highest rate of TBI due to falls?

Answer 15

0-4 and 75+

Question 16

Describe the TBI continuum of care

Answer 16

acute, post acute and long term
non-linear

Question 17

Why is progression along continuum of care non-linear?

Answer 17

dependent upon medical complexity, practitioner expertise, severity and type of injury, funding, referral patterns/biases

Question 18

Who establishes standards for rehab facilities?

Answer 18

Jco and CARP

Question 19

List 3 types of compliance requirements

Answer 19

-infection control
-patient rights
-staff qualifications/competencies

Question 20

How has the Olmstead Decision changed service delivery for ppl with disabilities?

Answer 20

It created several federal and state level initiatives to make living in community a reality. Increased community services, greater integration

Question 21

What agency funds TBIMS?

Answer 21

US Dept. of Health and Human Services’ Administration for Community Living’s National Institute on Disability, Independent Living and Rehab Research (NIDILRR)

Question 22

What is meant by disease-causative and disease-accelerative?

Answer 22

It is a chronic, progressive disease that isn’t always cured. It can impact multiple organs systems

Question 23

How does TBI affect life expectancy?

Answer 23

Decreased by 7 years, individuals with TBI are 1.5x more likely to die compared to non-injured

Question 24

List 4 ways ppl with BIs are at increased risk for illness/death due to multiple conditions

Answer 24

Aspiration PNA, seizures, PNA, suicide, digestive d/o

Question 25

Name 2 neurological conditions associated with BI

Answer 25

Epilepsy and Alzheimer’s Disease (also CTE)

Question 26

List 3 neuroendocrine disorders associated with BI

Answer 26

-growth hormone deficiency
-low thyroid fx
-gonadotropinin deficiency