S2_L1: Traumatic Brain Injury Flashcards
1
Q
Brain injury: Cell death occurs as a result of events that follow after tissue damage
A. Primary injury
B. Secondary injury
C. Both
D. Neither
A
B. Secondary injury
2
Q
Brain injury: Treatable and theoretically preventable
A. Primary injury
B. Secondary injury
C. Both
D. Neither
A
B. Secondary injury
3
Q
Brain injury: Result from brain tissue coming into contact with an object
A. Primary injury
B. Secondary injury
C. Both
D. Neither
A
A. Primary injury
4
Q
Brain injury: Result from brain tissue coming into contact with an external object which can penetrate the bone
A. Primary injury
B. Secondary injury
C. Both
D. Neither
A
A. Primary injury
5
Q
Mechanical force causing brain injury: Occurs when the head is prevented from moving after being struck
A. Contact forces
B. Inertial forces
A
A. Contact forces
6
Q
Mechanical force causing brain injury: Occurs when the head is set into motion and the brain tissue rapidly accelerates or decelerates
A. Contact forces
B. Inertial forces
A
B. Inertial forces
7
Q
Primary Injury: Result from relatively low-velocity impact such as blows (blunt trauma) and ground level falls
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
B. Cerebral / Cortical Contusion
8
Q
Primary Injury: Symptom duration to define persistent deficits range from 3-12 months
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
C. Concussion
9
Q
Primary Injury: Microscopic disruption and tearing of axons and small blood vessels from shear-strain of angular acceleration
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
A. Diffuse Axonal Injury (DAI)
10
Q
Primary Injury: Deceleration and acceleration injury causes shear, tensile,
and compression forces within / to the brain
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
A. Diffuse Axonal Injury (DAI)
11
Q
Primary Injury: Predominant MOI in most individuals with severe to moderate TBI
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
A. Diffuse Axonal Injury (DAI)
12
Q
Primary Injury: Occurs with translation acceleration result in head movement
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
B. Cerebral / Cortical Contusion
13
Q
Primary Injury: Mechanism behind initial loss of consciousness after TBI and results in more generalized deficits (e.g. confusion
and incoordination)
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
A. Diffuse Axonal Injury (DAI)
14
Q
Primary Injury: Elevates the risk for seizures and is more likely to produce focal deficits (e.g. aphasias and motor weakness)
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
B. Cerebral / Cortical Contusion
15
Q
Primary Injury: Headache, agitation, fatigue, irritability, memory deficit, and concentration loss occurring 3 months after the concussion.
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
D. Post Concussional Syndrome
16
Q
Common areas of a contusion are the undersurface of the (1)____ and (2)____ lobes due to the presence of bony prominences on the base of the skull creating brain tissue and vascular
disruption.
A
- frontal lobe (leads to long term amnesia)
- anterior temporal lobe (leads to short term amnesia)
17
Q
TRUE OR FALSE: Comatose is a common manifestation of diffuse axonal injury. Recovery from DAI is usually gradual and is commonly
linked to the duration of the coma.
A
True
18
Q
Primary Injury: Loss of consciousness d/t direct axonal shearing and
disruption of the intra-axonal cytoskeleton. Then, the axonal disruption leads to swelling.
