TBI Flashcards
Males are often more affected by TBI than females (true/false)
true
Which cause of TBI is the most common?
a. MVA
b. Sports
c. falls
d. other collisions
falls
This mechanism of injury in TBI causes more susceptibility to brain damage, infection and rupture of blood vessels
a. open head injury
b. high velocity injury
c. closed head injury
d. low velocity injury
open head injury
This mechanism of injury in TBI is more perforation or depressed fracture with diffused axonal damage
a. low-velocity injury
b. high-velocity injury
c. penetration
d. hypoxia
high velocity injury
This mechanism of injury in TBI is more linear with fracture contusion at side of impact and possible tear or blood vessels
a. low-velocity injury
b. hypoxia
c. penetration
d. high-velocity injury
low velocity injury
What are potential mechanisms of injury with TBI?
fractures
direct blow without fracture
penetrating
loss of blood supply from neck injury
A direct blow without fracture will have brain damage due to
anoxia
What are the types of primary damage in TBI?
focal injury
diffuse axonal injury
This type of TBI is shown as damage to the exact area where hit, with any severity and more severe neurological signs
focal injury
This primary damage is acceleration, deceleration and/or rotational damage to the brain
diffuse axonal injury
this type of damage may not show signs initially but it will get more severe with edema over time
diffuse axonal injury
What is secondary damage with TBI?
increased intracranial pressure hypoxic-ischemic damage infection seizures electrolyte imbalance
Increased intracranial pressure can be due to
herniation
hematomas
increased intracranial pressure is related to
poorer outcomes
increased mortality rates
A direct blow to the head is a cause of diffuse axonal injury (true/false)
false
A bruise directly at site of impact is called
a. open head injury
b. closed head injury
c. coup
d. contrecoup
coup
As the brain is jolted back, it can hit the skull on the opposite side, this is defined as
a. open head injury
b. closed head injury
c. coup
d. contrecoup
countercoup
All of the following are secondary damage to TBI except
a. hypoxic-ischemic damage
b. diffuse axonal injury
c. infection
d. seizure
diffuse axonal injury
This type of imaging is good for showing fractures in the skull
a. CT
b. MRI
c. x-ray
d. PET
x-ray
Which neurological imaging is good for nonresponsive patients in order to see brain activity?
a. CT
b. PET
c. EEG
d. fMRI
EEG
This type of imaging shows mass lesions and brain shifting from acute injury after TBI
a. CT
b. MRI
c. x-ray
d. PET
CT
_ is more sensitive than CT
MRI
This type of imaging shows disturbances in cerebral metabolism that may not show on other
a. CT
b. MRI
c. x-ray
d. PET
PET
This type of imaging shows cognitive dynamics and overall neuroplasticity
a. CT
b. MRI
c. fMRI
d. PET
fMRI
What autonomic nervous system changes are seen with TBI?
changes in pulse and respiratory rates temperature elevations blood pressure changes excessive sweating, salivation, tearing dilated pupils vomiting
All of the following include changes in the autonomic nervous system except
a. temperature elevations
b. constricted pupils
c. vomiting
d. changes in pulse
constricted pupils
All of the following include changes in the autonomic nervous system except
a. dilated pupils
b. changes in pulse and respiratory
c. temperature decreased
d. vomiting
temperature decreased
What are the neuromuscular changes that occur?
sensory impairments abnormal tone motor function impairments impaired balance loss of bowel or bladder control CN involvement locked-in syndrome
What sensory impairments can occur with TBI?
changes in primary sensation light touch, deep touch, position sense
What abnormal tone is seen with TBI?
a. low tone
b. high tone
c. normal tone
d. full spectrum
full spectrum possible
A patient’s LE is in extension and UE in flexion this describes
a. low tone
b. decorticate
c. rigidity
d. decerebrate
decorticate
All of the extremities are in an extension posture, this describes
a. low tone
b. decorticate
c. rigidity
d. decerebrate
decerebrate
All of the extremities are in an _ posture = decerebrate
extension
Decorticate position
a. LE in flexion and UE in flexion
b. LE in extension and UE in flexion
c. LE in extension and UE in extension
d. none of the above
LE in extension and UE in flexion
What are the motor function impairments possible with TBI?
motor control and learning impairments loss of selective motor control impairments in coordination, timing, sequencing paresis abnormal reflexes
TBI patients have a loss of bowel or bladder control (true/false)
true
What are the cognitive changes seen with TBI?
coma/altered level of consciousness memory loss altered orientation attentional deficits impaired insight and safety awareness problem-solving preservation impaired executive functioning
Learning is not affected with memory loss (true/false)
false
This is referred to as the time between injury and then the ability to remember ongoing events
PTA
Orientation includes
person
place
time
situation
This is defined as an inability to stay on task, concentrate or focus and inhibit distraction
a. impaired executive functioning
b. perservation
c. attentional deficit
d. problem-solving impairment
attentional deficit
This is usually when they are stuck on one idea and it is all they think about
a. impaired executive functioning
b. perservation
c. attentional deficit
d. problem-solving impairment
persevation
What visual changes occur with TBI?
