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Neuro 1 > TBI Intro: Clinical Presentation > Flashcards

TBI Intro: Clinical Presentation Flashcards

1
Q

what cognitive deficits do they have

A
  • arousal dysfxn
  • disorientation
  • poor attention span
  • loss of memory
  • poor organization & reasoning skills
  • inability to control emotional responses
  • learning difficulties
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2
Q

walkie talkie pt’s typically ..

A
  • may be able to ambulate independently without an AD negotiating barriers but might not remember their name or family members
  • may fill in info with fabricated stories: confabulation
  • could be more problematic to functional independence than the physical limitations
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3
Q

what is the most common and debilitating cognitive deficit following tbi

A

impaired attention

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4
Q

executive function deficits looks like

A

impairment to volition/planning, problem solving, insight, social pragmatics, self-regulation

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5
Q

what can u see with executive fxn deficits

A
  • difficulties with motivation, preparation and organization
  • poor problem solving
  • impulsivity
  • mood disturbances
  • difficulty in social situations
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6
Q

what memory deficits do we see

A
  • retorgrade and/or anterograde amnesia
  • posttraumatic amnesia
  • short term > long term memory deficits
  • declarative and procedural memory often impaired
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7
Q

what is common about language deficits

A
  • non-aphasic nature and related to cognitive impairment
  • disorganized and tangential oral and written communication, imprecise language, word retrieval difficulties, disinhibited language
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8
Q

most enduring and socially disabling of impairments after TBI

A
  • sexual disinhibition
  • apathy
  • aggressive disinhibition
  • agitation
  • hyperactive, restless
  • low frustration tolerance
  • depression
  • easily over stimulated**
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9
Q

dysexecutive syndrome

A

frontal lobe syndromes

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10
Q

orbitofrontal lobe syndrome

A
  • disinhibited
  • impulsive behavior
  • inappropriate jocular affect, euphoria
  • emotional liability
  • poor judgement and insight
  • distractibility
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11
Q

frontal convexity syndrome

A
  • apethetic
  • apathy
  • indifference
  • psychomotor retardation
  • motor perseveration and impersistence
  • stimulus bound behavior
  • motor programming deficits
  • poor word list generation
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12
Q

focal lesions result in what strength deficits

A

hemiparesis/hemiplegia

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13
Q

diffuse injury results in what strength deficits

A

motor control and coordination deficits over true strength deficits

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14
Q

tone abnormalities could look like

A

flaccidity
rigidity
hypertonicity

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15
Q

brainstem injuries result in

A

posturing

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16
Q

decorticate rigidity

A

LE ext & UE flex

17
Q

decerabrate rigidity

A

LE & UE ext

18
Q

what sensory deficits are most common

A

proprioceptive and kinesthetic

19
Q

how often is CN I damaged in TBIs

A

7% of them

20
Q

what CN are crucial to examine

A

optic
occulomotor
trochlear
abducens

21
Q

intact pupillary fxn indicates what about the location of the injury …

A

the injury is above the level of the brainstem

22
Q

if a pt has conjugate gaze palsy, what is that due to

A

CNS

23
Q

if a pt has unilateral gaze palsy, what is that due to

A

PNS

24
Q

if a pt has tonic downward gaze, what is that due to

A

severe injury to thalamus, midbrain or pons

25
Q

if a pt has tonic upward gaze, what is that due to

A

severe injury to both hemispheres

26
Q

if a pt has rapid horizontal eye movement, what is that due to

A

seizure activity

27
Q

optic n. damage may result in what

A

monocular blindness, absent pupillary response

28
Q

what is the common culprit of gaze abnormalities

A

abducens n.

29
Q

which nerve damage is the most uncommon with tbi and what do you see instead

A

CN 3 & 4

damage to actual muscle bellies/tendons

30
Q

where is the trigeminal n. damaged and what is the effect of that

A

peripheral injury to where divisions leave orbit

loss of sensation to the nose, eyebrow and forehead

31
Q

where is the facial n. damaged and what is the effect of that

A

perioheral injury when the temporal bone damaged

muscle weakness, loss of tear production, decreased saliva secretion, taste

32
Q

how many pt’s experience vestibular dysfunction

A

50% - dizzy and imbalance

33
Q

how do you end up with vestibular dysfunction

A

injury to vestibulocochlear n.
injury to vestibulocerebellum
damage to brainstem or cortex involving vestibular pathways

34
Q

S&S for vestibular dysfunction

A 
dizziness
vertigo
imbalance
nausea
vomiting
inability to perform sensory integration for balance
35
Q

for pt’s who have TBI, how long does vestibular rehab take

A

3x as long compared to those not with TBI

36
Q

what are common ANS symptoms seen with TBI

A 
HR, RR, BP variability
elevated body temp
excessive sweating, salivation, tearing
dilated pupils
vomiting
anxiety, panic disorder, PTSD

Neuro 1 (21 decks)

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