A. Diffuse Axonal Injury (DAI)
B. Cerebral / Cortical Contusion
C. Concussion
D. Post Concussional Syndrome
A
A. Diffuse Axonal Injury (DAI)
19
Q
Primary Injury: Refers to neurons remote from a site of injury, but anatomically connected to the damaged area, becoming functionally depressed
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
B. Diaschisis
20
Q
Primary Injury: Focal cortical lesions that can affect contralateral cortical functioning by way of interconnections in the corpus callosum
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
B. Diaschisis
21
Q
Primary Injury: Local impact and subsequent laceration of underlying
dural veins and arteries
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
C. Epidural Hematoma
Note: It’s usually associated to a damaged artery
22
Q
Primary Injury: Caused by inertial forces and the tearing of bridging
veins
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
D. Subdural Hematoma
23
Q
Primary Injury: Neurologic emergency
because of its quick expansion and rapidly causing neurological degeneration
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
C. Epidural Hematoma
24
Q
Primary Injury: Caused by metallic or bony fragments that can be brought about by significant blunt trauma, penetrating injury, depressed skull fracture, or gunshot or other missile injury
A. Direct Laceration
B. Diaschisis
C. Epidural Hematoma
D. Subdural Hematoma
A
A. Direct Laceration
25
Genetic disorders related to inadequate lipid metabolism, where fatty cells deposit in organs like liver & spleen. These progress to loss of function of the nerves and brain.
Gaucher’s / Niemann-Pick
26
Non-traumatic brain injury: Toxic exposure to
1. Manganese
2. Zinc
3. Copper
A. Wilson's disease
B. Parkinson's disease
C. Multiple sclerosis
1. B
2. C
3. A
27
2nd leading cause of TBI
Motor vehicle/traffic accidents
28
Leading cause of TBI
Falls
29
AAN Concussion Grading Scale: Concussion symptoms or mental status changes resolve in less than 5 min
A. Grade 1
B. Grade 2
C. Grade 3
A. Grade 1
30
AAN Concussion Grading Scale: Concussion symptoms or mental status change lasts longer than 15 min
A. Grade 1
B. Grade 2
C. Grade 3
B. Grade 2
31
AAN Concussion Grading Scale: Loss of
consciousness (brief or prolonged)
A. Grade 1
B. Grade 2
C. Grade 3
C. Grade 3
32
Enumerate the key criteria of a concussion
Pt experiences at least one of the following:
1. Confusion
2. Disorientation
3. Loss of consciousness for less than 30 mins
4. Post-Traumatic Amnesia (PTA) for less than 24 hours
5. Other transient focal neurologic abnormalities
Pt has a GCS score of 13-15 after 30 minutes or
presentation to a healthcare facility
33
Assesses 18 domains of function for children of ages 0-7
A. Disability Rating Scale
B. Functional Independence Measure
C. WeeFIM
D. 6-minute walk test
C. WeeFIM
34
An observer-rated, 30-point, 30-point continuous scale that provides quantitative information to document the progress of patients with severe head injury from coma to community
reintegration.
A. Disability Rating Scale
B. Functional Independence Measure
C. WeeFIM
D. 6-minute walk test
A. Disability Rating Scale
Note: The higher the score, the more disabled
34
Secondary Injury: Lack of oxygenated blood flow to the brain tissue that may cause severe damage to parenchymal tissues
A. Increased Intracranial Pressure
B. Brain Infection
C. Hemorrhage
D. Hypoxic - Ischemic Injury
D. Hypoxic - Ischemic Injury
35
Secondary Injury: Caused by systemic hypotension, anoxia, or damage to specific vascular territories of the brain
A. Increased Intracranial Pressure
B. Brain Infection
C. Hemorrhage
D. Hypoxic - Ischemic Injury
D. Hypoxic - Ischemic Injury
36
Secondary Injury: This leads to a decrease in the cerebral perfusion pressure and it can cause herniations of the tonsillar part of the brain.
A. Increased Intracranial Pressure
B. Brain Infection
C. Hemorrhage
D. Hypoxic - Ischemic Injury
A. Increased Intracranial Pressure
37
A major problem for active combat military personnel due to frequent use of explosives in the battlefront. This particular MOI is very important to ask in patients whose occupation involved military or police services.
