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Neuro II > Exam 3: TBI - Part 1 > Flashcards

Exam 3: TBI - Part 1 Flashcards

1
Q

True or False:

Over half of people that sustain a TBI, die soon after

A

False. 2.5 million have them per year and only 50,000 die.

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2
Q

True or False:

Less than half of those who end up hospitalized after sustaining a TBI, will have permanent disabilities

A

True. 300,000 are hospitalized and 80-90K will have permanent disabilities

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3
Q

TBI are a leading cause of death in children, teen and young adult. How does the TBI happen in this population

A

child abuse or car collisions

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4
Q

How does the elderly typically sustain a TBI

A

falls

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5
Q

True or False:

Females sustain more TBI than men

A

false, men have more

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6
Q

What are the four types of MOI in TBI

A

Fractures
Direct blow without fracture
Penetrating
Loss of blood supply from neck injury.

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7
Q

What is another name for a fracture TBI

A

open head injury (OHI)

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8
Q

What are other terms for a TBI

A 
Head Injury (HI)
Closed head injury (CHI)
Brain injury (BI)
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9
Q

A (open/closed) fracture leads the injury to be susceptible to infection or rupture of blood vessels leading to hematoma

A

open

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10
Q

True or False:

The majority of those who die from a TBI have a fx

A

True, 80% die from fx

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11
Q

What are the two types of penetrating TBI

A

high velocity and low velocity

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12
Q

Describe the characteristics of a high velocity TBI

A

Tends to produce a peripheration or a depression fx with a diffuse axonal damagewidespread damage

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13
Q

A depression fx is a type of (low/high) velocity TBI

A

high

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14
Q

Describe the characteristics of a low velocity TBI

A

Tends to produce a linear fx with a contusion at the site of impact and maybe some tearing of the blood vessels

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15
Q

A linear fx is a type of (low/high) velocity TBI

A

low

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16
Q

True or False:

A direct blow is also called a CHI

A

true

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17
Q

Can a direct blow/CHI have devastating effects? Why or why not?

A

Yes, it can because of the devasting primary and secondary effects

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18
Q

What term is used to describe a loss blood that equals a loss of oxygen

A

anoxia

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19
Q

What is anoxia

A

A loss of blood that equals a loss of oxygen

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20
Q

What are the two types of primary damage in TBI

A

Focal injury and diffuse injury

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21
Q

(focal/diffuse axonal) injury occurs when the exact area that was impacted is damaged

A

focal

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22
Q

(focal/diffuse axonal) injury can be associated with a fx or CHI of any severity

A

focal

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23
Q

(focal/diffuse axonal) injury involves acceleration, deceleration, and/or rotation components

A

diffuse

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24
Q

(focal/diffuse axonal) injury has a widespread or sloshing effect that tears multiple neurons and tissues

A

diffuse

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25
Q

(focal/diffuse axonal) injury involves tissue that is contused by bony surfaces and folds in the brain

A

diffuse

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26
Q

True or False:

The more severe a focal injury is, the more likely neurological signs will be present

A

True

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27
Q

If a patient has a focal TBI to the front of the head, what might be impacted

A

decision making and behavior

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28
Q

If a patient has a focal TBI to the back of the head, what might be impacted

A

Eye sight

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29
Q

True or False:

A diffuse axonal TBI can always be diagnosed with imaging

A

False, it may not show signs initially, but will become more severe as edema prevails

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30
Q

(focal/diffuse axonal) injury can involve posturing as a part of the damage

A

diffue

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31
Q

True or False:

A scan may not pick up on tears of a diffuse axonal TBI

A

true

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32
Q

What is the term that relates to damage not directly related to the event of the trauma, but deficits that could result second to the injury

