TBI

Question 1

Other names for TBI

Answer 1

Acquired brain injury
Craniocerebral Trauma

Question 2

Two types of TBI

Answer 2

Open
Closed

Question 3

MOI of Open TBI

Answer 3

Object pierces through skull and meninges, enters the brain

Question 4

MOI of Closed TBI

Answer 4

Injury to brain without penetration of skull

Question 5

Which type of TBI is more detrimental?

Answer 5

Closed, no where for the pressure and swelling to go

Question 6

Primary Brain Injury

Answer 6

Initial injury to the brain that occurs at the initial impact

Question 7

What is a coup lesion?

Answer 7

Direct lesion on the brain under point of impact

Question 8

What is a contrecoup lesion?

Answer 8

Injury on the opposite side of the brain caused by the rebound effect of the brain after impact

Question 9

Secondary Brain Injury

Answer 9

Damage that occurs later, as a result of initial injury

Question 10

What are examples of secondary injury?

Answer 10

Hematoma
Hypoxia
Ischemia
Increased intracranial pressure
Post-traumatic epilepsy

Question 11

Subdural Hematoma forms between what layers?

Answer 11

Dura and arachnoid mater

Question 12

What is a subdural hematoma secondary to?

Answer 12

Venous rupture

Question 13

Epidural Hematoma forms between what layers?

Answer 13

Skull and dura matter

Question 14

If hematoma is suspected, what is the action?

Answer 14

IMMEDIATE emergency action

Question 15

Focal damage

Answer 15

Brain damage is focal and direct at the point of injury

Question 16

Is a focal damage minor?

Answer 16

Yes

Question 17

Patient presentation from focal damage to brain?

Answer 17

“presents like stroke”
localized or specific deficits

Question 18

Diffuse damage

Answer 18

Widespread damage that affects other parts of brain

Question 19

Patient presentation from diffuse damage to brain?

Answer 19

“presentation varies”
global deficits
prolonged vegetative state
involves many body systems/structures

Question 20

What happens in a diffuse axonal injury (DAI)?

Answer 20

Neural cells in brain are stretched to the point of tear, axons pulled away from cell body

Question 21

What causes a higher risk for dementia associated with DAI?

Answer 21

Deposition of tau and APP proteins (plaques and tangles)

Question 22

Most common causes of DAI?

Answer 22

Falls
MVA
Assault/Acts of Violence
Suicide attempt
Shaken Baby Syndrome

Question 23

What is a hallmark sign of a DAI (cellular level)?

Answer 23

“Retraction ball”
Axon draws back towards cell body

Question 24

Why is it bad to have high levels of calcium from TBI?

Answer 24

Calcium cascade leads to apoptosis (cell death!)

Question 25

Complication in axonal regeneration in CNS?

Answer 25

More scar tissue build (glial scar formation) Oligodendrocytes are not as fast and efficient in healing process Lack of clearance of debris

Question 26

Is axonal regeneration easier or harder in CNS vs PNS?

Answer 26

Harder in CNS Easier in PNS

Question 27

What are the three components to Glasgow Coma Scale?

Answer 27

Eye Opening Verbal Response Motor Response

Question 28

How are mild TBI objectively diagnosed?

Answer 28

Acute Concussion Evaluation (ACE) Sport Concussion Assessment Tool 5 (SCAT 5)

Question 29

What is Ranchos Los Amigos used for?

Answer 29

To assess how much assistance the individual will need to function on a daily basis (general assessment)

Question 30

Ranchos Los Amigos: Level 1

Answer 30

No response: Total Assistance

Question 31

Ranchos Los Amigos: Level 2

Answer 31

General Response: Total Assistance

Question 32

Ranchos Los Amigos: Level 3

Answer 32

Localized Response: Total Assistance

Question 33

Ranchos Los Amigos: Level 4

Answer 33

Confused/Agitated: Max Assist

Question 34

Ranchos Los Amigos: Level 5

Answer 34

Confused, Inappropriate Non-Agitated: Max Assist

Question 35

Ranchos Los Amigos: Level 6

Answer 35

Confused, Appropriate: Mod Assist

Question 36

Ranchos Los Amigos: Level 7

Answer 36

Automatic, Appropriate: Min Assist w/ Daily Living Skills

Question 37

Ranchos Los Amigos: Level 8

Answer 37

Purposeful, Appropriate: Stand-by Assist

Question 38

Ranchos Los Amigos: Level 9

Answer 38

Purposeful, Appropriate: Stand-by Assist on Request

Question 39

Ranchos Los Amigos: Level 10

Answer 39

Purposeful, Appropriate: Mod Independent