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Neurology > Traumatic Brain Injury > Flashcards

Traumatic Brain Injury Flashcards

1
Q

Alteration of brain function secondary to an external force

A

TBI

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2
Q

5 sources of TBI

A

Falls, MVA, Sport-related, Violence, Blast Injury

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3
Q

Two classifications of TBI

A

Open head and Close head

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4
Q

Classifications of TBI: Mild TBI

A

Close head

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5
Q

Classifications of TBI: Skull is open and damaged dura mater

A

Open head

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6
Q

Classifications of TBI: Most common

A

Close head

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7
Q

Classifications of TBI: Penetrating

A

Open head

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8
Q

Classifications of TBI: Skull remains intact

A

Close head

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9
Q

Classifications of TBI: Severe TBI

A

Open head

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10
Q

3 types of Primary Brain Injury

A

Diffuse Axonal Injury, Concussion, Contusion

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11
Q

Primary Brain Injury secondary to high-velocity forces

A

Diffuse Axonal Injury

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12
Q

Primary Brain Injury secondary to shaking of the brain

A

Concussion

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13
Q

Primary Brain Injury secondary to low-velocity forces

A

Contusion

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14
Q

DAI MOI

A

Acceleration-deceleration angular forces (MVA)

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15
Q

Three sites of DAI

A

Corpus Callosum, Parasagittal white matter, Pons & midbrain

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16
Q

DAI is responsible for _______?

A

Initial LOC and Coma

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17
Q

Concussion is responsible for ________>

A

Alterations of consciousness

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18
Q

It is a distinguishing feature of TBI

A

DAI

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19
Q

The most common site of DAI

A

Corpus Callosum

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20
Q

Two other names of Concussion

A

Mild TBI/Mild DAI

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21
Q

Level of Consciousness: (+) visual tracking

A

Minimally Conscious State

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22
Q

Level of Consciousness: (+) Ventilator support

A

Coma state

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23
Q

Level of Consciousness: (+) Sleep-wake cycle

A

Vegetative state

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24
Q

Level of Consciousness: Mildly depressed

A

Lethargy

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25
Q

Level of Consciousness: (+) Unresponsiveness

A

Stuporous

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26
Q

Level of Consciousness: (-) Sleep-wake cycle

A

Coma State

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27
Q

Level of Consciousness: (+) Reflex crying/smiling

A

Vegetative State

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28
Q

Level of Consciousness: Cannot be aroused but can be aroused briefly via vigorous repetitive sensory stimulus

A

Stuporous

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29
Q

Level of Consciousness: More depressed

A

Obtunded

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30
Q

Level of Consciousness: (+) Minimal evidence of self and environment awareness

A

Minimally Conscious State

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31
Q

Level of Consciousness: GCS 3-8

A

Coma State

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32
Q

Level of Consciousness: Can be fully aroused with little difficulty

A

Lethargy

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33
Q

Level of Consciousness: Cannot be fully aroused

A

Obtunded

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34
Q

What is the indicator to say that the patient is out of the coma?

A

If the patient resume following commands

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35
Q

How can you say that the patient is in a persistent vegetative state?

A

If they are in a vegetative state for >30 days and >1 year

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36
Q

Level of Consciousness: Decrease interest/drowsy

A

Obtunded

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37
Q

Two types of contusion

A

Coup injury and Countercoup injury

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38
Q

Contusion on opposite site of impact

A

Countercoup injury

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39
Q

Contusion at the site of impact

A

Coup injury

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40
Q

Two sites of Contusion

A

Inferior frontal lobe and anterior temporal lobe

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41
Q

What site of contusion will result in memory loss?

A

Anterior temporal lobe

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42
Q

What site of contusion will result in behavioral changes?

A

Inferior frontal lobe

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43
Q

Behavioral Change: Excited

A

Agitated

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44
Q

Behavioral Change: Quick

A

Impulsive

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45
Q

Behavioral Change: Moody

A

Irritable

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46
Q

Behavioral Change: Violent

A

Aggressive

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47
Q

Behavioral Change: Decrease interest

A

Apathy

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48
Q

The length of time from the injury up until the time in which the patient remembers a going event.

A

Post-traumatic amnesia

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49
Q

2 forms to assess Post-traumatic amnesia

A

Galveston Orientation Test (GOAT) and Orientation Lag Test

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50
Q

What form is used to assess severe TBI?

A

Orientation Lag Test (10)

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51
Q

What form is used to assess mild TBI?

A

Galveston Orientation Test (GOAT)

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52
Q

What is the normal score of the Galveston Orientation Test (GOAT)?

