Flashcards in Exam 3- TBI part 1 Deck (83)
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1
Cultural sensitivity (some details on it)
~Check your baggage at the door
~Leave religious beliefs at the door
~They have the right to not believe in a type of treatment
~If you work at a hospital that is faith based, you can talk about faith
~If ok to ask if there is anything that will offend them
~If its unsafe, then you can tell them not to do something
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CTE- stands for
chronic traumatic encephalopathy
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chronic traumatic encephalopathy
~progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head
~has been known to affect boxers since the 1920s
~recent reports have been published of neuropathologically confirmed CTE in retired professional football players and other athletes who have a history of repetitive brain trauma
~trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau
~these changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement
~brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia
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Different types of TBI
~traumatic
~atraumatic
~acquired brain injuries
~secondary injuries
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Traumatic (type types)
A trauma to the body (duh)
~open
~closed
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Traumatic- closed
~Coup-contra coup- injury-the inside of the skull is very sharp
~what direction was the force, etc (twisting, head down, head up
~hard to figure out where the injury is
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Traumatic- open
~the head has to open
~GWS, baseball bat, hit a stair and the skull comes open, a horse kicks you
~you know where the injury is
~you can have a contra-coup as well
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What is something you need to look out for when you have an open traumatic injury?
INFECTION!- secondary problems from the cranial vault being opened up
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Traumatic- Closed can lead to DAI (stand for)
diffused axonal injury
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Traumatic- Closed can lead to DAI
~lots of micro trauma
~has little deficits
~everything else looks fine, but they have a few little problems/ some changes
~emotions are usually involved- changed
**Shaken baby (closed, acquired, anoxic)
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Non traumatic (2 main types)
~Infection
~Anoxic
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Non traumatic- some examples
Drowning, CO victim, strangulation
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Non traumatic- anoxic details
~loss of oxygen
~pediatrics can happen a lot in peds
~affects every single cell in your brain- every cell is starting to die
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Acquired brain injury
~a lot of peds
~When you have it at birth/ during the birthing process
~If you have the cord stuck coming out of the wound (deprived of O2)
MB: Did you mean womb? Lol!
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Secondary injuries ((there's lots of them))
~Inflammation/ swelling
~Need to watch closely for the 1st 24 hours to see if there are any changed in mental status
~Uncal Herniation, herniation through the hole (you will keep the craniotomy open if there is increased pressure)
~**don’t walk them without the helmet
~Lack of oxygen- can create cell death
~Infection
~Cell mediators that can kill some brain tissues
~Hydrocephalus- can occlude our normal sinuous that can cause it
~*when in doubt, go to the doctor
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Secondary injuries- inflammation/ swelling details
~can make the injury worse
~can create the bleed that was not there at first
~we vasodialate to make better
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Differentiating concussions/ LOC
~mild
~moderate/ severe
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Differentiation- Mild defining
~Concussion/ LOC- less than 30 minutes
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Differentiation- Mild s/s
~Memory problem
~headaches
~attention deficits
~mood swings
~irritable
~a disconnect
~cant focus
~frustration
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Differentiation- Mild details
~Over looked a lot- in football a lot
~Can last, but these problems are most prominent the next day
~15% of these people will still have these symptoms in upwards of a year
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Differentiation- Mild- Post-concussive symptom
*the long term symptoms
*A lot of the military comes home with
~Fatigue
~HA
~coup-contracoup
~balance
~vision
~attention
~sleep problems (all the time or they don’t need to sleep)
~irritability
~depression
~seizures (can last)
~nausea
~vomiting
~olfactory N- loss or sense of smell (decrease in appetite)
~slowness in thinking
~get lost
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Moderate- defining
Concussion/ LOC- great than 30 to 6 hours
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Severe- defining
Concussion/ LOC greater than 6 hours
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Moderate/ Severe- cognitive s/s
**A lot more cognitive problems
~attention
~concentration
~memory
~distractibility
~processing speed
~confusion
~perseveration
~impulsiveness
~language processing
~executive functions
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Moderate/ Severe- Speak and language s/s
~Broca’s and Wernicke’s aphasia (and other aphasias)
~inability to form words
~speak fast/ slow
~foreign accent syndrome (change how you pronounce things)
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Moderate/ Severe- Sensitivity s/s
Light touch/ pain/ etc can be gone
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Moderate/ Severe- Vision s/s
~complete
~partial loss
~diplopia from weakness of muscles
~blurred vision
~depth perception
~nystagmus
~photophobia (light sensitivity)
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Moderate/ Severe- Hearing s/s
~complete loss or decrease or increase
~tinnitus (ringing in the ear)
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Moderate/ Severe- Smell s/s
loss or diminished
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