Stolove Final - TBI Flashcards
difference between open vs closed injury
Open - meninges breached, brain exposed, generally from penetrating missle
closed - no fracture, coup mechanism, contracoup side is where tissue damage usually occurs
with what ROM is their an increased likelihood of diffuse axonal damage and brainstem injury?
rotation (of neck)
what is a gliding contusion?
gray matter moves over white matter
what type of hemorrhage can trigger a vasospasm where the area bcecomes ischemic?
subarachnoid
Diffuse axonal injury due to shear and tensile forces potential 4 results of this.
Edema
Increase in Glutamate
Increase in Free Radicals
Frank blood in parachyma
4 results of compressive damage
herniations
ANS changes (RR, HR, Temp, Sweating, Salvation)
swelling or pooling of blood in brain
2 results of hypoxia (decreased oxygen)
decreased blood to brain
hypertension result
lower pressure, blood cant get in
Clinical manifestations of a concussion
how long to heal?
brief LOC
dizziness, nausea, irritable
migraine with or without aura
1 week, longer if athlete
locked in syndrome occurs due to injury to what area?
ventral pons
how long do comas usually last?
4 weeks
the following areas of the brain affect what mental thing?
frontal, oribital frontal, septal, pseudobulbar
learning, memory
behavoir disinhibited
irritability
emotional lability
Cognitive/behavioral disturbance associated with Frontal Lobe pathology (5)
distractable sexually innapropriate apathy anosognosia (denial of deficit) anosodiaphoria (lack of concern about deficit)
Behavioral Disturbances after TBI (8)
Abrupt physical actions Rambling speech Interrupts conversations Socially inappropriate Irritable Labile affect Anger Depression /restricted affect
Ranchos los amigos scale level 1-8 means what?
1: unresponsive to
8: purposeful/appropriate (not a return to baseline)
3 ways memory is affected tbi with LOC
retrograde amnesia
post-traumatic amnesia
anterograde memory
3 types of pain which may result from a TBI
Neuropathic pain from aberrant somatosensory processing
Myofacial pain with trigger points
Fibromyalgic pain
what cranial nerves are affected during corneal refulex stimulation of cornea “eye closes”
glossopharyngeal, and vegas nerves - medulla
what is decorticate posturing? decerebate posturing?
both upper extremities flexed and both lower extremities extended
all four extremities in extension
how long after injury can heterotopic ossification occur?
4-12 weeks after injury
3 respiratory compromises which develop from TBI’s
Pulmonary edema
Aspiration pneumonia
Pulmonary emboli secondary to DVT
what is second impact syndrome?
effects of multiple consussions are cumulative among athletes
any score of 9 or less on the glascow scale indicates what?
coma
which imaging is best to use for posterior fossa lesions, corpus collosal and intraventricular hemorrhages, and better for testing increased intracranial pressure?
MRI