A

76-100

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53
Q

Three types of secondary brain injury

A

Hydrocephalus, Herniation, ICP & CPP

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54
Q

What is the adult communicating form of hydrocephalus?

A

Normal Pressure Hydrocephalus

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55
Q

What is the problem in Normal Pressure Hydrocephalus?

A

There is no absorption

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56
Q

Triad of Hydrocephalus

A

DIG: Dementia, Incontinence (urinary), Gait Ataxia

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57
Q

Intervention for Hydrocephalus

A

Shunting

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58
Q

What is the first to improve after shunting?

A

Gait Ataxia

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59
Q

Three types of herniation

A

Uncal, central, Tonsilar

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60
Q

Most common CN affected in Herniations?

A

CN 3

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61
Q

4 areas affected in the Uncal Herniation

A

Cerebral Peduncle, RAS, Oculomotor, PCA

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62
Q

2 areas affected in the Central Herniation

A

Midbrain & Pons, RAS

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63
Q

3 areas affected in the Tonsilar Herniation

A

Cerebellar Tonsil, RAS, Medulla Oblongata

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64
Q

If RAS is affected, what manifestation will come out?

A

Coma

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65
Q

If PCA is affected, what manifestation will come out?

A

Hemianopsia

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66
Q

If Midbrain & Pons is affected, what manifestation will come out?

A

Decerebrate Rigidity

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67
Q

If Cerebellar Tonsil is affected, what manifestation will come out?

A

Neck Pain

68
Q

If Cerebral Peduncle is affected, what manifestation will come out?

A

Paresis

69
Q

If Medulla Oblongata is affected, what manifestation will come out?

A

Alteration of HR, RR, BP

70
Q

If the Oculomotor nerve is affected, what manifestation will come out?

A

Gaze palsy

71
Q

If the Above midbrain is affected, what manifestation will come out?

A

Decorticate rigidity

72
Q

What fracture affects CN 9-12?

A

Basilar skull fracture

73
Q

What fracture affects CN 3, 4, 6?

A

Orbital fissure fracture

74
Q

What fracture affects CN 5, 7, 8?

A

Temporal fracture

75
Q

What fracture affects CN 2?

A

Optic canal fracture

76
Q

What fracture affects CN 1?

A

Cribriform plate of ethmoid fracture

77
Q

If CN 1 is affected, what manifestation will come out?

A

CSF Rhinorrhea

78
Q

The normal amount of ICP

A

<20 mmHg

79
Q

Four clinical manifestations associated with Increased ICP

A

Headache, vomiting, nausea, papilledema

80
Q

Swelling of opting disc

A

Papilledema

81
Q

What cranial nerve lesion that results in Papilledema?

A

CN 2

82
Q

The medication used to decrease ICP

A

Diuretics (Mannitol)

83
Q

According to Sullivan, what intervention can you do to the patient experiencing increasing ICP?

