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TBI > Mindstorms > Flashcards

Mindstorms Flashcards

1
Q

When brain cells receive INADEQUATE oxygen.

A

Hypoxemia

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2
Q

When brain cells do not receive ANY oxygen.

A

Anoxia

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3
Q

What are the 4 major types of brain injury?

A

*Focal Contusional *Focal Hemorrhagic (or Ischemic Injury) *Diffuse Axonal Injury *Diffuse Hypoxemic or Anoxic Injury

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4
Q

Focal Contusional Injury

A

Bruising of specific areas of the brain

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5
Q

Focal Ischemic or hemorrhagic injury

A

caused by blockage or rupture of specific blood vessels that supply certain areas of the brain with oxygen - Stroke

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6
Q

injuries affecting the entire brain are termed ______

A

Diffuse

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7
Q

How long can brain cells survive without oxygenated blood?

A

Not more than 6 or 7 minutes

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8
Q

“Method is much, ____________________, ________________.” - Benjamin Cardozo

A

technique is much, but inspiration is even more.

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9
Q

Why shouldn’t you let someone with a possible head injury go to sleep?

A

You wouldn’t be able to tell if they fell into a coma.

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10
Q

Happiness is something no doctor can order up: It comes from _________________________________________________________.

A

doing things in your life that produce a sense of well-being.

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11
Q

What do you do if someone is having a seizure?

A

* Put them on their side (protects from aspirating) * Protect their head (put in lap or on pillow) * Call 911 for immediate medical attention * Never put anything in the mouth of someone who is in the midst of a seizure. * Many seizures end just minutes after they begin. * Risk of subsequent seizures.

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12
Q

Hypopituitarism

A

* Underactive pituitary glad. * Caused by injury to hypothalamus * Often overlooked in TBI diagnostic * Doesn’t appear until 3 months after TBI * Results in: weight gain, confusion, dry skin, stunted growth (in youths), amenorrhea (absent menstruation), infertility in women, and impotence in men. * Diagnosed with blood tests.

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13
Q

Hemiplegia:

A

Weakness or paralysis on one side of the body, most commonly seen following strokes.

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14
Q

Dysarthria:

A

A loss of oral muscle function that results in the inability to articulate words clearly, even though a patient’s knowledge of language is intact.

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15
Q

Dysphagia:

A

An inability to swallow caused by damage to the neurons that control the coordinated movement of the muscles in the back of the throat.

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16
Q

Ataxia:

A

An inability to coordinate muscle movements leading to awkward gait and imbalance.

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17
Q

What are the 2 subdivisions of long term memory?

A

Explicit (or declarative) and implicit.

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18
Q

What are the 2 subdivisions of explicit memory?

A

Episodic and semantic

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19
Q

Episodic memory

A

account of what occurs in our lives (what you had for breakfast, or who visited)

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20
Q

Semantic memory

A

* Facts * Learned from others * “textbook learning” * sometimes called “crystallized memory”

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21
Q

Implicit memory

A

* muscle memory or procedural memory
* doesn’t require conscious thought
* uses different parts of brain than other memory

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22
Q

retrograde amnesia:

A

loss of pre injury memories

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23
Q

postraumatic amnesia

A

unable to lay down new memories

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24
Q

Aphasia:

A

loss of speech and language

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25
Q

fluent aphasia

A

problems understanding spoken and written language (also known as sensory aphasia or Wernicke’s aphasia)

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26
Q

nonfluent aphasia

A

difficulty communicating both orally and in writing (also called motor aphasia or Broca’s aphasia)

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27
Q

global aphasia

A

can’t speak or comprehend language usually resolves into fluent or nonfluent aphasia

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28
Q

Episodic dyscontrol syndrome (EDS)

A

primitive emotion unchecked by higher executive functioning of frontal lobes (often leading to inappropriate expressions) If damage is restricted to outer areas of frontal lobes (dorsal lateral areas), the person may just not care about anything. This is often confused with depression as symptoms are similar. Both expressions called frontal lobe syndromes

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29
Q

Percentage of prisoners in our jails with TBI?

A

82% 65% had lost consciousness more than once due to head injury

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30
Q

Anosognosia

A

Brain-based disorder resulting with compromised frontal function, in which subject stubbornly refuses, and truly lacks the ability to understand, that they have problems.

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31
Q

Loss of sexual restraint caused by damage to which lobes?

A

Frontal and temporal

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32
Q

Abnormally high or low sex drive caused by damage to the __________

A

hypothalamus

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33
Q

Time is _____. - Anonymous

A

Brain

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34
Q

Hobbies can provide ___________________________

A

Real life therapy

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35
Q

The medical director

A

*team leader (symphony conductor) * drives treatment planing and therapeutic strategies * oversees and supervises entire staff * specialty may be in neurology, neuropsychiatry, or physical medicine and rehabilitation.

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36
Q

Complete TBI team usually has staff members from 3 disciplines

A

Neurology Neuropsychiatry Physical medicine and rehabilitation

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37
Q

Neuropsychologists perform:

A

*psychological, behavioral, and neuropsychological testing * cognitive therapies (to strengthen and compensate)

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38
Q

Clinical Psychologists

A

Provide counseling for patients and families (usually through teaching, cognitive behavioral manner, not “talk therapy”).

