TBI

Question 1

Open injury

Answer 1

direct penetration through the skull to the brain
Examples: gunshot, knife or sharp object, skull fragments, and direct trauma.

Question 2

Closed injury

Answer 2

without penetration to the skill.
Examples: concussion, contusion, hematoma, injury to extracranial blood vessels, hypoxia, drug overdose, near drowning, acceleration and deceleration injuries.

Question 3

Primary injury

Answer 3

initial injury to brain sustained by impact.
Examples: skill penetration, skull fractures, contusions to gray and white matter.

Question 4

Coup lesion

Answer 4

direct lesion of the brain under the point of impact. Local brain damage

Question 5

Contrecoup lesion

Answer 5

opposite side of brain because of rebound effect after impact

Question 6

Secondary injury

Answer 6

as a response to initial injury.
Examples: hematoma, hypoxia, ischemia, increased intracranial pressure and post-traumatic epilepsy.

Question 7

Epidural hematoma

Answer 7

between skull and dura

Question 8

Subdural hematoma

Answer 8

between dura and arachnoid

Question 9

Obtundity

Answer 9

state of consciousness characterized by state of sleep, reduced alertness to arousal, and delayed responses to stimuli

Question 10

Clouding of consciousness

Answer 10

state of consciousness characterized by quiet behavior, confusion, poor attention, and delayed responses.

Question 11

Concussion grades:
Grade 1

Answer 11

no loss of consciousness.
Symptoms typically resolve within 15 minutes of event.
Athlete should be removed and return only if symptom free for 1 week.

Question 12

Concussion grades:
Grade 2

Answer 12

moderate head injury with transient confusion that will last longer than 15 minutes.
Receive medical evaluation. CT scan is indicated if symptoms worsen and return to play should be deferred until athlete is asymptomatic for 2 weeks with rest and exertion.

Question 13

Concussion grades:
Grade 3

Answer 13

loss of consciousness
ER
hospitalization warranted if altered consciousness or mental status persists.
Athlete withheld from competition once symptom free for 1 month. Secondary to diffuse axonal injury and if severe can result in coma.

Question 14

Rancho Los Amigos Level of Cognitive Functioning:
I. No response

Answer 14

deep sleep and unresponsive

Question 15

Rancho Los Amigos Level of Cognitive Functioning:
II. Generalized response

Answer 15

reacts inconsistently and non-purposefully to stimuli in a nonspecific manner.

Question 16

Rancho Los Amigos Level of Cognitive Functioning:
III. Localized response

Answer 16

reacts specifically but inconsistently to stimuli.
may follow simple commands but they are inconsistent and delayed.

Question 17

Rancho Los Amigos Level of Cognitive Functioning:
IV. Confused-Agitated

Answer 17

heightened state of activity.
Behavior is non-purposeful.
Unable to cooperate directly with treatment.
Verbalizations frequently are incoherent and/or inappropriate to envrionment.

Question 18

Rancho Los Amigos Level of Cognitive Functioning:
V. Confused-inappropriate

Answer 18

able to respond to simple commands fairly consistently.
Responses are non-purposeful, random or fragmented.
Highly distractable and lacks ability to focus attention.
Verbalization is often inappropriate
Memory is severely impaired

Question 19

Rancho Los Amigos Level of Cognitive Functioning:
VI. Confused-appropriate

Answer 19

shows goal-directed behavior, but is dependent on external input or direction.
follows simple directions consistently and shows carryover for relearned tasks such as self-care.
Responses may be incorrect due to memory problems, but they are appropriate to the situation.

Question 20

Rancho Los Amigos Level of Cognitive Functioning:
VII. Automatic-Appropriate

Answer 20

Appropriate and oriented within the hospital and home setting.
Goes through daily routine automatically but frequently robotic like.
Shows minimal to no confusion.
Has shallow recall of activities
Shows carryover for new learning but at a decreased rate.
With structure can initiate social or recreational activities; judgment remains impaired.

Question 21

Rancho Los Amigos Level of Cognitive Functioning:
VIII. Purposeful-Appropriate

Answer 21

Basically normal but may still show decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress and judgment in emergencies or unusual circumstances.

Question 22

Additional levels of VIII.

Answer 22

standby assistance upon request
modified indep

Question 23

Glasgow coma scale scoring
8 or less=
9-12
13-15

Answer 23

severe brain injury or coma
moderate brain injury
mild brain injury

Question 24

Anterograde amnesia

Answer 24

inability to create new memory.
Usually last to recover after comatose state

Question 25

Post-traumatic amnesia

Answer 25

Does not recall the injury or events leading up to recovery.
Used as an indicator of extent of damage.

Question 26

Retrograde amnesia

Answer 26

inability to remember events prior to injury.
May progressively decrease with recovery.