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CBIS > Ch 6: Medical Complications > Flashcards

Ch 6: Medical Complications Flashcards

1
Q

How many people in the US are living with a long term disability as the result of brain injury?

A
  1. 2 to 5.3 million

1. 1 to 1.7% of the US population

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2
Q

What is the incidence of DVT in TBI?

A

54%

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3
Q

What are some musculoskeletal complications of TBI?

A

Spasticity
Hyperreflexia
Contractures
HO

Tx include:
Exercise, casting/orthotic techniques, ultrasounds/estim, meds, surgery/radiation

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4
Q

Dysphagia level 1

A

Mod-severe
Puréed diet
No bolus formation required

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5
Q

Dysphagia level 2

A

Mechanically altered
Mild to moderate and/or pharyngeal dysphagia

Moist, soft and easily form bolus

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6
Q

Dysphagia level 3

A

Dysphagia advanced
Mild
Includes most textures except hard, sticky, or crunchy foods
Requires chewing ability

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7
Q

How are UTIs sometimes detected in the early and late post injury phase?

A

Through early cognitive or behavioral changes. (Ie: increased agitation or decreased level of alertness)

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8
Q

In comparison to pre injury, how many calories should a person consume during the acute phase of TBI healing?

A

40% more calories

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9
Q

Diabetes insipidus

A

Occurs when too little vasopressin is produced and the person produces significantly more urine d/t increased thirst.

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10
Q

Syndrome of inappropriate anti diuretic hormone (SIADH)

A

Caused by changes to the hypothalamus or d/t certain medications

Blood sodium level is low and urine is not concentrated

Symptoms: nausea, vomiting, irritability, confusion, seizures, coma

**fluid restriction

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11
Q

Metabolic syndrome

A

Combination of medical disorders that increase the risk for both cardiovascular disease and diabetes.

Marked by abdominal obesity, insulin resistance, HTN, and dyslipidemia

Affects 40% of adults over 60

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12
Q

UTI and brain injury

A

60% experience UTI within the first 6 weeks after TBI

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13
Q

What percent of brain injury patients report sleep disorders?

A

30-70% of TBI patients

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14
Q

Post traumatic hypersomnia

A

Excessive sleepiness that occurs as a result of traumatic event involving CNS; daytime sleepiness; cognitive and physical fatigue

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15
Q

Cataplexy

A

Sudden loss of bilateral muscle tone; collapsing affect

Consciousness, memory, and respiration intact

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16
Q

Insomnia

A

Treatment includes:

Lifestyle changes, exercise, reg sleep schedule, avoiding naps, limiting fluid before bed, and decreasing caffeine

17
Q

What is the reported occurrence of post traumatic seizures?

A

4-53%

3 different categories of seizures
Immediate post traumatic convulsions (IPTC)
Early post traumatic seizures (EPTS)
Late post traumatic seizures (LPTS)

18
Q

Immediate post traumatic convulsions (IPTC)

A

+LOC and involuntary movement within seconds of impact

Non epileptic events; convulsive syncope

Brief period of tonic positioning followed by clonic or myoclonic jerks of less than 2-3 min

Altered state of consciousness with associated retrograde and anterograde amnesia

Loss of cerebral brain function d/t reflex brainstem activation

19
Q

Early post traumatic seizures (EPTS)

A

Occur within 1st week (up to 7 days) following brain injury

Result from primary direct effects of trauma

Incidence report: 2-10% and can occur in mTBI

50% occur within 24hrs of impact; 25% 1st hr

Strong risk factor for LPTS

20
Q

Status epilepticus

A

> 30min of continuous seizure activity or two or more consecutive seizures without full recovery of consciousness between seizures

Occurs in 10% of individuals after acute head injury and has a high mortality rate even with mTBI

Early to to prevent secondary damage d/t increased metabolic demands, elevations in ICP, and other seizure induced stressors

Common in children

21
Q

Late post traumatic seizures (LPTS)

A

Occur later than 1 week post injury , but usually within the first 18-24 months (has been reported later)

Incidence: 1.9-50%

Interchangeable with post traumatic epilepsy as the occurrence of one seizure likely Leeds to more (seizures reoccur in 86% of pts with moderate brain injuries within a 2 year follow up

Common in 65+

22
Q

Post traumatic headache (PTH)

A

Starts within 14 days of LOC

More prevalent in mTBI (95%) in comparison to 22% of mod-severe reporting pain

23
Q

Most common type of headache reported by all TBI pts?

A

Migraine

24
Q

Peripheral nocioception

A

Peripheral receptors in the head and neck which are very sensitive to pain

Located on the ends of nerves that initiate near the spinal cord and communicate back to pain centers in the brain

CN 5 trigeminal, CN 9 glossopharyngeal, CN 10 vagus nerve, greater occipital nerve, lesser occipital nerve

25
Q

Primary headache

A

No specific cause

26
Q

Secondary headache

A

Identifiable cause that can be determined

27
Q

Chronic headache

A

Occurs at least 15 days per month for at least 3 months

28
Q

Tension type headache

A

Most common form of primary headache

Presents with bilateral pressing head pain

Do not worsen with activity

Prevalence: 38% (chronic TTH= 2.2%)

Occur after strained muscle in neck or head; swelling creates noxious stimuli

29
Q

Migraine headache

A

Affect one side of the head, are throbbing, and worsen with physical activity

+sensitivities

30
Q

Cervicogenic headache

A

Pain generated from the Cspine

31
Q

Craniomandibular headache

A

Subtype of tension headache that causes pain in jaw with eating and talking

32
Q

Post traumatic migraine (PTM)

A

Emerging concept within the study of TBI.

Nearly 1/3 of soldiers returning from deployment who sustained a concussion met criteria for PTH, and of these, most (58%) were considered PTM

33
Q

Which cranial nerve plays a role in the pathophysiology of headaches?

A

CN5 trigeminal

34
Q

What are the 4 phases of migraine?

A

Prodrome
Aura
Headache
Postdrome

35
Q

Having low sodium levels is a risk for _______.

A

Seizures

36
Q

What percent of CSF reduction can lead to headaches?

A

10%

37
Q

Neuralgia

A

Type of pain that is caused by damage or change to a nerve

38
Q

Neuroma

A

Nerve becomes entrapped in scar tissue

39
Q

C-O-L-D-E-R Acronym

A

Character: throbbing, sharp, dull etc & severity

Onset: does anything set off the headache? Prior hx of headaches, migraines, neck pain, or other related pain involving the head

Location: one side of the head, or both? Front or back? Start in neck? Shooting or radiating?

Duration/freq: when did it start and how often?

Exacerbation: anything that makes it worse?

Relief: does anything help to relieve/resolve the headache?

CBIS (25 decks)

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