Blast Injury
38
Enumerate the components of the Cushing's Triad
Bradycardia
Hypertension
Irregular breathing
39
Normal Intracranial Pressure (ICP)
5-20 cm of H2O (Accd to Sullivan)
40
Normal Cerebral Perfusion Pressure (CPP)
50-70 mmHg
41
Ancillary Procedure: Bone lesions/fractures
A. Skull X-ray
B. Ventriculography
C. Computerized Tomography Scan
D. Magnetic Resonance Imaging
E. Positron Emission Tomography
A. Skull X-ray
42
Ancillary Procedure: Tumors, increase in ICP
A. Skull X-ray
B. Ventriculography
C. Computerized Tomography Scan
D. Magnetic Resonance Imaging
E. Positron Emission Tomography
B. Ventriculography
43
Ancillary Procedure: Primary method in examining tumors
and vascular abnormalities, blood flow
A. Skull X-ray
B. Ventriculography
C. Computerized Tomography Scan
D. Magnetic Resonance Imaging
E. Positron Emission Tomography
D. Magnetic Resonance Imaging
44
Ancillary Procedure: Calcifications, hemorrhage, cerebral edema, cerebral infarction, tumor
A. Skull X-ray
B. Ventriculography
C. Computerized Tomography Scan
D. Magnetic Resonance Imaging
E. Positron Emission Tomography
C. Computerized Tomography Scan
45
Ancillary Procedure: Imaging for cerebral blood flow and brain metabolism
A. Skull X-ray
B. Ventriculography
C. Computerized Tomography Scan
D. Magnetic Resonance Imaging
E. Positron Emission Tomography
E. Positron Emission Tomography
46
Cerebral edema occurs within ___ after vascular occlusion
30 mins
47
Assesses the participation restriction domain of ICF
A. Disability Rating Scale
B. Functional Independence Measure
C. WeeFIM
D. 6-minute walk test
A. Disability Rating Scale
48
Blast Injury: May be brought about by shrapnel or other objects hurled to the individual e.g. blunt or
penetrating traumas
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
B. Secondary injury
49
Blast Injury: victim is flung backward and
hits an object (wall / ground)
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
C. Tertiary injury
50
Blast Injury: Occurs as a concomitant closed injury brought about by asphaxia (lack of oxygen), and exposure to toxic inhalants
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
D. Quarternary injury
51
Blast Injury: Direct effect of blast overpressure, direct blast wave propagation transcranially
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
52
Blast Injury: Fragmentation injuries
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
B. Secondary injury
53
Blast Injury: Open or closed brain injuries
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
C. Tertiary injury
54
Blast Injury: Effects of structural collapse and of persons being
thrown by the blast wind
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
C. Tertiary injury
55
Blast Injury: Leads to concussion
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
56
Blast Injury: Leads to rupture of tympanic membranes
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
57
Blast Injury: Leads to subdural hematoma and diffuse axonal injury
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
58
Blast Injury: Transfer of blast energy to the blood vessels trigger oscillations going to the brain, thus
increasing CSF or venous pressure.
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
Additional: The elevations in CSF or increased venous
pressure may be due to the compression of
thorax and abdomen brought about by the blast wave propagation through the blood vessels or CSF.
