TBI intro Flashcards
what is a traumatic brain injury
bolt, jolt, or a penetrating injury to the head that causes a disturbance in the brain
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
what is the leading causes of death and disability in children in the US
TBI
how does the clinical presentation of TBI change
the length of lack of blood supply
with anoxic BI do we suspect local or gobal impairments
global impairments
what are some causes of ABI
cardiac/respiratory distress
drug overdose
near -drowning
anaphylaxis
Cardon monoxide poisoning
what are the areas of the brain that are most effected by ABI
cerebellum
BG
cerebral cortex: partial and occipital lobes
hippo
thalamus
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
if you knock out the BG what happens
myoclonus, poor inciation
this will effect motor output
what is myoclonus
quick jerking movement that you can’t control
EX: hiccups, sleep starts
cere - occipital lobe knocked out
visual disturbances
cere - parietal lobe knocked out
apraxia, poor body awareness, neglect
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
hippocampus knocked out
memory loss
thalamus knocked out
sensory and motor impairment, poor arousal
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
what are examples of diffused TBI injury
concussion
diffused axonal injury
blast
abusive head shake/shaken baby syndrome
what is a diffused TBI injury
the brain does not have a specific area of injury
what is a focal TBI
there is a specific area in the brain that is damaged
example of focal TBI
penetrating
contusion
hemotoma
what is a hematoma
a collection of blood on the brain
what are the different types of hemotomas
epidural
subarachnoid
subdural
interventricular
intercerebellar
how to we get a CT scan
it is a stacked x-ray
what is a contusion
bruise or bleeding on the brain
due an object hitting the head or the head hitting an object
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
15
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
