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Patho 2 > TBI > Flashcards

TBI Flashcards

1
Q

caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.

A

TBI

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2
Q

Who has higher risk of TBI?

A

Males

1-34

> 65

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3
Q

Risk factors for TBI death

A

Male
Older
Previous TBI
Drug/ LQ use

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4
Q

What is used to measure severity of TBI

A

Glasgow coma scale

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5
Q

What can alter score on glasgow coma scale?

A

Intoxication
Intubation
Language barrier

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6
Q

What is best predictor of outcome of TBI?

A

Depth and duration of unconciousness

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7
Q

How is amnesia assessed?

A

GOAT (>75 twice withing 48hr)

Orientation log (>25 2 days in a row)

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8
Q

Primary injury ….

A

Coup

Focal, diffuse

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9
Q

Secondary injury

A

Contre coup

Diffuse, inflammation, cell receptor dysfunction seen

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10
Q

Bleeding b/w skull and dura?

A

Epidural hematoma

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11
Q

First symptom of epidural hemorrhage?

A

Fixed and dilated pupil on side of injury

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12
Q

Worst case of epidural hematoma?

A

Transtentrial herniation

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13
Q

Bleed b/w dura and brain?

A

Subdural hematoma

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14
Q

What is most deadly of all head injuries?

A

Acute subdural hematoma

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15
Q

Bleeding into subarachnoid space?

A

Subarachnoid hemorrhage

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16
Q

Signs and symptom of subarachnoid hemorrhage?

A

Headache
Vomit
Confusion
Seizures

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17
Q

Bleeding into brain tissue

A

Intraparenchymal hemorrhage

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18
Q

Bleeding into ventricles?

A

Intraventricular Hemorrhage

19
Q

Which herniation compresses pericallosal arteries?

PCA/occulomotor nerve?

Pons and medulla?

A

Subfalcine

Transtentorial

Tonsillar

20
Q

Secondary mechanisms of injury include

A 
Ischemia
Hypoxemia
Hypotension
Cerebral edema
^ ICP
Acidosis
Excitotoxicity
21
Q

Level 1 clinical consciousness description

2?

3?

A

Coma

Vegetative state

Minimally conscious

22
Q

State of unarousable unresponsiveness

A

Coma

23
Q

Brainstem function intact; cortical function severely impaired

Sleep/wake cycle returns

General response to stimuli?

A

Vegetative state

24
Q

inconsistent, but clearly discernible behavioral evidence of consciousness

A

Minimall conscious state

25
Q

Favorable prognosis

A 
GCS>5
Smart
Pupil response
Social support
Young
Low severity
26
Q

Unfavorable prognosis

A

Midline shift
Repeat
Anoxia
Elevated ICP

27
Q

Around 30% of patients with moderate to severe TBI will experience some manifestation of

A

Agitation

28
Q

Agitation comes from damage to

A

Front/temporal lobe

29
Q

Pharmacological managment of agitation?

A 
Anti-epileptics
Dopamine
Antidepressant
Antipsychotics
Betablockers
30
Q

•“motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex as one component of the UMN Syndrome

A

Spasticity

31
Q

Spasticity is loss of

A

Descending inhibitory control (reticulospinal)

32
Q

observe resting position in bed and in wheelchair and note side to side differences in resting postures of extremities, head, and neck

A

Clinical observation

33
Q

0,1,1+,2,3 in ashworth

A 
0=no increase in tone
1=increase (catch +release)
1+= catch with minimal resistance following
2=increase through most of range
3=passive movement difficult
34
Q

1/10 ppl with TBI have

A

Seizures

35
Q

caused by electrical disturbances in the brain, usually localized to the area of initial trauma

A

Seizure

36
Q

Mgmt of seizure?

A

Anti-epileptics

37
Q

Can be caused by either overproduction of CSF, blockage of CSF flow, or insufficient absorption of CSF (or combination)

A

Post-traumatic hydrocephalus

38
Q

Postraumatic hydrocephalus classified as

A

Noncommunicating (obstructive)

Communicating

39
Q

Symptoms of hydrocephalus

A

Gait disorder
Impaired cognition
Urinary incontinence

40
Q

Most common symptoms of non-comunicating hydrocephalus

A

Papilledema

Cognitive changes

41
Q

Mgmt of hydrocephalus

A

Shunt

PT

42
Q

Why is pediatric TBI unfavorable prognosis?

A

Lack of brain maturation and skillz

43
Q

Concussion described by having at least on of the following

A

Loss of consciousness
Memory loss
Alter mental state
Neuro defecits (focal)

44
Q

Injury severity of concussion does not exceed

A

PTA<24 hours
LOC<30 minute
GCS 13-15

Patho 2 (14 decks)

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