59
Blast Injury: Examples are eardrum rupture and lung injury
A. Primary injury
B. Secondary injury
C. Tertiary injury
D. Quarternary injury
A. Primary injury
60
Glasgow Outcome Scale (Extended) Category: Needs full assistance in ADL throughout the
day
A. Dead
B. Vegetative State
C. Lower Severe Disability
D. Upper Severe Disability
C. Lower Severe Disability
61
Glasgow Outcome Scale (Extended) Category: Needs some supervision / assistance in ADL but can be alone for >8h/d
A. Dead
B. Vegetative State
C. Lower Severe Disability
D. Upper Severe Disability
D. Upper Severe Disability
62
Glasgow Outcome Scale (Extended) Category: No cerebral cortical function that can be
judged by behavior; Not able to follow simple commands or communicate
A. Dead
B. Vegetative State
C. Lower Severe Disability
D. Upper Severe Disability
B. Vegetative State
63
Glasgow Outcome Scale (Extended) Category: Complete return to previous lifestyle with no reported problems
A. Lower Moderate Disability
B. Upper Moderate Disability
C. Lower Good Recovery
D. Upper Good Recovery
D. Upper Good Recovery
64
Glasgow Outcome Scale (Extended) Category: Able to resume previous position or lifestyle with alternative / modified duties or
part-time due to injury
A. Lower Moderate Disability
B. Upper Moderate Disability
C. Lower Good Recovery
D. Upper Good Recovery
B. Upper Moderate Disability
65
Glasgow Outcome Scale (Extended) Category: Able to resume previous position or lifestyle (may be modified, but reporting some problems)
A. Lower Moderate Disability
B. Upper Moderate Disability
C. Lower Good Recovery
D. Upper Good Recovery
C. Lower Good Recovery
66
Glasgow Outcome Scale (Extended) Category: Independent in ADL and can shop and travel
independently on public transportation, but
has not returned to previous position or
lifestyle
A. Lower Moderate Disability
B. Upper Moderate Disability
C. Lower Good Recovery
D. Upper Good Recovery
A. Lower Moderate Disability
67
Loss of consciousness between 0-30 mins
A. Mild TBI
B. Moderate TBI
C. Severe TBI
A. Mild TBI
68
Post-traumatic amnesia between >1 and <7 days
A. Mild TBI
B. Moderate TBI
C. Severe TBI
B. Moderate TBI
69
GCS score between 9-12
A. Mild TBI
B. Moderate TBI
C. Severe TBI
B. Moderate TBI
70
Post-traumatic amnesia for >7 days
A. Mild TBI
B. Moderate TBI
C. Severe TBI
C. Severe TBI
71
Post-traumatic amnesia between 0-1 day
A. Mild TBI
B. Moderate TBI
C. Severe TBI
A. Mild TBI
72
Alteration of consciousness was brief, >24 hr
A. Mild TBI
B. Moderate TBI
C. Severe TBI
A. Mild TBI
73
Loss of consciousness between >30 min and <24 hr
A. Mild TBI
B. Moderate TBI
C. Severe TBI
B. Moderate TBI
74
Loss of consciousness for >24 hr
A. Mild TBI
B. Moderate TBI
C. Severe TBI
C. Severe TBI
75
GCS score of <9
A. Mild TBI
B. Moderate TBI
C. Severe TBI
C. Severe TBI
76
GCS score between 13-15
A. Mild TBI
B. Moderate TBI
C. Severe TBI
A. Mild TBI
77
Test for CV endurance and patient’s level of
tolerance in sustaining activities especially
during the early stages of PT treatment
A. Disability Rating Scale
B. Functional Independence Measure
C. WeeFIM
D. 6-minute walk test
D. 6-minute walk test
78
GCS score of >7
A. Better prognosis
B. Poorer prognosis
C. No change
A. Better prognosis
79
Post-traumatic amnesia for >2 weeks
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
80
During the pupillary light reflex, constriction of one pupil is an indication that the pt is nearing death d/t affectation of the ___, that is responsible for automatic breathing,
and possible brain herniation.
brainstem
81
TRUE OR FALSE: Both Doll's eye sign and Caloric testing are involved with the brainstem.
True
82
RLA Level of Cognitive Functioning: No response, person appears to be in deep sleep and is completely unresponsive to any stimuli
A. Level 1
B. Level 2
C. Level 3
D. Level 4
E. Level 5
A. Level 1
83
RLA Level of Cognitive Functioning: Localized response, reacts inconsistently, directly in response to stimuli
A. Level 1
B. Level 2
C. Level 3
D. Level 4
E. Level 5
C. Level 3
Note: May follow simple commands such as closing eyes or squeezing hand in an inconsistent, delayed manner
84
RLA Level of Cognitive Functioning: Confused / Agitated. Behavior is bizarre and non-purposeful relative to the immediate
environment.
