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Nature of Disorders of Language and Communication > Traumatic Brain Injury (TBI) > Flashcards

Traumatic Brain Injury (TBI) Flashcards

1
Q

acquired brain injury (ABI)

A
  • umbrella term for all brain injuries occurring after birth
  • an injury to the brain that is not hereditary, congenital, or degenerative
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2
Q

2 types of ABI

A
  • traumatic brain injury (TBI)
  • non-traumatic brain injury
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3
Q

TBI

A
  • from external force
  • injury to the head caused by a trauma to the head (head injury)
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4
Q

non-traumatic brain injury

A
  • internal cerebral event that kills or damages brain cells
  • stroke, brain infection
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5
Q

causes of TBI

A
  • external cerebral event
  • falls
  • road traffic accidents
  • shaken baby syndrome
  • abuse
  • gunshot wounds/stabbings
  • failed suicide attempts
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6
Q

types of TBI

A

closed head injury
- typical, does not expose the skull contexts
- brain damage from violent movement or shearing of the brain within the skull

open or penetrating head injury
- usually caused by heavy blunt or sharp objects
- brain damage results from direct contact with brain with increased risk of complications

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6
Q

non-traumatic ABI

A
  • internal cerebral event
  • stroke (aneurysm, thrombus, blood clot)
  • infection (encephalitis, meningitis)
  • seizure disorders
  • tumors (surgery, radiation, chemo)
  • toxic exposure
  • metabolic disorders (insulin shock)
  • neurotoxic poisoning (carbon monoxide)
  • hypoxia, anoxia (cardio-respiratory, airway obstruction)
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6
Q

2 types of TBI injuries

A
  • primary
  • secondary
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7
Q

primary injury (TBI) definition and causes

A
  • occurs at the moment of impact
  • caused directly by the blow
  • may result in a loss of consciousness

causes:
- cerebral contusion
- brain swelling/edema
- diffuse axonal injury

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8
Q

secondary injury (TBI) definition and causes

A
  • complications which are potentially treatable

causes:
- intracranial hematoma
- ischemic brain damage (raised intracranial pressure, brain swells into an immovable skull)
- brain infection

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9
Q

severity of TBI is measured by ?

A
  • post traumatic amnesia (PTA)
  • loss of consciousness (LOC)
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10
Q

post concussion symptoms (PCS)

A
  • headache
  • dizziness
  • irritability
  • decreased concentration
  • memory problems
  • fatigue
  • visual disturbances
  • sensitivity to noise
  • judgement problems
  • anxiety
  • depression
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11
Q

long-term TBI impacts depend on ?

A
  • how much damage
  • location and type of damage
  • length of coma
  • pre-morbid characteristics
  • awareness and insight (ex: I know I get tired when thinking, but why can’t I drive?)
  • coping skills and support
  • circumstances and supports
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12
Q

TBI risk factors

A
  • males 3:1
  • peak in injury between 16 and 24
  • pre-existing problems (alcohol/substance use, psychiatric history)
  • low socioeconomic groups, homeless and unemployed
  • multiple concussions
  • risk increase after initial injury
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13
Q

Slinky Model of Rehabilitation Service Delivery

A

goals:
- hospital: reduced impairment and pathology
- both: improved activity (reduced disability)
- home: enhanced participation

hospital:
- acute care/neurosurgery
- post-acture inpatient (rehab)

home:
- community-based rehab (outpatient)
- long-term community support (specialist care, review)
- re-access as required

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14
Q

(true/false) management of symptoms following TBI is simple

A

false, can be complex

15
Q

possible biopsychosocial changes from a TBI

A
  • prolonged disorders of consciousness (PDoC)
  • adverse behavioral, cognitive, and psychiatric effects
  • subtle high-functioning executive communication changes
  • personal relationships
16
Q

4 main areas effected by TBI

A
  • physical
  • cognitive/communicative
  • emotional
  • behavioral
17
Q

physical effects of TBI

A
  • speech intelligibility and efficiency
  • balance and coordination
18
Q

cognitive/communicative effects of TBI

A
  • cognitive domains underlying communication competencies
  • effectiveness of social interactions
19
Q

emotional effects of TBI

A
  • desire, motivation
  • management of social interactions
  • emotional domains
20
Q

behavioral impacts of TBI

A
  • impact of underlying SLCNs
  • anger, sadness
21
Q

SLT role in TBI

A
  • differential diagnosis of communication following a TBI
  • identify residual and emerging abilities
  • identify factors that facilitate or act as a barrier to recovery
22
Q

TBI and associated acquired communication disorder(Togher, 2014)

A
  • cognitive communication deficits (CCD), >81%
  • aphasia, 2%
  • speech disorders, rare
    (Togher, 2014)
23
Q

early stage of TBI

A
  • acute to chronic (<1 week to lifespan)
  • coma and emerging from coma
24
Q

middle stage of TBI

A

regaining functional learning skills

25
Q

high/late stage of TBI

A

vocational-executive and cognitive recovery

26
Q

2 assessment early stage of TBI

A
  • Glasgow Coma Scale UK
  • Rancho Los Amigos Scale USA
27
Q

prolonged disorders of consciousness (PDoC)

A

coma = unarousable, no sleep/wake cycle, typically < 8 weeks)

  • < 4 weeks
  • not purposefully responding
  • indicative of severe/profound brain injury
  • slow course of recovery likely
  • permanent ongoing cognitive and physical impairment, disability
28
Q

a person is no longer in a minimally conscious state when there’s…

A
  • some consistent reponse beyond a reflex pattern
  • demonstrates inconsistent responses with a functional component
  • can communicate or begin to follow instructions and show meaningful emotional response
  • moves into a confused state typically
29
Q

SLT priority in assessment early stage

A
  • responsiveness: visual, arousal, social, auditory, cognition/comprehension
  • prompt, consistent, replicable
30
Q

most comprehensive severe TBI SLT assessment

A
  • Julia Farr Post-Traumatic Amnesia Scale (PTA)
  • Ross Information Processing Assessment (RIPA)
  • Wessex Head Injury Matrix (WHIM)
  • baseline aphasia test to rule out comprehension difficulties
31
Q

SLT indirect assessments

A
  • cognitive and behavioral presentation post-injury
  • social and communicative history
  • family and support systems
32
Q

SLT direct assessments (broad)

A
  • listening and speaking
  • reading and writing
  • social conversation
33
Q

difficulties post-tbi

A
  • communication > 80%
  • cognition and executive functioning > 80%
  • sensory/perceptual changes > 10%
  • physical changes < 10%

Nature of Disorders of Language and Communication (9 decks)

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