cortical blindness
hemianopsia
Awareness of body parts, position of body in relationship to environment is defined as
a. body image
b. right left discrimination
c. spatial relations disorder
d. body scheme
body scheme
Dont recognize visual, auditory, or tactile
a. somatoagnosia
b. finger agnosia
c. unilateral neglect
d. agnosia
agnosia
Denial or lack of awareness of the problem on one side of the body
a. apraxia
b. agnosia
c. anosognisa
d. somatoagnosia
anosognisa
Impairment in scheme, inability to correctly identify or orient the parts of one’s body or the body of another
a. apraxia
b. agnosia
c. anosognisa
d. somatoagnosia
somatoagnosia
Ability to perceive self in relation to other objects
a. spatial relations disorder
b. figure-ground discrimination
c. form discrimination
d. body scheme
spatial relations disorder
Ability to distinguish foreground from background
a. spatial relations disorder
b. figure-ground discrimination
c. form discrimination
d. body scheme
figure ground discrimination
Ability to understand concepts like over, under, around, above and below
a. spatial relations disorder
b. position in space
c. body scheme
d. topographic disorientation
position in space
Ability to find ones way from one place to another
a. spatial relations disorder
b. position in space
c. body scheme
d. topographic disorientation
topographic disorientation
What are the behavioral deficits seen in TBI?
disinhibition impulsiveness physical and verbal aggressiveness apathy lability sexual inappropriateness irritability egocentricity
What are communication deficits seen in TBI?
receptive aphasia expressive aphasia dysarthria auditory deficits impaired reading comprehension impaired writing expression impaired pragmatics
TBI patients can have dysphagia (true/false)
true
List the secondary impairments
contractures skin breakdown DVT heterotrophic ossification decreased bone density muscle atrophy decreased endurance infection pneumonia
The Glascow coma scale is used primarily to measure severity of TBI in which setting?
a. Outpatient rehab
b. Acute
c. ICU
d. Home health
Acute
Posttraumatic amnesia is defined as
a. Time between injury and ability to motor recovery
b. Time between injury and ability to come out of coma
c. Time between injury and ability to remember ongoing events
Time between injury and ability to remember ongoing events
A mild TBI is considered a concussion (true/false)
true
Which stage of severity of TBI considers physical, cognitive and behavioral impairments for months that could become permanent
a. Mild
b. Moderate
c. Severe
Moderate
Which clinical rating scales can be used to measure employability?
a. GCS and GOS
b. GOAT and GOS
c. DRS and FIM
d. DRS and FAM
DRS and FAM
Which category in the ICF table would FAM fit under?
a. Body function/impairment
b. Participation
c. Activity
d. Environment internal
Participation
Which category in the ICF table would DRS fit under?
a. Body function/impairment
b. Participation
c. Activity
d. Environment internal
Participation
Which clinical rating scale is used at discharge and then 6 months after injury?
a. GCS
b. GOAT
c. GOS
d. Rancho
GOS
Which clinical rating scale is used in the subacute stage measuring consciousness?
a. GCS
b. GOAT
c. GOS
d. Rancho
Rancho
The glascow coma scale measures what activities?
a. Cognitive status and postural control
b. Cognitive status, motor response and verbal response
c. Eye opening and vegetative state
d. Eye opening, best motor response and verbal response
Eye opening, best motor response and verbal response
The purpose of the GOS is to measure
a. Outcome
b. Prognosis
c. Current state of cognition
d. Motor response
Prognosis
If a patient is in a coma more than 2 weeks the prognosis for cognitive function is
a. Moderate to good recovery on GOS
b. Moderate to severe on GOS at 1 year
c. Moderate disability to good recovery
d. Moderate to severe on GOS
Moderate to severe on GOS at 1 year
If a patient is in a coma less than 1 week, the prognosis for cognitive function is
a. Moderate to good recovery on GOS
b. Moderate to severe on GOS at 1 year
c. Moderate disability to good recovery
d. Moderate to severe on GOS
Moderate to good recovery on GOS
If a patient is PTA is measured more than 12 weeks, the prognosis for cognitive function is
a. Moderate to good recovery on GOS
b. Moderate to severe on GOS at 1 year
c. Moderate disability to good recovery
d. Moderate to severe on GOS
Moderate to severe on GOS
If a patient PTA is measured less than 4 weeks, the prognosis for cognitive function is
a. Moderate to good recovery on GOS
b. Moderate to severe on GOS at 1 year
c. Moderate disability to good recovery
d. Moderate to severe on GOS
Moderate disability to good recovery
A patient scores a 14 on the GCS, their loss of consciousness was less than 30 minutes and PTA was 12 hours. What level of severity should they be categorized under?
a. moderate
b. severe
c. mild
mild
A patient scores 10 on the GCS, loss of consciousness for 10 hours and 4 days of PTA. What is their TBI severity level?
a. moderate
b. severe
c. mild
moderate
A patient scores a 4 on the GCS, loss of consciousness for 42 hours and has PTA for 14 days. What is their TBI severity level?
a. moderate
b. severe
c. mild
severe
GCS of 13-15
loss of consciousness <30 min
PTA 0-1 day
what is the severity level?
mild
GCS of 9-12
loss of consciousness 30 minutes-24 hours
>1 to <7 days
what is the severity level?
moderate