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Neuro > TBI > Flashcards

TBI Flashcards

1
Q

definition: any injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma.

A

Acquired brain injury (ABI)

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2
Q

(true/false) TBI is not a type of ABI.

A

FALSE

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3
Q

Cerebral palsy is a ___ that occurs before birth.

A

TBI

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4
Q

(true/false) The number of people who sustain TBIs and do not seek treatment is UNKNOWN.

A

true

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5
Q

___% of persons discharged after acute TBI hospitalizations develop long-term disability

A

43%

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6
Q

What is the high risk population of TBI?

A

Males 0-4 y/o and 15-19 y/o

elderly 65-75 y/o

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7
Q

Alcohol is a factor in ___% of TBI incidents

A

50%

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8
Q

What is the leading cause of TBI?

A

falls

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9
Q

Secondary injury after a TBI causes (less/more) damage than the primary injury.

A

More

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10
Q

Contusions, lacerations, and hematomas cause (focal/diffused) damage.

A

focal damage

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11
Q

definition: scattered areas of hemorrhage or bruising usually along the undersurface of the frontal and temporal lobes due to the brain striking a ridge on the skull or dural fold. Seen with individuals with a serious head injury and often accompanied with SDH or EDH

A

contusions

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12
Q

definition:

TBI caused by:
Acceleration/Deceleration of the brain in the skull

Shearing and rotational forces

Axonal disruption in cerebrum, cerebellum and brainstem

Widespread/diffuse damage

Can now be found on imaging

A

Diffuse axonal injury

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13
Q

Anoxia/hypoxia is a (ABI/TBI)

A

ABI (not traumatic)

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14
Q

What has a worse prognosis… anoxia/hypoxia or TBI?

A

anoxia/hypoxia due to it having more diffusion

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15
Q

definition: injury that is a result of the brain’s reaction to trauma or other system failure.

A

secondary intracranial insults

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16
Q

Secondary intracranial insults occur primarily due to what?

A

lack of oxygen (can occur from minutes to days after)

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17
Q

definition: Collection of blood in between the skull and dura mater

Brief LOC
Lucid interval
Progressive neurological deterioration

A

epidermal hematoma (EDH)

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18
Q

What is more common… epidural hematoma or Subdural hemorrhage?

A

subdural hemorrhage

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19
Q

What is the key to survival for a person with an epidural hematoma?

A

early detection

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20
Q

definition: a collection of blood between dura mater and arachnoid space

A

subdural hemorrhage (SDH)

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21
Q

(acute/chronic) SDH is the most lethal of ALL head injuries.

A

acute SDH

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22
Q

You can possibly see chronic SDH in the elderly due to _____.

A

brain atrophy

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23
Q

definition: a collection of blood in the subarachnoid space (b/w arachnoid and pia mater)

A

subarachnoid hemorrhage (SAH)

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24
Q

SAH can potentially cause ______.

A

arterial vasospasm

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25
Q

What is the cognitive progression scale?

A
  1. coma
  2. vegetative state
  3. minimally conscious state
  4. low level/traditional
  5. high level
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26
Q

definition: “Represents a state of unarousable responsiveness in which the eyes remain continuously closed and there is no understandable response to environmental or intrinsic stimulation”

A

coma

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27
Q

definition: “A state with no sign of conscious awareness of self or environment but with preserved autonomic or ‘vegetative’ functions, typically including eye opening and sleep/wake cycles”

A

vegetative state

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28
Q

definition: “A condition of severely altered consciousness in which minimal, but definite behavioral evidence of self or environmental awareness is demonstrated”

A

minimally conscious state (MCS)

29
Q

What are medical complications of TBI?

A
  • hypermetabolism (catabolism
  • Elevated rested energy expenditure
  • electrolyte imbalance (hyponatremia)
  • SIADH
  • hypotension/ HTN
  • tachycardia
  • increased CO
  • ANS dysfunction (PSH)
  • DVT
  • arrythmias
  • ARDS
  • apnea
  • decreased O2 saturation
30
Q

Hyponatremia is a deficit in ____ levels.

A

sodium

31
Q

hydrocephalus is often due to what type of hemorrhage?

A

subarachnoid

32
Q

What is the treatment for hydrocephalus?

A

ventriculoperitoneal shunt

33
Q

A person with TBI is more susceptible to (early/late) seizures related to increased ICP

A

early

34
Q

What are the risk factors for HO?

A
  • multiple limb Fx
  • immobility
  • prolonged unconsciousness
  • increased muscle tone
  • high velocity accidents
35
Q

What are clinical signs of HO?

A
  • warmth
  • redness
  • decreased ROM
  • pain
  • swelling/edema
36
Q

What are the functions of the frontal lobe?

A

Executive functions
emotions
attention
motor component of speech (Broca’s area)
Primary motor cortex

37
Q

definition: bruising around the ear

A

battle’s sign

38
Q

What are the functions of the temporal lobe?

A

primary auditory cortex
comprehension and expression of language
memory
learning
vestibular issues (Raccoon eyes and battle’s sign)

39
Q

What does temporal lobe dysfunction cause?

