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CASLD 2 > TBI > Flashcards

TBI Flashcards

1
Q

the result of abrupt external forces acting on the skull and the brain

A

TBI

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2
Q

It was noted a higher percentage of TBI is reported in the regions of ____ and _____

A

56% – Africa and Southeast Asia

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3
Q

in ______ countries experience nearly 3 times more TBI cases

A

lower middle income countries

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4
Q

the cause of the overall traumatic death or it’s considered the 3rd most common cause of overall death due to TBI

A

central nervous system

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5
Q

Etiologies of TBI

A

falls, vehicular accidents, violent assaults, being hit by or running into an object

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6
Q

Risk factors of TBI

A

Age
sex
substance abuse
School adjustments and social history
Socioeconomic status
Personality
Hx of TBI
High risk sports

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7
Q

young _____ adults are more likely to experiences head injuries

A

male

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8
Q

2 types of head injuries

A

penetrating head injuries (open TBI)
non-penetrating head injuries

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9
Q

Happens when an object pierces the skull and enters the brain tissue

A

penetrating head injuries (open TBI)

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10
Q

Typically damages only a part of a brain

A

penetrating head injuries (open TBI)

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11
Q

pathophysiology of penetrating head injuries (open TBI)

A

missiles, some by blunt object, and a few by falls

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12
Q

The degree and nature of damage caused by the missile are dependent on the ___________

A

velocity of the missile

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13
Q

how does penetrating brain injury happen

A

High-velocity missile perforates the skull and tunnel through the brain before exiting to the opposite side of the entry

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14
Q

High-velocity missiles create ____ that destroys the tissue on both sides of the projectile’s track and diffuses bleeding and tissue disruption throughout the brain and the brainstem

A

pressure wave

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15
Q

Almost always fatal within minutes to hours

A

penetrating head injuries (open TBI)

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16
Q

________ are less often fatal

A

Low velocity injuries

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17
Q

Perforates the skull and brain causing tissue damage adjacent to the missile’s track

A

Low velocity injuries

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18
Q

May fracture the skull
Damage to the brain may be mild

A

Low velocity injuries

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19
Q

High mortality for penetrating injury caused by a ________

A

handgun

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20
Q

threats after the first day of injury

A

Infection
Bleeding
Increased intracranial pressure

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21
Q

Another term for Closed Head Injury or Blunt TBI

A

NON-PENETRATING HEAD INJURIES

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21
Q

Caused by an external force or strong enough to move the brain within the skull

A

NON-PENETRATING HEAD INJURIES

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22
Q

type of TBI where there is NO VISIBLE WOUND

A

NON-PENETRATING HEAD INJURIES

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23
Q

trauma is damaging the brain because of the force affecting the intracranial contents

A

NON-PENETRATING HEAD INJURIES

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24
Q

Deformation of the skull at the point of impact

A

Non-acceleration injury

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25
Q

types of NON-PENETRATING HEAD INJURIES

A

Non-acceleration injury (fixed head trauma)
Acceleration injury (moving head trauma)
Traumatic hemorrhage

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26
Q

The primary consequences of non-acceleration injuries

A

related to the deformation of the skull by the impact of the object striking the skull

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27
Q

Localized damage to the meninges and the brain cortex at the point of impact

A

impression trauma

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28
Q

there’s damage in the meninges and it’s not really clear whether it’s caused by the impact of the depressed skull against the brain or by the negative pressure that develops when the skull snaps back

A

impression trauma

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29
Q

The skull is forced from oval shape to circular shape d/t a slow-moving object with a large surface

A

ellipsoidal deformation

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30
Q

true or false

Fractures at the base of the skull are more dangerous than fractures higher up

A

true

because basal skull fractures may damage cranial nerves or the carotid arteries and that could actually endanger the patients life

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31
Q

The movement is caused by inertial forces

A

acceleration injury

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32
Q

Refers to when a TBI is caused by a sudden acceleration or deceleration of the head the brain and brain stem often suffer diffuse damage caused by their movement inside the skull.

A

acceleration injury

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33
Q

this type of non-penetrating injury depends on the direction from which the head is struck.

