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NBCOT LAST Attempt > TBI > Flashcards

TBI Flashcards

1
Q

closed injuries

A

rapid acceleration/deceleration movement of head, brain strikes skull (blunt external force)

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2
Q

open injuries

A

object enters brain

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3
Q

primary TBI

A

at moment of impact

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4
Q

secondary TBI

A

several days to many weeks after injury

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5
Q

focal injury

A
  • direct blow to head/contact
  • collision with external object, fall, penetrating injury
  • scalp injury, skull fx, surface contusions
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6
Q

multifocal/diffuse injury

A
  • Includes diffuse axonal injury (DAI), hypoxic-ischemic damage, meningitis, and vascular injury
  • caused by acceleration-deceleration forces
  • can be due to MVA, bike, skateboard accident, high fall
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7
Q

what score on the GCS is decerebrate rigidity?

A

2

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8
Q

what score on the GCS is decorticate rigidity?

A

3

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9
Q

at what RLA level is inpatient rehabilitation phase?

A

V (confused, inappropriate, nonagitated)

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10
Q

how is apraxia treated?

A

hand-over-hand activities to repair damaged neural paths, following steps in pics or written on card

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11
Q

what approach to recovery is used during early recovery stages?

A

remediation/biomechanical

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12
Q

what approach to recovery is used during later recovery stages?

A

compensatory/rehabilitative

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13
Q

when does the greatest improvement occur for TBI

A

in the first 5 months

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14
Q

L hemisphere TBI

A
  • language (speech, reading, writing) deficits
  • logic deficits
  • depression & anxiety
  • insight of deficits (anosognosia)
  • slow cautious behavior
  • easily distractible
  • perseveration
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15
Q

R hemisphere TBI

A
  • spatial temporal deficits
  • visual-spatial deficits
  • poor body scheme/neglect
  • lack of insight/poor judgement
  • increased safety risk
  • difficulty with abstract reasoning
  • euphoria
  • difficulty perceiving emotions
  • impulsive
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16
Q

bilateral TBI

A
  • impaired vision
  • confusion
  • emotion abnormalities
  • short attention span
  • memory loss
  • poor EF
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17
Q

brain stem TBI

A
  • swallowing & speech difficulties
  • unstable vitals
  • potential organ failure
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18
Q

frontal brain TBI

A
  • personality changes
  • body scheme deficits
  • poor problem solving
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19
Q

parietal TBI

A
  • attention deficits
  • contralateral neglect
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20
Q

temporal TBI

A
  • agnosia
  • prospopagnosia
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21
Q

occipital TBI

A
  • vision impairments
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22
Q

cerebellum TBI

A
  • dysmetria
  • delayed reaction time
  • ataxia
  • tremor
23
Q

perseveration

A

repetitive and continuous behavior, speech or thought that occurs due to changes in cognitive skills

24
Q

dysmetria

A

can’t control distance, speed & ROM necessary to perform smoothly coordinated movements

25
Q

ataxia

A

lack of coordination of involuntary movements

26
Q

prospopagnosia

A

face blindness

27
Q

agnosia

A

can’t recognize familiar objects via the senses

28
Q

focus of acute phase of TBI rehab

A

PHASE 1: in intensive care unit & acute care units of hospitals
- IMPORTANT: wc positioning, inhibit primitive reflexes, increase sitting tolerance, improve respiration/swallowing, interact with environment
- bed positioning
- splinting/casting
- sensory stimulation
- agitation

29
Q

focus of inpatient rehabilitation phase of TBI rehab

A

PHASE 2: stimulus specific responses (RLA Level V)
- INITIAL: optimize motor function, motor learning, skill acquisition, exercise (GM)
- ataxia
- apraxia
- visual abilities
- visual-perceptual abilities
- cognitive function
- voice & speech
- competence in self management (dysphagia/self-feeding, bed mobility, wc management, functional emulation, community mobility, transfers, home management, community reintegration)
- mediate problem behaviors (environmental/interactive interventions)
- caregiver support

