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PTRS 852 - Neuro PT 1 Final > Traumatic Brain Injury [Guest Lecture] > Flashcards

Traumatic Brain Injury [Guest Lecture] Flashcards

1
Q

List the protective coverings of the brian from outside in

A

Scalp/Hair [2-6mm thick, thinner at temporal fossa]

Dura mater [inelastic]

Arachnoid mater [elastic]

Pia mater [vessels]

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2
Q

Define TBI

A

Sudden external trauma that causes injury to the brain

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3
Q

Describe the difference between an closed and open/penetrating TBI

A

closed = everything says inside

open = tissue can escape the site, ex. GSW, stab wound, etc

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4
Q

Describe the difference between a focal and diffuse TBI

A

Focal = pinpoint, severity depends on locaiton

Diffuse = widespread, “storm in their head” “everything bothers me” “cant get a hold on it”, angry, HA, easily agitated

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5
Q

Type of Injury:

  • Forceful blow to resting, moveable head
  • Max injury at point of cranial impact
  • Contusion w/w/o skull fx
  • Ex. hit over head with a bat
A

Coup Injury

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6
Q

Describe a coup injury

A
  • Forceful blow to resting, moveable head
  • Max injury at point of cranial impact
  • Contusion w/w/o skull fx
  • Ex. hit over head with a bat
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7
Q

Type of Injury:

  • Moving head
  • Injury is opposite of impact
  • Frontal and temporal lobes
  • Ex. Run into fence and land on face, injury to back of brain
A

Contracoup Injury

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8
Q

Describe a contracoup injury

A
  • Moving head
  • Injury is opposite of impact
  • Frontal and temporal lobes
  • Ex. Run into fence and land on face, injury to back of brain
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9
Q

Type of Injury:

  • Whiplash injury
  • Multiple areas of the brain injuried: temporal, frontal, occipital
  • Ex. MVA, Quarterback sacked
A

Coup/Contracoup Injury

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10
Q

Describe a coup/contracoup injury

A
  • Whiplash injury
  • Multiple areas of the brain injuried: temporal, frontal, occipital
  • Ex. MVA, Quarterback sacked
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11
Q

Describe the function of teh CSF

A
  • Shock absorber
  • Dissipates forces
  • Acts as a buffer
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12
Q

Describe primary damage post TBI

A

Combination of all the forces on the brain tissue i.e.

  • Compression/swelling
  • Tensile/stretching
  • Shearing/tearing (hard/slow recovery)
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13
Q

Type of force: axon tearing

A

Shearing or diffuse axonal injury (DAI)

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14
Q

Describe secondary damage post TBI

A
  • Brain swelling resulting in cerebral edema, increased ICP, seizure, and hypoxic ischemic injury
  • Anoxia or no oxygen
  • Hypo/hypertension
  • Hematoma/compression
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15
Q

List the types of hematoma

A
  • Epidural = b/t skull and ura
  • Subdural = b/t dura and arachnoid
  • Intracerebral = w/in cerebrum
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16
Q

List the top causes of TBI

A
  • MVA
  • Violence/GSW/War
  • Falls
  • Sports injuries
  • Pedestrian/cycling accident
  • OD/Poisoning
  • Drowning
  • Carelessness
17
Q

Type of brain injury:

  • No loss of consciousness
  • Experiences changes in one of the following areas: physical, cognitive, behavioral
  • Ex. concussion
A

Mild Brain injury

18
Q

Describe second impact syndrome

A

Second impact syndrome occurs when a secondary TBI occurs shortly after a primary TBI. This results in loss of autoregulation of the blood supply to the brain which causes swelling, and can be fatal

19
Q

Describe the physiology behind second impact syndrome

A

When the second impact occurs there is excitotoxicity due to lack of cerebroregulation

  • Na/K pump disrupted > Ca leaks into vessels > Lactic acid/H+ ion build up > lactate (salt) > decrease pH/increase acidity > blow off excess CO2
  • Brain detects acid change > increased breathing, HR, vasodilation
20
Q

Describe the sequence of events involved with second impact syndrome

A

Initial concussion impairs normal brain function

Second impact unleashes series of metabolic events

Loss of autoregulation of blood vessels in the brain

Congestion, vasodilation, and large increase in BF

Large increase in ICP

Herniation of brain structures through foramen magnum

21
Q

List the long term consequences of repetitive mild TBI

A

Neurodegenerative diseases

Mild cognitive impairment

Alzheimer’s

Chronic Traumatic Encephalopathy

Depression

22
Q

Type of brain injury:

  • Loss of consciousness (minutes to hours)
  • Confusion (days to weeks)
  • Changes in physical, cognitive, behavioral traits (months-permanent)
  • Can make complete recovery and compensate for deficits
A

Moderate TBI

23
Q

Type of brain injury:

  • Coma or prolonged unconsciousness
  • Can recover
  • Deficits in physicallity, congition, and behavior are permanent
A

Severe TBI

24
Q

List the factors that contribute to the amount of improvement made s/p TBI

A

Extent of injury

Neuroplasticity

25
Q

Describe the ways the brain makes adapatations s/p TBI

A
  • Old pathways can take new routes
  • Uninjured neurons can tak over via regenerative or collateral sprouts
  • The brain reorganizes to store new information
  • New connections can be formed
26
Q

Describ ethe Glasgow Coma Score and it’s cut off scores

A

It is a scale that looks at eye opening, verbal repsonse, and motor response to assess severity of injury in the field and the ability to recover

< 8 = poor px

> 12 = good chance of recovery

Max score = 15

27
Q

Level of consciousness: unresponsive but aroused by strong stimulus

A

Stupor

28
Q

Level of consciousness: unconscious, unaware, unarousable, absnet sleep/wake cycle

A

Coma

29
Q

Level of consciousness: unconscious and unaware but have sleep/wake cycle and periods of alertness

A

vegetative state

30
Q

Level of consciousness: don’t recover within 30 days

A

persistent vegetative state (PVS)

31
Q

Level of consciousness: Aware and awake but can’t move or communicate except by blinking

A

Locked-in syndrome

32
Q

Describe the Rancho Los Amigos recovery classification system

A

Assess the level of cognitive functioning by looking at the whole person from information gathered across disciplines

The scale goes to 10

You can jump levels

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PTRS 852 - Neuro PT 1 Final (13 decks)

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