A

acceleration injury

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34
Q

this occurs when the head is struck by a force aligned with the center axis of the head

A

Linear acceleration injuries

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35
Q

One is initially resting and there is a lag in the movement (does not move in the same time with the skull) so that might cause bruises or abrasions because of the compression of the brain against the skull

A

coup injuries

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36
Q

Associated with a moving object impacting a stationary head

A

coup injury

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37
Q

Moving head (brain) strikes a stationary object

A

countrecoup

38
Q

Occurs more likely after blows to the front or back of the head than blows to the side of the head

A

translational trauma

39
Q

Combination of coup and contrecoup injuries

A

translational trauma

40
Q

Occurs only with linear acceleration and deceleration of the head

A

translational trauma

41
Q

Caused by blows that strike the head off-center

A

Angular Acceleration Injuries

42
Q

it can cause the brain to retate (rotate) and move it an angle away from the point of impact

A

Angular Acceleration Injuries

43
Q

these are common with acceleration injuries to the brain.

A

cranial nerve injuries

44
Q

true or false
Diffuse axonal injury → diffuse cognitive and behavioral impairments

A

true

This might result in the stretching of the nerve cell axons throughout the brain and the brainstem. This is what we call diffuse axonal injury, which can result to diffuse cognitive and behavioral impairments.

45
Q

Cuts, bruises, twisting, and shearing forces in the brain cause bleeding (hemorrhages) and accumulations of blood (hematomas).

A

traumatic hemorrhage

46
Q

most common (type?) of traumatic hemorrhage

A

Epidural hematomas

47
Q

signs and symptoms of TBI

A

Physical Problems
Sensory Problems
Behavior Changes
Social Communication Issues
Swallowing Problems
Problems w/ Thinking Skills
speech and language problem

48
Q

signs and symptoms

physical problems

A

Headache
Convulsions or seizures
Blurred or double vision
Unequal eye pupil size or dilation
Clear fluids draining from the nose or ears
Nausea and vomiting
New neurologic deficit (slurred speech; weakness of arms, legs, or face; loss of balance)

49
Q

signs and symptoms

sensory problems

A

Light-headedness, dizziness, vertigo, or loss of balance or coordination
Blurred vision
Hearing problems, such as ringing in the ears
Bad taste in the mouth
Sensitivity to light or sound
Mood changes or swings, agitation, combativeness, or other unusual behavior
Feeling anxious or depressed
Fatigue or drowsiness

50
Q

what type of signs and symptoms

Loss of or change in consciousness anywhere from a few seconds to a few hours

A

cognitive/behavioral changes

51
Q

signs and symptoms

cognitive/behavioral changes

A

Decreased level of consciousness (e.g., hard to awaken)
Mild to profound confusion or disorientation
Problems remembering, concentrating, or making decisions
Changes in sleep patterns
frustration, irritability

52
Q

may require only resting and over the counter pain relievers

A

mild TBI

53
Q

2 types of severity

A

mild TBI and severe TBI

54
Q

Treatment focuses on symptom relief and brain rest.

A

mild TBI

55
Q

type of severity wherein Surgery, Medications, Rehabilitation and Over the counter drugs are usually prescribed

A

severe TBI

56
Q

OTC medicine for severe TBI

anticonvulsant drugs that are used to treat ____

A

seizures

57
Q

OTC medicine for severe TBI

anticoagulants to prevent ________

A

blood clots

58
Q

OTC medicine for severe TBI

_______ to increase the awareness

A

stimulants

59
Q

OTC medicine for severe TBI

________ to reduce fluid build up and reduce pressure in the brain

A

diuretics

60
Q

OTC medicine for severe TBI
__________ and _________ to treat the feelings of fear and nervousness

A

antidepressants and anti-anxiety medications

61
Q

levels of consciousness

A

coma
vegetative state
minimally conscious state

62
Q

pathologic unconsciousness in which the patient’s eyes are continuously closed and in which the patient cannot be aroused.

A

coma

63
Q

a condition in which the patient’s awareness of self and his or her environment are presumed absent.

A

vegetative state

64
Q

a condition in which the patient makes minimal but unmistakable evidence of consciousness.

A

minimally conscious state

65
Q

Typically resolves within 3 to 4 weeks of injury

A

coma

66
Q

TBI diagnostic imaging

A

Computed tomography (CT)
Magnetic resonance imaging (MRI)

67
Q

immediate assessment

A

head injuries and the neurological exam

this exam will judge motor and sensory skills testing speech, coordination and balance, mental status, changes in mood or behavior, and other abilities

68
Q

Neuropsychological tests

A

Glasgow Coma Scale

This would involve looking into the cognitive behavioral aspects as well as the symptoms.

