TBI Flashcards
What are some of the risk factors?
1) Age
2) gender
3) SES
4) Substance abuse
5) School adjustment & social hx
6) personality type (type A)
7) participation of high risk sports
What are the two types of brain injuries and which one is more common?
1) Penetrating
2) Non-penetrating (closed-head injury; CHI) <– more common.
Two types of penetrating brain injury?
1) high velocity missile- goes through completely
2) Fracture w/ low velocity missile. Less severe.
T/F meninges stays in tact with Closed Head Injuries.
True.
What are the common occurances in CHI?
Traumatic hemorrhage & hematoma.
What are the two types of non-penetrating injuries (CHI)?
1) Non- acceleration
2) Acceleration injuries
What happens in non acceleration injuries?
A still head is hit by an outside moving object.
What are the types of acceleration injuries?
1) Linear
2) Angular
Which one is more severe- linear or angular acceleration? and why?
Angular b/c of the twisting and shearing of the brainstem, etc.
What are the two types of linear acceleration injuries and what kind of damage occurs? Give an explanation.
Coup & contrecoup. Focal damage.
Shaken baby syndrome & whiplash.
Ex. getting hit from the back in a car accident.
What are some secondary consequences of TBI?
1) Cerebral edema (swelling-increased pressure)
2) Ischemic brain damage
3) Cerebral Vasospasm
4) Alterations in blood-brain barrier
What is the Glasgow Coma Scale?
What are the levels?
rates the level of consciousness based on eye opening, motor behavior, and verbal responses. Typically given 6 hours after. 8 or less= coma 3-8= severe head injury 9-12= moderate head injury 13-15= mild head injury
What is the CLOCS?
Comprehensive level of consciousness scale; developed to meet problems of Glasgow. More sensitive to subtle changes. Broader range of responses.
What are some prognostic indicators of TBI?
1) duration of coma
2) duration of post-traumatic amnesia.
3) patient related variables
- age, substance abuse, SES & intelligence, premorbid personality.
T/F If the duration of post-traumatic amnesia lasts less than 2 weeks, it is associated with good recovery in 80% of the cases.
True.
T/F If the duration of post-traumatic amnesia lasts more than 12 weeks, it is associated with good recovery.
False.- not associated with good recovery.
What is the GOAT?
Galveston Orientation and Amnesia Test.
Tests for orientation and amnesia. Given to pts emerging from coma.
What are the three types of orientation (ox1, ox2, ox3)?
1) place
2) person
3) time
Other batteries that assess the outcome of a patient (2)?
1) Glasgow Outcome Scale (GOS).
2) Rancho Los Amigos Scale of Cognitive Levels
What are the general steps for recovery for TBI?
1) period of unconsciousness
2) return but with little response
3) More responsive and alert
WHat level are pts on RLAS if they are conscious?
@ least 4 or 5.
What level of RLAS should patients be at before they undergo any testing?
level 5.
At level 5 of RLAS you should test for…
Alertness, attention, visual processing, and memory.
What do you use to assess abstract thinking in pts with TBI?
1) proverb interpretation task.
2) similarities and differences tasks.
3) categorizing and sorting tasks.