A

secondary damage

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33
Q

Is this a primary or secondary damage of a TBI

Increased intracranial pressure

A

secondary

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34
Q

What could cause an increase of intracranial pressure after a TBI

A

herniation and hematomas

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35
Q

Where are the three places that a hematoma could occur due to a TBI

A

epidural, subdural, and intracerebral

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36
Q

The higher the intracranial pressure, the (better/poorer) the outcome of a TBI

A

poorer

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37
Q

Is this a primary or secondary damage of a TBI

Hypoxic-ischemic damage

A

secondary

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38
Q

What is the prognosis like for someone with hypoxic damage

A

Poor for mental and physical outcomes

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39
Q

Is this a primary or secondary damage of a TBI

infections

A

second

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40
Q

Is this a primary or secondary damage of a TBI

Seizures

A

second

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41
Q

Is this a primary or secondary damage of a TBI

Electrolyte imbalance and acid base imbalance

A

second

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42
Q

If they occur, when do seizures happen in TBI

A

can occur right away so a patient will be put on meds so that a seizure doesn’t cause extra damage

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43
Q

A TBI patient is at risk for developing epilepsy. When will this occur

A

onset to 2 years post TBI

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44
Q

Why is having an electrolyte or acid-base imbalance a problem in TBI

A

The cells will swell and burst, so this is more common in diffuse axonal injuries

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45
Q

Who performs a neurological exam on a TBI patient

A

Whoever is in charge of the main rehab

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46
Q

Why is neuropsychological testing done in patients with TBI

A

to screen cognitive or behavior deficits

47
Q

Why is an xray used in diagnosing a TBI

A

to dx a fx

48
Q

Why is an EEG used in diagnosing a TBI

A

used when patients are nonresponsive to determine the amount of brain activity

49
Q

Why is a CT scan used in diagnosing a TBI

A

Used in the ER or for a mass lesion or acute stage

50
Q

Is and CT scan or MRI better to dx a TBI

A

MRIs are more sensitive than CT scans, but they may not show signs early on

51
Q

Why is a PET used in diagnosing a TBI

A

It shows disturbances in cerebral metabolism

52
Q

Why is a fMRI used in diagnosing a TBI

A

Used for functional dynamics and overall neuroplasticity

53
Q

What are the top three most common diagnostic tools for a TBI

A

Xray, EEG, and CT scan

54
Q

What are the 8 primary general typical deficits following a TBI

A 
Autonomic nervous system dysfunction
Neuromuscular 
Cognitive
Visual
Perceptual
Behavioral 
Communication 
Dysphagia
55
Q

What are the 6 autonomic nervous system deficits that can occur following a TBI

A 
Changes in pulse/RR
Temp elevations
Blood pressure changes
Excessive sweating, salivation, and tearing
Dilated pupils
Vomiting
56
Q

What are the neuromuscular deficits that can occur following a TBI

A 
Sensory impairments
Abnormal tone
Rigidity/posturing
Motor control issues
Balance
Bowel/bladder
CN involvement/pediatric reflex return
Locked in syndrome
57
Q

True or False:

TBI patients will present abnormal tone in a full spectrum. Could be high tone, normal, or low tone.

58
Q

What are the two types of posturing that can occur following a TBI

A

decorticate and decerebrate

59
Q

Under which general category of primary effects does rigidity and posturing fall under

A

Neuromuscular

60
Q

True or False:

Severe TBI will more than likely have neuromuscular problems

61
Q

Describe the decorticate posturing

A

LE in extension

UE in flexion

62
Q

Describe the decerebrate posturing

A

Rigidity with all extremities in an extension posture

63
Q

In both decorticate and decerebrate posturing, the extremities will _____ each other

64
Q

Locked in syndrome falls under which general primary effect following a TBI

A

neuromuscular

65
Q

What are the 8 cognitive deficits that can occur following a TBI

A 
Coma/altered state of consciousness
Memory loss/PTA
Altered orientation x 4
Attentional deficits 
Impaired insight/safety
Problem solving/reasoning
Perseveration
Impaired executive control (self control)
66
Q

Are cognitive deficits more or less common in TBI patients than they are in CVA patients

A

more cognitive deficits in TBI

67
Q

If a patient has PTA, they might also show signs of confabulation. What is this?

A

When the brain fills in the gaps with false information but they think its the truth.

