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Neuro-TBI for adults, kids

Who was the first documented case of a TBI? phineas Gage
What two age populations are at the greatest risk of a TBI? 15-24 and 60-65
What are potential reasons for sustaining a TBI? MVA, risk taking behaviors, failure to fly, blast injuries, assults, falls (moreso in the elderly population)
At wha age is the brain fully matured? 21
T/F Alcohol is realtaively common in adults diagnosed with a brain injury. TRUE 30-40%
What is the difference between an open vs. a closed head injury? open: fx and penetration of the skull, closed: no skull fx or peneration
What is the difference between primary and secondary brain injuries? primary: the actual force of trauma to the brain, secondary: what happens to the brain following the injury including edema, inc ICP, HTN, hemorrhage, ischemia, etc.
What is cou/contracoup? cou is the initial impact and contracou is when the head then moves reverse direction
what is the difference between a focal and a diffuse distribution? focal: contusion and focal infarcts, defined to a space, diffuse: distributed
What are the layers within the cranium? epidural, subdural, subarachnoid, intracerebral or intracerebellar
What are the three grades of diffuse axonal injury? grade I: no focal accentuation of midline structures, grade 2: focal lesion in corpus callosum, grade 3: focal lesion in cc and brain stem and cc is shifted
What are the three components to the glasgow coma scale? eye opening, verbal response, and motor response
What is the difference between anterograde and retrograde amnesia? antero: loss of events after and retro: loss of events prior
What is the definition of a vegetative state? there is no awareness of self or environment, the cortex is disrupted but the brainstem is spared
T/F A person in a vegetative state can have reflexes anf involuntary movement to noxious stim. TRUE
What is locked-in syndrome? Sate of wakefullness and awareness wth quadruplegia and paralysis of lower cranial nerves
What is minimally conscious vs vegetative state? Minimally conscious are a little less severe but hvae fragments of awareness (these are in the news about waking up)
What is a requirement for a minimally conscious state? one of the following: give a yes or no response, verbalize intelligence, demo purposeful behavior, etc.
What is the Rancho Cognitive Scale? These are the levels given to a person who has had a TBI and is recoverying. A 1 is the lowest level and the person is unresponsive. A 10 is completely purposeful and appropraite modified independence.
What is the Rancho scale 4? confused agitated, heightened state of activity but dec ability to process info and respond to internal confusion
What is the Rancho scale 6? confused appropraite
What is the Rancho scale 7? automatic appropraite minimal assistance
What is the Rancho scale 8? purposeful appropriate stand by assistance
What is the Rancho scale 5? confusion inappropraite non agitated max assistance
What is the Glasgow outcome scale? score 1-5, 1) death, 2) vegetative, 3) severe disability, 4) moderate disability, 5) good recovery
What is the best way to handle TBI pts? keep things simple and routine, avoid things that bother the pt and use what calms them down
T/F the token economy is a good way to provide a automatic, quick, and easy reinforcement. TRUE
What is the largest killer and disabler of children? brain injury
When and what gender is most likely to sustain a TBI? after school and boys
T/F A TBi is an acquired brain injury due to an external physical force TRUE
What are secondary injury to an inital TBI? edema, hemorrhages, hypoxia, ischemia, excitotoxicity, seizures, infection
What care causes of TBI in toddlers? MVA, balls in street, falls
What is the second impact syndrome? second concussion within hours or days of the first. 50% die and the other 50% will have permanent brain damage
T/F In order to have the classification of a concusion, consciousness must be lost FALSE
When is a mild TBI diagnosed (hint timeframe) when there is a change in metal status at the time of injury
When is a moderate TBI diagnosed (hint timeframe) a loss of consciousness for minutes to hours, confusion for days to weeks, impairments for months or are permanent
T/F a lot of time more pressure is put on mental and cognitive recovery than physical recovery FALSE, the opposite
What does executive function involve? ability to monitor and regualte behvaior, understand feedback and mistakes, cognitive flexibility, thinking, sequencing, relationships, and what makes me me
What part of the brain is responsible for emotions? frontal lobes and limbic systems
How can one manage a child with a TBI behavior? environmental controls and reinforcement
What are the stages of acceptance? denial, anger, depression, barganing, acceptance
What are some possible motor problems related to a TBI? spasticity, abnormal tone, ataxia, tremors (hyper and hypo), dysarthria, apraxia
What is opisthotonic posutring? extreme posturing due to high tone and requires padding
What are some possible sensory problems related to a TBI? visual, perceptual, hemianopsia, diplopia, anosimai, dec auditory acuity, aphasia, hyper/hypo sensitivity
What are possible secondary motor impariments following a TBI that can develop overtime? contractures, deformities, heterotropic ossifications
What are some physical therapy interventions? improve functional abilities / motor control, increase: awareness to environment, purposeful responses. prevent musculoskeletal impairments, work with vestibular system (swings, bouncy balls), positioning, stretching, mobilization, cast/splint.
T/F serial casting can be done to manage tone or fix contractures until the pt is ready for orthotics TRUE
What are some medical managements for high tone? ablation surgery, excitation implantable device, inrathecal baclofen pump, botox, phenol
Created by: Leeli.PT



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