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Pathphysiology 2 > spinal cord injury and brain injury > Flashcards

spinal cord injury and brain injury Flashcards

(61 cards)

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1
Q

What is an acquired brain injury?

A

an injury caused to the brain since birth

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2
Q

What is a traumatic brain injury?

A

a brain injury caused by trauma to the head

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3
Q

How long does someone with a minor brain injury lose consciousness for?

A

less than 15 minutes

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4
Q

How longs does someone with a minor brain injury have post traumatic amnesia for?

A

less than an hour

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5
Q

How long does someone with a moderate brain injury lose consciousness for?

A

15 mins - 6 hours

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6
Q

How long does someone with a moderate brain injury have post traumatic amnesia for?

A

1 hour -24 hours

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7
Q

How long does someone with a severe brain injury lose consciousness for?

A

6 hours to 48 hours

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8
Q

How long does someone with a severe brain injury have post traumatic amnesia for?

A

24 hours to 7 days

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9
Q

How long does someone with a very severe brain injury lose consciousness for?

A

more than 48 hours

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10
Q

How log does someone with a very severe brain injury have post traumatic amnesia for?

A

more than 7 days

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11
Q

Name some causes of a traumatic brain injury

A

road traffic collisions
slipping and falling
something falling or being thrown that strikes the head
being shaken violently
sports-related events or activities
acts of violence

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12
Q

What are the three types of traumatic brain injury?

A

open (or penetrating) wounds
crushing injuries
closed head injury

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13
Q

Name some immediate signs and symptoms of a TBI

A

difficulty concentrating or confusion
changes in consciousness
headaches or dizziness
vomiting and nausea
changes in mood, behaviour, or personality
changes in the eyes/dilated pupils
hallucinations
swelling at the site of the suspected brain injury
inability to remeber
difficulty breathing
any fluid leaking from the nose, eyes, or ears
difficulties with language or speech
changes in vision, especially blurred vision

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14
Q

Name some causes of a non-traumatic brain injury

A

tumour
stroke
brain haemorrhage
encephalitis
carbon monoxide poising
hydrocephalus
meningitis

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15
Q

What is a cerebral anoxia?

A

a complete interruption of the supply of oxygen to the brain

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16
Q

What is a cerebral hypoxia?

A

When there is still a partial supply of oxygen, but at a level which is inadequate to maintain normal brain function

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17
Q

Name some causes of anoxic brain injury

A

cardiac or respiratory arrest
irregular heart rhythm or poor function of the heart muscle after a heart attack, resulting in inefficient supply of blood to the brain
very low blood pressure following massive trauma
suffocation
choking
strangulation
very severe asthma attack
near drowning
exposure to high altitudes
smoke inhalation
carbon monoxide inhalation
poisoning
drug overdose
electric shock
attempted suicide

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18
Q

In all cases what medical treatment will there be for an anoxic brain injury?

A

efforts will be directed at restoring a normal heartbeat, blood pressure and a good supply of oxygen to the brain

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19
Q

What are the immediate signs and symptoms of anoxic brain injury?

A

confusion
loss of consciousness
feeling woozy or dizzy
intense headache
vomiting
changes in behaviour or sensation

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20
Q

What are some hidden long term effects of acquired brain injuries?

A

changes in behaviour or personality
difficulty with previously unchallenging tasks
changes in relationships
difficulty with short or long-term memory
trouble recognising familiar people or animals
new fears or phobias
psychological symptoms such as unexplained depression or anxiety
frequent headaches
unexplained pain in the limbs

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21
Q

What is a vegetative state?

A

severe, have sleep-wake cycles but no conscious awareness of themselves or their surrounding

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22
Q

What is a minimally conscious state?

A

shows distinct but limited signs awareness and response to stimulation. very difficult to remain aware or responsive for any length of time or in a predictable way

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23
Q

What is locked-in syndrome?

A

this is a rare condition in which a person is aware of themselves and their surroundings but is unable to move or speak. Often people can move their eyes or eyelids and may be able to communicate by blinking

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24
Q

What does prognosis of a brain injury depend on?

A

age - recovery prognosis declines with age
location of contusion on the brain
length of time spent in coma - paired with post-traumatic amnesia, this can dictate how long the recovery period will take

