Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

becky: neuro MSK > TBI LECTURE > Flashcards

TBI LECTURE Flashcards

1
Q

length of stay for acute and IP Rehab

A

acute 18
IP rehab 21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

early med management for TBI

A
  1. OPEN AIRWAY
    positioning
    provide O2
    endotracheal tube
    tracheostomy
    provide vent support
  2. VITAL SIGNS, FLUID REPLACEMENT
  3. NEURO CHECKS 15-30 MIN (no sleep!!!)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Glasgow coma scale

A

-used at accident scene, ER, acute care
-used as predictor of outcome
-used in research
-high inter-rater reliability
-total score 3-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

minimum score for GCS

A

3, highest 15!
may be separate into 3 sections (eye opening, best motor response, verbal response V-T MEANS CAN’T BE SCORED DUE TO TRACH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

total score 3-8 for GCS

A

severe! (90% defined as coma)

44% of ED ADMIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

limitations of GCS

A

-pre-existing cond (like language)
-aphasia
-alcohol/meds
-other injuries (like jaw crushed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is mod injury for GCS

A

9-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is mild injury for GCS

A

13-15
41% of people admitted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

local brain injury is defined as

A

TBI localized to site of impact on skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diffuse brain injury

A

widely scattered shearing of axons (head bounced back and forth!)
HIGH VELOCITY LIKE CAR, SKII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

secondary insults can cause more injury than primary true or false

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ABOVE ___ MMHG ICP IS CONTRAINDICATION FOR PT

A

20 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

____ mmHg causes neurologic dysfunction

A

2-40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

normal while lying down

A

0-10 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

__mmHg almost always results in death

A

60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

intracranial infections can happen due to

A

fx of skull
gunshot wound
open brain injury!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

for cerebral arterial vasospasms, velocities over 100 means

A

NO OOB ACTIVITIES!
JUST SUPINE EXERCISES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

hydrocephalus

A

CSF on the brain
due to:
-foramina blocked by brain herniation
-or ventricles can push onto brain surrounding it

19
Q

secondary insults in TBI

A

-intracranial infection
-cerebral arterial vasospasm
-hydrocephalus
-post-traumatic epilepsy
-brain edema

20
Q

arterial hypoxemia

A

*breathing centers depressed
-present in 1/3 of pts in ER

21
Q

arterial hypotension

A

seldom produced by TBI
alone
-fx of bones, organs, etc

22
Q

anemia

A

blood loss from injury

23
Q

Hyponatremia

A

(serum sodium levels)

24
Q

hypoxia and ischemic brain damage

A

most commonly seen in hippocampus, BG, scattered sites of cerebral cortex, cerebellum

25
Q

what are two ways to evacuate a hematoma surgically?

A

craniotomy: less severe
craniectomy: often leaves skull flap off, HELMET, go back for surgery months later

26
Q

what is a ventriculostomy

A

insertion of a device to measure ICP, requires burr hole usually of frontal bone

thin catheter tube going through frontal bone…External ventricular drain OR bolt which measures only!

27
Q

everytime patient moves, what should happen with EVD?

A

must be re-leveled!
MUST BE CLAMPED

28
Q

metabolic care of TBI

A

-in dwelling catheter
-serum electrolytes
-artificial feedings once bowel sounds return

29
Q

POPS

A

26 items in 5 categories
-domestic life
-major life activities
-transportation
-interpersonal interactions and relationships
-community, recreational and civic life

30
Q

__% of individuals require some level of supervision at __ year post op
__% require some supervision __ years post op

A

37% at 1 year
31% 2 years post op

31
Q

Rancho Los Amigos Levels of Cog Functioning Scale

A
  1. NO RESPONSE (coma)
  2. Generalized response (limited, inconsistent, non-purposeful, often to pain only)
  3. localized response
    (purposeful responses, MAY follow simple commands, may focus on presented objects ***PULL AWAY TO PAIN
32
Q

WHAT COMA SCALE distinguishes Rancho II vs III?

A

JFK! more sensitive than GCS and Rancho
-MINIMALLY CONSCIOUS STATE RANCHO III
-frequent misdiagnosis without JFK, HUGE implications for DC placement from acute care

33
Q

post-traumatic amnesia (PTA)

A

period of time from accident to time patient starts to have on going short term memory

34
Q

What test is used to determine when patient progresses out of PTA?

A

GOAT galveston orientation and amnesia test
must have 3 consec scores of over 75 to be out of PTA

35
Q

Rancho Level 4

A

confused, agitated
Heightened state of activity; confusion, disorientation; aggressive behavior; unable to do self-care; unaware of present events; agitation appears related to internal confusion.

36
Q

what are causes of agitation?

A

-fronto-orbital
anterior temporal loves
sylvian fissure
-temporal lobe seizures
-diffuse axonal injuries, esp corpus callosum, dorsolateral columns of midbrain
-secondary effects of hypoxia, compression, neurohormonal effects

premorbid personality

37
Q

causes of agitation

A

environment: sensory overload or deprivation
reversible factors: seizures, sleep disturbances, electrolytes, meds, nutrition

38
Q

agitated behavior scale

A

observational tool
Observational tool to assess the extent of agitation during acute phase of recovery from TBI
14 item instrument
Minimum score of 14, maximum of 56
Each item rated 1 (not present) to 4 (present to extreme degree)

39
Q

MOSS attention rating scale

A

Observational tool to measure attention-related behaviors after TBI
22 items
Scores range 22-110
Includes phrases with both good and impaired attention
Higher score = better attention
Appropriate for moderate to severe brain injury

40
Q

RANCHO LEVEL 5

A

confused, inappropriate, non-agitated

Appears alert; responds to commands; distractible; does not concentrate on task; verbally inappropriate, does not learn new information.

41
Q

RANCHO LEVEL 6

A

confused, appropriate (still in PTA)

Good directed behavior, needs cueing; can relearn old skills (ADL); serious memory problems; some awareness of self and others.

42
Q

RANCHO LEVEL 7

A

automatic, appropriate

Robot-like appropriate behavior with minimal confusion; shallow recall; poor insight into condition; initiates tasks but needs structure; poor judgment, problem-solving and planning skills

43
Q

RANCHO LEVEL 8

A
  1. Purposeful, appropriate.

Alert, oriented; recalls and integrates past events; learns new activities and can continue without supervision; cognitively independent in living skills; capable of driving; defects in stress tolerance, judgment, abstract reasoning persist; many function at reduced levels in society.

44
Q
A

becky: neuro MSK (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions