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CONDITIONS 2 > Unit 4 Traumatic Brain Injury > Flashcards

Unit 4 Traumatic Brain Injury Flashcards

1
Q

Define traumatic brain injury

A

Trauma in the brain. It can be based on the severity:

-Open brain injury or closed brain injury

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2
Q

What are 5 types of impairments you will expect to see in someone following a TBI?

A
  • Long-term functional problems
  • Altered or declined LOC
  • Motor, perception and cognitive functions
  • Behaviour and emotional changes
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3
Q

Explain coup and contrecoup

A
  • Coup: injury occurs under the site of impact with an object
  • Contrecoup: injury occurs on the side opposite the area that was hit
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4
Q

What are the 4 pathophysiological processes?

A
  • Disruption of synapses
  • Functional, but not structural damages
  • Contusion on surface of brain
  • Due to rupture of small blood vessels
  • Could be on same side or opposite site
  • Frontal and temporal lobes most affected
  • Diffuse axonal injury
  • Axons stretched and rotated
  • Hemorrhaging –> Hematomas
  • Epidural *Subarachnoid
  • Subdural *Intracerebral
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5
Q

What is diffuse axonal injury (DAI) and explain how it happens?

A
  • Cause
  • High velocity
  • Result in stretching and shearing forces
  • And strong rotational forces (twisting)
  • Pathophysiology
  • Micro-bleeding
  • Chemical changes in brain
  • Effect
  • Can cause widespread brain damage
  • Affects central areas of brain
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6
Q

What are 4 complications that could occur following traumatic brain injury?

A
  • LOC
  • Seizures
  • Infection
  • Increased intracranial pressure
  • Can be life-threatening
  • Can occur immediately, within days, or up to months later
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7
Q

Describe the mechanisms of closed TBI?

A
  • Blow to head –> the head accelerates
  • Head suddenly stops –> the head decelerates and then accelerates back the other way
  • Brain movement without skull impact but movement of brain inside the skull.
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8
Q

Explain why traumatic brain injuries results in such varied impairments

A

Due to coup and contrecoup affects and it depends on where the area of the brain is affected.

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9
Q

True or false: Seizures are only a concern immediately following a traumatic brain injury?

A

False. 80% of seizures can develop within first 2 years.

  • approx. 30% of people with TBI develop post-traumatic seizures
  • more common with open head injuries, subdural hematoma and older adults
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10
Q

What should you do if your patient starts to have seizure?

A
  • Don’t try to stop it
  • Transfer to floor
  • Position on side
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11
Q

What are the 3 ways to assess severity of brain injury?

A
  • Glasgow Coma Scale
  • Post-traumatic amnesia (PTA)
  • Level of Consciousness (LOC)
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12
Q

What does the Glasgow Coma Scale do?

A
  • Considers 3 responses of stimulation
  • Eye opening, movement and speech in response to stimulation
  • Indicates
  • Level of arousal
  • Function of cerebral cortex
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13
Q

True or false: A person with a severe brain injury will have a Glasgow Coma Scale of 13 when they come to the hospital.

A

False, scores of less than 8, indicates coma, severe brain injury

  • Scores range from 3-15
  • The higher the score, the less severe the brain damage
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14
Q

What does PTA stand for and describe

A
  • Stand for: Post-Traumatic Amnesia
  • It is use in period of confusion when come out of coma

Individuals are:

  • Disoriented
  • Inattentive
  • Have difficulty learning new things
  • Have significantly decreased short-term memory
  • Not remember since injury
  • Maybe agitated
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15
Q

What does MTBI stand for?

A

Mild Traumatic Brain Injury

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16
Q

The other name for MTBI is ________

A

Concussion

17
Q

What are five symptoms for mild brain injury?

A

Acute

  • Headache - mild or moderate
  • Dizziness
  • Nausea
  • Blurred vision
  • Sensitive to light

Later

  • Trouble with thinking, memory or concentrating
  • Ringing in ears (tinnitus)
  • Decreased energy
  • Changes in sleep patterns
  • Drowsiness
18
Q

Do the upper or lower limbs tend to have a greater increase in extensor tone?

A

LE: rigidly in full extension

19
Q

What are 4 common cognitive impairments following severe brain injury?

A
  • Short-term memory loss
  • Lack of attention
  • Insight
  • Orientation
20
Q

What are 4 common behavioral impairments following severe brain injury?

A
  • Impulsive
  • Disinhibition
  • Inflexibility
  • Emotional lability
21
Q

Describe the development of spasticity following TBI

A
  • Often develops quickly
  • LE: increase extensor tone
  • UE: can be extension or flexion
  • One side may be more affected than the other
  • Often increase extensor tone of back and neck
22
Q

What is the difference between decerebrate and decorticate positioning?

A
  • Decerebrate position: Body held rigidly in full extension, including arms, legs, and neck ( Most serious)
  • Decorticate position: Arms are held rigidly in flexion. Legs held rigidly in full extension
23
Q

True or False: People wake up from a coma quickly

A

False

24
Q

Define head Injury, brain injury, and acquired brain injury

A

Head injury:

  • trauma to the head
  • may or may not include injury to brain

Brain injury:

  • generally synonymous with ABI
  • can have brain injury without skull injury

ABI:
-any brain damage that occurs after birth

25
Q

Location and the difference of subdural and epidural

A

Subdural:

  • below dura
  • severe BI
  • due to rupture of menigeal artery –> develop quickly
  • neurosurgery needed

Epidural:

  • between skull and dura
  • often results from falls, as with the elderly
  • often due to rupture of veins –> develops more slowly
  • may require surgical removal
26
Q

What are the 4 implications for RA if the client has a seizures episode?

A
  • know behaviours that may trigger
  • know what to do if client seizures during treatment
  • some seizure medications affect level of arousal which affects ability to respond
27
Q

What are the 3 common seizures medication that affects level of arousal?

A

-Dilantin, Phenobarbital and Tegratol

28
Q

What are the 4 trigger points of seizures?

A
  • flickering lights
  • infection
  • stress, anxiety
  • drugs
29
Q

What is the purpose of Glasgow Coma Scale?

A

The most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury. It is used to help gauge the severity of a brain injury.

30
Q

What is the medical and surgical management of BI?

A

Manage or treat acute problems:

  • respiratory care
  • decrease secondary damage

Treat other injuries:

  • fractures
  • internal injuries

Surgery:
-evacuation of haematomas

31
Q

What are impairments NOT related to BI?

A
  • orthopaedic
  • respiratory
  • neurologic
32
Q

What are impairments DUE to BI?

A
  • decreased level of LOC
  • abnormalities of tone
  • abnormal postures
  • contractures
33
Q

What are 5 neurologic impairments of motor after BI?

A
  • abnormal tone
  • abnormal balance
  • ataxia (inability to coordinate voluntary muscular movements)
  • contractures
  • weakness
34
Q

What are 5 neurologic impairments of cognition after BI?

A
  • orientation
  • organisation
  • attention
  • abstract thinking
  • memory
35
Q

What are 5 neurologic impairments of behavioural after BI?

A
  • agitation
  • impulsive
  • disinhibition
  • inflexibility
  • emotional lability

CONDITIONS 2 (12 decks)

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