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39
Q

6 supporting members of a good TBI team

A

* Physical therapists * Occupational therapists * Speech and language pathologists * Rehabilitation nurses * Recreational therapists * Vocational therapists

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40
Q

Case managers

A

Supportive liaisons between patients and their funding sources. Ideally remains involved after patient discharge.

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41
Q

Factors in depression

A

* genetic predisposition * environmental stressors * hormonal imbalances * abnormal brain chemisty

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42
Q

SSRI’s

A

selective serotonin reuptake inhibitors

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43
Q

A person with severe TBI will rarely say that she is depressed - she will more likely demonstrate it by exhibiting the following symptoms:

A

* fatigue * inability to pay attention * obsessive thinking

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44
Q

SSNRI’s

A

Selective serotonin and norepinephrine reuptake inhibitors

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45
Q

Alternative to SSRI’s and SSNRI’s

A

inhibit reuptake of norepinephrine and dopamine (doesn’t produce weight gain or sexual dysfunction common in SSRI’s) bupropion (Wellbutrin)

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46
Q

Tricyclics

A

* Older class of antidepressants * impact whole array of neurotransmitters * may provide releif from pain * side effects: dry mouth, blurry vision, and constipation

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47
Q

emotional incontinence

A

* loss of control of emotions * can go from laughing to crying in minutes

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48
Q

What are Benzodiazepines (BDZ) used for?

A

* short term management of debilitating anxiety or insomnia

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49
Q

Alprazolam (Xanax)

A

Benzodiazepine

Xanax

50
Q

Exelon

A

* Rivastigmine * Works by increasing acetylcholine

51
Q

What natural salt can help balance mood?

A

Lithium carbonate * Can stabilize lives of TBI survivors * Can be toxic to cardiac and central nervous system if levels get too high

52
Q

Why are stimulants used for TBI’s?

A

* reduce distraction and impulsivity * wake sleepy and lethargic patients * increase processing and ability to pay attention

53
Q

Many stimulants increase what neurotransmitter?

A

dopamine

54
Q

Common stimulants for TBI’s

A

* methlphenidate (Ritalin) * amphetamine (Dexedrine) * pemoline (Cylert)

55
Q

Common SSNRI’s

A

* venlafaxine (Effexor) * mirtazapine (Remeron)

56
Q

Common tricyclics

A

* impipramine (Tofranil) * amitriptyline (Elavil) * nortriptyline (Pamelar)

57
Q

What non stimulant induces wakefulness, and what are it’s advantages over stimulants?

A

modifinil (Provigil) * non habit-forming * doesn’t increase heart rate and blood pressure

58
Q

Key points to managing frustrated patients

A

* back off for a few minutes * after they cool down ask if they want help * ask if anger helped them accomplish their goal * see if they can “express rationale for the breakdown” * never assume you understand the patients rationale or problem

59
Q

Why is routine easier on a brain injured individual?

A

Short-term memory can be so impaired by deficits in attention and concentration that new learning cannot take place. Routine impresses unconscious (procedural) learning stored in implicit memory. It doesn’t require the conscious thought involved in explicit memory and uses completely different neuronal pathways.

60
Q

Repetition is key

A

break down tasks into simple steps and practice the important ones with added repetition Ex: practice putting shoes on more than once a morning

61
Q

People cannot learn without

A

awareness

62
Q

Ultimately, therapies directed at improving cognition are also designed to impact a persons _________, ___________________________________.

A

behavior, the observable manifestations of thought.

63
Q

Reorganize bedroom to minimize _________ and establish _________ that will not require him to _______.

A

distractions routines think

64
Q

Behavioral therapy works on the basis of what two simple strategies?

A

Reward the good and ignore the bad

65
Q

Why try and ignore bad behavior?

A

humans are wired to crave attention, even if it’s negative attention. We’d rather argue and fight than be ignored.

66
Q

“Many patients complain that they are “just too tired” to do these exercises, but if the family caregivers permit these activities to be set aside, _________________________________________.

A

the fatigue will only get worse.

67
Q

When adults with moderately severe brain injuries are trying to return to work or school, the author thinks it is time for what?

A

Neuropsychological testing and structured vocational evaluation

68
Q

How did Sigmund Freud define the good life?

A

As having the ability to both love and work.

69
Q

Today, there is practically an epidemic of traumatic brain injury - a staggaring ___________ Americans disabled by TBI.

A

6.3 million

70
Q

“If the human brain were so simple that we could understand it, we would be so simple that we couldn’t”

A

Emerson M. Pugh (research scientist for IBM)`

71
Q

Peripheral nervous system (PNS)

A

all the nerves outside of the spinal cord and brain (usually run parallel with our blood vessels)

72
Q

Central nervous system (CNS)

A

brain and spinal cord

73
Q

Four major structures of brain stem:

A

* midbrain * reticular activating system * pons * medulla oblongata

74
Q

Function of brain stem:

A

most basic functions * regulation of heart * breathing rates * blood pressure * general arousal

75
Q

Function of limbic system

A

memories and emotional responses

76
Q

2 other names for the cerebral cortex are:

A

* neocortex (“new brain”) * also called gray matter

77
Q

Why is grey matter grey?