A. Level 1
B. Level 2
C. Level 3
D. Level 4
E. Level 5
D. Level 4
85
RLA Level of Cognitive Functioning: Generalized response, person reacts inconsistently, not
directly in response to stimuli.
A. Level 1
B. Level 2
C. Level 3
D. Level 4
E. Level 5
B. Level 2
Note: Responses may be physiological
changes, gross body movements, and/or vocalization.
86
RLA Level of Cognitive Functioning: Confused-Inappropriate / Non-Agitated, person responds inaccurately to commands.
A. Level 1
B. Level 2
C. Level 3
D. Level 4
E. Level 5
E. Level 5
Note: Demonstrates gross attention to the environment but is highly distractible and lacks ability to focus attention on a specific task
87
RLA Level of Cognitive Functioning: Automatic-Appropriate, person goes through daily routine with minimal confusion
A. Level 6
B. Level 7
C. Level 8
D. Level 9
E. Level 10
B. Level 7
Note: Shows carryover for new learning but at
a decreased rate. Pt has shallow recall of activities.
88
RLA Level of Cognitive Functioning: Purposeful-Appropriate / Modified Independent, goes
through daily routine but may require more time or compensatory
strategies, periodic depression may occur
A. Level 6
B. Level 7
C. Level 8
D. Level 9
E. Level 10
E. Level 10
89
RLA Level of Cognitive Functioning: Purposeful-Appropriate, person has functioning memory, responsive to environment, may display depression
A. Level 6
B. Level 7
C. Level 8
D. Level 9
E. Level 10
C. Level 8
90
RLA Level of Cognitive Functioning: Confused-Appropriate, person is confused and responds accurately to commands
A. Level 6
B. Level 7
C. Level 8
D. Level 9
E. Level 10
A. Level 6
Note: Responses may be incorrect due to
memory problems, but they are appropriate to the situation
91
RLA Level of Cognitive Functioning: Purposeful-Appropriate, goes through daily routine aware of need for stand-by-assistance, depression may continue
A. Level 6
B. Level 7
C. Level 8
D. Level 9
E. Level 10
D. Level 9
92
Large blood clot seen on CT Scan
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
93
Pupillary light reflex: Contract
A. Better prognosis
B. Poorer prognosis
C. No change
A. Better prognosis
94
(-) eye deviation during Caloric Testing
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
95
Localized motor response
A. Better prognosis
B. Poorer prognosis
C. No change
A. Better prognosis
96
Decerebrate posture
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
Note: This posture indicates brainstem affectation particularly
pontine affectation and possible herniation of cerebellar tonsils
97
Pupillary light reflex: Dilate
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
98
Rigid motor response
A. Better prognosis
B. Poorer prognosis
C. No change
B. Poorer prognosis
99
Decorticate posture
A. Better prognosis
B. Poorer prognosis
C. No change
A. Better prognosis
100
(+) Doll's eye sign
A. Better prognosis
B. Poorer prognosis
C. No change
A. Better prognosis
101
Most common artery involved in an Epidural Hematoma
Rupture of meningeal artery
102
Most common cause of Diffuse Axonal Injury
Motor vehicular accident (MVA)
-Because there are acceleration, deceleration, and rotational forces involved
103
Most widely used primary initial assessment tool for
determining the severity of brain injury
Glasgow Coma Scale (GCS)
104
Commonly used measure of functional mobility, ADL function, cognition, and communication. It is useful for monitoring pt. progress and
evaluating outcomes.
