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Adult Neuro > TBI > Flashcards

TBI Flashcards

1
Q

What is the leading cause of TBI?

A

falls (32)
MVA (19)
acts of violence
sports

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2
Q

What factors predict the outcome for TBI?

A

Amount of immediate damage from the impact or insult
Cumulative effects of 2◦ brain damage
Individual’s premorbid cognitive characteristics
substance abuse
personality

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3
Q

Primary Brain Damage:

A

DIA
focal injury
coup-contrcoup injury

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4
Q

Diffuse axonal injury (DIA):

A

disruption and tearing of axons and small blood vessels from shear-strain of angular acceleration > neuronal death and possible hemmhorage

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5
Q

Focal Injury:

A

contusions, lacerations, mass effect from hemorrhage and edema (hematoma)

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6
Q

Secondary Brain Damage:

A

hypoxic/ischemic injury
swelling/edema
electrolyte imbalance

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7
Q

Concussion

A

Loss of consciousness, either temporary or permanent
Results from injury or blow to head
Impaired functioning of the brainstem reticular activating system: may seen changes in HR, RR, BP

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8
Q

Open injuries:

A 
Result from penetrating types of wounds
Gunshots
Knife
Sharp objects
Skull: fractured or displaced
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9
Q

What is compromised with an open injury?

A

meninges: risk of infection

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10
Q

Closed injury:

A

Impact to the head but the skull is not fractured
Neural (brain) tissue is damaged
Dura remains intact

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11
Q

Subtypes of closed injuries

A 
Concussion
Contusion
Hematomas
Locked-in Syndrome
Acquired Brain Injuries
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12
Q

What is a concussion?

A

Momentary loss of consciousness & reflexes: Shearing forces disrupt synapses
Momentary loss of consciousness may or may not occur!

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13
Q

Symptoms of a concussion:

A 
Dizziness 
Disorientation
Blurred vision
Difficulty concentrating
Alternations in sleep patterns
Nausea
Headache
Loss of balance
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14
Q

Retrograde amnesia

A

Loss of memory of events prior to injury

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15
Q

Post-traumatic amnesia:

A

Unable to remember or learn new information

Duration is a clinical indicator of severity of the injury

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16
Q

Coup lesion

A

Contusion on the same side of the brain as the impact

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17
Q

Contrecoup lesion

A

Surface hemorrhages on the opposite side of the brain trauma as a result of deceleration

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18
Q

Epidural hematoma:

A

between the Dura mater & the skull
Often seen after a blow to the side of the head or severe trauma from a MVA
Rupture of the Middle Meningeal Artery in the temporal fossa can cause epidural hematomas
Unconsciousness – Alert – Deteriorate

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19
Q

Subdural hematoma

A

Acute venous hemorrhage results because of rupture to the cortical bridging veins
Develops between the Dura & Arachnoid
Blood leaks slowly over several hours or weeks
Seen in elderly after falls with a blow to the head
Symptoms can be similar to those of a CVA

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20
Q

Locked-on-Syndrome

A

Complete paralysis of all voluntary muscles except those that control movement of the eyes
Individual remains conscious & possesses cognitive function
UNABLE to move

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21
Q

Causes of acquired brain injuries:

A

airway obstruction, near-drowning, MI, CVA, exposure to toxins, electrical shock or lightening strike

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22
Q

What do acquired brain injuries result from?

A

changes in the neuronal activity affecting physical integrity, metabolic activity or functional ability of the cell

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23
Q

Loss of consciousness for mild TBI

A

0-30 mins

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24
Q

Alteration of consciousness for mild TBI

A

brief, less than 24 hours

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25
Q

Post traumatic amnesia for mild TBI

A

less than 1 day

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26
Q

Loss of consciousness for moderate TBI

A

greater than 30 mins but less than 24 hours

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27
Q

Alteration of consciousness for moderate TBI

A

greater than 24 hours

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28
Q

Post traumatic amnesia for moderate TBI

A

greater than 1 day but less than 7 days

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29
Q

Loss of consciousness for severe TBI

A

greater than 24 hours

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30
Q

Alteration of consciousness for severe TBI

A

greater than 24 hours

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31
Q

Post traumatic amnesia for severe TBI

A

greater than 7 days

32
Q

Precentral (frontal lobe) Area structures

A 
Primary motor area
Premotor area
Prefrontal area
Supplementary motor
Middle frontal gyrus
Motor speech area (Broca)
33
Q

