Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

neuromuscular II > final exam mild TBI > Flashcards

final exam mild TBI Flashcards

1
Q

do you need to have a bleed or positive imaging to have a severe or moderate TBI?

A

no!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

traumatic injury that affects the brain induced by biomechanical forces transmitted to the head by a direct blow to or forces exerted on the body but that does not result in an extended period of unconsciousness, amnesia, or other significant neurological signs indicative of a more severe brain injury

A

concussion aka mild TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a combination of what 5 things differentiates the state of a TBI?

A

LOC
AOC
GCS
imaging
PTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

mild, moderate or severe TBI?
- LOC: 0-30 minutes
- AOC: brief-24 hours
- PTA: 0-1 day
- GCS: 13-15
- neuroimaging: normal

A

mild TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mild, moderate or severe TBI?
- LOC: >30 minutes and < 24 hours
- AOC: > 24 hours
- PTA: > 1 and < 7 days
- GCS: 9-12
- neuroimaging: normal or abnormal

A

moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 3 major categories on the Glasgow Coma Scale?

A

eye opening
best motor response
verbal response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which Rancho level?
No response. deep sleep, unresponsive

A

I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which Rancho level?
Generalize response. inconsistent, non-purposeful response to stimuli

A

II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which Rancho level?
localized response. inconsistent localized response to a stimulus

A

III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which settings will you most likely see Rancho levels I-III?

A

ICU and LTACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which Rancho level?
Heightened state of activity, non-purposeful, confused, hard to learn

A

IV: confused agitated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which Rancho level?
can follow simple commands inconsistently, minimal attention, inappropriate verbalizations

A

V: confused inappropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which Rancho level?
can show goal directed behavior, but need external cuing, follows simple directions consistently, some learning

A

VI: confused appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which levels are more related to mild TBI stages?

A

Rancho VII: automatic appropriate - can get through daily activities, but robotically and needs routine
VIII: purposeful appropriate - responsive to environment, has carryover for new learning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is post-traumatic amnesia (PTA)?
- what do you measure it with?

A

duration of memory loss post injury
measured with: O Log and Galvaston orientation and amnesia test (GOAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what’s the most likely reason an older person would be hospitalized from a TBI?

A

falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the two main mechanism of injury for mTBI?

A
  1. blow to head –> direct trauma
  2. forces exerted on the body –> pressure, movement of the brain inside a closed system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

can you get a concussion without hitting your head?

A

yes
Coup/contrecoup forces (acceleration/deceleration)
example: whiplash
injury to cells or structure itself. sagittal, frontal, rotational, angular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the 5 subtypes of concussion?

A

anxiety/mood
cognitive
migraine -> headache is the first highest symptom
ocular
vestibular –> dizziness is 2nd highest symptom

20
Q

what are 2 other under represented subtypes?

A

cervical
sleep disturbances

21
Q

is concussion an isolated problem or is it electrical and metabolic problems too?

A

electrical and metabolic
can affect multiple systems

22
Q

depolarization leads to:

A

glutamate influx
increased Na and Ca2+
decreased potassium (K+)
decreased cerebral blood flow –> this impacts the function of mitochondria

23
Q

decreased cerebral blood flow leads to:

A

energy crisis
decreased ability to produce ATP –> we need to bring more O2 to the area

24
Q

there is decreased ATP due to (3)

A

lack of glucose
decreased mitochondria function
decreased cerebral blood flow and oxygen

25
Q

if the force was applied in the sagittal plane, what structures are involved?

A

frontal lobe - functional execution
occipital lobe - vision
brainstem area - CN involvement

26
Q

if the force was applied in the frontal plane, what structures are involved?

A

temporal parietal lobe - strength, sensation, speech

27
Q

TRUE OR FALSE. sheer forces and rotational injuries would not happen with mild TBI?

A

false - both can also be involved

28
Q

it takes ____ days to recover from metabolic cascade.
___% resolved in 1 week
symptom resolution for collegiate athletes is ____ days. why?

A

7-10 days
60%
28 days - have higher return to function

29
Q

if symptoms do not resolve in 1-3 months what could be the case?

A

PCS - post concussion syndrome

30
Q

diagnosis for PCS:
cognitive deficits in attention and memory AND at least 3 of the following symptoms:

A

fatigue
sleep disturbance
dizziness
irritability
affective disturbance
apathy or personality changes that persist 3+ months

31
Q

what three things do you need to make sure to ask in your subjective history for mTBI?

A

mechanism of injury
baseline levels (any history of concussion)
questions surrounding subtypes

32
Q

in order to conduct a more efficient screening of mTBI, what is one thing you should work to identify?

A

the subtype of concussion

33
Q

what are the 4 major categories to eval concussion per the CPG?

A

cervical/MSK
vestibular/oculomotor
autonomic/exertional tolerance
motor function: balance and gait

34
Q

vestibular/oculomotor exam should include:

A

ocular alignment
smooth pursuits
saccades
vergence and accommodation
gaze stability
dynamic visual acuity
visual motion sensitivity
vertigo caused by BPPV
light-headedness due to orthostatic hypotension

35
Q

balance/gait exam should include:

A

static and dynamic balance
motor coordination and control
dual/multitasking tests

36
Q

what are 4 outcome measures specific to concussion

A

SCAT 6 (sports concussion assessment tool)
HiMAT (high level mobility assessment tool)
BCTT (buffalo concussion treadmill test)
BESS (balance error scoring system)

37
Q

how should you base your interventions for concussion?

A

specific to subtype and individual
CPG
within symptom tolerance –> you CAN push them too hard & make them worse

38
Q

which subtype is there best evidence for?

A

vestibular-ocular subtype
consider head turns with vestibular rehab –> slow these down to 1Hz due to MOI

39
Q

what are things you need to educate your patient on post-concussion?

A

self management of symptoms
importance of relative rest
importance of sleep
gradual progressive return to activities with pacing strategies
signs and symptoms that warrant further follow up care
POC and expected time to recovery

40
Q

what are two things PTs need to factor in when making interventions for concussion?

A

irritability of patient
Self-management ability of the patient

41
Q

in the past, we were told not to sleep after a concussion. why?
what are we told is best now?

A

past: don’t sleep bc we are worried about brain bleeds
now: relative rest, NOT strict rest. strict rest prolongs recovery

42
Q

what is stimulation schedules? why is this found to be the best now?

A

scheduled times with decreased stimulation (can sleep, don’t have to) followed by times with stimulation (light activity)

we still need sleep, just not all day and don’t stay up all night

43
Q

what are return to sport protocol rules?

A

must have full 24 hours between each stage –> this is why it often takes ~ 1 week to return post-concussion
must be completely symptom free to move to next stage
need physician approval to initiate protocol, initiate full contact, & return to competition

44
Q

what are the 6 stages that must be met to return to sport?

A
  1. back to regular activity
    - recovery
  2. back to light aerobic activity
    - increase heart rate
  3. moderate activity
    - add movement
  4. heavy, non-contact activity
    - exercise, coordination, cognitive load
  5. practice and full contact
    - restore confidence and assess functional skills by coaching staff
  6. competition
45
Q

who is part of the healthcare team with concussion?

A

PT
SLP
OT
Athletic trainer
Physician
Neuropsychologist

46
Q

what settings will concussion show up in?

A

sports –> on field
military
outpatient (ortho, neuro, geriatrics, peds, sports)
ED
acute care
acute rehab (secondary injuries most likely)

neuromuscular II (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions