EXAM 3 TBI Flashcards
Primary Damage
- happens right when the injury occurs.
- caused by sudden movements, like when the head moves quickly back and forth or spins, which can affect the brain.
Secondary Damage
- don’t show up right away. Can appear either right after the injury or days later
- Pressure building up in brain
- Brain tissue shifting or getting squished
- Blood flow getting blocked
- Brain swelling
- Bleeding in the brain
- Other issues like seizures, infections, or pain.
Childhood TBI Physical and Sensory symptoms
Auditory: Trouble hearing in noise, dizziness, hypersensitivity, tinnitus, hearing loss, vertigo
Visual: Double vision, sensitivity to light, perception changes of color/shape/distance
Other Sensory: Loss of taste/smell, touch sensitivity, swallowing issues
Physical: Dizziness, headaches, balance issues, muscle weakness
Childhood TBI Cognition and behavior
Attention & Memory: Trouble with focus, memory, and learning
Executive Functioning: Slow processing, confusion, orientation issues, spatial problems
Metacognition: Lack of insight into strengths/weaknesses, unaware of deficits
Behavioral & Emotional: Agitation, anxiety, apathy, mood swings, sleep issues, depression, impulsivity, irritability, emotional sensitivity
Childhood TBI Communication
Pragmatic/Social Communication: Verbosity, trouble starting or maintaining conversations, Difficulty taking turns or using nonverbal cues
Spoken Language: Word retrieval issues, disorganized speech, Struggles with following directions and making inferences, Apraxia/Dysarthria and voice changes
Cognitive-linguistic deficits TBI
- Orientation
- Attention
- Memory
- Executive Functioning
- Processing Speed
- Self-Awareness and Theory of Mind
- Cognitive-Communication Skills
- Pragmatics
- Swallowing Function
- Motor Speech
- Language
- Hearing
- Vision
TBI
Acquired injury to the brain due to and applied force that results in widespread damage to cortical and subcortical structures
risk factors
Heart disease
High blood pressure
Mental illness
Substance abuse
Previous head injury
Homeless
Have a low socio-economic status
etiologies
Blows to the head
Falls
Motor Vehicle Accidents
Gunshot wounds
Hypoxia
Anoxia
Abusive Head Trauma
Blast Injury
Whiplash
Mild TBI
May or may not lose consciousness; loss of consciousness for less than 30 minutes, an initial Glasgow Coma Scale (GCS) or Pediatric GCS of 13-15 after 30 minutes of injury onset
Moderate TBI
Loss of consciousness and/or PTA for 1-24 hours but less than 7 days, and a GCS of 9-12
Severe TBI
Loss of consciousness for more than 24 hours and PTA for more than 7 days with a GCS of 3-8
Roles of SLP in TBI
Coma Stimulation: help with emergence from coma
Assessment: Identify when its appropriate to assess
Education: Educate family on patient’s level
Orientation Deficits in TBI
Orientation of person, place, time, and situation can be evaluated daily or multiple times daily.
Orientation to person and situation is likely to return last, and deficits may persist well into injury recovery
Attention Deficits in TBI
Impacts all areas of attention: Focused, selective, sustained, alternating, and divided attention.
Lack of attentional flexibility and poor working memory.
Attention deficits in people with TBI are likely to interfere with recovery
Memory Deficits in TBI
Most individuals with TBI have difficulty with storing and retrieving declarative(i.e., factual) information as opposed to non-declarative (i.e., procedural)information
Executive Functioning Deficits in TBI
Two general categories of executive functioning impairments in individuals with TBI:
Initiation impairments
Inhibition impairment
Awareness of Deficits in TBI
Mild: Mildly acknowledge disability but feel indifferent
Moderate: Acknowledge, but underestimate the severity or minimize the effects
Severe: Deny the existence of major disabilities, Claim to perform activities clearly beyond abilities
Psycho-Social-Behavioral issues
Poor emotional regulation, poor tolerance, agitation, lability, impulsive aggression , compulsivity, lack of empathy, poor judgment and decision making, etc.
Navigating these issues greatly impact the patient’s independence and ability to work, go to school, manage their everyday life, etc.
Cognitive Communication Impairments in TBI
Impaired comprehension of language, difficulty with abstract and indirect language, making inferences, figurative language, etc.
Pediatric TBI
- Potential for better physiological recovery and neuroplasticity
- however, long term effects on quality of life can be more severe due to the impact in development
Functional domains affected are similar to those for adult TBI
- because these are still in the process of development some children may not present with immediate effects of TBI, but will experience challenges later in their development, particularly as academic demands increase
