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TBI Flashcards

1
Q

What is the leading cause of TBI?

A

falls (32)
MVA (19)
acts of violence
sports

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2
Q

What factors predict the outcome for TBI?

A

Amount of immediate damage from the impact or insult
Cumulative effects of 2◦ brain damage
Individual’s premorbid cognitive characteristics
substance abuse
personality

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3
Q

Primary Brain Damage:

A

DIA
focal injury
coup-contrcoup injury

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4
Q

Diffuse axonal injury (DIA):

A

disruption and tearing of axons and small blood vessels from shear-strain of angular acceleration > neuronal death and possible hemmhorage

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5
Q

Focal Injury:

A

contusions, lacerations, mass effect from hemorrhage and edema (hematoma)

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6
Q

Secondary Brain Damage:

A

hypoxic/ischemic injury
swelling/edema
electrolyte imbalance

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7
Q

Concussion

A

Loss of consciousness, either temporary or permanent
Results from injury or blow to head
Impaired functioning of the brainstem reticular activating system: may seen changes in HR, RR, BP

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8
Q

Open injuries:

A 
Result from penetrating types of wounds
Gunshots
Knife
Sharp objects
Skull: fractured or displaced
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9
Q

What is compromised with an open injury?

A

meninges: risk of infection

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10
Q

Closed injury:

A

Impact to the head but the skull is not fractured
Neural (brain) tissue is damaged
Dura remains intact

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11
Q

Subtypes of closed injuries

A 
Concussion
Contusion
Hematomas
Locked-in Syndrome
Acquired Brain Injuries
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12
Q

What is a concussion?

A

Momentary loss of consciousness & reflexes: Shearing forces disrupt synapses
Momentary loss of consciousness may or may not occur!

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13
Q

Symptoms of a concussion:

A 
Dizziness 
Disorientation
Blurred vision
Difficulty concentrating
Alternations in sleep patterns
Nausea
Headache
Loss of balance
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14
Q

Retrograde amnesia

A

Loss of memory of events prior to injury

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15
Q

Post-traumatic amnesia:

A

Unable to remember or learn new information

Duration is a clinical indicator of severity of the injury

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16
Q

Coup lesion

A

Contusion on the same side of the brain as the impact

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17
Q

Contrecoup lesion

A

Surface hemorrhages on the opposite side of the brain trauma as a result of deceleration

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18
Q

Epidural hematoma:

A

between the Dura mater & the skull
Often seen after a blow to the side of the head or severe trauma from a MVA
Rupture of the Middle Meningeal Artery in the temporal fossa can cause epidural hematomas
Unconsciousness – Alert – Deteriorate

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19
Q

Subdural hematoma

A

Acute venous hemorrhage results because of rupture to the cortical bridging veins
Develops between the Dura & Arachnoid
Blood leaks slowly over several hours or weeks
Seen in elderly after falls with a blow to the head
Symptoms can be similar to those of a CVA

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20
Q

Locked-on-Syndrome

A

Complete paralysis of all voluntary muscles except those that control movement of the eyes
Individual remains conscious & possesses cognitive function
UNABLE to move

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21
Q

Causes of acquired brain injuries:

A

airway obstruction, near-drowning, MI, CVA, exposure to toxins, electrical shock or lightening strike

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22
Q

What do acquired brain injuries result from?

A

changes in the neuronal activity affecting physical integrity, metabolic activity or functional ability of the cell

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23
Q

Loss of consciousness for mild TBI

A

0-30 mins

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24
Q

Alteration of consciousness for mild TBI

A

brief, less than 24 hours

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25
Post traumatic amnesia for mild TBI
less than 1 day
26
Loss of consciousness for moderate TBI
greater than 30 mins but less than 24 hours
27
Alteration of consciousness for moderate TBI
greater than 24 hours
28
Post traumatic amnesia for moderate TBI
greater than 1 day but less than 7 days
29
Loss of consciousness for severe TBI
greater than 24 hours
30
Alteration of consciousness for severe TBI
greater than 24 hours
31
Post traumatic amnesia for severe TBI
greater than 7 days
32
Precentral (frontal lobe) Area structures
``` Primary motor area Premotor area Prefrontal area Supplementary motor Middle frontal gyrus Motor speech area (Broca) ```
33
Function of primary motor area
discrete volitional movements
34
Function of premotor area
motor planning or praxis
35
Function of prefrontal area
motor association area
36
Function of supplementary motor
bilateral control of posture
37
Function of middle frontal gyrus
conjugate eye movements
38
Function of motor speech area
language production
39
Lesion in primary motor area
contralateral paralysis and paresis
40
Lesion in premotor area
apraxia or motor planning deficits
41
Lesion in supplementary motor
loss of bilateral control of posture
42
Lesion in middle frontal gyrus
transitory paralysis of conjugate eye movements to opposite side
43
Lesion to motor speech area
nonfluent aphasia
44
Prefrontal (frontal lobe) areas
``` dorsolateral orbitofrontal oribital gyri (posterolateral) ```
45
Function of dorsolateral area
motivation, problem solving
46
Function of oribitofrontal area
emotions, behavior
47
Function of orbital gyri area
olfaction
48
Lesion to dorsolateral area
bilateral lesions: impaired ability to conentrate
49
Lesion to orbitofrontal area
bilateral lesion, impaired ability to concentrate
50
Lesion to orbital gyri
inability to discriminate odors
51
Structure in parietal lobe:
postcentral gyrus primary somatosensory area secondary somatosensory area gustatory cortex parietal lobe
52
Function of postcentral gyrus primary somatosensory area somatosensory area
somesthetic sensations
53
Function of secondary somatosensory area
sensory interpretation
54
Function of gustatory cortex
taste
55
Function of parietal lobe
perceptual function
56
Lesion of postcentral gyrus primary somatosensory area
loss of contralateral stimulus location, intensity
57
Lesion of secondary somatosensory area
tactile agnosia, astereognosis, agraphesthesia, loss of 2 point discrimination, extinction
58
Lesion in gustatory cortex
impairment of taste in contralateral side of tongue
59
Lesion in parietal lobe
visual spatial disorders, body scheme disorderd, apraxias, tactile and auditory perceptual disorders
60
Temporal lobe structures
``` primary auditory cortex Wernicke's speech area superior temporal gyrus temporal cortex parhippocampal region ```
61
Function of primary auditory cortex:
hearing
62
Function of Wernicke's speech area:
language
63
Function of superior temporal gyrus:
storage of auditorially presented information
64
Function of temporal cortex (non-dominate side)
storage of visually presented information
65
Function of parhippocampal region
recent memory
66
Lesion of primary auditory cortex:
subtle decrease in hearing and ability to localize sounds; both contralaterally
67
Lesion of Wernicke's speech and superior temporal gyrus:
fluent aphasia
68
Lesion of temporal cortex:
impairment of learning and memory
69
Lesion of parhippocampal region:
profound memory loss of recent events, no new learning
70
Structures of Occipital Lobe:
primary visual cortex visual association cortex posterior multimodal area
71
Function of primary visual cortex:
vision
72
Function of visual association cortex
visual understanding
73
Function of posterior multimodal
intergrates sensory information
74
Lesion of primary visual cortex:
contralateral homonymous hemianopsia, impairment of vision
75
Lesion of visual association cortex
visual agnosia
76
Lesion of posterior multimodal
perceptual impairment

Adult Neuro (26 decks)

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