Week 1 - ABI Flashcards
What can cause an ABI?
- 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
What are the 2 types of ABI?
- Closed brain injury
2. Penetrating brain injury
What is a closed brain injury?
- 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)
What is a penetrating brain injury?
- open head injury
- break in the skull
- eg. something pierces the brain, skull fracture, cerebral contusions, diffuse axonal injury (tearing of axons), haemorrhage.
What are the 2 most frequent indicators of ABI injury?
- Level of consciousness/coma (depth and duration)
2. Post traumatic amnesia (PTA)
What is a coma?
The absence of awareness of self and the environment despite maximal external stimuli
True or false: Coma involves a period of wakefulness?
False. There is no period of wakefulness in a coma.
How long does a coma last for?
4 weeks once sedating and hypnotic medications have been discontinued
What are the 2 states a person can be in after the coma resolves?
- Partially aware of self and the environment
2. Vegetative
What is a TBI?
Traumatic brain injury
What causes a TBI?
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
What is a contra-coup contusion?
An injury to the brain on the opposite side of impact
What is whiplash?
A closed head injury with no external force to the head
How many people are affected globally by TBI each year?
69 million
what causes the highest burden of TBI disease?
Road trauma injury
True or false: TBI affects more males than females?
True
What is the peak age group for TBI?
15-35 years old
What are the top 5 risk factors for TBI?
- Vehicular collision
- Horse riding
- Falls (mainly elderly)
- Assault
- Gunshot wounds
What 3 responses does the Glasgow coma scale measure?
- Eye opening response
- Verbal response
- Motor response
True or false: The higher the score on the Glasgow coma scale, the more severe the brain injury?
False. The lower the score is, the more severe the brain injury
What is post traumatic amnesia?
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.
What are the three domains of PTA?
- Orientation
- Memory
- Behaviour
What is the most widely used tool to assess PTA?
Westmead PTA Scale
True or false: The Westmead PTA scale is standardised?
True
True or false: The Westmead PTA scale is not validated?
False
How many questions are in the Westmead PTA scale?
12
Who cannot use the Westmead PTA scale?
- 70 years or older with cognitive impairment
- 7 years or younger
- Open head injuries
- Hypoxic TBI
Who can conduct the Westmead PTA Scale?
OT and trained medical staff
What physical status impairments and activity limitations can result from a TBI?
- postural defects and balance
- limited ROM
- sensation
- integration of total body movements
- dysphagia
- self feeding
What sensory status impairments and activity limitations can result from a TBI?
- 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
What is accommodative dysfunction?
Blurred vision
What is convergence insufficiency?
A decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target
What is strabismus?
One eye cannot focus with the other due to imbalance of eye muscles
What is Nystagmus?
An involuntary, rapid, and repetitive movement of the eyes, either horizontal, vertical or rotary
What is hemianopia?
Sight is lost in half of the visual field
What behavioural impairments and activity limitations can result from ABI?
- Agitation
- confusion
- inappropriate behaviour
- reduced insight into impairments
True or false: Behavioural impairments are a natural part of recovery from ABI?
True
What cognitive impairments and activity limitations can result from ABI?
- executive function
- problem solving
- decision making
- memory
- insight
- attention
- concentration
What perceptual impairments can result from ABI?
- Visual perception
- body schema perception
- speech and language perception
What psychosocial impairments can result from ABI?
- Altered self concept
- social roles change
- relationships affected
- independent living status affected
- Dealing with loss
- affective changes such as depression, anxiety and agitation
What communication/language impairments can result from ABI?
- Aphasia
- Broca’s Aphagia
- Wernicke’s Aphagia
- Dysarthria
What is Aphagia?
difficulty understanding and producing spoken word and language
What is Broca’s Aphagia?
Trouble recalling words and speaking in complete sentences
What is Wernicke’s Aphagia?
Have little meaning in their speech, even though they can speak in full sentences with correct grammar.
What is dysarthria?
Weakness or inability to co-ordinate muscles of speech. Speech is slow, slurred and garbled.
What functional impairments can result from ABI?
- washing
- dressing
- feeding
- swallowing
- meal prep
- community access
- employment
What 3 roles can OT play in ABI?
- Acute care
- Rehabilitation
- Community integration
What can OT do in Acute Care?
- Coma - sensory stimulation
2. Positioning, splinting and casting.
What do OT’s do in rehabilitation of ABI?
- Splinting
- cognitive and perceptual rehabilitation
- Maximise occupational engagement and independence
- Provide aids and equipment
- Speech - communication device use
What do OT’s do in community integration for ABI?
- living environment and managing occupations
- work
- driving