Function of primary motor area

A

discrete volitional movements

34
Q

Function of premotor area

A

motor planning or praxis

35
Q

Function of prefrontal area

A

motor association area

36
Q

Function of supplementary motor

A

bilateral control of posture

37
Q

Function of middle frontal gyrus

A

conjugate eye movements

38
Q

Function of motor speech area

A

language production

39
Q

Lesion in primary motor area

A

contralateral paralysis and paresis

40
Q

Lesion in premotor area

A

apraxia or motor planning deficits

41
Q

Lesion in supplementary motor

A

loss of bilateral control of posture

42
Q

Lesion in middle frontal gyrus

A

transitory paralysis of conjugate eye movements to opposite side

43
Q

Lesion to motor speech area

A

nonfluent aphasia

44
Q

Prefrontal (frontal lobe) areas

A 
dorsolateral
orbitofrontal
oribital gyri (posterolateral)
45
Q

Function of dorsolateral area

A

motivation, problem solving

46
Q

Function of oribitofrontal area

A

emotions, behavior

47
Q

Function of orbital gyri area

48
Q

Lesion to dorsolateral area

A

bilateral lesions: impaired ability to conentrate

49
Q

Lesion to orbitofrontal area

A

bilateral lesion, impaired ability to concentrate

50
Q

Lesion to orbital gyri

A

inability to discriminate odors

51
Q

Structure in parietal lobe:

A

postcentral gyrus primary somatosensory area
secondary somatosensory area
gustatory cortex
parietal lobe

52
Q

Function of postcentral gyrus primary somatosensory area somatosensory area

A

somesthetic sensations

53
Q

Function of secondary somatosensory area

A

sensory interpretation

54
Q

Function of gustatory cortex

55
Q

Function of parietal lobe

A

perceptual function

56
Q

Lesion of postcentral gyrus primary somatosensory area

A

loss of contralateral stimulus location, intensity

57
Q

Lesion of secondary somatosensory area

A

tactile agnosia, astereognosis, agraphesthesia, loss of 2 point discrimination, extinction

58
Q

Lesion in gustatory cortex

A

impairment of taste in contralateral side of tongue

59
Q

Lesion in parietal lobe

A

visual spatial disorders, body scheme disorderd, apraxias, tactile and auditory perceptual disorders

60
Q

Temporal lobe structures

A 
primary auditory cortex
Wernicke's speech area
superior temporal gyrus
temporal cortex
parhippocampal region
61
Q

Function of primary auditory cortex:

62
Q

Function of Wernicke’s speech area:

63
Q

Function of superior temporal gyrus:

A

storage of auditorially presented information

64
Q

Function of temporal cortex (non-dominate side)

A

storage of visually presented information

65
Q

Function of parhippocampal region

A

recent memory

66
Q

Lesion of primary auditory cortex:

A

subtle decrease in hearing and ability to localize sounds; both contralaterally

67
Q

Lesion of Wernicke’s speech and superior temporal gyrus:

A

fluent aphasia

68
Q

Lesion of temporal cortex:

A

impairment of learning and memory

69
Q

Lesion of parhippocampal region:

A

profound memory loss of recent events, no new learning

70
Q

Structures of Occipital Lobe:

A

primary visual cortex
visual association cortex
posterior multimodal area

71
Q

Function of primary visual cortex:

72
Q

Function of visual association cortex

A

visual understanding

73
Q

Function of posterior multimodal

A

intergrates sensory information

74
Q

Lesion of primary visual cortex:

A

contralateral homonymous hemianopsia, impairment of vision

75
Q

Lesion of visual association cortex

A

visual agnosia

76
Q

Lesion of posterior multimodal

A

perceptual impairment

Adult Neuro (26 decks)

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