TBI

Question 1

What TBI stands for?

Answer 1

Traumatic Brain Injury

Question 2

Causes of TBI

Answer 2

Motor Vehicular Accidents, Falls

Question 3

Types of TBI

Answer 3

Open penetrating injury & Closed non penetrating injury

Question 4

Causes of Open Brain Injury

Answer 4

Gun shot wounds, fragments from exploding objects

Question 5

Symptoms of Open Brain Inury

Answer 5

Focal neurological symptoms and post traumatic seizures

Question 6

Causes of Closed Brain Injury

Answer 6

Motor Vehicle accidents

Question 7

Symptoms of Closed Brain Injury

Answer 7

Contusions, bruises, DAI, Bilateral Asymmetrical injuries, skull fractures, subdural and epidural hemorrhage, tentorial herniation, coma, brief loss of consciousness

Question 8

Diffuse Axonal Injury (DAI)

Answer 8

Shearing of the white fibers of the brain

Question 9

Hematoma

Answer 9

blood clot

Question 10

Concussions

Answer 10

mild injury to the brain, often resulting from a blow to the head, that can cause temporary disorientation, memory loss and unconsiousness

Question 11

Criteria to determine the severity of TBI

Answer 11

length of amnesia, depth and duration of coma

Question 12

Method used to categorize level of consciousness after TBI

Answer 12

motor responses, verbal responses, eye opening

Question 13

Ranchos Los Amigos Scale of Cognitive Functioning

Answer 13

used to determine effective intervention for BEHAVORIAL ASPECTS of recovery

Question 14

What are the assessments that are delayed or postponed until later in the recovery?

Answer 14

Cognition, sensation and perception

Question 15

Decorticate Posturing

Answer 15

results from damage to corticospinal tracts - arms ADD and Flexed, wrist and fingers flexed, legs are stiffly extended and internally rotated with plantar flexion of the feet

Question 16

Decerebrate posturing

Answer 16

results from damage to the upper brain stem - arms are abducted and Extended, wrist pronated and fingers flexed, legs are stiffly extended with plantar flexion of the feet

Question 17

Coup

Answer 17

direct hit to the head

Question 18

Countercoup

Answer 18

result of brain moving inside the skull from the coup impact

Question 19

Laceration

Answer 19

a cut or gash to the skin, and the wound is deep and irregular edges requiring stitches

Question 20

Main goal of treatment in ICU

Answer 20

Medical Stability

Question 21

contributes to a better outcome

Answer 21

early mobilization and participation in functional activities

Question 22

Ranchos Los Amigos Scale Level I.

Answer 22

No response - deep sleep, completely unresponsive to any stimuli

Question 23

Ranchos Los Amigos Scale Level II

Answer 23

Generalized response - reacts inconsistently and non purposefully to a stimuli in a non-specific manner - may be delayed

Question 24

OT Tx in Level 2

Answer 24

Stim program with olfactory enhancement - really strong scent, and PROM

Question 25

Ranchos Los Amigos Scale Level III

Answer 25

Localized response - reacts specifically but inconsistently to stimuli - follow simple commands in an inconsistent and delayed manner

Question 26

OT Tx in Level 3

Answer 26

Continue stim program, simple gross motor actions, one step commands with no choice, basic self care, simple reality orientation

Question 27

Ranchos Los Amigos Scale Level IV

Answer 27

Confused Agitated - a heightened state of activity with severely decreased ability to process information, not able to cooperate directly with treatment efforts, gross attention to environment for a very short duration, confabulation may be present, ST recall is lacking, behavior is bizarre and non-purposeful relative to the environment

Question 28

OT Tx in Level 4

Answer 28

simple gross motor skills, vanilla room (non threatening and predictable, familiar and automatic tasks

Question 29

Ranchos Los Amigos Scale Level V

Answer 29

Confused Inappropriate Non Agitated - with structure, may be able to converse on a social automatic level for short periods of time

Question 30

OT Tx in Level 5

Answer 30

evaluate visual perception, provide redundancy and repetition, review biographical info, play simple games, go fish, war etc.

Question 31

Ranchos Los Amigos Scale Level VI

Answer 31

Confused Appropriate - goal directed but dependent on external input for direction , shows appropriate responses to discomfort and shows carry over of new learning

Question 32

OT Tx in Level 6

Answer 32

gradually decrease structure, work on ADLs less assistance, do simple math drills (single digit), sequencing cards, make simple treats, follow written directions, start with cooperation with others, start to put things away

Question 33

Ranchos Los Amigos Scale Level VII

Answer 33

Automatic Appropriate - oriented to familiar settings, goes through daily routines automatically but robot like with minimal to absent confusion, has superficial awareness but lack insight into own condition with decrease judgement and problem solving, unrealistic planning for future

Question 34

OT Tx in Level 7

Answer 34

focusing on community reentry skills, use phone, checkbook, money exchange, cross streets signs and grocery shop

Question 35

Ranchos Los Amigos Scale Level VIII

Answer 35

Purposeful Appropriate - alert and oriented and able to recall integrate past and recent events, responsive to own culture and shows carry over for new learning and no longer requires supervision once the activity is learned, can make STG and LTG for future, driving can occur (do 1 step of activity)

Question 36

OT Tx in Level 8

Answer 36

Home safety, ID dangerous situations in non predictable settings, (do full activity)

Question 37

Ranchos Los Amigos Scale Level IX

Answer 37

Purposeful Appropriate with Stand by Assistance on request

Question 38

Ranchos Los Amigos Scale Level X

Answer 38

Purposeful Appropriate with Modified Independent