A. Disability Rating Scale
B. Functional Independence Measure
C. WeeFIM
D. 6-minute walk test
B. Functional Independence Measure
Additional: It measures the level of disability and burden of care in
individuals undergoing inpatient rehabilitation (Acute inpatient rehabilitation setting)
105
Most commonly injured in temporal bone fractures
A. CN I
B. CN II
C. CN III
D. CN VII
E. CN VIII
D. CN VII
106
2nd most injured CN
A. CN I
B. CN II
C. CN III
D. CN VII
E. CN VIII
C. CN III
107
Involved in basal skull fractures and rhinorrhea
A. CN I
B. CN II
C. CN III
D. CN VII
E. CN VIII
A. CN I
108
Involved in basal skull fractures and otorrhea
A. CN I
B. CN II
C. CN III
D. CN VII
E. CN VIII
E. CN VIII
109
Associated with scotoma (blurring of the central part of an image)
A. CN I
B. CN II
C. CN III
D. CN VII
E. CN VIII
B. CN II
110
CSF ____, which is leakage of CSF into one nostril when the head is tilted forward is indicative of a basal
skull fracture.
rhinorrhea
Additional: The pt. may also subjectively report a metallic taste in the mouth and sensation of drainage at the back of the mouth
111
CSF ____, which is leakage of CSF into one of the ears, is an indication of basal skull fractures.
otorrhea
112
TRUE OR FALSE: Sensory assessment can be done in TBI patients who can follow simple instructions or not in a state of confusion (i.e., RLA 6-8).
True
113
RLA levels ___ are not candidates for cerebellar examination, as this examination can only be done if pt can follow simple commands.
1-4
114
The length of time between the injury and the time at which
the pt. is able to consistently remember ongoing events
Post-traumatic amnesia
115
Loss of memory but with ability to recall
A. Post-traumatic amnesia
B. Retrograde / Evocation Amnesia
C. Anterograde / Fixation Amnesia
A. Post-traumatic amnesia
116
Inability to learn new things
A. Post-traumatic amnesia
B. Retrograde / Evocation Amnesia
C. Anterograde / Fixation Amnesia
C. Anterograde / Fixation Amnesia
117
Loss of previous memories after the accident
A. Post-traumatic amnesia
B. Retrograde / Evocation Amnesia
C. Anterograde / Fixation Amnesia
B. Retrograde / Evocation Amnesia
118
Lowers the inflammatory process of the body
A. Progesterone
B. Phenytoin
C. Corticosteroids
C. Corticosteroids
119
Anti-convulsant, effective in decreasing the risk of early post-traumatic seizures
A. Progesterone
B. Phenytoin
C. Corticosteroids
B. Phenytoin
120
Has neuroprotective properties
A. Progesterone
B. Phenytoin
C. Corticosteroids
A. Progesterone
121
Associated with increased mortality rate after 2 weeks of treatment d/t elevated CSF cortisol in the body
A. Progesterone
B. Phenytoin
C. Corticosteroids
C. Corticosteroids
122
TRUE OR FALSE: Post-traumatic seizure is commonly seen in patients who suffered from severe TBI.
True
123
Enumerate the 2 areas in the brain that are prone to anoxia
1. Hippocampus
2. Basal ganglia
124
Head-on vehicular collision: Forward acceleration of the body is suddenly
stopped by the impact. The brain
tissue still moves forward hitting the skull while the body has already stopped.
A. Coup injury
B. Countercoup injury
C. Coup-countercoup injury
A. Coup injury
125
Head-on vehicular collision: Sudden recoil of the body after impact will lead
to deceleration and translate to the brain a little delayed, so the brain will again translate backward hitting the skull.
