TBI Part 3

Question 1

components of GCS

Answer 1

eye opening, motor response, verbal response

Question 2

discuss scoring in GCS

Answer 2

lowest: 3
highest: 15

mild: 13-15
mod: 9-12
severe: <8

Question 3

RLA 1

Answer 3

no response - coma

PT approaches:
- signs of consciousness
- OI, palp, PROM, FMT, FA, reflexes

Question 4

RLA 2

Answer 4

generalized response - vegetative state

PT approaches:
- loud voice
- diff stim produce similar responses: chewing, posturing, breathing

Question 5

RLA 3

Answer 5

localized response - minimal conscious

PT approaches:
- calm and soothing voice
- exp the exams
- give time to respond: 10 secs
- small stim: TV
- plenty of rest

Question 6

RLA 4

Answer 6

confused agitated - hitting, yelling, foul language

PT approaches:
- simple and familiar activities
- do not force pt
- inc rest
- FA muna
- low stim
- safe distance and protect

Question 7

RLA 5

Answer 7

confused inappropriate - post-traumatic confusional state

PT approaches:
- step by step and repeat
- dont assume they remember
- dont quiz
- quiet and less distractions

Question 8

RLA 6

Answer 8

confused appropriate - PTA

PT approaches:
- establish routines

Question 9

RLA 7 and 8

Answer 9

automatic appropriate and purposeful appropriate

PT approaches:
- promote independence
- use compensatory strats

Question 10

criteria for cerebellum exam

Answer 10

BAWAL RLA 1-4

RLA 5 dpat - pt should follow commands

Question 11

criteria for CN exam

Answer 11

for pt RLA 1-4 and unable to follow commands u can test for reflexes

Question 12

TBI CN 1 testing

Answer 12

leakage of CSF in one nostril
metallic taste
feeling of drainage in mouth

indicates basal skull fx and CSF rhinorrhea

Question 13

TBI CN 2 testing

Answer 13

testing for visual field - scotoma

Question 14

TBI CN 3 testing

Answer 14

2nd most commonly injured - ptosis

PLR and EOM

Question 15

TBI CN 4,5,6

Answer 15

done as usual

Question 16

TBI CN 7

Answer 16

if facial symm is evident

commonly injured in temporal bone fx

Question 17

TBI CN 9,10,11,12

Answer 17

done as usual

Question 18

criteria for sensory testing in TBI

Answer 18

RLA 6-8

dapat able to follow instructions si pt

Question 19

criteria for reflex testing in TBI

Answer 19

all levels of RLA