A

Nerves in this area lack the insulating myelin

78
Q

Bulges on brain are called?

A

Gyri

79
Q

Fissures on brain are called?

A

Sulci

80
Q

largest opening at the bottom of the skull

A

foramen magnum

81
Q

3 membranes covering the brain

A

dura, pia, arachnoid

82
Q

dura

A

*first membrane under the skull *toughest layer covering the brain

83
Q

pia

A

thin lining that hugs the brain

84
Q

arachnoid

A

web-like lining between dura and pia

85
Q

brain incased in what fluid

A

cerebrospinal fluid (CSF)

86
Q

medulla oblongata

A

* lowest part of the brain stem * takes care of automatic responses like: - breathing - swallowing - blood pressure - body temperature - pupils

87
Q

reticular activating system

A

* within the brain stem, adjacent to and above the medulla * reponsible for: - producing arousal - controlling sleep-wake cycles

88
Q

pons

A

* “bridge” from lower brain stem to midbrain and cerebellum
* coordinates motor movements
* helps maintain balance

89
Q

midbrain

A

*reflexive control of visual and auditory information and orientation * dorsal part connects RAS and cerebellum

90
Q

cerebellum

A

* “little brain” attached to back of brain stem * 3 lobes * coordinates all our movements * including regulating fluid speech * remembers learned motor responses like riding a bike

91
Q

thalamus

A

* the brain’s relay center to the cerebral cortex * “every bit of information, every message… goes through the thalamus … look like testicles in the middle of your brain

92
Q

The thalamus and hypothalamus are the two all-important gateways to ___________, _________, and _________.

A

higher thought, emotion, mental health

93
Q

Hypothalamus

A

* right below thalamus * one of the brains control towers * “Although no bigger than a pea, it’s a dynamo of function”. * controls eating patterns * sleeping and waking cycles * body temperature * blood sugar levels * emotional tone * sex drive * hormonal balances via pituitary gland

94
Q

pituitary gland

A

regulates hormonal production and secretion

95
Q

cortisol

A

* a steroid that promotes healing * produced by adrenal gland * controlled by hypothalamus * can create chronic stress response if constantly produced

96
Q

Limbic system

A

* network of nerve cells that providing the “biological basis of our emotional lives” * right below higher functioning cerebral parts of the brain * “ensures that emotions reach our conscious thoughts - and our thoughts affect our emotions.” * limbic system and cerebral cortex actively influence each other (why emotional events are well remembered) * damage to limbic system can leave patient distant and disconnected from others

97
Q

Hippocampus and amygdala are responsible for ____________________________________.

A

much of what we remember and the tone of our emotions. (Triggers limbic system)

98
Q

Hippocampus is directly connected to what functions.

A

the senses.

  • touch
  • sight
  • hearing
  • smell
99
Q

Neocortex

A

Uniquely human additions to the cerebral cortex that all mammals share. “new brain”

100
Q

prefrontal cortices are responsible for:

A

executive functions (reasoning and judgment)

101
Q

The frontal lobes are where your….

A

personality anatomically exists. Where it is created, honed, and refined. Where the ego is housed.

102
Q

“If someone suffers damage to his frontal lobes, …”

A

“… he will not be himself - literally.”

103
Q

What is the general function of the parietal lobes?

A

Sensation and perception

104
Q

The frontal and parietal lobes meet where there are strong connections for what?

A

Muscle movement and sensation.

105
Q

The main function of temporal lobes

A

* make sense of what we hear (via the auditory cortex) * perceptions and memories (via limbic system and it’s connections)

106
Q

What is the primary function of the occipital lobes?

A

analyze what we are seeing

107
Q

In general the left hemisphere controls:

A

* details * logical thinking * language skills * numerical calculations * and movement on the right side of the body

108
Q

In general the right hemisphere controls:

A

* big picture concepts * visual memories * artistic talents * and movements of the left side of the body

109
Q

Brain hemispheres. The right side sees “_________”, the left side sees “__________’.

A

the forest the trees

110
Q

What chemicals carry messages between neurons?

A

Neurotransmitters

111
Q

Prozac

A

flouxetine SSRI

112
Q

Paxil

A

paroxetine SSRI

113
Q

Zoloft

A

sertraline SSRI

114
Q

Lexapro

A

excitalopram SSRI

115
Q

Celexa

A

citalopram SSRI

116
Q

What might help TBI Patients with memory loss

A

Exelon (Rivastigmine) * Already used in treating Alzheimer’s * Because TBI’s increase the likelihood of Alzheimer’s, it might be reason to use these medications earlier in management.

117
Q

Chlordiazepoxide

A

Benzodiazepine

(Librium)

118
Q

Clonazepam

A

Benzodiazepine

(Klonopin)

119
Q

Diazepam

A

Benzodiazepine

(Valium)

120
Q

Lorazepam

A

Benzodiazepine

(Ativan)

TBI (2 decks)

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