Physiological Psychology Lecture #7 Flashcards

1
Q

Traumatic Brain Injury

A

“When a sudden, external, physical assault damages the brain”.

In the U.S.:
- 27,000 are hospitalized.
- 52,000 die from their injury.

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2
Q

Causes of traumatic brain injury

A

In adolescence and young adults:
- Motor vehicle collisions.

In older adults:
- Falls

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3
Q

TBI Sex and Age Breakdown

A
  • Most common age: 15-24
  • More common in men than women (at age 15-24), becomes more even as age progresses.
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4
Q

Closed Brain Injury

A

Non-penetrating injury to the brain-no break to the skull. Injury can result from:
- Rapid forward and backward movement of brain in the skull–tearing and bruising of brain tissue and blood vessels.

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5
Q

Coup

A

point of impact

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6
Q

Countercoup

A

Injury of opposite side

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7
Q

Diffuse Axonal Injury

A

Car crash, falls, sports, shaken baby syndrome.

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8
Q

Penetrating Brain Injury

A

Penetrating or open head injuries where there is a break in the skull. Injury results from:
- Penetrating objects, and skull bone fragments damaging brain tissue and blood vessels = deprivation of normal blood supply and accumulation of blood.
- Cognitive impairment tend to be more focal.

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9
Q

Ischemia

A

Deprivation of normal blood supply

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10
Q

Hemorrhage

A

Accumulation of blood.

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11
Q

Diffuse Axonal Injury (DAI)

A

“The shearing (tearing) of the brain’s long connected nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull”.
- Damage to white matter.
- Changes are microscopic.
- Can lead to disorders of consciousness (persistent vegetative state, coma).
- Difficult to see on CT scan or MRI
- Can occur without other visible damage.

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12
Q

Grade 1 Axonal Injury

A

Mildest form of DAI
- Microscopic changes in the white matter of the cerebral cortex, corpus callosum, brain stem, and cerebellum.

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13
Q

Grade 2 Axonal Injury

A

Moderate form of DAI (diffuse axonal injury)
- Grossly evident focal lesions isolated to the corpus callosum.

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14
Q

Grade 3 Axonal Injury

A

Severe form of DAI
- Additional and severe focal lesions on the brainstem itself.

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15
Q

Primary Injury

A
  • Skull lacerations
  • Skull fractures
  • Contusions
  • Cerebral lacerations
  • Intercranial hemorrhage
  • Diffise axonal injury
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16
Q

Primary Injury

A
  • Skull lacerations
  • Skull fractures
  • Contusions
  • Cerebral lacerations
  • Intracranial hemorrhage
  • Diffuse axonal injury
17
Q

Secondary Injury

A

Due to:
- Increased intracranial pressure.
- Hypoxia
- Hypotension
- Hypothermia
- Electrolyte disturbance (Na, Ca, K)
- Toxic amino acids
- Oxygen radicals.

18
Q

Chronic Traumatic Encephalopathy (CTE)

A
  • Produces neurodegeneration due to repeated head trauma.
  • Prevalence in athletes who participate in contact sports.
  • Mood and cognitive impairment can appear years after the injury occurred.
  • Characteristic deficits include: dysexecutive functioning and mood liability.
19
Q

How can CTEs be confirmed postmotem?

A

Examination of brain tissue:
- Abnormal tau protein accumulation (similar to Alzheimer’s disease)

  • Reduced brain volume (in corpus callosum and limbic system).
  • Ventricular enlargement.
20
Q

True/False Individual will remember what happened/occurred after TBI

A

False

21
Q

Mild TBI

A

<30 minutes unconscious
- 13-15 Glasgow coma scale
- <24hrs post-traumatic amnesia

22
Q

Moderate TBI

A

30 min-24hours unconscious
9-12 Glasgow coma scale
1-7 days post-traumatic amnesia

23
Q

Severe TBI

A

> 24hrs unconscious
3-8 Glasgow coma scale
7days post traumatic amnesia

24
Q

Limitations to Glasgow Coma Scale

A
  • Substance use.
  • Administered drugs
  • Intubation
  • Injury to eye
  • Hemiplegia
  • Language
25
Q

Post-Traumatic Amnesia

A

state of confusion and disorientation that occurs immediately after TBI–part of healing process.
- Brain is unable to form continuous day to day memories–memory is the slowest part of conscious mint to recover.

26
Q

Post-Traumatic Amnesia Behaviorally can present with:

A
  • Confused and disoriented
  • Agitation and aggression
  • Inability to recognize loved ones
  • Childlike/clingy behaaviors
    -Confabulations
  • Can be difficult to remember family members
  • Goal is support re-orientation and sense of safety
  • Do not ask they to recall the injury–they cannot do this.
27
Q

Rancho Los Amigos Scale Revised (RLAS-R)

A

IV: Confused/Agitated: Maximal Assistance

28
Q

Dose Response Relationship

A

Most well-designed studies, using a representative, non-clinically referred study sample show:
- Cognitive changes after TBI resolve within weeks to about 3 months at most spontaneously without treatment while changes tend to persist for less than or equal to 2 years following moderate to severe TBI

29
Q

Non-Injury Risk Facotrs that Can Influence TBI Outcomes

A
  • pre-injury psychiatric status and conduct issues/incarceration
  • age at injury
  • level of education
  • stable employment 6 months pre-injury (best predictor of return to employment post injury.
  • marital status
  • other non-neurological injuries sustained–physical injuries can prevent return to meaningful activities.