TBI

Question 1

Characteristics of a closed tbi

Answer 1

Skull intact
Focal and diffuse
Result of an outside force that impacts the head

Question 2

Eg of a closed TBI

Answer 2

MVA
Falls
Acceleration or deceleration injury

Question 3

Characteristics of an open TBI

Answer 3

Skull penetrated or fractured
More focal than diffuse
Dependent on shape, size, direction, and speed of the object

Question 4

Where does the damage occur in an open TBI

Answer 4

Along the route of the object if it penetrates the skull

Question 5

Eg of an open TBI

Answer 5

Gunshot wound

Question 6

What is the glasgow coma scale

Answer 6

way to assess lvl of consciousness

Question 7

What are the 3 categories of the GCS

Answer 7

Eye opening
Verbal Response
Motor Response

Question 8

Levels of eye opening

Answer 8

4. spontaneous
5. To voice
6. To pain
7. none

Question 9

Levels of verbal response

Answer 9

5. normal convo
6. disoriented convo
7. words but no content
8. no words, only sound
9. none

Question 10

what are the lvls of motor response

Answer 10

6. normal
7. localized to pain
8. w/draw to pain
9. decorticate posture
10. decerebrate posture
11. none

Question 11

What is decorticate posture

Answer 11

UE flex

LE ext

Question 12

What is decerebrate posture

Answer 12

UE ext

LE ext

Question 13

which form of posture indicates a more serious injury

Answer 13

Decerebrate

Question 14

Characteristics of primary damage

Answer 14

Usually focal

Occurs at time of injury

Question 15

Kinds of primary damage

Answer 15

Cou-counter coup
Contusion
N. damage
Skull farctures

Question 16

what is coup-counter coup

Answer 16

contusion and bruising on both sides of brain where it occured and opposite side

Question 17

What is a contusion

Answer 17

direct impact to the head where there’s bruising and bleeding

Question 18

Where are the most common places to see damage in a primary injury

Answer 18

Frontal and temporal lobes

Question 19

How to tell if its a primary damage

Answer 19

PET

MRI

Question 20

What kind of n damage occurs in Primary damage

Answer 20

diffuse axonal injury or traumatic axonal injury
unmoving brain lags behind skull, causes shearing and tearing of n tissue and releases chemials causing more damage
E.g. shaken baby, whiplash

Question 21

When does secondary damage occur

Answer 21

in response to primary damage

Question 22

What increases in secondary damage

Answer 22

Intercranial pressure

Question 23

Kinds of secondary damage

Answer 23

Hematoma
Subarachnoid hemorrhage
Epilepsy

Question 24

what is a hematoma

Answer 24

abnormal collection of blood outside the blood vessel

Question 25

What is a subarachnoid hemmorhage

Answer 25

bleeding b/t brain and thin layers of tissue covering the brain

Question 26

Who is subarachnoid hemorrhage common in

Answer 26

older adults after falls

Question 27

Med management of TBI

Answer 27

Ventriculostomy | cooling (hypothermia)

Question 28

what is a ventriculostomy

Answer 28

drains trapped fluid | regulates how much and how fast it drains

Question 29

Why is hypothermia used

Answer 29

Reduce ICP and further damage

Question 30

What does med management depend on

Answer 30

Severity GCS Posturing Rancho los amigos

Question 31

Rancho levels

Answer 31

``` I. no response ii. Generalized response iii. Localized response IV. Confused-agitated V. Confused- inappropriate VI. confused-appropriate VII. Automatic- appropriate VIII. purposeful- appropriate (w/ SBA) IX. Purposeful- apporpriate (w/ occasional SBA) X. purposeful- appropriate (w/ mod I) ```

Question 32

What does the rancho scale do

Answer 32

puts a rating to observable behavior and cog lvl

Question 33

OTs role in acute rehab

Answer 33

``` Posturing Tone Reflexes ROM Sensory loss Ataxia Dysphagia Edu Coma Stim cognition ```

Question 34

What is coma stim

Answer 34

developed to increase arousal by providing env stimuli

Question 35

OT role in rehab OP

Answer 35

``` EDU cog Vision/perception ADL psychological Home mng/safety community reentry/IADL Vocational ROM ```

Question 36

What is the leading cause of TBI

Answer 36

Falls