TBI intro Flashcards by VB VB

what is a traumatic brain injury

bolt, jolt, or a penetrating injury to the head that causes a disturbance in the brain

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what is anoxic/hypoxic brain injury

inadequate or lack of oxygen supply to the brain

due to interruption or decrease in neural tissue blood supply

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what is the leading causes of death and disability in children in the US

TBI

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how does the clinical presentation of TBI change

the length of lack of blood supply

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with anoxic BI do we suspect local or gobal impairments

global impairments

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what are some causes of ABI

cardiac/respiratory distress
drug overdose
near -drowning
anaphylaxis
Cardon monoxide poisoning

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what are the areas of the brain that are most effected by ABI

cerebellum

cerebral cortex: partial and occipital lobes

hippo

thalamus

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if you knock the cere out what happen to the indivduals

discoordination

the cere effects every motor plan and therefore it uses a lot of O2

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if you knock out the BG what happens

myoclonus, poor inciation

this will effect motor output

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what is myoclonus

quick jerking movement that you can’t control

EX: hiccups, sleep starts

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cere - occipital lobe knocked out

visual disturbances

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cere - parietal lobe knocked out

apraxia, poor body awareness, neglect

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what is apraxia

is the loss of ability to execute or carry out skilled movement and gestures, despite having the physical ability and desire to perform the

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hippocampus knocked out

memory loss

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thalamus knocked out

sensory and motor impairment, poor arousal

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what is the MOI for TBI

rapid acc and dec

external force hitting the head or the head hitting an object

blast injury

penetrating object: knife, bullet, fireworks

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what are examples of diffused TBI injury

concussion

diffused axonal injury

blast

abusive head shake/shaken baby syndrome

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what is a diffused TBI injury

the brain does not have a specific area of injury

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what is a focal TBI

there is a specific area in the brain that is damaged

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example of focal TBI

penetrating

contusion

hemotoma

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what is a hematoma

a collection of blood on the brain

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what are the different types of hemotomas

epidural

subarachnoid

subdural

interventricular

intercerebellar

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how to we get a CT scan

it is a stacked x-ray

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what is a contusion

bruise or bleeding on the brain

due an object hitting the head or the head hitting an object

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what contusions are the CN impacted

they may be depending on where the injury is common: optic, vestibulocochlear, abducens, and facial

what is a coup injury

moving object hitting a stationary head

what is a coutercoup injury

this injury occur after the initial impact the brain bounces in the opposite direction of the of the hitting skull this results in a contusion opposite to the actual site of impact

what is a penetrating injury

when a object enter the cranium and injuries the brain high: bullet, shell fragments low: knife, sharp object

what has a poorer prognosis penetrating injury or closed head trauma

penetrating injury

when do penetrating injuries have a higher mortality rate

when it crosses midline or it hits a ventricle

what is a hemotoma

a collection of blood on the brain

what is a epidural hemotoma

blood accumalation between the skull and the brain dura

what is a epidural hemo caused by

blunt or shearing injuries with an associated skull fracture requires urgent surgical evacuation

what is a subdural hemo caused but

blunt or shearing injury that causes bridging veins to be torn and bleed into the space

what is a subdural hemo

accumulation of blood under the dura mater

where is subarachnoid hemo

between the arachnoid and the pia mater

where is a intraparenchymal injury

this is bleeding in the brain tissues

where is a inter-ventricular injury

accumulation of blood in the ventricles

how are focal injuries named

they are named based on where they occur

is a diffused axonal injury diffused or focal injury

diffused

what is a diffused axonal injury

shearing of the white matter tracts of the brain leads to microscopic and gross damage to the axon at the juction of white and grey matter

what causes a diffused axonal injury

acc and dec motion

what is the white matter of the brain

deep subcortical tissues myelinated axons

why are white axon more likely to be ripped

white and grey matter are different weights and therefore experience different acc, dec, and rot during rapid head movement/impact

what type white matter is most likely going to impact in a diffused axonal injury

corpus callosum brain stem

when does a blast injury occur

when a solid of liquid explosive material explodes into gas causes stress and shearing injuries

what are 2ndary injuries to TBI

increased ICP cerebral hypoxia electrolyte imbalance infection seizure

how is cere hypoxia a 2nd injury to TBI

blood vessels are ruptured or compressed resulting in a lack of blood lack of oxy in the brain due to an airway obstruction

how is electrolyte imbalance a 2nd injury to TBI

due to IV resuscitation, diuretic use, an massive blood loss

how does the clincial presentation of TBI change

depends on the areas involved and the severity if the injury

what are some things we can do for increase CP

ventricular shunt EVD/LD brain flap

doe ABI or TBI have better outcomes

ABI has a longer length of stay TBI is more likely to be discharged home overall functional improvement was shown to be better for TBI no sig difference in cog scores

what is the leading contributer to DVT

immobility early immobilization can help to prevent this

when is the peak presentation of DVT after TBI

2-7 days

medical management of hydrocephalus

BP management medications inter-ventricular drains surgery

what is heterotrophic ossifications

presence of bone in soft tissues where it does not exist - burr hole or crainoectomy

sleep/wake disturbance

often seen with TBI daytime sleepiness, increased sleep need, insomnia, sleep fragmentation

pressure injuries interventions

early mobilization, proper positioning , and turning schedule

what will happen if someone is a aspiration risk

they will be put on a NPO diet from SLP things in the lungs that are not supposed to be there

what does the GCS measure for

impaired cognition

how many points is the GCS out of

what is post traumatic amnesia

the time between injury and when the pt memory is restored inability to form day to day memories disoriented to time, place, and person

GCS mild score

13-15

GCS mild LOC

<30 min

GCS mild PTA

0-1 days

GCS moderate score

9-12

GCS moderate LOC

30 min - 24 hrs

GCS moderate PTA

>1 - 7 days

GCS severe score

3-8

GCS severe LOC

>24

GCS severe PTA

>7 days

what is the rancho los amigo scale

scale used to describe cog and behavior patterns

what is the difference between a contusion and a hemotoma

contusion is a type of traumatic brain injury (TBI) that causes bruising of the brain tissue; a hematoma is heavy bleeding into or around the brain