TBI

Question 1

What are some of the risk factors?

Answer 1

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

Question 2

What are the two types of brain injuries and which one is more common?

Answer 2

1) Penetrating

2) Non-penetrating (closed-head injury; CHI) <– more common.

Question 3

Two types of penetrating brain injury?

Answer 3

1) high velocity missile- goes through completely

2) Fracture w/ low velocity missile. Less severe.

Question 4

T/F meninges stays in tact with Closed Head Injuries.

Answer 4

True.

Question 5

What are the common occurances in CHI?

Answer 5

Traumatic hemorrhage & hematoma.

Question 6

What are the two types of non-penetrating injuries (CHI)?

Answer 6

1) Non- acceleration

2) Acceleration injuries

Question 7

What happens in non acceleration injuries?

Answer 7

A still head is hit by an outside moving object.

Question 8

What are the types of acceleration injuries?

Answer 8

1) Linear

2) Angular

Question 9

Which one is more severe- linear or angular acceleration? and why?

Answer 9

Angular b/c of the twisting and shearing of the brainstem, etc.

Question 10

What are the two types of linear acceleration injuries and what kind of damage occurs? Give an explanation.

Answer 10

Coup & contrecoup. Focal damage.
Shaken baby syndrome & whiplash.
Ex. getting hit from the back in a car accident.

Question 11

What are some secondary consequences of TBI?

Answer 11

1) Cerebral edema (swelling-increased pressure)
2) Ischemic brain damage
3) Cerebral Vasospasm
4) Alterations in blood-brain barrier

Question 12

What is the Glasgow Coma Scale?

What are the levels?

Answer 12

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

Question 13

What is the CLOCS?

Answer 13

Comprehensive level of consciousness scale; developed to meet problems of Glasgow. More sensitive to subtle changes. Broader range of responses.

Question 14

What are some prognostic indicators of TBI?

Answer 14

1) duration of coma
2) duration of post-traumatic amnesia.
3) patient related variables
- age, substance abuse, SES & intelligence, premorbid personality.

Question 15

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.

Answer 15

True.

Question 16

T/F If the duration of post-traumatic amnesia lasts more than 12 weeks, it is associated with good recovery.

Answer 16

False.- not associated with good recovery.

Question 17

What is the GOAT?

Answer 17

Galveston Orientation and Amnesia Test.

Tests for orientation and amnesia. Given to pts emerging from coma.

Question 18

What are the three types of orientation (ox1, ox2, ox3)?

Answer 18

1) place
2) person
3) time

Question 19

Other batteries that assess the outcome of a patient (2)?

Answer 19

1) Glasgow Outcome Scale (GOS).

2) Rancho Los Amigos Scale of Cognitive Levels

Question 20

What are the general steps for recovery for TBI?

Answer 20

1) period of unconsciousness
2) return but with little response
3) More responsive and alert

Question 21

WHat level are pts on RLAS if they are conscious?

Answer 21

@ least 4 or 5.

Question 22

What level of RLAS should patients be at before they undergo any testing?

Answer 22

level 5.

Question 23

At level 5 of RLAS you should test for…

Answer 23

Alertness, attention, visual processing, and memory.

Question 24

What do you use to assess abstract thinking in pts with TBI?

Answer 24

1) proverb interpretation task.
2) similarities and differences tasks.
3) categorizing and sorting tasks.

Question 25

What are some test batteries for TBI?

Answer 25

1) RIPA
2) Brief test of Head Injury
3) SCATBI

Question 26

What are the 4 categories of compensatory strategies?

Answer 26

1) External compensations
2) Situational compensations
3) Recognition compensations
4) Anticipatory compensations

Question 27

What are 2 compensatory strategies for memory problems?

Answer 27

1) Internal Strategies
- Mnemonic devices
- Imagery
2) External Strategies
- lists, post-its, audio recordings, calendars, checklists.

Question 28

Why is group tx important for TBI pts?

Answer 28

1) practice pragmatics
2) Practice orientation
3) Aids in support
4) Practice for communication
5) Practice for communication

Question 29

What is the final stage of TBI?

Answer 29

Community re-entry.

Question 30

Name the three stages for working with families with pts with TBI?

Answer 30

Stage 1 = comatose. families need objective info on problem and probable outcome.
Stage 2= return to consciousness, families need to be educated on TBI recovery process and stages involved.
Stage 3= pt is in rehabilitation; must exaplin to families the recovery (it is slow). Need to cope with future impaired TBI pt. They need to accommodate to his/her new needs.