TBI Flashcards

1
Q

______ = change in brain function due to external force

A

TBI

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2
Q

____ is the leading cause of death in people under than 45 y/o in Canada

A

TBI

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3
Q

MVA’s account for __% of the severe TBI;s in adults and ___% in children

A

60;92

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4
Q

_____ TBI = meninges not breaded and does not require hitting head

A

closed

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5
Q

_____ TBI = meninges breathed, exposes brain or laceration

A

open

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6
Q

What are 6 mechanisms of injury in TBI?

A
  1. coup
  2. contre-coup
  3. bruising
  4. axonal tearing
  5. shearing
  6. anoxia injury
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7
Q

What are 6 mechanism that occur in coup and contre-coup injury?

A
  1. primary mechanical injury
  2. secondary mechanical injury
  3. ischemia
  4. edema
  5. shearing forces
  6. torsion forces
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8
Q

Why is shaken baby syndrome so traumatic to childrens brains?

A

bc they lack the neck muscles to stabilize their head

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9
Q

Being in close approximation to an explosion can cause ____ syndrome.

A

blast

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10
Q

_______ injury = damage caused at time of impact, can be local or diffuse

A

primary

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11
Q

In a primary brain injury, the diffuse axonal injury is due to both _______ and ______ forces.

A

shearing; deceleration

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12
Q

______ ______ _____ = shearing of the brains long connecting nerve fibres (axons)

A

diffuse axonal injury

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13
Q

DAI occurs when the brain is injured as it ____ and _____ inside the bony skull

A

shifts; rotates

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14
Q

DAI usually causes ____ and injury to many different parts of the brain.

A

coma

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15
Q

Changes in DAI can be detected by CT and MRI scans. (T/F)

A

FALSE; often microscopic

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16
Q

__________ injury is related to trauma

A

secondary

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17
Q

Auto-regulation of cerebral blood flow may be lost after head injury, leading to ____ systemic BP.

A

low

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18
Q

Raised _____ _____ _____ is serious and often fatal.

A

inter-cranial pressure

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19
Q

If the underlying cause of raised ____ is treatable the outlook generally looks better for pt’s.

A

ICP

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20
Q

Post-traumatic ________ occurs in 2-5% of TBI and is more common with severe or penetrating injuries.

A

epilepsy

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21
Q

Most seizures due to TBI occur immediately after the injury or within the ____ year.

A

first

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22
Q

Post-traumatic epilepsy may surface years later (T/F).

A

TRUE

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23
Q

Second point were seizure disorder emerges is __-__ months post injury.

A

9-12

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24
Q

______ = altered state of consciousness that may be very deep (unconsciousness) so that no amount of stimulation will cause the pt to respond.

A

coma

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25
Q

_____ can be a state of reduced consciousness, so that the pt may move about or respond to pain.

A

coma

26
Q

The depth of the coma and the time a pt spends in a coma varies greatly depending on the ________ and ______ of the brain injury.

A

location; severity

27
Q

What are the 3 categories of the glasgow coma score?

A
  1. eye opening
  2. verbal response
  3. motor response
28
Q

Is a higher or lower score on the glasgow coma scale more favourable?

A

higher

29
Q

How do you score the glasgow coma scale?

A

add the 3 category scores together

30
Q

What is mild for the glasgow coma scale?

A

13-15

31
Q

What is moderate for the glasgow coma scale?

A

9-12

32
Q

What is severe for the glasgow coma scale?

A

<8

33
Q

Extension posturing?

A

decerebrate rigidity

34
Q

Abnormal flexion?

A

decorticate

35
Q

Is decerebrate or decorticate positioning worse?

A

decerebrate

36
Q

Is lower or higher worse in the Rancho levels of Cognition?

A

Lower

37
Q

___ - ___ % of pt’s with severe head injury have C spine injury

A

5-10

38
Q

Patients with GCS less than __ require early intubation.

A

8

39
Q

What is the full assessment of of acute head injuries?

A
  1. GCS
  2. pulse, BP
  3. assessment of pupil diameter and response
  4. assessment of limb movement
40
Q

What are the 8 deficit categories seen in TBI?

A
  1. cognitive
  2. motor
  3. sensory
  4. communication
  5. functional
  6. social
  7. regulatory
  8. personality
41
Q

What are the 5 outcomes int he Glasgow Scale?

A
  1. good recovery
  2. moderate disability
  3. severe disability
  4. vegetative state
  5. dead
42
Q

The treatment for TBI takes an average of __-__ months.

A

3-6

43
Q

Recovery may take place for ____ following an injury.

A

years

44
Q

What are the two factors influencing the nature of the acquired brain injury?

A
  1. unilateral vs. bilateral/brainstem

2. extent of brain damage

45
Q

What are the 4 factors influencing outcome?

A
  1. Nature of acquired brain injury
  2. premorbid health
  3. family support
  4. age
46
Q

Rehabilitation begins during the ____ treatment phase.

A

acute

47
Q

Goal of ______: to help the patient return to the highest level of function and independence possible, while improving the overall QOL - physically, emotionally and socially.

A

rehabilitation

48
Q

What 5 things does the success of rehabilitation depend on?

A
  1. nature and severity of brain injury
  2. type and degree of resulting impairments
  3. overall health/age
  4. maximizing pt’s capabilities at home/community
  5. positive reinforcement promotes self-esteem/independence
49
Q

concussion = ____ TBI

A

mild

50
Q

Grade __ concussion: does not lose consciousness, dazed

A

1

51
Q

Grade __ concussion: does not lost consciousness, period of confusion, does not recall event

A

2

52
Q

Grade __ concussion: classic concussion, loses consciousness for a brief period of time

A

3

53
Q

Grade 3 concussion = __ memory of the event, requires evaluation ASAP

A

no

54
Q

What are the 5 post concussion syndrome symptoms?

A
  1. persistent headaches
  2. dizziness
  3. irritability
  4. memory changes
  5. vision changes
55
Q

Symptoms may begin _____ or even _____ after the initial injury.

A

weeks; months

56
Q

Seriously increased risk if _____ concussion before symptoms of initial one has resolved.

A

second

57
Q

_____ tissue damage associated with concussion.

A

subtle

58
Q

_______ may provoke or increase post-concussion symptoms if done too leary,

A

exertion

59
Q

Patients in strict _____ condition experience higher total symptoms.

A

rest

60
Q

What 3 things may aerobic exercise improve in concussion?

A
  1. reduced cognitive impairment
  2. facilitate neuroplasticity
  3. improve learning outcomes
61
Q

_____ _____ _____ is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well asymptomtic subconcussive hits to the head

A

CTE

62
Q

Neuropathological hallmark of CTE = ____ deposits

A

tau