A. Coup injury
B. Countercoup injury
C. Coup-countercoup injury
B. Countercoup injury
126
Occurs on both the site of impact and an area remote or away from injury site
A. Coup injury
B. Countercoup injury
C. Coup-countercoup injury
C. Coup-countercoup injury
127
Occurs on site of impact
A. Coup injury
B. Countercoup injury
C. Coup-countercoup injury
A. Coup injury
128
Occurs on an area remote or away from injury site and
opposite cortex
A. Coup injury
B. Countercoup injury
C. Coup-countercoup injury
B. Countercoup injury
129
Dissociation between wakefulness and
awareness
A. Comatose
B. Vegetative State
C. Minimally conscious state
D. Stupor
E. Obtunded
B. Vegetative State
130
Minimal evidence of self or environmental
awareness
A. Comatose
B. Vegetative State
C. Minimally conscious state
D. Stupor
E. Obtunded
C. Minimally conscious state
131
Ventilator-dependent, arousal system is non-functional, closed eyes, no sleep-wake cycle, no auditory and visual function, no
communicative function, abnormal postural reflexes may be present
A. Comatose
B. Vegetative State
C. Minimally conscious state
D. Stupor
E. Obtunded
A. Comatose
Note: Usually comatose is not permanent. These patients may go to brain dead, vegetative state, minimally conscious, or on to full recovery.
132
Cognitive behaviors are inconsistent, reproducible, or sustained. Presence of sleep-wake cycle. Pt can localize painful stimuli, sound stimuli, and may demonstrate visual pursuit of an object.
A. Comatose
B. Vegetative State
C. Minimally conscious state
D. Stupor
E. Obtunded
C. Minimally conscious state
133
Enumerate the 3 structures spared in diffuse axonal injury
1. Upper medulla
2. Glossopharyngeal nerve (CN 9)
3. Accessory nerve (CN 11)
133
Enumerate the 3 common sites of disruption in diffuse axonal injury
1. Corpus callosum
2. Subcortical white matter
3. Brainstem
134
TRUE OR FALSE: Primary and secondary brain injuries are not mutually exclusive and often do not occur in isolation.
True
135
This area is for the conjugate horizontal movement of the eyes away from the stimulus.
A. Frontal Eye Field (BA 8)
B. Primary Visual Cortex (BA 17)
C. Secondary Visual Cortex (BA 18, 19)
D. Prefrontal Cortex (BA 9, 10, 11, 12)
A. Frontal Eye Field (BA 8)
136
This area contains a well-defined map of the spatial information required for vision.
A. Frontal Eye Field (BA 8)
B. Primary Visual Cortex (BA 17)
C. Secondary Visual Cortex (BA 18, 19)
D. Prefrontal Cortex (BA 9, 10, 11, 12)
B. Primary Visual Cortex (BA 17)
137
This area receives visual signals where they are interpreted and the form is recognized.
A. Frontal Eye Field (BA 8)
B. Primary Visual Cortex (BA 17)
C. Secondary Visual Cortex (BA 18, 19)
D. Prefrontal Cortex (BA 9, 10, 11, 12)
C. Secondary Visual Cortex (BA 18, 19)
138
This region is the highest cortical area responsible for motor planning, organization, and regulation, and sustaining attention and working memory.
A. Frontal Eye Field (BA 8)
B. Primary Visual Cortex (BA 17)
C. Secondary Visual Cortex (BA 18, 19)
D. Prefrontal Cortex (BA 9, 10, 11, 12)
D. Prefrontal Cortex (BA 9, 10, 11, 12)
139
Affectation of this Brodmann's area leads to Gerstmann Syndrome
A. Frontal Eye Field (BA 8)
B. Primary Auditory Cortex (BA 41, 42)
C. Wernicke's Area (BA 22)
D. Broca's Area (BA 44, 45)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
140
These gyri are situated on the upper part of the superior temporal gyri where tonotopic maps for different tones are located.
A. Frontal Eye Field (BA 8)
B. Primary Auditory Cortex (BA 41, 42)
C. Wernicke's Area (BA 22)
D. Broca's Area (BA 44, 45)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
B. Primary Auditory Cortex (BA 41, 42)
Additional: It is also located in Heschl's gyrus
141
This region is situated close to the external ear and involves complex language and auditory processing.
A. Frontal Eye Field (BA 8)
B. Primary Auditory Cortex (BA 41, 42)
C. Wernicke's Area (BA 22)
D. Broca's Area (BA 44, 45)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
C. Wernicke's Area (BA 22)
142
This region is associated with the praxis of speech.
