week 9 Flashcards
acquired brain injury
brain damage post-birth, not from disease
- trauma, seizure, tumor, lack o2
some CP happens after birth, complicates diagnosis
prevalence 1.5mil ppl
incidence/new cases 160,000/yr
aetiology ABI
- traumatic: from injury…shaken baby, gunshot, fall
- non-traumatic: w/in body i.e. stroke, seizure, tumor
open-head injury: visible laceration or openings, w injury limited to site
closed-head injury: injury diffuses and many areas can be impacted
stages of ABI treatment
emergency and acute care: at hospital post-accident
intensive care and surveillance: ensure safety and urgent needs i.e. swelling, stroke
- may be in or induce coma to allow healing
rehabilitation unit: individualized and intense rehab
transitional family living: additional support before return to community
- may stay indefinetly
glasgow coma scale
gauge lvl conc
if score 8 or below, SEVERE injury
eye opening, verbal resp, motor resp
racho los amigos scale
eight lvls to rate place in recovery process
1 = no resp
4 = confused and agitated
8 = inc mem and improvement
helps family deal w stages
manifestations of ABI
phys function: rehab to inc stability and mobility…paralysis
perceptual: ID, org, interpret info
- agnosia, lose senses i.e. vision
speech and lang: muscles impacted, cause slurring
cog manisfestations: recall, make mems, recognize, plan, make goals
- may repeat many times
- difficulty w attention
personality and behaviour: new personas, anger, depression, may lack self awareness
spinal cord injury
loss of function depends on
1: severity of SC injury….NERVES, not vert
2. severity
3. anatomical position affected
higher SC = more body parts impacted
vertebrae injury is not SC injruy
- damage must be to cord and interrupt messages b/w brain and body
types of SC injury
traumatic: from external force
non-traumatic: tumours, spina bifida, infection…less common
complete injury: completely sever SC, total loss sensation below injury
incomplete injury: mashing SC/damage from swelling and bruising
- some sensation loss, still some
paraplegia: legs and part/entire trunk
tetra/quadriplegia: all 4 limbs and trunk
- neck down, from neck injury
levels of injury
cervical lvl: high-cord/quadriplegia
- c1-c2 are fatal bcs resp muscles stop working
- may be on ventilator
- sip and puff tech: inhale thru straw in neck
thoracic lvl: paraplegia
- back and chest musc can be impaired
- brace and support
- can use wheelchair, may use leg braces
lumbar lvl: most leg muscs functional
- cane, crutches
- bowel and bladder issues
sacral lvl: bowel and bladder, full independence
treatment of SC injury
hospital phase: surgery, assess brain damage, quick transfer to rehab
rehab phase: learn assistive devices
- basic living skills
- many practitioners involved
- PT first to prevent contracture, then hygiene, mobility, transition to home
return to home environ: may have to move in w fam members
pressure sores
breakdown bcs continuous pressure
- may not notice if lack sensation
- where soft tissue pressed to bone
- impacts blood flow
phases
1: red mark that doesn’t fade in 30mins
2: open sore, skin deep
3: opening in skin to muscle
4: opening to muscle and bone
spasticity
can occur randomly
concern for contracture
CV complications
highest cause of death for SC injury
blood clots and sedentary lifestyle
autonomic dysreflxia
body overreacts to stim below lesion
sudden inc BP, sweat, headache
risk of stroke
thermoregulation
SC injury can have hypo/erthermia bcs interrupted neural response
UTI and bowel complications
inadequate emptying of bladder
catheterization
incontinence
goals for SC injury PA
- dev leisure lifestyle that maximizes independence
- redevelop self-esteem: body image, mobility devices
- coping skills
- dev strong support system
APA program for SC injury
strengthening and flexibility, improve gait and mvmnt
- don’t reach exhaustion
- rest periods, max sleep
posture and body mechanics
when brain injury, compensate for sensory i.e. visual deficits
- repetition to relearn skills
support groups
