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NPTE NM > Trauma > Flashcards

Trauma Flashcards

1
Q

TBI - pathophys - primary brain damage - diffuse axonal injury

A

disruption and tearing of axons and small BVs from shear strain of angular acceleration
results in neuronal death and petechial hemorrhages

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2
Q

TBI - pathophys - primary brain damage - focal injury

A

contusions, lacerations, mass effect from hemorrhage and edema

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3
Q

TBI - pathophys - primary brain damage - Coup contracoup injury

A

injury at point of impact and opposite point of impact

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4
Q

TBI - pathophys - secondary brain damage - hypoxic-ischemic injury

A

results from systemic problems that compromise cerebral circulation

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5
Q

TBI - pathophys - secondary brain damage - swelling/edema -

A

can result in mass effect, with inc intracranial pressures, brain herniation, and death

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6
Q

TBI - pathophys - concussion

A

loss of consciousness either temporary or permanent - resulting from injury or blow to head with impaired functioning of brainstem reticular activating system (RAS)

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7
Q

TBI - recovery stages from diffuse axonal injury - coma

A

state of unconsciousness in which there is neither arousal nor awareness
eyes remain closed
no sleep/wake cycles

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8
Q

TBI - recovery stages from diffuse axonal injury - unresponsive vigilence/vegetative state

A

marked by the return or sleep/wake cycles and normalization of vitals
persistent veg state id remains in veg state for over 1 yr of TBI

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9
Q

TBI - recovery stages from diffuse axonal injury - mute responsiveness/minimally responsive

A

state in which pt is not vegetative and does show signs, even if intermittent, of fluctuating awareness

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10
Q

TBI - recovery stages from diffuse axonal injury - confusional state

A

mainly a disturbance of attention mechanisms
all cognitive operations are affected
pt is unable to form new memories
may demonstrate either hypoarousal or hyperarousal

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11
Q

TBI - recovery stages from diffuse axonal injury - emerging independence

A

cofusion is clearing and some memory is possible; significant cognitive problems and limited insight remain; frequently uninhibited social bx

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12
Q

TBI - recovery stages from diffuse axonal injury - intellectual/social competance

A

inc indp. although cog difficulties persist along with bx and social problems

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13
Q

SCI - etiology - traumatic causes

A

MVA (most common cause of SCI)

jumps, falls, diving, gunshot wounds

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14
Q

SCI - etiology - mechanism of injury

A

flexion - most common for lumbar
flexion-rotation - most common for cervical
compression, hyperextension

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15
Q

SCI - spinal areas of greatest frequency of injury

A

C5, C7, T12, L1

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16
Q

SCI - nontraumatic causes

A

disc prolapse, vascular insult, cancer, infection

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17
Q

SCI - pathophys - primary injury -

A

interruption of blood supply

18
Q

SCI - pathophys - secondary sequelae -

A

ischemia, edena, demyelination, necrosis of axons, progressing to scar tissue formation

19
Q

SCI - classification - level of injury -

A

lesion level indicates most distal uninvolved nerve root segment with normal function
MM must have a grade of at least 3+ or fair+ function

20
Q

SCI - tetra/quad

A

injury occurs between C1 and C8 levels, involves all 4 extremities and the trunk

21
Q

SCI - para

A

injury occurs between T1 and T12-L1

Involves both lower extremeties and trunk

22
Q

SCI - degree of injury - complete

A

no sensory or motor function below level of lesion

23
Q

SCI - degree of injury - incomplete

A

preservation of sensory or motor function below level of inury; spotty sensation, some mm function

24
Q

SCI - ASIA scale A

A

complete, no motor or sensory function is preserved in sacral segment S4/5

25
Q

SCI - ASIA scale B

A

incomplete, sensory but no motor function is preserved below neuro level and includes sacral segments S4/5

26
Q

SCI - ASIA scale C

A

incomplete, motor function is preserved below neuro level and most key muscle below the neuro level have a muscle grade of less than 3

27
Q

SCI - ASIA scale D

A

incomplete, motor function is preserved below the neuro level, and most key mm below neuro level have a muscle grade of 3 or more

28
Q

SCI - ASIA scale E

A

normal - motor and sensory function is normal

29
Q

SCI - clinical syndromes - central cord syndrome

A

loss of more centrally located cervical tracts/arm function, with preservation of more peripherally located lumbar and sacral tracts/leg function
Typically caused by hyperextension injuries to C spine

30
Q

SCI - clinical syndromes - Brown sequard syndrome

A

hemisection of spinal cord typically caused by penetration wounds (gunshot or knife) with asymmetrical symptoms

31
Q

SCI - clinical syndromes - Anterior cord syndrome

A

damage is mainly in anterior cord resulting in loss of motor function, pain and temp with preservation of light touch, prop, and postiion sense
Typically caused by flexion injuries to C spine

32
Q

SCI - clinical syndromes - Posterior cord syndrome

A

loss of post columns with preservation of motor function, sense of pain and light tough
extremely rare

33
Q

SCI - clinical syndromes - cauda equina

A

injury below L1 results in injury to lumbar and sacral roots of peripheral nerves (LMN) with sensory loss and parlysis and some capacity for regeneration
LMN lesion with auonomous or nonreflex bladder

34
Q

SCI - clinical syndromes - sacral sparing

A

sparing of tracts to sacral segments, with preservation of perianal sensation, rectal sphincter tone, or active toe flexion

35
Q

WC - patients with high cervical lesion (C1-C4)

A

electric wc with tilt in space seating or reclining seat back
microswitch or puff and sip controls

36
Q

WC - pts with cervical lesions, shoulder function, elbow flexion (C5)

A

manual chair for propulsion with aids
indp. for short distances on smooth flat surfaces
may choose electric for longer distance for energy conservation

37
Q

WC - pts with cervical lesions, radial wrist extensors (C6)

A

manual wheelchair with friction surface hand rims

indpendent

38
Q

WC - pts with cervical lesions, triceps (C7)

A

manual wc with friction surface hand rims with icnreased propulsion

39
Q

WC - pts with hand function (C8-T1 and below)

A

manual wc with standard hand rims

40
Q

Locomotor training - pts with midthoracic lesions (T6-9)

A

supervised ambulation for short distances
require KAFOs and crutches
swing to gait pattern

41
Q

Locomotor training - pts with high lumbar lesions (T12 - L3)

A

inp in ambulation on all surfaces and stairs using swing through or four gait pattern with bilateral KAFOs and crutches

42
Q

LT - pts with low lumbar lesions (l4-5)

A

inp with bilateral AFOs and crutches or canes

NPTE NM (16 decks)

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