A

Elevate the head up to 30 degrees from supine

84
Q

The formula for Cerebral Perfusion Pressure

A

CPP = MAP - ICP

85
Q

The normal amount of CPP

A

> 50 mmHg

86
Q

The normal amount of MAP

A

60-110 mmHg

87
Q

The formula for Mean Arterial Pressure

A

MAP = DBP + 1/3 PP

88
Q

The formula for Pulse Pressure

A

PP = SBP - DBP

89
Q

Mild TBI: LOC

A

0-30 min

90
Q

Severe TBI: PTA

A

> 7 days

91
Q

Mild TBI: GCS

A

13-15

92
Q

Moderate TBI: LOC

A

30 min - 1 day

93
Q

Severe TBI: GCS

A

3-8

94
Q

Moderate TBI: PTA

A

1-7 days

95
Q

Severe TBI: LOC

A

> 1 day

96
Q

Moderate TBI: GCS

A

9-12

97
Q

Mild TBI: PTA

A

0-1 day

98
Q

GCS: EO to sound

A

3

99
Q

GCS: EO to pressure

A

2

100
Q

GCS: Verbal words

A

3

101
Q

GCS: Verbal sound

A

2

102
Q

GCS: Withdraws to pain

A

4

103
Q

GCS: Localizes pain

A

5

104
Q

GCS: Verbally confused

A

4

105
Q

GCS: Decorticates

A

3

106
Q

GCS: Decerebrates

A

2

107
Q

Scale that assesses the reflex

A

Glasgow Liege Scale

108
Q

Glasgow Liege Scale: 5

A

(+) Fronto-orbicular reflex

109
Q

Glasgow Liege Scale: 1

A

(+) Oculocardiac Reflex

110
Q

Glasgow Liege Scale: 4

A

(+) Vertical oculocephalic

111
Q

Glasgow Liege Scale: 2

A

(+) Horizontal oculocephalic

112
Q

Glasgow Liege Scale: 3

A

(+) Pupillary light reflex

113
Q

Glasgow Liege Scale: 0

A

No reflex activity

114
Q

Ommaya Scale: Patient not obeying the command

A

3

115
Q

Ommaya Scale: Patient is not recording ongoing events

A

2

116
Q

Ommaya Scale: Patient is in decerebrate rigidity

A

4

117
Q

Ommaya Scale: Patient is oriented

A

1

118
Q

Ommaya Scale: Patient is still talking and obeying commands

A

2

119
Q

Ommaya Scale: Patient is not responding to stimulus correctly

A

4

120
Q

Ommaya Scale: Patient is totally unresponsive

A

5

121
Q

Ommaya Scale: Patient is recording ongoing events

A

1

122
Q

Ommaya Scale: Patient is responding to stimulus correctly

A

3

123
Q

Ommaya Scale: Patient is disoriented

A

2

124
Q

Ommaya Scale: Patient is fully conscious

A

1

125
Q

Glasgow outcome scale extended: Good Recovery

A

8-7

126
Q

Glasgow outcome scale extended: Vegetative State

A

2

127
Q

Glasgow outcome scale extended: Moderate Disability

A

6-5

128
Q

Glasgow outcome scale extended: Death

A

1

129
Q

Glasgow outcome scale extended: Severe Disability

A

4-3

130
Q

Glasgow outcome scale extended: Assistance 24 hours per day

A

3

131
Q

Glasgow outcome scale extended: Returned to the previous lifestyle completely

A

8

132
Q

Glasgow outcome scale extended: Indep ADL but has not returned to the previous lifestyle

A

5

133
Q

Glasgow outcome scale extended: Returned to the previous lifestyle with some problem

A

7

134
Q

Glasgow outcome scale extended: Assistance 8 hours per day

A

4

135
Q

Glasgow outcome scale extended: Returned to the previous lifestyle with modification

A

6

136
Q

Criteria used to assess cognitive functions of TBI

A

Ranchos Los Amigos

137
Q

RLA: 1

A

No Response

138
Q

RLA: 3

A

Localized Response

139
Q

RLA: 7

A

Automatic Appropriate

140
Q

RLA: 9

A

Purposeful Appropriate with standby assistance upon request

141
Q

RLA: 4

A

Confused-Agitated

142
Q

RLA: 5

A

Confused-Inappropriate

143
Q

RLA: 2

A

Generalized Response

144
Q

RLA: 8

A

Purposeful Appropriate

145
Q

RLA: 6

A

Confused-Appropriate

146
Q

RLA: 10

A

Purposeful Appropriate with modified independence

147
Q

RLA: Responses are related to stimulus

A

RLA 3: Localized Response

148
Q

RLA: Responses are not related to stimulus

A

RLA 2: Generalized Response

149
Q

RLA: Follow simple commands inconsistently

A

RLA 3: Localized Response

150
Q

RLA: Follow simple commands fairly consistently

A

RLA 5: Confused-Inappropriate

151
Q

RLA: Follow simple commands consistently

A

RLA 6: Confused Appropriate

152
Q

RLA: (+) Bizzare Behavior

A

RLA 4: Confused-Agitated

153
Q

RLA: (+) Goal-directed behavior

A

RLA 6: Confused-Appropriate

154
Q

RLA: (+) Robot-like behavior

A

RLA 7: Automatic Appropriate

155
Q

RLA: No learning is possible

A

RLA 5: Confused-Inappropriate

156
Q

RLA: Carry-over of relearned task

A

RLA 6: Confused Appropriate

157
Q

RLA: New learning at a decrease rate

A

RLA 7: Automatic Appropriate

158
Q

RLA: New learning without supervision

A

RLA 8: Purposeful Appropriate

159
Q

RLA: Response is physiologic body changes, limited, same, stereotypic

A

RLA 2: Generalized Response

160
Q

RLA: (-) STM/LTM

A

RLA 4: Confused-Agitated

161
Q

RLA: Impaired Judgement

A

RLA 7: Automatic Appropriate

162
Q

RLA: Has environmental awareness

A

RLA 8: Purposeful Appropriate

163
Q

RLA: Patient is in a heightened state of activity

A

RLA 4: Confused-Agitated

164
Q

RLA: Non-agitated

A

RLA 5: Confused-Inappropriate

165
Q

RLA: (+) Abstract Reasoning

A

RLA 8: Purposeful Appropriate

166
Q

RLA: Patient is in deep sleep

A

RLA 1: No Response

Neurology (14 decks)

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