TBI Flashcards

1
Q

TBI

A

negative effect on brain function resulting from external physical force

almost 1/2 of those sustaining closed head injury die on site

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2
Q

what is the main cause of persistent morbidity

A

TBI

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3
Q

pathogenesis TBI

A

secondary damage = changes compromising brain function

(brain swelling and impaired perfusion)

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4
Q

TBI secondary changes

A

vascular changes

hypoxia

hypertension

parenchymal changes

compressive damage

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5
Q

vascular changes TBI

A

cerebral contusions

–> increased blood volume and ICP

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6
Q

hypoxia TBI

A

caused by blockages or by decreased O2 in blood from pulmonary insult

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7
Q

hypertension TBI

A

intracranial hypertension can interfere with cerebral perfusion

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8
Q

parenchymal changes TBI

A

axonal injury from shear and tensile forces disrupt the axolemma

–>impairs transport of proteins form the cell body and causes swelling of the axon

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9
Q

compressive damage TBI

A

increased in ICP can produce herniation

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10
Q

clinical manifestations TBI

A

cognitive and behavioral impairments

cranial nerve damage

motor deficits

heterotopic ossification

medical complications

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11
Q

cognitive and behavioral impairments TBI

A

problems w/ attention, memory, concentration and executive functions

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12
Q

cranial nerve damage

A

assess eye movement

facial nerve often damaged

hearing and vestibular dysfunction

lower cranial nerve palsies

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13
Q

motor deficits

A

monoplegia

hemiplegia

abnormal reflexes

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14
Q

heterotopic ossifications

A

abnormal bone growth around a joint

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15
Q

medical complications

A

cardiovascular effects

respiratory complications

intravascular coagulation

hyponatremia

diabetes insipidus

stress gastritis

infection

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16
Q

treatment TBI

A

acute

subacute

rehab

community re-entry

17
Q

acute treatment TBI

A

goal is stabilization and prevention of secondary complications

18
Q

subacute treatment TBI

A

maintain homeostasis in the brain

manage spasticity, seizures, aggressive behavior, depression

19
Q

rehab treatment TBI

A

return to optimal function

restoration of mobility

self-care

employment

ADLs

20
Q

community re-entry

A

to transition from rehab unit to independent living

21
Q

concussion

A

mild TBI

22
Q

symptoms concussion

A

headache

dizziness

variable amnesia

difficulty concentrating

depression

apathy

anxiety

23
Q

how long do symptoms take to resolve concussion

A

7-10 days

24
Q

diagnosis concussion

A

graded symptoms checklists

sports concussion assessment tool

25
Q

basal skull fracture

A

fracture to base of skull

anterior

posterior

26
Q

anterior basal skull fracture

A

superior portions of sphenoid and ethmoid bones

27
Q

posterior basal skull fracture

A

occipital bone

temporal bone

portions of sphenoid bone

28
Q

clinical manifestations basal skull fracture

A

bones may be broken around the foramen magnus causing palsy of CN 9-11

battle’s sign

raccoon eyes

CSF rhinorrhea

CSF otorrhea

hemotympanum

29
Q

battle’s sign basal skull fracture

A

bruising over mastoid process

develops w/in 24-48 hours

30
Q

raccoon eyes basal skull fracture

A

“black eyes”

develops periorbital ecchymosis

bruising w/ bleeding under

31
Q

CSF rhinorrhea basal skull fracture

A

CSF drain through nose

usually unilateral

metallic taste of CSF

32
Q

CSF otorrhea basal skull fracture

A

CSF drains through ears

rare but potentially life threatning

33
Q

hemotympanum basal skull fracture

A

blood in tympanic cavity

bleeding from nose and ears

34
Q

prognosis basal skull fracture

A

pts w/ basal skull fracture are especially at risk for meningitis

35
Q

PT for TBI

A

be aware of over stimulation