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Clinical Medicine - OT > Week 1 - ABI > Flashcards

Week 1 - ABI Flashcards

1
Q

What can cause an ABI?

A
  • Trauma to the head (TBI)
  • Stroke
  • Infection
  • Oxygen deprivation (anoxic/hypoxic injury)
  • Drug use
  • Degenerative brain conditions
  • Poisoning (eg. carbon monoxide)
  • Intercranial surgery/vascular disruption
  • Metabolic disorders
  • Tumour (Intracranial neoplasms)
  • Seizures
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2
Q

What are the 2 types of ABI?

A
  1. Closed brain injury

2. Penetrating brain injury

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3
Q

What is a closed brain injury?

A
  • non-penetrating injury
  • no break to the skull
  • caused by rapid backward and forward movement and shaking the brain.
  • eg. acceleration, deceleration, rotational acceleration, compression (Haemorrhage or swelling)
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4
Q

What is a penetrating brain injury?

A
  • open head injury
  • break in the skull
  • eg. something pierces the brain, skull fracture, cerebral contusions, diffuse axonal injury (tearing of axons), haemorrhage.
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5
Q

What are the 2 most frequent indicators of ABI injury?

A
  1. Level of consciousness/coma (depth and duration)

2. Post traumatic amnesia (PTA)

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6
Q

What is a coma?

A

The absence of awareness of self and the environment despite maximal external stimuli

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7
Q

True or false: Coma involves a period of wakefulness?

A

False. There is no period of wakefulness in a coma.

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8
Q

How long does a coma last for?

A

4 weeks once sedating and hypnotic medications have been discontinued

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9
Q

What are the 2 states a person can be in after the coma resolves?

A
  1. Partially aware of self and the environment

2. Vegetative

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10
Q

What is a TBI?

A

Traumatic brain injury

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11
Q

What causes a TBI?

A

A TBI is caused by external forces for example:

- when a head suddenly and violently hits an object or something pierces the skull and enters brain tissue

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12
Q

What is a contra-coup contusion?

A

An injury to the brain on the opposite side of impact

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13
Q

What is whiplash?

A

A closed head injury with no external force to the head

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14
Q

How many people are affected globally by TBI each year?

A

69 million

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15
Q

what causes the highest burden of TBI disease?

A

Road trauma injury

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16
Q

True or false: TBI affects more males than females?

A

True

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17
Q

What is the peak age group for TBI?

A

15-35 years old

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18
Q

What are the top 5 risk factors for TBI?

A
  1. Vehicular collision
  2. Horse riding
  3. Falls (mainly elderly)
  4. Assault
  5. Gunshot wounds
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19
Q

What 3 responses does the Glasgow coma scale measure?

A
  1. Eye opening response
  2. Verbal response
  3. Motor response
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20
Q

True or false: The higher the score on the Glasgow coma scale, the more severe the brain injury?

A

False. The lower the score is, the more severe the brain injury

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21
Q

What is post traumatic amnesia?

A

A loss of memory of events from the period immediately following a head injury until the return of day-to-day memory on a continuous basis.

22
Q

What are the three domains of PTA?

A
  1. Orientation
  2. Memory
  3. Behaviour
23
Q

What is the most widely used tool to assess PTA?

A

Westmead PTA Scale

24
Q

True or false: The Westmead PTA scale is standardised?

A

True

25
Q

True or false: The Westmead PTA scale is not validated?

A

False

26
Q

How many questions are in the Westmead PTA scale?

A

12

27
Q

Who cannot use the Westmead PTA scale?

A
  • 70 years or older with cognitive impairment
  • 7 years or younger
  • Open head injuries
  • Hypoxic TBI
28
Q

Who can conduct the Westmead PTA Scale?

A

OT and trained medical staff

29
Q

What physical status impairments and activity limitations can result from a TBI?

A
  • postural defects and balance
  • limited ROM
  • sensation
  • integration of total body movements
  • dysphagia
  • self feeding
30
Q

What sensory status impairments and activity limitations can result from a TBI?

A
  • pain
  • vision
  • accommodative dysfunction (causes blurred vision)
  • convergence insufficiency (inability to maintain single vision while fixating on an object = diplopia)
  • Lateral or medial strabismus
  • nystagmus
  • Hemianopia
  • impairment of scanning
31
Q

What is accommodative dysfunction?

A

Blurred vision

32
Q

What is convergence insufficiency?

A

A decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target

33
Q

What is strabismus?

A

One eye cannot focus with the other due to imbalance of eye muscles

34
Q

What is Nystagmus?

A

An involuntary, rapid, and repetitive movement of the eyes, either horizontal, vertical or rotary

35
Q

What is hemianopia?

A

Sight is lost in half of the visual field

36
Q

What behavioural impairments and activity limitations can result from ABI?

A
  • Agitation
  • confusion
  • inappropriate behaviour
  • reduced insight into impairments
37
Q

True or false: Behavioural impairments are a natural part of recovery from ABI?

A

True

38
Q

What cognitive impairments and activity limitations can result from ABI?

A
  • executive function
  • problem solving
  • decision making
  • memory
  • insight
  • attention
  • concentration
39
Q

What perceptual impairments can result from ABI?

A
  • Visual perception
  • body schema perception
  • speech and language perception
40
Q

What psychosocial impairments can result from ABI?

A
  • Altered self concept
  • social roles change
  • relationships affected
  • independent living status affected
  • Dealing with loss
  • affective changes such as depression, anxiety and agitation
41
Q

What communication/language impairments can result from ABI?

A
  • Aphasia
  • Broca’s Aphagia
  • Wernicke’s Aphagia
  • Dysarthria
42
Q

What is Aphagia?

A

difficulty understanding and producing spoken word and language

43
Q

What is Broca’s Aphagia?

A

Trouble recalling words and speaking in complete sentences

44
Q

What is Wernicke’s Aphagia?

A

Have little meaning in their speech, even though they can speak in full sentences with correct grammar.

45
Q

What is dysarthria?

A

Weakness or inability to co-ordinate muscles of speech. Speech is slow, slurred and garbled.

46
Q

What functional impairments can result from ABI?

A
  • washing
  • dressing
  • feeding
  • swallowing
  • meal prep
  • community access
  • employment
47
Q

What 3 roles can OT play in ABI?

A
  1. Acute care
  2. Rehabilitation
  3. Community integration
48
Q

What can OT do in Acute Care?

A
  1. Coma - sensory stimulation

2. Positioning, splinting and casting.

49
Q

What do OT’s do in rehabilitation of ABI?

A
  1. Splinting
  2. cognitive and perceptual rehabilitation
  3. Maximise occupational engagement and independence
  4. Provide aids and equipment
  5. Speech - communication device use
50
Q

What do OT’s do in community integration for ABI?

A
  1. living environment and managing occupations
  2. work
  3. driving

Clinical Medicine - OT (35 decks)

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