A

petit mal seizures
poor short-term memory
explicit memory deficit
storage and retrieval loss
loss of auditory processing
wernicke’s aphasia

40
Q

Receptive/fluent aphasia

A

wernicke’s aphasia

41
Q

Expressive/non-fluent aphasia

A

broca’s aphasia

42
Q

What are the functions of the parietal lobe?

A

primary sensory area
orientation of time and space
object recognition
processing of somatic and visual information
ability to process written information

43
Q

What does parietal lobe dysfunction cause?

A

Visual-spacial deficits (inattention)
Difficulty recognizing objects (agnosia)
touch, proprioception, and pressure sensory loss
loss of ability to read and write
loss of right/left discrimination

44
Q

definition: difficulty recognizing objects

A

agnosia

45
Q

definition: loss of ability to read

A

alexia

46
Q

What are the occipital lobe functions?

A

vision

47
Q

What does occipital lobe dysfunction cause?

A

visual agnosia
field cuts
nystagmus
cortical blindness

48
Q

What are the functions of the cerebellum?

A

Coordination
postural control
balance
Vestibulo-ocular function
unconscious proprioception

49
Q

What does cerebellar dysfunction cause?

A

hypotonia
incoordination/ataxia
decomposition of movements
intention tremor
dysmetria
Wide BOS
scissoring gait
Vestibulo-ocular deficits
balance disorders
proprioceptive/kinesthetic loss

50
Q

What is one of the cardinal signs of cerebellar damage?

A

ataxia

51
Q

Hypotonicity occurs on the (ipsilateral/contralateral/both) side(s) of the cerebellar lesion if it is NOT central

A

ipsilateral side

52
Q

Hypotonicity occurs on the (ipsilateral/contralateral/both) side(s) of the cerebellar lesion if it is central

A

both sides

53
Q

What are the functions of the brainstem?

A

CVP control
reflexes
postural tone
autonomic function
swallow/gag reflex

54
Q

What does brainstem dysfunction cause?

A

apnea
arrythmias
rigidity
diplopia
dysarthria
dysphagia
CN disorder
Disorder of conscious state
locked-in syndrome

55
Q

What is the first thing to do when experiencing a person with a TBI in emergent situations?

A

ABC’s (airway, breathing, circulation)

56
Q

What should the ICP be in an adult lying in supine?

A

0-10 mmHg

57
Q

What should the CPP be in an adult?

A

80-100 mmHg

58
Q

What MAP range is needed to maintain cerebral blood flow?

A

50-100 mmHg

59
Q

What are s/s of elevated or increasing ICP?

A

Change in arousal
Disorientation, confusion, combativeness
Change in cranial nerve exam
Pupil changes
Altered RR
Altered HR, rhythm
Altered BP
Increased posturing, tone
Decreased motor response
Increased temperature
HA/N/V

60
Q

How should you as a PT help prevent secondary complications of TBI?

A
  • maintain ROM
  • optimize positioning
  • integumentary care
61
Q

What signs show positive prognosis for a person when emerging from unresponsiveness?

A
  • young age
  • reactive pupils and conjugate eye movements
  • decorticate posturing
  • early spontaneous eye opening
  • absence of ventilator and/or hydrocephalus
  • shorter time period between injury and rehab
  • higher DRS score
  • early rapid functional improvement
62
Q

definition: Traumatically induced physiological disruption of brain function with at least one of the following:

  • Any period of loss of consciousness
  • Any loss of memory for events immediately before or after the trauma
  • Any alteration in mental status at the time of the trauma
  • Focal neurological deficits that may or may not be transient
A

mild TBI

63
Q

definition: When the severity of the injury exceeds the following:

LOC > 30 min
After 30 min, initial GCS of < 12
Post-traumatic amnesia > 24 hours

Cognitive/behavioral problems = major long-term source of disability

A

moderate/severe TBI

64
Q

(true/false) Those with a moderate /severe TBI usually do not physically recover.

A

FALSE (they usually physically recover well)

65
Q

What is another name for a mild TBI?

A

concussion

66
Q

Pharmacology:

MOA: not entirely known.
- Facilitates dopamine release.
- Glutamate antagonist.

Used to reduce agitation in severe TBI

Also used as a psychostimulant for those in the VS/MCS

Side effects: Orthostasis, peripheral edema, livedo reticularis, lowers seizure threshold, hallucinations

A

amantadine (symmetrel)

67
Q

Pharmacology:

MOA: enhances dopaminergic transmission

Uses:
- Attention
- Mood
- Alertness
- Arousal
- information processing

Side effects: tachycardia, insomnia, decreased appetite, GI upset, headaches, dizziness, motor tics, irritability, anxiousness, tearfulness

A

Methylphenidate (Ritalin)

68
Q

pharmacology:

MOA: dopamine agonist

Uses:
- Parkinson’s disease for autonomic regulation, motor control, and arousal

Side effects: orthostatic hypotension, nausea/vomiting, vertigo, edema, headaches, dyskinesias, dystonia, sleep disturbance, hypersexuality

A

bromocriptine (Parlodel)

Neuro (45 decks)

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