TBI Flashcards
forceful blow to resting, moveable head
maximum injury is at the point of cranial impact
coup injury
Moving head
injury is opposite of impact
contracoup
forces on the brain tissue
compression
tensile
shearing
Primary damage post TBI
brain swelling
anoxia
hypotension
secondary damage post TBI
no oxygen
anoxia
occurs due to loss of autoregulation of blood supply to the brain
happens more easily after initial concussive event
presents with rapid deterioration of status, colapse and can be fatal
Second impact syndrome
Long term consequences of TBI
neurodegenerative diseases loss of autoregulation of blood supply mild cognitive impairment alzheimers disease chronic tramatic encephalopathy CTE depression
progressive degenerative brain disease
repetitive concussive or sub-concussive brain injuries
Chronic traumatic encephalopathy
Loss of consciousness
Moderate TBI
coma or prolonged unconsciousness
can recover - deficits will remain physically, cognitively, and behaviorally
severe TBI
tone, contracture botox baclofen nerve blocks serial casting
spasticity management
improvements with TBI depend on
extent of injury
how the brain func/adapts after injury
eye opening+verbal ressponse+motor response
glasgow coma score
unresponsive but aroused by strong stimulus
stupor
unconscious, unaware, unarousable, absent sleep-wake cycle
coma
unconscious and unaware but have sleep-wake cycle and periods of alertness
vegatative state
don’t recover within 30 days
persistent vegatative state
aware and awake but can’t move or communicate (except blinking)
locked in syndrome
no response: total assistance
complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli
Rancho Los amigos level 1
generalized response: total assitance demonstrates generalized reflex response to painful stimuli respondt to repeated auditory stimuli responses inconsistent and delayed responses may be significantly delayed
Rancho Los amigos level 2
Localized response: total assistance
Demonstrates withdrawal or vocalization to painful stimuli
turns toward or away from auditory stimuli
blinks when strong light crosses visual field
follows moving object passed within visual field
responses: discomfort by pulling tubes, inconsistent to simple commands
Rancho Los amigos level 3
Confused/agitated; maximal assistance
alert and in heightened state of activity
purposeful attempts to remove restraints
perform motor activities but without any apparent purpose
divided attention
absent short-term memory
Rancho Los amigos level 4
Confused/agitated: maximal assist may cry out or scream to stimulus aggressive or flight behavior unable to cooperate incoherent and/or inappropriate consistent routine important
Rancho Los amigos level 4
confused, inappropriate non-agitate: maximal assist alert, not agitated not oriented to person, place, time non purposeful sustained attention imparied recent memory absent goal directed unable to learn new info
Rancho Los amigos level 5
confused, appropriate: moderate assistance
inconsistently oriented
attend to highly familiar tasks no distractors
vague recognition
assistive memory aide with max assist
emerging awareness or appropriate response
unaware of disability
Rancho Los amigos level 6
Automatic, appropriate: minimal assistance for daily living skills
consistently oriented to person and place
attend to highly familiar tasks
initiates and carries out steps to complete familiar personal and household routine
able to monitor accuracy and completeness of each step in routine personal and household ADLs and modify plan with minimal assitance
Rancho Los amigos level 7
purposeful, appropriate: stand-by assistance
consistently oriented
completes familiar tasks with distractions
recall and integrate past and recent
independent with assistive memory devices for recall
can modify plan when needed
over/underestimates abilities
depressed or irritable
Rancho Los amigos level 8
purposeful, appropriate: stand by assistance on request
Rancho Los amigos level 9
Purposeful, appropriate: modified independent
Rancho Los amigos level 10
