Medical & Physical Issues

Question 1

Primitive, involuntary responsiveness to the world; demonstrated by a reflex (generalized) responses to both internal & external stimuli

Answer 1

Arousal

Question 2

An individuals ability to receive & process sensory info & use that info to relate in an intentional way to the outside world; this is required for voluntary responses to stimuli & regulated by the higher cortical areas in the cerebrum

Answer 2

Awareness

Question 3

no behavioral evidence of arousal & demonstrates no voluntary response to internal or external stimuli; no vocalizations > 1 hour; impaired spontaneous breathing.

Answer 3

Coma

Question 4

usually resolves in 2-4 weeks /c the person dying or progressing into vegetative or MCS

Answer 4

Coma

Question 5

characterized by the complete absence of behavioral evidence for awareness of self or environment /c preserved capacity for spontaneous or stimulus-induced arousal; responses are generalized & non specific & not purposeful. may grimace to pain, localize sounds inconsistently.

Answer 5

Vegetative state

Question 6

may perisist for months to years /c no measurable improvement in the persons neurobehavioral presentation.

Answer 6

Vegetative State

Question 7

intermittent or inconsistent behavioral reactions that demonstrate conscious awareness, such as responses to simple verbal directives, discernible verbal or gestural responses to yes/no questions or intelligible vocalization

Answer 7

Minimally Conscious State (MCS)

Question 8

Emergence from DOC

Answer 8

1. Functional Communication as evidenced by verbal or gestural yes/no response
2. Functional use of 2 or more objects (hairbrush/cup)

Question 9

Lack of signals from the brain to the muscles controlling breathing

Answer 9

Central Apnea

Question 10

Abnormal hormone response producing a marked increase in energy demands

Answer 10

Metabolic Distress

Question 11

Involuntary muscle contraction causing slow, repetitive movements or abnormal postures

Answer 11

Dystonia

Question 12

occurs in 15-33% of those /c severe TBI’s; thought to be due to an imbalance in the ANS.
Symptoms Include: dystonia, tachycardia, diaphoresis (sweating), hyperthermia, hypertension, tachypnea (rapid breathing)

Answer 12

Autonomic Dysfunction Syndrome (ADS)

Question 13

involuntary increase in muscle tone & exxagerated deep tendon reflexes

Answer 13

Hyperreflexia

Question 14

abnormal, usually permanent condition of joints characterized by decreased range of motion, often in a flexed position & fixation due to wasting away & shortening of muscle fibers & loss of skin elasticity.

Answer 14

Contractures

Question 15

Clinical presentation may reveal a swollen, painful warm area often /c decreased ROM; can be mistaken for a DVT

Answer 15

HO

Question 16

a combination of medical disorders that increase the risk for both cardiovascular diseases & diabetes; common in aging adults, it is marked by abdominal obesity, insulin resistance, High BP & dyslipidemia

Answer 16

Metabolic Syndrome

Question 17

product of poor hygiene such as poor hand washing by care providers & repeated use of soiled clothing

Answer 17

MRSA

Question 18

more than ____% of TBI’s will experience a UTI within 6 weeks of their injury

Answer 18

60%

Question 19

Skin infection caused by bacteria; could be deadly if spreads to deeper tissues

Answer 19

Cellulitis

Question 20

excessive sleepiness that occurs as a result of traumatic event involving the CNS

Answer 20

post-traumatic hypersomnia

Question 21

Sleep disturbances after a TBI are reported by ___% of individiuals

Answer 21

30-70%

Question 22

vivid dream-like auditory, visual, or tactile sensations one experiences between sleep & wakefulness

Answer 22

hypnagogic hallucinations

Question 23

sudden loss of bilateral muscle tone, in which a standing individual will suddenly collapse in sleep

Answer 23

Cataplexy

Question 24

Sleep Laboratory Test

Answer 24

polysomnography

Question 25

events that involve LOC & involuntary movement within seconds of impact

Answer 25

Immediate post-traumatic convulsions (IPTC)

Question 26

short period of time following seizure where there is an altered state of consciousness

Answer 26

Postictal Period

Question 27

convulsions that occur within 7 days following an injury & result from primary, direct effects of the trauma; approx. 50% occuring within 24 hours of impact & is a strong risk factor of late post-traumatic seizures

Answer 27

Early Post-Traumatic Seizures

Question 28

Defined as more than 30 mins of continuous seizure activity or 2 or more sequential seizures without full recovery of consciousness between seizures. occurs in about 10% of individuals after acute head injury & is especially common in children

Answer 28

Status Epilepticus

Question 29

Occur later than 1-week after the initial head trauma; onset is usually within the first 18-24 months of the brain injury.