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25
How do physios manage brain injury patients?
respiratory care rehabilitation - starting early and ongoing sensory assessment asses and treat symptoms
26
What are the 3 different mechanisms for a traumatic SCI?
destruction from direct trauma compression by bone fragment, hematoma or disc material ischemia from damage or impingement on the spinal arteries
27
What are some non traumatic causes of SCI?
degenerative disc diseases and spinal canal stenosis spinal infarct tumour inflammation of spinal cord viral infection development/congenital abnormalities
28
What is a complete SCI?
complete loss of function below the point of injury
29
What is an incomplete SCI?
some sparing of neural activity below the level of the lesion
30
What is tetraplegia or quadriplegia SCI?
impairment at cervical segments of the cord affects all four limbs: upper and lower limbs
31
What is paraplegia SCI?
impairment at thoracic, lumbar or sacral segments of the cord involving lower limbs depending on level of injury, trunk, legs and pelvis may be involved
32
What are areas of the vertebral columns have a higher risk of SCI?
cervical spine, typically C5-7 thoracolumbar, typically T12 mid thoracic T4-&
33
What immediate management is required for a SCI?
Need to have normal oxygenation, perfusion and acid/base balance to aid management of the injury
34
What are the 5 main incomplete spinal cord injuries?
central cord syndrome anterior cord syndrome brown-sequard syndrome posterior cord syndrome cauda equina syndrome
35
Describe central cord syndrome
motor dysfunction in upper limbs bladder dysfunction corticospinal and spinothalamic tracts May be due to hyperextension trauma to the neck or could be due to spondylosis
36
Describe anterior cord syndrome
motor paralysis below lesion loss of pain and temperature sense retained proprioception and vibration caused by disc herniation
37
Describe Brown-Sequard
motor deficit and numbness to touch and vibration on the same side of lesion loss of pain and temperature on opposite side of lesion most common cause is stab or gunshot wound to cervical or thoracic spine
38
Describe posterior cord syndrome
sensory disturbance and less motor loss compression to posterior/sensory section of the spinal cord cause = posterior impact or hyper-extension trauma
39
Describe cauda equina syndrome
lower motor neurone lesion motor and sensory loss in lower limbs saddle anaesthesia, bilateral lower limb sensory changes causes = lumbar stenosis, spinal trauma, metastatic tumour
40
What is the difference between traumatic brain injury and anoxic brain injury?
A TBI is as a result of a blow or trauma to the head, an ABI is due to the brain becoming deprived of oxygen
41
What are the signs and symptoms of a TBI that people with BI report can be more disturbing that the motor signs and symptoms?
cognitive and emotional symptoms: personality changes and increased agression
42
Define concussion
temporary disruption of brain function
43
the severity of a brain injury is defined by what two main criteria?
loss of consciousness post traumatic amnesia
44
Name two common injuries following an anoxic brain injury
low tone and ataxia
45
how long can the brain survive without oxygen?
4 minutes
46
What is EDH?
extradural haemotoma
47
What is DAI?
diffuse axonal injury
48
What is SAH/IVH?
subarachnoid haemorrhage/intraventricular haemorrhage
49
How many main ascending tracts are there and what kind of information do they transmit?
there are three main ascending tracts - they transmit sensory information from peripheral nerves to the cerebral cortex
50
Name all the major ascending tracts and identify the type of sensory information they transmit
Dorsal column - touch, position, sense and vibration Spinothalamic - pain and temperature information Spinocerebellar - proprioceptive information
51
How many descending pathways are there and what type of information do they transmit?
There are 5 main descending tracts, they transmit motor information from the cerebral cortex to peripheral nerves to innervate muscle movement
52
What are the main descending pathways?
corticospinal tracts (anterior and lateral) = lateral - motor information to limbs, anterior - motor information to axial muscles vestibulospinal - integration of head and neck with trunk and extremities reticulospinal = lateral - facilitates flexion and inhibits extension rubrospinal - fine motor movements in upper limbs tectospinal - control muscles in response to visual stimuli
53
What areas are affected in a person who is tetraplegic?
all 4 limbs and trunk
54
Name 5 symptoms that occur as a result of autonomic dysfunction
impairment of vasomotor control postural hypertension autonomic dysreflexia problems with bowel and bladder function problems with sexual function
55
Name the two sections that the autonomic nervous system is divided into
parasympathetic and sympathetic
56
What is the ASIA scale?
gold standard for classifying spinal cord injuries
57
What is the ASIA scale used to determine?
complete or incomplete injury ASIA impairment scale grade sensory level on both sides motor level on both sides single neurological level
58
Describe the grades of the ASIA scale
A (complete) = no motor or sensory function is preserves in the sacral segments S4-S5 B (incomplete) = sensory but not motor function is preserves below the neurological level and includes sacral segments S4-5 C (incomplete)= motor function is preserved below the neurological level and more than half of the key muscles below the neurological level have a muscle grade less than 3 D (incomplete) = motor function is preserved below the neurological level and at least half of the key muscles below the neurological level have a muscle grade of more than 3 E (normal) = motor and sensory function are normal
59
How do you establish whether the motor and sensory functions of sacral segments remain in tact?
rectum examination in order to establish whether any anal sensation and/or tone is present (done by a doctor)
60
What is autonomic dysreflexia?
an uninhibited sympathetic nervous system response to a variety of noxious stimuli occurring in people with spinal cord injury at T6 level and above
61
What are the signs and symptoms of autonomic dysreflexia?
raised BP bradycardia pounding headache flushing sweating or blotching above level of injury pale, cold, goosebumps below level of injury

Pathphysiology 2 (14 decks)

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