Rehab Guidelines for TBI pt 1 Flashcards
which type of TBI patients typically have better outcomes
traumatic have better functional outcomes than non-traumatic
what is the majority of TBI?
75% are concussion/mild TBI
long term implications of repetitive concussions?
CTE
primary TBI pathologies (4)
focal injury (coup-contracoup)
DAI
hypoxic-ischemic
blast
secondary TBI pathologies (3)
- increased ICP/edema
- hypoxic-ischemic injury
- chem/NT imbalance
what is normal ICP? what ICP is “problematic?”
normal: 5-15 mmHg
problematic: >20 mmHg
what is the biggest concern with ICP uncontrollably increasing
brainstem herniation through the foramen magnum
describe blast injuries
- primary - kinetic energy and blast wave
- secondary - shrapnel
- tertiary - impact (coup contracoup)
what is the polytrauma triad
TBI, PTSD, and pain
T/F: TBI is a risk factor for suicide
TRUE
what is a coma
unresponsive unarousable unaware (GCS <8)
what is a vegetative state
aka unresponsive wakefulness state - sleep-wake cycles with no evidence of awareness or purposefulness
what is a MCS
severely altered consciousness with minimal but definite evidence of awareness of self/env
what is stupor
general unresponsiveness, brief arousal with vigorous stimulation
what is obtunded
heavy sleep but arousable
what is a persistent vegetative state
VS/UWS lasting > 1 month
permanent > 1 year
how would you measure attention deficits in TBI?
Moss Attention Rating Scale
Observable evidence of agitation
restlessness/akathisia(inner restlessness)
fidgeting hands
bouncing legs
pacing
medical evidence of agitation
hyperadrenergic state
- tachycardia
- diaphoretic
- febrile
- HTN
how would you measure agitation in TBI
agitated behavior scale
what can cause dysphagia
CN damage, motor control deficits/apraxia, or poor postural control
in what lobe are we concerned about visual problems
occipital
Red Nucleus influences ____ of the UEs via the ______ tract
flexion; rubrospinal
define decorticate
disinhibition of the RN (UE flexion)
