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-nm Npte > TBI, Rancho Los Amigos, Concussions 1/11 > Flashcards

TBI, Rancho Los Amigos, Concussions 1/11 Flashcards

1
Q

What type of TBI- open or closed?

Gun shot wound, knife or sharp object penetration skull fragments, direct trauma

A

open - direct penetration through skull

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2
Q

What type of TBI- open or closed?

Concussion, contusion, hematoma, injury to extracranial blood vessels?

A

closed - No penetration through the skull

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3
Q

What type of TBI- open or closed?

Hypoxia, drug overdose, near drowning, acceleration or deceleration injuries

A

closed - No penetration through the skull

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4
Q

what type of TBI injury - primary or secondary?

Skull penetration, skull fractures

A

primary - initial injury to brain during impact

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5
Q

what type of TBI injury - primary or secondary?

Contusions to gray and white matter

A

primary - initial injury to brain during impact

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6
Q

what type of TBI injury - primary or secondary?

Hematoma, hypoxia, ischemia

A

secondary - Damage as a response to initial injury

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7
Q

what type of TBI injury - primary or secondary?

Increased intracranial pressure, post traumatic epilepsy

A

secondary - Damage as a response to initial injury

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8
Q

Level of consciousness?

State of unconsciousness, unresponsive to all internal and external stimulus

A

coma

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9
Q

Level of consciousness?

General unresponsiveness with arousal from repeated stimulus

A

stupor

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10
Q

Level of consciousness?

State of consciousness person in state of sleep, reduced alertness to arousal, delayed responses to stimuli

A

Obtundity

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11
Q

Level of consciousness?

State of consciousness person is disoriented, confused, agitated, loud

A

Delirium

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12
Q

Level of consciousness?

State with quiet behavior, confusion, poor attention, delayed responses

A

clouding of consciousness

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13
Q

what grade of concussion? and what next?

  • no loss of conscioussness
  • transient confusion
  • symptoms resolve in 15 min
  • full memory of event
A

grade 1

athlete removed from competition and return if symptom free after 1 week of rest

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14
Q

what grade of concussion? and what next?

  • moderate injury with transient confusion
  • symptoms last >15min
  • poor concentration and retrograde or anterograde amnesia
A

grade 2
immediately remove athlete from competition, get medical evaluation
- CT scan if symptoms worsen
- return to play if asymptotic for 2 weeks during rest and exertion

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15
Q

what grade of concussion? and what next?

- any form of loss of conscioussness

A

grade 3
immediately go to ER for full neuro eval
hospitalize if altered consciousness or mental status persists
- withhold athlete from competition unless symptom free at least 1 month
- grade 3 is secondary to diffuse axonal injury if severe can result in coma

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16
Q

rancho level of cognitive function?

deep sleep, Completely unresponsive to any stimuli

A

level 1

no response

17
Q

rancho level of cognitive function?

  • Reacts and consistently and non-purposefully to stimuli and non-specific manner
  • Response is limited and same regardless of stimulus
  • Response may be physiological changes, gross body movements, and or vocalization
A

level 2

generalized response

18
Q

rancho level of cognitive function?

  • Reacts specifically but inconsistently to stimuli
  • responds directly to type of stimuli
  • may follow simple commands - close eyes, squeeze hand in inconsistent, delayed manner
A

level 3

localized response

19
Q

rancho level of cognitive function?

  • Heightened state of activity, bizarre behavior, behavior non-purposeful relative to environment
  • Does not discriminate among person or objects
  • Unable to cooperate with the treatment efforts
A

level 4

confused agitated

20
Q

rancho level of cognitive function?

  • Verbalizations incoherent and or inappropriate to environment
  • May make confabulations
  • Gross attention to environment is brief, no selective attention
  • Lack short and long-term recall
  • bizarre agitated behavior
A

level 4

confused agitated

21
Q

rancho level of cognitive function?

  • Goal directed behavior but dependent on external input or direction
  • Follow simple directions consistently
  • Shows carryover for relearned tasks
  • Responses may be incorrect due to memory problems but appropriate situation
  • Past memories show more depth and detail then recent memory
A

level 6

confused appropriate

22
Q

rancho level of cognitive function?

  • Able to respond to simple commands fairly consistently
  • If increased complexity of command or lack of external structure, responses are non-purposeful and random
  • Gross attention to environment but highly distractible and unable to focus on specific task
  • Inappropriate use of objects
A

level 5

confused inappropriate

23
Q

rancho level of cognitive function?

  • With structure may converse and social automatic level for short periods of time
  • Verbalization inappropriate and confabulatory
  • Memory severely impaired
  • Unable to learn new information
A

level 5

confused inappropriate

24
Q

rancho level of cognitive function?

  • Appropriate and oriented in home or hospital setting
  • Go through daily routine automatically robotlike
  • Minimal to no confusion
  • Carryover for new learning at decreased rate
  • Judgment impaired
  • With structure able to initiate social and recreational activities
A

level 7

automatic appropriate

25
Q

rancho level of cognitive function?

  • Able to recall and integrate past and recent events
  • Aware and responsive to environment
  • May showed decreased ability relative to pre-morbid abilities for abstract reasoning, tolerance for stress, judgment in emergencies
A

level 8

purposeful appropriate

26
Q

rancho level of cognitive function?

- Carryover for new learning and needs no supervision once activities or learned

A

level 8

purposeful appropriate

27
Q

How many Rancho Los amigos of cognitive functioning scale levels are there

A

8
new modified has 10
9 - purposeful appropriate - stand by assist on request
10 - purposeful appropriate - modified independent

-nm Npte (28 decks)

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