Flashcards in Module 9 Deck (23)
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What is the definition of traumatic brain injury (TBI)?
An insult to the brain that is caused by an external force. Symptoms resulting from TBI may be temporary or permanent depending upon the extent of the neurological damage.
1
What is the range for age of onset of TBI?
15-24
2
What is the gender influence of TBIs?
Males 2:1
3
What is the prevalence of TBIs?
2.5-6.5 million
4
What is the average mortality rate of TBIs?
50,000
5
What are the diagnostic procedures of TBIs?
Computerized tomography (CT)
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Single-photon emission computerized tomography (SPECT)
Functional magnetic resonance imaging (fMRI)
Diffusion tensor imaging (DTI)- can see diffuse axon injury breaks in the axons.
6
What are the primary injuries caused by a TBI?
Facial injury-blunt trauma
Diffuse axonal injury (DAI)
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What are the secondary injuries of a TBI?
Hypoxic-ischemic injury-cell death
Intracranial hematoma-blood causing compression
Open wounds
Soft tissue injuries
Fractures
Spinal cord injury
Peripheral nerve injury
Internal organ injury
8
What are the three different levels of the Glasgow coma scale?
Severe=<8 points
Moderate=9-12 points
Mild=13-15 points
9
What are the different levels of the Glasgow outcome scale?
Dead
Vegetative
Degree of disability (severely disabled, moderately disabled, good recovery)
10
What are the levels of consciousness?
Concussion
Stupor
Coma
Persistent vegetative state
11
What are the ten levels of the rancho Los amigos cognitive functioning?
1-no response
2-generalized response
3- localized response
4- confused-agitated
5- confused-inappropriate
6-confused-appropriate
7-automatic-appropriate
8- purposeful-appropriate
9- PA stand by assist (request)
10- PA modified independent
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What levels of the rancho Los amigos cognitive functioning scale are total assist?
Levels 1-3
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What levels of the rancho Los amigos cognitive functioning scale are max assist?
Level 4-5
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What level of the rancho Los amigos cognitive functioning scale is moderate assist?
Level 6
15
What level of the rancho Los amigos cognitive functioning scale is minimal assist ADL?
Level 7
16
What levels of the rancho Los amigos cognitive functioning scale are stand by assist?
Levels 8-9
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What level of the rancho Los amigos cognitive functioning scale is modified independence?
Level 10
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What are the factors influencing rehabilitation?
Pre-morbid status including previous sizable neuronal loss secondary to brain injury, disease, or age result in a worse brain injury.
19
What are the drugs associated with TBIs?
Seizures- Dilantin
Spasticity- Baclofen
Antipsychotics- haldol
Arousal-sinemet
Disinhibited behavior- atenolol
Pain- Vicodin
Insomnia- ambien
Depression- Paxil
Nausea/gastric stasis- reglan
20
What's part of the rehabilitation process for TBI?
Participation/communication
Family support
Medically stable
Functional recovery potential
Guide to physical therapist practice (strength impairments, sensory and perceptual impairments, coordination impairments, balance impairments, functional impairments)
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What are the implications for O and P for TBIs?
Hypertonicity
Contractures
Heterotopic ossification-joints get irritated and form bone and freeze up. Need stretching and ROM.
Amputations
Flaccidity-low tone
Fractures/walking boots-axial resist AFOs
TLSO, halo
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