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Neuro PT > TBI > Flashcards

TBI Flashcards

1
Q

2 types of TBI?

A

traumatic: from ext force/ open or closed

Non-traumatic: not ext, called aquired brain injury

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2
Q

in more severe injuries, what happens? as oppose to contusion from coup

what are the types of bleeding?

A

Diffuse axonal injury
Sheering
Tensile stress

epidural, subdural,subarachnoid,intraparenchymal

these are primary mechanisms of brain injury

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3
Q

2ndary mechanisms of TBI?

A 
Ischemia
Hypoxia
Hypotension
Edema
ICP inc
Hypercapnia (inc CO2)
Excitotoxicity from inc chem/NT
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4
Q

What are the non traumatic Brain injury mechanisms?

A 
hemorrhage
stroke
hydrocephalus
Tumor
Anoxia
Infection
Encephalopathies (from toxic or metabolic --fluid levels)
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5
Q

What are signs and symptoms of increasing ICP?

A 
Dec level of consciousness ***
Cushings Triad (^SBP/bradycardia/abn. respiration)****
headache
vomit
ocular palsy
Papilledema
dilated pupil
abducens palsy
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6
Q

Awareness of injury mechanism assists with what?

A

Tx planning

and prognosis

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7
Q

DVTs in TBI are common because

what do we look for?

A

lack of mobility

Warmth
Redness
Swelling
patient may not be able to notice cuz TBI .

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8
Q

Where is seizure more common?

What are their nature?

A

more common in open Fx

can be general or focal

Therapist usually notice focal ones.

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9
Q

Heterotpic ossification?

A

laying of bone on jt.. MO is on muscle.

usually have dec ROM

given drugs and PROM

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10
Q

Anterograde vs Retrograde Amnesia?

A

A: cant form new memories
R: can’t recall old memories

this can help classify severity of brain injury

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11
Q

What to Assess for TBI?

A 
ROM
Strength
Sensation
Edema
Qual tone: observe
Quan tone: MAS

want to be observant of spontaneous movement of limbs

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12
Q

What to assess for Brain stem/Cranial nerve

A 
Pupil
alignment/motility
Visual startle
Localization to sound
Fixate
Pursuit
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13
Q

What to do to assess cog/arousal/attention?

A

If disorder of consciousness use CRS
Vegetative: no purposeful response
Minimal: respond but inconsistent
Emerged:normal conscious but Fx may not be.

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14
Q

What is orientation log?

A

10 questions scored out of 30 used when pt minimally conscious every day at diff times of day.

3: spontaneous answer
2: require cue
1: multiple choice
0: cant answer

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15
Q

What to note for assessing executive Fx and memory?

A

cant have one without other so test both.

via: GOAT/MOCA/Cog-log

test broad to capture deficits

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16
Q

Level 1 classification of Cognitive Fx?

A

Coma: no sleep/wake/response
usually in ICU/stepdown

PT: PROM/position/casting or spasticity

want to examinee BS reflex/resp/patho reflex (UMN)

17
Q

Level 2 classification of Cognitive Fx?

A

Vegetative State: general but not purposeful response
acute rehab

PT: PROM/mobilizstion
Casting/use coma recovery Scale

18
Q

Level 3 classification of Cognitive Fx?

A

Minimally Conscious: purposeful response inconsistent.

PT:mobilize/PROM
can use more traditional PT like gait.

19
Q

Level 4 classification of Cognitive Fx?

A

confuse/agitated: weird non purposeful behavior STM loss
can be restless/agressive

PT: behavior management
Gait training
give choices and reward
quiet environment
DONT PROMISe
20
Q

Rehab considerations for level 4?

A

Reorient (But can trigger them)
dec Amt of interaction
mitts to prevent harming.

21
Q

Level 5 classification of Cognitive Fx?

A

Confused/inappropriate
less agitate than 4

PT: build tolerance to external stimuli
Provide a schedule
encourage automatics: brushing teeth and stiff

22
Q

Level 6 classification of Cognitive Fx?

A

Confused but appropriate:
not consistently oriented

PT: encourage external cues, recall, schedule to reorient them

23
Q

Level 7+8 classification of Cognitive Fx?

A

7: can do things from before, but judgement is impaired so need supervision
8: oriented and responds appropriately

PT:use remediation manage stress, emphasize self-awareness.

24
Q

What are some assessment tools for TBI?

A

Himat: high-level function asses running, jumping.

25
Q

Management of Spasticity?

A

is a 2ndary complication

oral meds (baclofen)
inject/intrathecal
stretch
cast

most common synergy is extension.

26
Q

What is favorable prognosis?

A 
young (not too young)
high IQ
good home life
fam support
no substance abuse.
27
Q

unfavorable prognosis?

A

prolong coma >1wk
long amnesia >2wk
coexisting injury
no trauma

28
Q

TBI in older adults?

A

usually from falls
less brain density cuz old
mortality higher

Neuro PT (12 decks)

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