TBI (MedBridge)

Question 1

Grades of DAI

Answer 1

Grade I - microscopic axonal injury only
Grade II - I + CC lesion
Grade III - II + brainstem lesion

Question 2

Metabolic cascade during TBI

Answer 2

• Depolarization of cell leads to relapse of glutamate into synaptic cleft
• K- goes out of the cell, Ca+ goes into the cell
• Lactate accumulates
• Energy crisis that leads to cell death

Question 3

Thalamic storming

Answer 3

Increased sympathetic input causes posturing, tachycardia, tachypnea, diaphoresis, and increased BP
**Can lead to more cerebral anoxia

Question 4

Ocular reflexes: Pupillary, blink to threat, and corneal

Answer 4

Pupillary - CN II & III
Blink to threat - CN II & VII
Corneal - CN V & VII

Question 5

Presentation based on area of frontal lobe involvement:

Answer 5

Orbitofrontal - disinhibition
Dorsolateral - dysexecutive function
Medial - apathetic presentation

Question 6

Moderate + severe TBI are at an increased risk of developing what?

Answer 6

Dementia and PD

Question 7

Disability Rating Scale

Answer 7

• Measures coma to community

- Less sensitive to small change

Question 8

Cog-log

Answer 8

Looks at memory, attention, and orientation

Question 9

MiniBest Cut-off scores

Answer 9

Stroke: <18/28
PD: <21/28

Question 10

Full Outline of UnResponsiveness

Answer 10

• Eye, motor, brainstem, and respiration (doesn’t look at verbal)
• Recognizes locked-in syndrome

Question 11

Evidence for sit <> stand training

Answer 11

Improved functional abilities

Question 12

Evidence for functional reach training

Answer 12

Improved compared to traditional reaching

Question 13

Evidence for Partial BWS gait training

Answer 13

No better then conventional gait training

Question 14

Evidence for balance/coordination training

Answer 14

Good for improving balance

Question 15

Evidence for stretching

Answer 15

No evidence supporting its use