TBI Flashcards
Signs of localized lesion to:
Frontal: primary motor cortex
fxn: discrete volintional mvmt
lesion: CL paralysis and paresis (most pronounced in distal parts of limbs and lower part of face)
Signs of localized lesion to:
Frontal: premotor area
fxn: motor planning or praxis
lesion: apraxia or motor planning difficulties
Signs of localized lesion to:
Frontal: prefrontal area
fxn: motor association area
lesion: loss of specific motor plans
Signs of localized lesion to:
Frontal: supplementary motor
fxn: B control of posture
lesion: loss of B control of posture
Signs of localized lesion to:
Frontal: middle frontal gyrus
fxn: conjugate eye mvmt
lesion: transitory paralysis of conjugate eye mvmts to CL side
Signs of localized lesion to:
Frontal area: motor speech area (Boca)
fxn: language production
lesion: nonfluent aphasia
Signs of localized lesion to:
Prefrontal area: dorsolateral
fxn: motivation, problem solving
lesion: B lesions: imparied ability to concentrate
Signs of localized lesion to:
Prefrontal area: orbitofrontal
fxn: emotions, behavior
lesion: unstable emotions, unpredictable behavior
Signs of localized lesion to:
Prefrontal area: orbitall gyri (posteriolateral)
fxn: olfaction
lesion: inability to distcriminate odors
Signs of localized lesion to:
Parietal: postcentral gyrus / primary somatosentory area
fxn: somesthetic sensations
lesion: loss of CL stimulus location, intensity
Signs of localized lesion to:
Parietal: secondary somatosensary area
fxn: sensory interpretation
lesion: tactile agnosia: asterognosis, agraphesthesia, loss of 2-point discrimination, extinction
Signs of localized lesion to:
Parietal: gustatory cortex
fxn: taste
lesion: impairment of taste in CL tongue
Signs of localized lesion to:
Parietal: parietal lobe (R hemisphere)
fxn: perceptual fxn
lesion: visual-spatial disorders, body scheme disorders, aprasias, tactile and auditory perceptual disorders
Signs of localized lesion to:
Temporal: primary auditory cortex
fxn: hearing
lesion: subtle decrease in hearing and ability to localize sounds, both CL
Signs of localized lesion to:
Temporal: Wernicke’s speech area
fxn: lanaguage understanding and formulation; storage of auditorially presented info
lesion: fluent aphasia
Signs of localized lesion to:
Temporal: superior temporal gyrus (L hemisphere)
Temporal: temporal cortex (nondominant side)
Temporal: parahippocampal region
*confusing in table in book
fxn: storage of visually presented info
fxn: recent memory
lesion: impairment of learning and memory
lesion: profound memory loss of recent events; no new learning
Signs of localized lesion to:
Occipital: primary visual cortex
fxn: vision
lesion: CL homonymous hemianopsia
Signs of localized lesion to:
Occipital: visual association cortex
fxn: visual understanding
lesion: visual agnosia
Signs of localized lesion to:
Occipital: posterior multimodal area (parietal, temporal, occipital)
fxn: integrates sensory info (somatosensory, visual, auditory)
lesion: perceptual impairment
TBI: etiology
contact forces to skull; rotational acceleration forces
TBI: pathophysiology
Primary brain damage
- diffuse axonal injury: disruption and tearing of axons and small blood vessels from shear-strain of angular acceleration; results in neuronal death and petechial hemorrhages
- focal injury: contusions, lacerations, mass effect from hemorrhage, and edema (hematoma)
- coup-contracoup injury: injury at point of impact and opposite point of impact
- closed or open injury (with fx of the skull)
Secondary brain damage
- hypoxic-ischemic: results from symptomatic problems (resp or cardiovasc) that compromise cerebral circulation
- swelling/edema: can result in mass effect with increased ICP, brain herniation (uncal, central or tonsillar), and death
- electrolyte imbalance and mass release of damaging neurotransmittors
Concussion: loss of consciousness, either temp or permanent, resulting from injury or blow to head, with impaired fxning of the BS reticular activating system (RAS); may see changes in HR, BP, RR
Characteristics of mild TBI
LoC: 0-30min Alteration of consciousness: brief; >24hrs Posttraumatic amnesia: <1 day GCS: 13-15 Imaging: normal
Characteristic of moderate TBI
LoC: 30min < x < 24 hrs Alteration of consciousness: >24 hrs Posttraumatic amnesia: 1 day < x < 7 days GCS: 9-12 Imaging: normal; abnormal
Characteristics of severe TBI
LoC: >24 hrs Alteration of consciousness: >24 hrs Posttraumatic amnesia: >7 days GCS: <9 Imaging: normal; abnormal
TBI: Outcome measures
GCS: Glasgow Coma Scale
LOCF: Rancho Levels of Cognitive Fuctioning
Rappaport’s Disability Rating Scale (DRS)
Glasgow Outcome Scale (GOS)
Hi-MAT
FIM/FAM
Neurological Outcome Scale for TBI (NOS-TBI)
Assessment of Life Habits (Life-H)
Coma Recovery Scale
Motor Attention Rating Scale
Diffuse axonal injury: recovery stages
Coma: no response Unresponsive vigilance/vegetative state Mute responsiveness/min responsiveness Confusional state Emerging independence Intellectual/social comptence
