NeuroPathology - TBI Objectives (EXAM ONLY) Flashcards
What is a primary injury for a TBI?
Result of forces exerted on the brain at impact
What is a secondary injury for a TBI?
Compromise of brain function from brain’s reaction to trauma, brain swelling, impaired cerebreal perfusion
What is a strong predictor of a poor outcome in TBI?
Low BP
What is the respiratory rate with damage to the bilateral hemispheric area or diencephalon?
Cheyne-Stokes breathing // Rhythmic pattern of alternating rapid breathing and momentary stopping of breathing
What is the respiratory rate with damage caused by lesions in the pontines or midbrain?
hyperventilation
What is the respiratory rate with damage caused by lesions of the mid- and caudal- portions of the pons?
apneustic breathing // prolonged pause at the end of inspiration
What is the respiratory rate with damage caused by lesions in the medulla
Ataxic breathing // irregular in both rate and tidal volume
What is Retrograde Amnesia?
partial or total loss of ability to recall events that have occurred during the period immediately preceding TBI
What is Post-Traumatic Amnesia (PTA)?
Time lapse between injury and when functional memory returns // automatic activities may improve // no carryover // ***indication of injury severity
What does loss of Anterograde amnesia look like?
The ability to form new memories, decreased attention or inaccurate perception, last function to return
______ damage results in ataxia, either on one side of the body or global
cerebellar
______ dysfunction results in tremor or bradykinesia
basal ganglia dysfunction
What is Decorticate Posturing caused by?
Loss of cortical control
What is Decerebrate Posturing caused by?
Injury at superior border of the pons
What are signs of Decorticate Posturing?
Hyperactive flexor reflexes in UEs + Hyperactive extensor response in LEs
What are signs of Decerebrate Posturing?
Hyperactive extensor reflexes in UEs & LEs + loss of inhibitory control of cortex and basal ganglia
What is the “cut off” for the Glasgow Coma Scale?
≤8
What range indicates a moderate severity on the GCS?
9-11
What range indicates a minor injury on the GCS?
> 12
What range indicates a severe rating on the GCS?
3-8
What are the 8 stages on the Rancho Los Amigos Scale?
I: No response // II: Generalized Response // III: Localized Response // IV: confused and agitated // V: confused and inappropriate // VI: confused and appropriate // VII: automatic and appropriate // VIII: purposeful and appropriate
What are negative prognostic indicators for TBI?
Loss of consciousness for >1min, significant cognitive symptoms, younger age, female gender, depression, high levels of activity
What are symptoms of a concussion?
headache, disorientation, dizziness, nausea, irritability, fatigue, etc
what do Diffuse Axonal Injuries cause impairments to?
cognitive, sensory function, and autonomic motor impairments
What is Level I of the RLA scale?
No response
- no response to sounds, sights, touch, or movements
What is Level II of the RLA Scale?
Generalized Response
- begins to respond slowly and inconsistently to sounds, sights, touch/movement
-*Same response for everything
What is Level III on the RLA scale?
Localized Response
- Reacts more specifically to tactical, auditory, and visual stimuli. Begins to recognize friends/family
- may follow SIMPLE commands
What is Level IV on the RLA Scale?
Confused and Agitated
- very confused/frightened and unaware that people are trying to help
highly focused on their basic needs!
What is Level V on the RLA scale?
Confused and Inappropriate
- pays attention for only a few min
- disoriented
- makes things up to fill in gaps in memory
- perseveration
- focused on basic needs
What is Level VI on the RLA Scale?
Confused and Appropriate
- remembers main conversation points but forgets/confuses details
- confused in routine changes
- pays attention for ~30min (except when noisy)
- impulsive
What is Level VII on the RLA scale?
Automatic and Appropriate
- able to do routine self care without help
- has problems in new situations
- continue to need supervision
What is Level VIII on the RLA scale?
Purposeful and Appropriate
ALMOSTTTT back to normal
- ready for driving/back to job training
- poor judgement in new situations
- needs some help in decision making
- becomes overloaded quickly
- learns new things Slowly