Answer 29

Late post-traumatic seizures (LPTS) or post-traumatic epilepsy (PTE)

Question 30

Pain related to the peripheral nerve fibers

Answer 30

Nociceptive

Question 31

associated with primary lesion of dysfunction of the nervous system

Answer 31

Neuropathic

Question 32

NSAIDS, acetaminophen, topical agents, anti-spasticity meds & opioids

Answer 32

Used to treat Nociceptive Pain

Question 33

topical agents, opioids, tramadol, Lyrica, anticonvulsants & antidepressants Tricyclics are useful but cause sedation & affect mobility Interventional techniques such as trigger point injections, nerve blocks & epidural steroids may also prove to be effective

Answer 33

Used to treat Neuropathic Pain

Question 34

headache that commences within 14 days of LOC; may resolve within 6 months or persist & become chronic

Answer 34

Post-Traumatic Headache (PTH)

Question 35

Headache with no specific cause

Answer 35

primary headache

Question 36

headache that may have an identifiable cause that can be determined

Answer 36

Secondary headache

Question 37

headache that occurs at least 15 days per month for at least 3 months & is not linked to overuse or withdrawal of medication

Answer 37

Chronic Headache

Question 38

most common form of primary headache; does not get worse with physical activity & patients do not present with other symptoms such as sensitivity toward light, sound & taste

Answer 38

Tension-Type Headache

Question 39

head pain generated from primarily from the cervical spine

Answer 39

Cervicogenic Headache

Question 40

subtype of tension-type headaches associated with the temporal mandibular joint; these headaches can be debilitating, causing the patient to have difficulty eating & talking

Answer 40

craniomandibular headache

Question 41

type of pain that is caused by damage to a nerve or structural change in a nerve

Answer 41

Neuralgia

Question 42

when the nerve becomes entrapped in scar tissue

Answer 42

Neuralgia

Question 43

to learn new motor skills & is defined as a set of internal processes associated with practice or experience leading to relatively permanent changes in the capability for skilled movement

Answer 43

Motor learning

Question 44

abnormal accumulation of CSF within the ventricles

Answer 44

Hydrocephalus

Question 45

velocity-dependent increase in tonic stretch with exaggerated tendon reflexes; occurs from damage to the upper motor neuron Symptoms include: increased muscle tone, exaggerated tendon reflexes & clonus

Answer 45

Spasticity

Question 46

standard care for severe spasticity; only used when individuals do not respond to oral medications. Works at the level of the spine to inhibit excitatory activity at the spinal reflexes

Answer 46

Intrathecal Baclofen (ITB)

Question 47

mass of platelets and/or fibrin that forms in a blood vessel (ex. blood clot)

Answer 47

thrombus

Question 48

often a piece of thrombus that has broken free & then circulates within the bloodstream

Answer 48

Embolus

Question 49

lack of muscle coordination during voluntary movements & typically impacts activities such as walking or picking up objects

Answer 49

Ataxia

Question 50

Writhing movements

Answer 50

Athetoid

Question 51

quick flailing movements

Answer 51

Ballisms

Question 52

continuous rapid unpredictable movements

Answer 52

choreiform

Question 53

extreme tone or stiffness limiting movements

Answer 53

dystonia

Question 54

unpredictable movements with motion or at rest

Answer 54

tremors

Question 55

inability to perform purposive actions due to damage in certain areas of the brain

Answer 55

apraxia

Question 56

inability to perform a task on command or imitate gestures; ex. person cannot blow out candles when asked on command however when presented with a lit candle, person will blow it out automatically

Answer 56

ideomotor apraxia

Question 57

inability to perform a task on command & automatically; these individuals may do better in a home setting vs clinical

Answer 57

ideational apraxia

Question 58

limitations in performing purposful movements of the lips, cheeks, tongue, larynx & pharynx; automatic expressions are easier compared to sequencing more complex language.

Answer 58

Buccofacial Apraxia