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cbis > Medical Complications and TBI > Flashcards

Medical Complications and TBI Flashcards

1
Q

obstructive / non communicating hydrocephalus

A

occurs when there is an obstruction of the CSF

can occur AFTER brain injury

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2
Q

hydrocephalus ex-vacuo

A

after brain injury, there is neuronal loss and shrinking of tissues which can cause enlarged ventricles (appearance) - this leads to “normal pressure hydrocelphalus”

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3
Q

types of hydrocephalus

A

obstructive or non communicating hydrocephalus

normal pressure hydrocephalus or hydrocephalus ex-vacuo

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4
Q

Treatment of hydrocephalus

A

shunt - placed from ventricles to abdominal
- promotes CSF flow
- overdrainage - headache and possible brain bleed
other risks - fever, neck pain, change in alertness

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5
Q

spasticity

A

motor disorder characterized by velocity dependent increase in tonic stretch

  • increased muscle tone, exaggerated tendon reflexes, and clonus
  • sudden flexing or extending of a limb which is not voluntary
  • can occur with minimal triggers like movement of limb or stretching
  • result of UMN damage
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6
Q

spasticity tx

A
  1. remove irritating factors that cause increased spasticity
  2. oral antispasmodics: baclofen, dantrolene, diazepam, tizanidine, monitor for SEDATING effects
  3. intrathecal baclofen (ITB) pump - implated reservoir that delivers baclofen to the spine - standard for severe spasticity - only considered at 1 year post
  4. neurotoxins - botox and phenol injections
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7
Q

spasticity management

A

treatment of spasticity should include therapy
PT, OT - address secondary complications such as skin breakdown and contractures and help with positioning

treatment should be multimodal - consider a combination of options to optimize recovery and reduce disability

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8
Q

heterotrophic ossification (HO)

A

formation of new bone around joints as a consequence of trauma/ immobility

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9
Q

Heterotrophic ossification identification

A

surface around the joint may be red / swollen and have increased pain, decreased range of motion, and / or spasticity
- lab studies and x-rays will detect HO

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10
Q

heterotrophic ossification intervention

A
  1. medications used might include Etidronate disodium or NSAIDS
  2. surgery may be required once abnormal bone has matured and maximal recovery has occurred
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11
Q

vascular thrombosis- DVT

A

DVT = deep vein thrombosis - occurs after a clot (thrombus) forms in one or more vein

  • usually legs
  • occurs from immobility
  • tx= prophylaxis of anti coagulant - heparin, lovenox, coumadin
  • without tx of prophylaxis a PE can occur - can damage breathing and cause death
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12
Q

cranial nerve dysfunction

A 
may cause: 
visual disturbances (acuity, diplopia, CN VI palsy) 
facial droop
postural instability
dysphagia
 autonomic dysregulation
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13
Q

somatosensory issues

A

deficits in proprioception, tactile sensation, thermal sensation, pressure sensation, pain

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14
Q

functional movement dysfunction

A

overall mobility - consider bed mobility, transfers, gait, balance

object manipulation - consider reaching, grab/release, object with 1 or both hands

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15
Q

interlimb coordination

A

coordination disorder caused by corpus callosum damage - motor impairments affect upper extremities and bimanual coordination
- can affect timing, sequencing, and force production

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16
Q

ataxia

A

coordination disorder caused by injury to cerebellum - motor impairment is characterized by lack of muscle coordination during voluntary movements
- may include trunk posture, facial muscles affecting swallow

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17
Q

athetoid

A

coordination disorder
slow, involuntary, convoluted hand and feet writhing movements
sometimes tongue, arm, neck

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18
Q

ballisms

A

coordination disorder

quick flailing movements

19
Q

choreiform

A

coordination disorder

continuous rapid and unpredictable movements

20
Q

tremors

A

coordination disorder

unintentional trembling or shaking movements in one or more parts of the body

21
Q

Visual Perception deficits

A

aka interpretation deficits

22
Q

visual acuity

A

clarity of vision (Snellen chart to test)

23
Q

eye movements

A

tracking, saccades, smooth pursuit, fixation

24
Q

visual fields

A

zone of vision, central vs. peripheral and quadrants

25
Q

binocular vision

A

left and right eye move together (conjugate)

26
Q

vergence

A

eyes semmetrically turn inward/ outward to adjust to object distance

27
Q

vestibular interactions

A

vestibular ocular reflex (VOR) to maintain gaze during head turning

28
Q

Sensation vs. perception

A

sensation = appreciation of stimuli through senses and peripheral cutaneous and internal receptors

perception = incorporates sensation and interprets information

29
Q

visual impairments

A 
visual field loss
decreased acuity
decreased contrast sensitivity
diplopia (double vision)
photophobia (light sensitivity)
30
Q

unilateral neglect

A

perceptual deficit

- not integrating stimuli from one side of body or environment

31
Q

anosognosia

A

lack of awareness or denial of paralysis or limb itself

32
Q

right/ left discrimination

A

cannot identify one’s own left and right

or distinguish with verbal commands

33
Q

somatognosia

A

lack of awareness of body structures and body part relationship

34
Q

spatial relation disorder:

form discrimination

A

challenges with objects if in different orientation or close in shape
(eg pen and toothbrush)

35
Q

spatial relations disorder

A

inability to perceive relationships between objects or between one’s self and object (e.g. difficulty crossing midline)

36
Q

spatial relation disorder:

vertical disorientation

A

difficulty maintaining upright position - noted in posture/ balance

37
Q

depth and distance perception disorder

A

inaccurately judging depth, distance, and direction

38
Q

figure ground discrimination disorder

A

cannot tell a figure from background

39
Q

visual object agnosia

A

cannot recognize objects visually

40
Q

auditory agnosia

A

inability to distinguist sounds unrelated to speech -

ex. doorbell vs. car alarm

41
Q

tactile agnosia

A

cannot recognize object with touch and manipulation

42
Q

ideomotor apraxia

A

inability to perform a task on command or imitate gestures

43
Q

ideational apraxia

A

inability to perform task automatically and on command

44
Q

buccofacial apraxia

A

limitations in performance of movements of the lips, cheeks, tongue, larynx, pharynx

cbis (30 decks)

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