A. Frontal Eye Field (BA 8)
B. Primary Auditory Cortex (BA 41, 42)
C. Wernicke's Area (BA 22)
D. Broca's Area (BA 44, 45)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
D. Broca's Area (BA 44, 45)
-Involved in motor speech programming
143
This area receives synthesized connections from the primary and secondary sensory cortices and respond to several types of inputs involved in complex associations
A. Primary Somatosensory Cortex (BA 3, 1, 2)
B. Somatosensory Association Cortex (BA 5, 7)
C. Primary Motor Cortex (BA 4)
D. Premotor Cortex (BA 6)
E. Primary Gustatory Cortex (BA 43)
B. Somatosensory Association Cortex (BA 5, 7)
144
This area is responsible for executing motor movements of the contralateral body segments.
A. Primary Somatosensory Cortex (BA 3, 1, 2)
B. Somatosensory Association Cortex (BA 5, 7)
C. Primary Motor Cortex (BA 4)
D. Premotor Cortex (BA 6)
E. Primary Gustatory Cortex (BA 43)
C. Primary Motor Cortex (BA 4)
145
This area is critical for the guidance of movement and control of proximal and trunk muscles, and contributes to the planning of complex and coordinated motor movements.
A. Primary Somatosensory Cortex (BA 3, 1, 2)
B. Somatosensory Association Cortex (BA 5, 7)
C. Primary Motor Cortex (BA 4)
D. Premotor Cortex (BA 6)
E. Primary Gustatory Cortex (BA 43)
D. Premotor Cortex (BA 6)
146
This structure is responsible for the perception of taste.
A. Primary Somatosensory Cortex (BA 3, 1, 2)
B. Somatosensory Association Cortex (BA 5, 7)
C. Primary Motor Cortex (BA 4)
D. Premotor Cortex (BA 6)
E. Primary Gustatory Cortex (BA 43)
E. Primary Gustatory Cortex (BA 43)
147
This area is associated with interpretation and localization of different sensations such as pain, temperature, touch and pressure.
A. Primary Somatosensory Cortex (BA 3, 1, 2)
B. Somatosensory Association Cortex (BA 5, 7)
C. Primary Motor Cortex (BA 4)
D. Premotor Cortex (BA 6)
E. Primary Gustatory Cortex (BA 43)
A. Primary Somatosensory Cortex (BA 3, 1, 2)
148
Considered to be part of the Wernicke's area for receptive speech
A. Frontal Eye Field (BA 8)
B. Primary Auditory Cortex (BA 41, 42)
C. Wernicke's Area (BA 22)
D. Broca's Area (BA 44, 45)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
E. Angular Gyrus (BA 39) and Supramarginal Gyrus (BA 40)
148
This Brodmann's area is found in the left dominant hemisphere in the superior temporal gyrus
Wernicke's area (BA 22)
148
This Brodmann's area is found in the insular cortex and frontoparietal operculum.
Primary Gustatory Cortex (BA 43)
149
This Brodmann's area is found in the inferior frontal gyrus
Broca's area (BA 44, 45)
150
3rd leading cause of TBI most often in sports
Struck by / against an
object
151
Leading cause
of sports related TBI
Diving
152
Enumerate the sequence of recovery after a coma
1: Eye opening (CN 3)
2: (+) Brainstem Function
3: (+) Hypothalamus function
4: Able to talk (best indicator of recovery)
153
Why does having an intact oculocephalic reflex indicate a good prognosis for patients in the persistent vegetative state?
Intact CN 3 and CN 6
154
Enumerate the 5 characteristics of the persistent vegetative state
1. (+) sleep wake cycle
2. (+) pupillary constriction
3. (+) oculocephalic reflex
4. (+) primitive behavior
5. Spontaneous response