69
Q

Prognosticating Factors for TBI

A

Duration of Coma
Patient-Related Variables
Duration of Posttraumatic Amnesia

70
Q

duration of coma indicates that ___

A

Longer durations of coma are associated with poorer eventual recovery

Good recovery is expected the sooner the patient recovers from the coma

71
Q

patient-related variable is defined in terms of ___

A

how old the patient is (because older patients with TBI had higher mortality rates than due younger patients)

71
Q

If the patient has a good score and GOAT, that would actually correlate to a ________

A

better prognosis

72
Q

duration of post-traumatic amnesia can be assessed using ____

A

Glasgow coma scale or GOAT

73
Q

type of assessment test wherein it is usually used to track the recovery of orientation and memory for patients with TBIs from coma

A

GOAT, or the Galveston Orientation & Amnesia Test

74
Q

5 Managements given to TBI px

A

Sensory stimulation and orientation
Behavior management
Pharmacologic intervention
Cognitive-communication rehabilitation
Community integration

75
Q

the goal/purpose of this management is to increase the patient’s alertness, arousal, and responsiveness to the environment and prevent sensory deprivation

A

sensory stimulation

76
Q

On early intervention _______ (type of collaboration) is important to maximize the recovery and they have a better prognosis for the patient

A

interdisciplinary

77
Q

this is an intervention for comatose or semi-comatose patients

A

sensory stimulation (coma stimulation or coma arousal therapy; repeated exposure to auditory, visual, tactile, olfactory and taste stimulation)

78
Q

Complements orientation training and environmental control by incorporating procedures to increase adaptive behavior or decrease maladaptive behavior

A

behavior management

78
Q

General Principles of Sensory Stimulation

A
  • Control the environment to eliminate distraction
  • Ensure that the patient is comfortable before beginning stimulation
  • Stimulate one modality at a time
  • Stimulate acoustic, tactile, olfactory, and kinesthetic senses
  • Select meaningful stimuli
  • Alternate intervals of no stimulation with intervals of stimulation prevent habituation and support the patient’s sense of the passage of time
  • Keep objective observational records of the nature and patient’s response to each stimulation interval
79
Q

true or false

Patients with TBI who are in the early stages of recovery usually are NOT affected by intangible consequences or information feedback

A

true

They are more responsive to the tangible / incentive feedback

80
Q

true or false

incorporating procedures to increase adaptive behavior or decrease maladaptive behavior, you can also provide information feedback

A

true

Providing the patient with information about the appropriateness or correctness of his response to the stimuli

81
Q

2 types of feedback

A

incentive and information feedback

82
Q

Denotes a class of response-contingent stimuli that can maintain (or eliminate) behaviors whose only function is to elicit (or avoid) the stimuli

A

incentive feedback

83
Q

Denotes a class of stimuli that provides information about the appropriateness, correctness, or accuracy of the responses that elicit the stimuli

A

information feedback

84
Q

It provides restorative intervention to repair compromised cognitive-communication processes

A

cognitive-communication rehabilitation

85
Q

true or false

if restorative approaches alone doesn’t work, you might try compensatory interventions or the adaptive interventions

A

true

For example, for disoriented patients you might use the visual aids for those who are suffering from attention, visual stimuli might also be used depending on how the patient responds to the external aids.

86
Q

type of cog-com rehab

mental muscle building

A

restorative intervention (remedial)

87
Q

type of cog-com rehab

focus on adaptive behaviors rather than cognitive processes compared to the restorative which seeks to promote the patient’s independence by treating the specific cognitive processes

A

Compensatory interventions

88
Q

To stimulate and reactivate cognitive and linguistic processes

A

component training

89
Q

You treat them to restore the impaired process (linguistic & cognitive)

A

component training

90
Q

FINAL STAGE of rehabilitation for patients with TBI to be able to access the opportunity to participate in family, vocational, and community settings

A

COMMUNITY INTEGRATION

91
Q

Participants spend part of their day working on their specific strategies that would make them practice their daily living skills, working on groups— they will discuss problems and potential solution, and provide emotional support to each other

A

COMMUNITY INTEGRATION

CASLD 2 (4 decks)

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