Brainscape's Knowledge GenomeTM

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


See full index

Neuro Block 8 > Traumatic Brain Injury > Flashcards

Traumatic Brain Injury Flashcards

1
Q

Defining features of concussion

A
  • closed-headed TBI following an impact
  • loss of consciousness
  • typically, transient, anterograde amnesia, period surrounding time of impact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Distribution of concussion

A
  • focal

- diffuse or non-localizing signs: confusion, disorientation, dizziness, HA

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

Mental status and supratentorial signs of concussion

A
  • disruption of executive functions: concentration, attention, working memory
  • language deficits
  • behavioral changes from baseline
  • olfactory deficits, VF deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cranial nerves and concussion

A
  • pupils: symmetrical? Reactive to light?

- oculomotor deficits, especially UMN signs; gaze deviation/palsy

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

Mobile patient eval for concussion

A

Lots of low tech tests and new apps for mental status

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

Histopathology and neuroimaging of concussion

A
  • single concussion typically do not produce a lesion
  • structural neuroimaging may be normal
  • swelling can occur, which is visible as change in signal intensity in CT and MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology of concussion

A
  • Focal or diffuse depression in neural activity
  • reduced cortical activity. Acute suppression of neural activity may be followed by an increase in neuronal excitability and potential vulnerability to excitotoxicity if another impact occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Metabolic impairment of concussion

A
  • reduced glucose utilization

- reduced mitochondrial function

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

Various other physiological changes of debatable significance or consistency in concussion

A
  • cortisol hyper secretion
  • gene expression changes
  • changes in extracellular environment-edema related ion gradient change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Course of concussion

A
  • single concussive event or mild TBU typically produce no permanent lesion
  • functional recovery is typically complete
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pathophysiological changes and recovery in concussion

A

Unclear if pathophysiological changes have fully reversed at point when functional recovery is back to baseline performance

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

Current consensus on recovery time for concussion

A

Do not return to risk related activities for at least 7 days

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

Current consensus on risk of multiple injuries

A

2nd concussion less than 7 days after 1st concussion will probably result in permanent damage and permanent deficits

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

Repeated concussion, especially the inner-impact interval is <7 days, can lead to neurodenegnerative process

A

Chronic traumatic encephalopathy (CTE)

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

Histological features of chronic traumatic encephalopathy (CTE)

A
  • hyper-phosphrylated tau, microtubule degeneration, axonal degradation
  • neurofibrillary tangles
  • diffuse distribution, but may heavily affect prefrontal and temporal lobes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Distribution of CTE

A

Initially focal (peri-vascular) but becoems diffuse

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

Temporal profile of CTE

A

Insidious, probably progressive

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

Cognitive changes in CTE

A

Impaired concentration, executive function, working memory, learning difficulty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Behavioral and emotional changes in CTE

A

Personality changes, co-morbid depression, irritability, volatile emotional expression

20
Q

What is CTE similar to

A

Alzheimers

21
Q

What is the difference in distribution of Alzheimer’s and CTE

A

Alzheimers starts in the hippocampus and goes to temporal lobe

CTE heavily affected in the prefrontal and temporal lobes

22
Q

What’s the difference in cognitive changes between CTE and alzheimers

A

CTE has very diffuse and large variety of problems

Alzheimers is specific memory loss

23
Q

What are the dark spots that you can see on brain tissue of CTE?

A

Neurofibrillary tangles

24
Q

What is the primary determinant in the severity of conscussion

A

Onset of loss of consciousness

25
Q

Loss of consciousness <1 hour ago

A

Mild

26
Q

Loss of consciousness 1-24 hours ago

A

Moderate

27
Q

Loss of consciousness >24 hours ago

A

Severe

28
Q

Glasgow coma scale: 13-15

A

Mild

29
Q

Glasgow coma scale: 9-12

A

Moderate

30
Q

Glasgow coma scale of <8

A

Severe

31
Q

Anterograde amnesia in mild TBI

A

<24 hours

32
Q

Anterograde amnesia in moderate TBI

A

> 24 hours

33
Q

Anterograde amnesia in severe TBI

A

> 7 days

34
Q

What’s the difference between a concussion and a contusion?

A

Contusion actually has a lesion.

-lesion and clearance/isolation of debris by glia

35
Q

Where is there potentially bleeding in a contusion

A
  • epidural
  • subdural
  • subarachnoid
  • intra-parenchymal
36
Q

Things to watch for in contusion

A

Mass effects, especially herniations

-brain can become bruised by contacting rough bony surfaces too

37
Q

Burst lobe contusion

A

Temporal lobe may be removed neurosurgical yo preserve rest of brain

38
Q

Coup, contra-coup concept of injury TBI

A

Being hit on frontal part of head and getting damage to both the frontal lobe and occipital lobe
-shockwave effect that can lead to more than one lesion site

39
Q

Which do you see diffuse axonal injury in, alzheimers or concussion/contusion

A

Concussion/contusion

40
Q

Scenarios that would give you diffuse axonal injury

A
  • repeated linear impact concussion
  • single cortical contusion event
  • rotational (angular acceleration) brain injury
41
Q

Pathophysiology of diffuse axonal injury

A
  • structures being compressed by de-acceleration on impact
  • white matter tracts getting stretched by shearing forces
  • if severe, axons can be severed
42
Q

Neuroimaging and histology of diffuse axonal injury

A
  • spots of hypointensities or absence of signal in neuroimaging of white matter
  • axons show swollen varicosities (bead like terminals)
  • some axons degenerate, leaving debris from varicosities
43
Q

What part of the brain is important to look at on a scan to check for diffuse axonal injury

A

Centrum ovale

44
Q

Rotational or angular acceleration injury

A
  • component of common scenarios of impact injuries of the brain (vehicle accidents)
  • rotation of head causes contusions against calvarium or skull base features
  • stretching and shearing forces cause diffuse axonal injury
45
Q

Blast-induced brain injury

A
  • proximity to explosion involves exposure to shockwave
  • compresses body and skull enough to produce mild TBI
  • diffuse axonal injury may be the main problem, but new avenue of research

Neuro Block 8 (11 decks)

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