Managment of Disorders of Consiousness I-III

Question 1

Acquired Brain Injury

Answer 1

-injury after birth, not birth related

Question 2

Traumatic Brain Injury

Answer 2

-insult to brain by external force

Question 3

Disordered Consiousness Rancho Scales

Answer 3

I-III
No Response
Generalized Response
Localized Response

Question 4

Disorders of Consiousness

Answer 4

-collective term describing conditions where consiousness or arousal have been affected by brain damange

Question 5

Coma

Answer 5

complete paralysis of cerebral funnction or state of unresponsiveness
-no arousal or alertness

Question 6

Vegetative State

Answer 6

-unresponsive wakefullness syndrome
-wakeful, reduced responsiveness with no cerebral cortical function
-eyes open, sleep/wake cycles
-high arousal, no alertness

Question 7

Minimally Consious State

Answer 7

-consiousness severely altered but signs of demonstrating self of environmental awareness
-eyes open, sleep/wake cycles, visual tracking, some emtion, command following
-high arousal, low alertness

Question 8

Emergence from Minimally Consious State

Answer 8

-awake most of the time but confused
-functional object use
-functitonal accurate communication

Question 9

Sympathetic Storming

Answer 9

-autonomic instabiltiy following TBI

S/s: agitation, sweating, HTN, tachy everyting, pupillary dilation, posturing

Goal: decrease BP and HR

Question 10

PT Examination Tests and Measures: Body Functions

Answer 10

-arousal/consiousness
-congition/communication
-responses
-vitals
-CNs
-tone/ROM/muscles/reflexes
-GCS, RANCHO, JFK, MAS

Question 11

PT Examination Tests and Measures: Activity and Participation

Answer 11

Activity:
-movement analysis
-Transfers
-balance
-gait
-FIM/FAM

Participation:
-jobs
-hobbies
-sports
-Disibility Rating Scale (DRS)

Question 12

Treatment Considerations

Answer 12

-activate Reticular Activatitng system (sit them up)
-earky mobilization
-sensory stitmulation
-proper positioning
-reduce complications: PI, contractures
-education
-collaboration with team

Question 13

Upright Positioning

Answer 13

-improves behvaioral responses for those in PVS

Pros:
-stretch
-Weight bearing
-head control
-circulatiton
-RAS

Cons:
-orth hypo
-fall risk\
-impulsiveness

Question 14

Organized Sensory Stimulation

Answer 14

-apllication of stimulation to one or more Pt senses to increase responsiveness

Auditory
Tactile
Visual: pictures, objects, family, light
Olfactory: perfume, citrus, coffee
Gustatory: oral swabs, lolipops, oral hygiene
Kinesthetic: change of positions, weight bearing, PROM
Vestibular: head turns, rolling

Question 15

Family Education

Answer 15

-room calm and quiet
-short and simple commands
-2-3 visitors
-allow time to respond
-orient the Pt
-bring pictures
-instruct ROM exercises/devices/transfers