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TBI

QuestionAnswer
What is the number one cause of TBI? falls (40.5%)
For the age group 5-24, what is the leading cause of TBI related death? >65 yrs? 0-4 yrs? motor vehicle accidents; falls; assault
What type of head injury includes an object penetrating the skull and entering the brain? open head injury
What type of head injury includes an external force or sudden, violent movement causing the brain to knock against the skull? closed head injury
When there is extensive or widespread damage d/t shearing forces (usually rotational) from rapid acceleration or deceleration? diffuse axonal injury
These result from direct impact to the head, bruising of the brain, usually more localized impairments than diffuse axonal injury. When an object comes into contact with a head that it stationary? Contusion
Contusions at the site of impact and the opposite side of the brain from the brain rebounding? When a moving head comes into contact with a stationary object? coup-contrecoup
When a sharp object (bullet, knife) breaks the skin and skull with a higher chance of infection? penetrating injury
Mass of blood between the dura and the skull; associated with skull fractures and causes rapid increase in intracranial pressure. epidural hematoma
Bleeding between the dura and arachnoid meningeal layers; associated with blunt trauma without skull fracture; usually from a tear in the veins of this area. subdural hematoma
majority of these occur in the frontal and temporal lobes; appearance on CT at be delayed intracerebral hematoma
increases in this result in displacement of the brain tissue, hydrocephalus, and ischemia intracranial pressure
what is normal intracranial pressure? 0-10 mmHg; increased is >20mmHg
What are the symptoms of increased ICP? headache, papilledema, vomiting, drowsiness, altered consciousness
What is the difference between the mean arterial pressure and intracranial pressure (net pressure gradient within the brain)? Cerebral perfusion pressure (normal CPP=/>70mmHg
At what level of cerebral perfusion pressure does it cause ischemia? <40-50mmHg
What values on the Glasgow coma scale coincide with mild, moderate, and severe TBI? mild:13-15; moderate: 9-12; severe: 3-8
What do you call the stage of recovery where there is unarousable unconsciousness, no periods of wakefulness or eye opening in response to stimulation; usually ventilator dependent? coma
Lack of awareness but preserved capacity for arousal (spontaneous or stimulus-induced); 7 criteria must be met (see slides); sleep-wake cycles are present; sufficient preservation of autonomic functions to permit survival with adequate medical care vegetative state
once >1 yr there is no improvement in neurological function, pt is deemed what? persistent vegetative state
discernable and reproducible evidence of awareness of self or environment by one or more of the following behaviors: simple command following, gestural or verbal yes/no responses, intelligible verbalization, purposeful behavior minimally conscious state
amnesia from events prior to injury retrograde amnesia
amnesia from events following injury anterograde amnesia
When do they deem post-traumatic amnesia as resolved? when a person can form and recall new memories
Describe the time parameters for severity of TBI based on duration of post-traumatic amnesia using the Westmead Post Traumatic Amnesia Scale Mild: 5-60 min; moderate: 1-24 hrs; severe: 1-7 days; very severe: 1-4 weeks; extremely severe: >4wks
RLA I no response
RLA II generalized response
RLA III localized response
RLA IV confused/agitated
RLA V confused, inappropriate, non-agitated
RLA VI confused, appropriate
RLA VII automatic, appropriate
RLA VIII purposeful, appropriate (SBA)
RLA IX purposeful, appropriate (SBA on request)
RLA X purposeful, appropriate (mod I)
Name 4 medications that are used for management of increased tone/spasticity. Baclofen-oral or pump (GABA receptor agonist); Diazepam (Valium)-benzodiazepine used to treat anxiety and relieve spasms; Dantrolene (muscle relaxant); Botulinum Toxin (neurotoxic protein)-injected for localized effects lasting 3-4 months
Name 3 other ways that contractures are managed. serial casting, dynamic splinting, surgery
How long is a joint typically immobilized during serial casting before having it removed and replaced? 7-10 days
Name an advantage and a disadvantage of dynamic splinting. (+) can doff splints monitor and clean skin; (-) pressure points are common because splints are not total contact
What are the common muscle groups that typically become contracted and are lengthened with tendon lengthening procedures? ankle PF, knee flexors, hip adductors, elbow flexors
Created by: metz
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