TBI Flashcards
1
Q
Common causes of TBI
A
- MVA
- GSW
- sports
- falls
- violence or abuse
- injuries related to war and military service
2
Q
Common casues of ABI
A
- near-drowning
- drug OD
- airway obstruction
- CVA
- MI
- trauma
- infection (AIDs meningitis)
3
Q
Types brain injury
A
- shearing.diffuse axonal injury
- coup-contrecoup injury
- focal brain injury
- closed: no skull fx
- open: skull fx
4
Q
Diffuse axonal injury
A
- related to acceleration/deceleration injuries
- cause axonal damage and wallerian degeneration
- may be microscopic
- commonly affects: parasagittal white matter, corpus callosum pontine-mesencephalic junction/superiro cerebellar peduncles
5
Q
Acute medical management
A
- airway: tracheostomy common if spontaneousbreathing does not return
- bed positioning/skin integrity
- intracranial pressure monitoring
- DVT prophylaxis (SCDs, cpmpression stockings, anticoagulants)
- other injuries, surgeries, tubes, and lines
6
Q
What is normal intracranial pressure
A
- normal =15mmhg
7
Q
Autonomic storming
A
- dysautonomia
- hypothalamic storming
- paroxysmal autonomic instability with dystonia
- increases in BP, HR, RR, sweating
- treatments: reduce amount of stimulation
- tends to be seen early on
8
Q
GCS:
A
- Best eye response
- best verbal response
- best motor response sections
- one for children under 5 for adjsuted verbal responses
9
Q
posturing: decerebrate
A
- damage to midbrain or brainstem
- lose influence of rubrospinal tract
- UE ext +LE ext
10
Q
Posturing Decorticate:
A
- superior to midbrain
- involvement of corticospinal tract
- Arms: Bent at the elbows and held close to the body.
- Hands: Clenched into fists, with wrists and fingers flexed and held on the chest.
- Legs: Extended and rigid.
- Feet: May turn inward, with toes pointed down.
11
Q
original rancho los amigos levels of cognitive function
A
- I: no response
- II: generalized response
- III: localized response
- IV: confused/agitated
- V: confused, inappropriate, non-agitated
- VI: confused/appropriate
- VII: automatic, appropriate
- VIII: purposeful, appropriate
there is a revised version of this
12
Q
recommended outcome meaures
A
- Action research arm test
- modified ashworth scale
- HiMAT
- mCTSIB
- DGI
- agitated behavior scale
13
Q
Terms to denote cognitive function
A
- coma: not awake or alert minimal or no response to stimuli
- persistent vegetative state/unresponsive wakefulness: generalized responses, sleep-wake cycle, arousal without interaction with environment
- minimall conscious state/minimally responsive state: inconsistent ability to follow directions, primitive reflexes awareness of environment
14
Q
Cognitive function
A
- rehabilitation is a team effort
- assessing funcion is a team effort
15
Q
Other test of cognition
A
- stroop test
- MMSE
- Proverbs:
- humor
16
Q
PT for TBI
A
- impairments in ROM, strength, motor control
- spasticity and hypertonia
- sitting and standing balance
- wheelchair positioning
- bed mobility, transfers, w/c mobility, gait
- BWS gait training
- motor planning
- cognitive retraining- all stages of recovery
17
Q
Reflexes to check for TBI
A
- hyperreflexia
- pathological reflexes: ATNR, palmar grasp, positive support
18
Q
functional activities for TBI patients
A
- weight-bearing activities
- upright activities: promotes cognition
19
Q
Air splints
A
- serial casting, bracing, orthotics
20
Q
serial casting
A
- fiberglass casting material is wrapped around the extremity
- one clinican does the wrapping while another holds the leg and foot in proper position
21
Q
Rancho los amigos level II
a persoanl will
A
- begin to respond to sounds, sights, touch or movement
- respond slowly, inconsistently or after a delay
- responds the same to what they hear, see or feel
- responses may include: chewing, sweating, breathing faster, moaning, moving, and/or increase in BP
22
Q
Rancho los amigos level III
A
- be awake on and off during the day
- make more movements than before
- react more specifically to what he sees, hears, or feels
- react slowly and inconsistently
- begin to recognize family and friends
- follow simple directions such as look at me or squeeze my hand
- begin to respons inconsistently to simple questions (yes or no head nods)
23
Q
Rancho los amigos level IV
A
- be very confused and frightened
- no understand what he feels or what is happening around him
- overreact to what he feels or what is happening around him
- overreact to what he sees, hears or feels by hitting, screaming, using abusive language or thashing about
- be highly focused on his basic needs: eating, relieving pain, going back to bed, going to the bathroom, or going home
- have difficulty following directions
24
Q
Rancho los amigos level V
A
- be able to pay attention for only a few minutes
- be confused and have difficulty making sense of things
- may need step-by-step instructions for basic ADLs even when physically able
- become overloaded and restless when tired or when there are too many people around
- have a poor memory, especially for recent events: try to fill in gaps in memory by making things up
25
Rancho los amigos level VI
- be somewhat fconfused because of memory thinking problems, he will remember the main points from a conversation but forget and cconfuse the details
- follow a schedule with some assistance but becomes confused by changes in the routine
- pay attention for about 30 minutes
- do or say things too fast without thinking first
- know that he is hospitalized becuase of an injury but will have poor insight into his deficits
26
Rancho los amigos level VII
- follow a set schedule
- be able to do routine self care without help if physically able
- may hjave problems in new situations and may become frustrated or act without thinking first
- have probelms planning, starting and following through with activities
- have trouble paying attention in distracting or stressful situations
- not realize how his thinking and memory problems may affect future plans and goals. Therefore he may no expect to return to his previous lifestyle or work
27
Rancho los amigos level VIII
- realize that he has a problem in his thinking and memory
- begin to compensate for his probelms
- be more flexible and less rigid in his thinking
- for ex: he may be able to come up with several solutations to a problem
- be ready for driving or job training evlauation
- be able to learn new things at a slower rate
- still become overloaded with difficulty, sressful or emergency situations
