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X. Strabismus > TBI - COMPLETE > Flashcards

TBI - COMPLETE Flashcards

1
Q

Difference between ABI thats a TBI vs. ABI thats not a TBI?

A

TBI - external forces
Non-TBI - internal forces

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2
Q

Acquired Brain Injury

A

Brain injury acquired after birth

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3
Q

Causes of Non-TBI

A

Stroke
Toxins
Drugs
Anoxia (e.g. drowning)
Infection
Tumors

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4
Q

TBI: occurrence of injury to the head, with one or more of the following conditions… (5)

A
  1. Decreased consciousness
  2. Amnesia
  3. Skull fracture
  4. Objective neuro/neurophysical abnormality
  5. Intracranial lesion
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5
Q

T/F: TBI can occur in absence of perceptible head injury

A

TRUE

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6
Q

Classification Systems for TBI (3)

A
  1. Glasgow Coma Scale (GCS)
  2. Post Traumatic Amnesia (PTA)
  3. Loss of Consciousness (LOC)
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7
Q

The ______ (lower/higher) the score on GCS, the more conscious the patient is.

A

HIGHER

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8
Q

The ______ (lower/higher) the score on GCS, the less conscious the patient is.

A

LOWER

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9
Q

T/F: abnormal imaging (MRI/CT) immediately classifies the patient as having a severe TBI

A

FALSE; moderate

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10
Q

Patient is considered Vegetative if GCS is < ______

A

3

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11
Q

What qualifies as an Open Head Trauma?

A

If dura is breached (invasion through skull)

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12
Q

Characteristics of mild TBI

A

GCS: 13-15
+/- LOC (< 30 min)
Normal imaging

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13
Q

Characteristics of moderate TBI

A

GCS: 9-12
LOC > 30 min (but < 24 hrs)
Normal or abnormal imaging

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14
Q

Characteristics of severe TBI

A

GCS: 3-8
Coma
Normal/abnormal imaging

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15
Q

Common Sources of Brain Damage (3)

A
  1. Subdural Hematoma (clot b/w dura and arachnoid)
  2. Diffuse Axonal Injury
  3. Contusions (bruising of brain)
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16
Q

Diff between Primary and Secondary Damage

A

Primary — at moment of injury
Secondary — manifests later

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17
Q

Post Traumatic Vision Syndrome (PTVS):
What are some functional vision issues caused by TBI? (7)

A
  1. Convergence Insufficiency
  2. Accommodation Insufficiency
  3. Oculomotor Dysfunctions
  4. ET/EP
  5. Low Blink Rate
  6. Visual Midline Shift (affects Balance/Posture)
  7. VF defects
18
Q

Post Traumatic Vision Syndrome (PTVS):
What are some symptoms caused by TBI? (8)

A
  1. Diplopia
  2. Blur at near
  3. Loss of reading place
  4. Asthenopia/HA
  5. Photophobia
  6. Visual memory deficits
  7. Visual perception deficits
  8. Bumping into things
19
Q

Key Visual Processing Systems (2)

A
  1. MP Pathway
  2. Top Down Processing
20
Q

Parvocellular System is for ____ vision and important for _____.

A

Parvocellular System is for central (foveal) vision and important for clear and precise vision.

21
Q

Describe course of Parvocellular System

A

Nerve fibers from retina —> ON —> optic chiasm —> optic tract —> LGN —> optic radiations —> primary visual cortex (occipital lobe) —> temporal lobe

22
Q

Magnocellular System is for ____ vision and important for _____.

A

Magnocellular System is for spatial orientation and important for balance, movement, coordination, and posture.

23
Q

What is the parietal cortex responsible for that contributes to spatial orientation?

A
  1. Spatial working memory
  2. Visually guided action
  3. Navigation
24
Q

Function of Top Down Processing

A

Selectively filters sensory info input

25
Q

Neuroplasticity

A

Ongoing reorganization of functional cortical map

26
Q

What is required for synaptic plasticity? (2)

A
  1. Internal Processing
  2. Repetition
27
Q

What is the major modulator for neuroplasticity?

A

Norepinephrine

28
Q

Why is VT the perfect environment for neuroplasticity? (5)

A
  1. Feedback
  2. Repitition
  3. Multisensory, intermodal approach
  4. Motor/sensory match
  5. Cortical involvement
29
Q

Causes of Disequilibrium
(And % of each)

A
  1. Otologic — 50%
  2. Idiopathic (includes visual & brain filtering problems)— 25%
  3. Psychological — 15%
  4. Central/Neuro — 5%
  5. Medical — 5%
30
Q

VOR requires stability of… (3)

A
  1. Ocular input
  2. Binocular input
  3. Processing of vestibular and visual info
31
Q

VOR regulates balance with… (4)

A
  1. Visual System
  2. Semicircular canals
  3. Otolith apparatus
  4. Vestibular nerve
32
Q

Feelings of ____, ____, and ___ are important for synaptic formation and thus, important components of VT.

A

Motivation
Repetition
Feedback

33
Q

What is the “underlying trigger for [neuroplasticity]”?

A

Synaptic plasticity

34
Q

Vision/Optical Related Causes of Disequilibrium (5)

A
  1. Aniso
  2. Uncorrected Hyperopia
  3. Uncorrected Astigmatism
  4. PAL Distortion
  5. Glare
35
Q

Fixation is a function of _______

A

Visual attention

36
Q

When evaluating fixation, we should look for…

A

Saccadic intrusions and/or latent nystagmus

37
Q

When evaluating saccades, what should we look for?

A

Slowness or over/udnershoots

38
Q

What modification should be made to W4D testing for TBI patients?

A

Should be dynamic (15 ft to nose)

39
Q

What does Fixation Dot c Head Shake test for?

A

Binocular Stability

40
Q

How to perform Fixation Dot c Head Shake?

A
  1. Use R/G glasses
  2. Ask pt “how many dots do you see?”
  3. Shake head side to side (1-2 rotations/sec)
  4. Ask “what happens?”
41
Q

How to test for Visual Midline Shift Syndrome

A
  1. Target (Wolff wand or pen) at 40 cm
  2. Test horizontally (target held vertical); move from left to right and ask to say when pen is directly in front of nose
  3. Repeat vertical (target held horizontal, tell when pen at eye level)

Note: examiner should not sit directly in front of— gives clues to midline

42
Q

Ways to correct for photophobia (4)

A
  1. Transitions
  2. 15% Blue tint and A/R
  3. Over 40% gray tint
  4. Wrap sunglasses for outdoors

X. Strabismus (8 decks)

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