30
Q

focus of postacute rehab phase of TBI rehab

A

PHASE 3 (last): home based therapy, residential program, day tx program, outpatient community re-entry program)
- cognitive function
- visual & visual perceptual
- self-maintainence
- leisure/social participation
- work
- behavioral/emotional adaptation
- caregiver support

31
Q

TBI splinting

A
  • resting/functional splint: not active/functional
  • cone splint: keep fingers from digging into palm
  • antispasticity splint: position hand/wrist in functional position, abduct fingers to decrease spasticity
  • elbow cast for loss of PROM in elbow flexors
32
Q

how to manage agitation

A
  • common in acute phase
  • behavior management strategies
  • track arousal/alertness
  • yes/no system with eye blinks, head nods, thumbs up
33
Q

bed positioning during acute phase of TBI

A

abnormal tone: lie on side/semi prone
- sensory input
- pillows, foam wedges, splinting

34
Q

how to treat ataxia

A
  • compensatory strategies for control (weighting body parts, weighted utensil/cup)
35
Q

how to treat apraxia

A
  • hand over hand exercises
  • following steps in pics or written on card
36
Q

how to optimize vision

A
  • environmental adaptation
  • vision correction
  • compensatory strategies: contrasting colors, textured tapes, sunglasses
37
Q

how to optimize visual perceptual abilities

A

compensatory & rehabilitative
- neglect: encourage use of affected side
- environmental adaptation: moving meal tray to that side
- COMPENSATORY: place all objects in that field of vision for success

38
Q

how to treat expressive aphasia

A
  • conversation exercises with OT recognizing client errors
  • ask client to verbalize what they meant to say
  • compensatory: communication devices, pictures, charts
39
Q

how should dysphagia be treated?

A

begin feeding instruction in isolated, quiet area to prevent distraction & grade to include social situations
- rocker knife, plate guard, non spill mug
- place fork down between bites to ensure full chew/swallow

40
Q

how to train in bed mobility

A

from scooting up/down to rolling, bridging, moving from/to supine, sitting & standing

41
Q

compensatory devices for functional empulation

A

walker with bags/baskets, canes, reachers

42
Q

community mobility AD

A

scooters, wheelchairs

43
Q

transfers in PHASE 2 of rehab

A

difficult due to memory issues
- train caregivers

44
Q

how are clients in PHASE 2 reintegrated back into community?

A

community trips to practice IADLs in natural environment

45
Q

how to decrease/mediate problem behaviors

A

isolated, quiet room without roommate
- AT: wander guards (wandering)
- environmental cues to orient to place/time
- calm, concise, deliberate speech
- behavioral management programs

46
Q

how to encourage leisure/social participation in PHASE 3 of TBI rehab

A
  • social skills training groups
  • behavior contracts
  • role play
  • self reflection through video feedback, role modeling
47
Q

how to restore competence in work in PHASE 3 of TBI rehab

A
  • punctuality/feedback response, follow work schedule
  • vocational rehabilitation
48
Q

what cognitive issues remain in PHASE 3 of TBI rehab?

A

memory problems, EF
- provide stable/consistent environment
- self awareness

49
Q

coup

A

tissue at point of impact

50
Q

contrecoup

A

opposite pole

51
Q

pharmacologic interventions for TBI

A

antibiotics, anticonvulsants, sedatives, antidepressants

52
Q

postconcussion syndrome

A

symptoms continuing for weeks, months, year+ after a concussion
- symptoms usually subside in a few weeks
- symptoms: concussion with/without LOC
- headache, fatigue, cog impairment, dizzy, depressed, impaired balance, irritable, apathy

53
Q

how is postconcussion syndrome dx?

A
  • exercise testing (treadmill)
  • neuropsych eval, vestibular testing
54
Q

interventions for postconcussion syndrome

A
  • cognitive/physical rest
  • CBT
  • antidepressants

NBCOT LAST Attempt (50 decks)

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