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TBI
| Question | Answer |
|---|---|
| Decorticate rigidity | UE spastic flexed position with internal rotation and adduction LE spastic extended with internal rotation and adduction |
| Decerebrate rigidity | UE and LE spastic extension, adduction, internal rotation Wrist and fingers flex Plantar portions of feet flex and invert Trunk extends Head retracts |
| Midbrain damage | impaired righting reflexes |
| Basal ganglia damage | absence of equilibrium reactions and protective extension |
| Peripheral nerve or plexus injury | muscle weakness with absence of tone |
| Cerebellar damage | ataxia |
| Coma | No response to environmental stimuli No sleep-wake cycle Eyes don't open to stimuli or spontaneously |
| Vegetative state | No awareness or ability to interact with self or env no sustained, reproducible, voluntary or behavioral response to sensory stim no language/expression sleep-wake cycles vary ability to regulate temp, breathing, circ incontinent onset w/i 1 month |
| Minimally conscious state | definite behavioral evidence of awareness of self, environment, or both discernible reproducible behavior in one or more of the following: ability to follow commands, gesterual or verbal yes-no, intelligble verbalization, purposeful movement |
| Glasgow coma scale | Scores below 8: severe Between 9 and 12: moderate 12 and up: minor Assesses motor response, verbal response, eye opening |
| Glasgow: Motor response in response to pain | No response 1 point Rigid and extended response to pain (decerebrate) 2 points flexion (decoritcate) 3 points Pull part of body away 4 points purposeful movement 5 points obeys commands to perform various movements 6 points |
| Glasgow: Verbal | No response 1 point incomprehensible speech 2 points inappropraite words 3 points confused conservation but able to answer questions 4 points oriented to person, place, time 5 points |
| Glasgow: Eye opening | No response 1 point to pain only 2 points when asked with loud voice 3 points spontaenous opens eyes on own 4 points |
| Ranchos Level 1 | no response, completely unresponsive |
| Ranchos Level 2 | Generalized response inconsistent and nonpurposeful reactions to stimuli |
| Rancho Level 3 | Localized response reacts specifically to stimuli inconsistenly |
| Rancho Level 4 | Confused/agitated Heightened state of activity with severely decreased ability to process information |
| Rancho Level 5 | Confused, inappropriate nonagitated alert with fairly conssitent reactions increased complexity of commands causes more random response IPR Level 5 and up |
| Rancho Level 6 | Confused, appropriate goal directed behavior but is dependent on external input for direction |
| Rancho Level 7 | automatic appropriate behaves appropriately and is oriented to palce and routine but displays shallow recall |
| Rancho 8-10 | purposeful and appropriate A and O able to recall and integrate past and recent events 8-10 varying level of assist for ADL |
| Acute phase of TBI intervention | positioning, PROM, splinting, sensory stimulation, agitation management |
| Optimizing motor function | skill acquisition, motor learning, exercise Begin with gross motor movements |
| Ataxia intervention | weighting body parts and utensils |
| apraxia intervention | hand over hand to repair damaged pathways |
| expressive aphasia intervention | conversation exercises with OT recognizing errors and asking client to verbalize what they meant |
| Feeding adaptive equipment | rocker knife, plate guard, nonspill mug |