68
Q

True or False:

Impaired memory in a TBI patient can be task related and only effect certain things

69
Q

What does altered orientation x 4 mean

A

4 meaning person, place, time and situation

70
Q

Explain why impaired insight falls under cognitive primary effects

A

because it involves understanding within yourself

71
Q

What is perseveration

A

When a patient is hyper-focused on one thing and can’t get past whatever it is because the brain won’t allow them too.

72
Q

What are the two visual impairments that can occur following a TBI

A

Cortical blindness

Hemianopsia

73
Q

What visual impairment will occur is there is a complete lesion of the right optic nerve

A

total blindness of the right eye

74
Q

What visual impairment will occur is there is a complete lesion of the left optic nerve

A

total blindness of the left eye

75
Q

What visual impairment will result due to a lesion in the midline chiasmal

A

bipolar hemianopsia

76
Q

What visual impairment will occur due to a lesion or pressure on the right optic tract or right occipital lobe

A

left homonymous hemianopsia

77
Q

What are the perceptual impairments seen following a TBI

A

Body scheme and body image disorders
Apraxia
Agnosias
Spatial relations disorders

78
Q

What is anosognosia

A

The patient does not perceive or is unaware of their own mental health condition

79
Q

What is somatoagnosia

A

The patient doesn’t understand what their body is

80
Q

What is finger agnosia

A

The inability to name, move, or touch specific fingers when asked to

81
Q

What is figure ground discrimination

A

unable to distinguish background from foreground; everything blends together

82
Q

What is form discrimination

A

Using once senses, like vision and touch, to judge/identify the shape, size, and texture of an object

83
Q

What is topographic disorientation

A

The patient gets disoriented or lost easily. Doesn’t have a sense of direction

84
Q

What does body scheme relate to

A

The orientation of the body in relationship to the environment

85
Q

What does body image relate to

A

How you feel about your looks/body style

86
Q

What are the 8 behavioral impairments that can occur following a TBI

A 
Disinhibition
Impulsiveness
Physical and verbal aggression
Apathy
Lability/mood swings
Sexual inappropriateness 
Irritability 
Egocentricity
87
Q

What is disinhibition

A

Basically having no filter

88
Q

True or False:

How a person acted prior to a TBI is a good indicator of the behavioral changes that might occur

A

False, there is no correlation or way to predict

89
Q

If a patient following a TBI completely changes their behavior, it is important to help _____ understand that it is not voluntary behavior

A

The family

90
Q

What is the impairment of dysphagia that could occur

A

swallowing impairments

91
Q

What are the communication impairments that might occur following a TBI

A 
Receptive/expressive aphasia
Dysarthria 
Auditory deficits 
Impaired reading comprehension 
Impaired written expression
Impaired pragmatics
92
Q

How could receptive and expressive aphasia be described as

A

A language processing deficit or motor problem

93
Q

Is this a primary or secondary impairment

Contracture

94
Q

Is this a primary or secondary impairment

Skin breakdown

95
Q

Is this a primary or secondary impairment

DVT

96
Q

Is this a primary or secondary impairment

Heterotopic ossifications

97
Q

Is this a primary or secondary impairment

Decreased bone density

98
Q

Is this a primary or secondary impairment

Muscle atrophy

99
Q

Is this a primary or secondary impairment

Decreased endurance/deconditioned

100
Q

Is this a primary or secondary impairment

Muscle atrophy

101
Q

Is this a primary or secondary impairment

Infection/Pneumonia

102
Q

Is this a primary or secondary impairment

Dysarthria

103
Q

Is this a primary or secondary impairment

Lability

104
Q

Is this a primary or secondary impairment

Disinhibition

105
Q

Is this a primary or secondary impairment

Apraxia

106
Q

Is this a primary or secondary impairment

Vertical disorientation

107
Q

Is this a primary or secondary impairment

Memory loss

108
Q

Is this a primary or secondary impairment

Attentional deficits

109
Q

Is this a primary or secondary impairment

Paresis

110
Q

Is this a primary or secondary impairment

Sensory impairments

111
Q

Is this a primary or secondary impairment

Dilated pupils

112
Q

Is this a primary or secondary impairment

Vomiting

113
Q

Is this a primary or secondary impairment

BP/RR and temp changes

Neuro II (3 decks)

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