TBI Flashcards

Question

Mild TBI

Answer 1

- GCS of 13 or higher - LOC less than 20 minutes - normal CT - awake when arriving to hospital - may present dazed, confused - c/o headache or fatigue

Answer 2

GCS 9-12 - confused and unable to answer questions - most have permanent physical, cognitive and behavioral deficits

Answer 3

GCS of 3-8 individual is in coma permanent functional and cognitive impairments

Answer 4

``` decreased level of consciousness cognitive deficits motor deficits sensory deficits communication deficits behavioral deficits associated problems ```

Answer 5

decreased level of awareness state of unconsciousness presents with: eyes remain closed unable to initiate voluntary activity sleep/wake cycle not present

Answer 6

person who demonstrates a return of brain stem functions - respiration - digestion - BP control no sleep/wake cycle may experience arousal and spontaneous eye opening pain responses may be evident unaware of external and internal needs

Answer 7

been in this state for a year or longer with no improvements in neurological status

Answer 8

regulated by RAS

Answer 9

consciousness of int/ext env. stimuli

Answer 10

state of being aware

Answer 11

condition of general unresponsiveness

Answer 12

people who sleep a great deal of the time when aroused demonstrate disinterest in env. and slow to respond to sensory stim.

Answer 13

disorientation, fear, misperception of sens. stim

Answer 14

state in which a person is confused, distracted and has poor memory

Answer 15

dysfunction can include: disorientation, poor attention span, loss of memory, poor orginizational and reasoning skills and inability to control emotional response affect ability to learn new skills

Answer 16

*when unconscious pt unable to initiate active movement | abnormal posture are frequently seen from brain stem injury

Answer 17

``` LE: Hip add Hip IR Knee ext PF supintation ``` UE: Shoulder ext and IR elbow ext pronation wrist/fingers flex

Answer 18

severing of the neuroaxis in midbrain region Pons medulla and SC remain functional

Answer 19

``` UE: shoulder flex, add, IR Elbow flex pronation wrist flex ``` LE: extension

Answer 20

dysfunction above the level of the red nucleus | between basal nuclei and thalamus

Answer 21

loss of sense of smell impairment or absence of tactile or kinesthetic sensations visual deficits perceptual and proprioceptive deficits

Answer 22

initially lost or severely impaired decreased awareness of env. can limit opportunities for interaction may not be able to initiate communication because of abnormal tone or posturing

Answer 23

- most enduring and socially disabling deficits | - can exhibit neuroses, pychoses, sexual disinhibition, apathy, irritability, agression, low frustration tolgerance

Answer 24

- 70% of TBI pts. will have other injuries | - may make care and rehab

Answer 25

- increase pt. level of arousal - preventing development of secondary impairments - improving pt. function - provide pt. and family with education **avg. length of stay in hospital is 2 weeks

Answer 26

- supine-facilitate extensor tone and tonic labyrinthine - sidelying or semi-prone: reduce influence of tonic labyrinthine refelx - UE: abd and ER to inhibit abnormal tone - Position out of decebrate or decorticate postures * contractures occur quickly

Answer 27

static then progressing to active movements | superimposed on static positions

Answer 28

abnormal bone formation in soft tissues and muscles presents with loss of ROM, pain, swelling and erythema no effective treatment DRUGS: NSAIDS

Answer 29

important even with coma pts. assume pt. can hear you and undestand explain what youre doing all the time orient pt. x4 and converse with pt. & family

Answer 30

decreased level of responsiveness | little interaction with env.

Answer 31

- physical function and alertness increased - risk of secondary impairments reduced - motor control improved - effects of tone managed - postural control improves - tolerance of activities and positions increased - joint integrity and mobility improved or remain functional - education of family and caregivers

Answer 32

-prevent indirect impairments -proper positioning both in bed and sitting -turn every 2 hrs. recline w/c or tilt in space -postural drainage, percussion and vibration -ROM and orthotics to prevent contractures

Answer 33

``` short sessions-15 to 30 mins avoid over stim normal toone and meaningful topics of auditory photographs-visual 10-15 sec of olfactory swabs low freq vibration or stroke/rub with wash cloth rolling and neck rolling ```

Answer 34

``` HR BP RR Diaphoresis Facial grimicing changes in posture head turning vocalization ```

Answer 35

positioning rom orthotics inhibitory tech.

Answer 36

confused | agitated

Answer 37

``` pt. edurance improved joint mobility and integrity maintained risk of 2ndary impairments decreased increase tolerance of activities pt family educated on dx, prognosis, pt outcomes ```

Answer 38

``` utilize same therapist, time and place of tx expect no carry over model calm behavior redirect provide options expect egocentricity ```

Answer 39

difficult to provide education directly at this level pt. does not have control of behavior entering this stage is good because it indicates improvement aggressive behaviors are usually short-lived keep consistency

Answer 40

confused but no longer agitated simple commands improved improved carry over

Answer 41

performance of fun. mobility and ADL skills increased gait, mobility and balance improves motor control, postural control increase risk of 2ndary impairments reduced strength and endurance increased safety with fun mobility & ADL skills improved pt. fam education tolerance of activities increased

Answer 42

ROM exercise & task physical conditioning focal lesions: balance and ataxia

Answer 43

1. Compensatory - improve functional skills by compensating for the lost ability 2. Restorative - locomotive training via BW support and treadmill - constraint induced movement therapy for UE function

Answer 44

``` maintain structure emphasize safety simple instructions short term goals: -gradual increased in the number of reps&exercise time practice should be distributed -sufficient rest periods to minimize physical and mental fatigue extrinsic feedback ```

Answer 45

emphasize safety awareness ed family should learn to assit pt. with fun mobility fam should learn to assist pt. with strength &ROM fam should be aware of methods to enhance decision making skills and safety

Answer 46

cognitive and emotional deficits are usually greater than the physical deficits

Answer 47

pt.& fam education safety of pt. & family is improved ability to perform physical tasks related to ADL skills, community, work integration and leisure is improved motor control, balance and postural control increased Strength & endurance increased level of supervision and assistance for task performance is decreased

Answer 48

ROM exercise and functional tasks physical conditioning ADL and IADL training - pt. integrating cognitive, physical and emotional skills necessary to function in community

Answer 49

pt. should be educated how to best compensate for residual impairments and disabilities pt. and family should contact local support group

Answer 50

NO RESPONSE; TOTAL ASSIST | -complete absence of change in behavior when stimuli presented

Answer 51

GENERALIZED RESPONSE; TOTAL ASSIST - reflex response to painful stimuli - response to repeated auditory stimuli - response to ext. stimuli with gross body movement or vocalization

Answer 52

LOCALIZED RESPONSE;TOTAL ASSIST - withdrawal or vocalization to pain stim - head turns with auditory stim - follows objects with eyes - responds to discomfort

Answer 53

CONFUSED/AGITATED; MAX ASSIST - alert and heightened state of activity - purposeful attempts to remove tubes and restraints - non purposeful movements of divided attention - may cry or scream to stimulus - unable to cooperate with treatment - mood swings for no apparent reason - incoherent verbalization

Answer 54

CONFUSED, INAPPROPRIATE NON AGITATED;MAX ASSIST - Alert not agitated - not oriented to person, place or time - may be able to perform learned tasks with cues - simple commands can be followed but random - able to converse on social, level for brief periods of time with cues

Answer 55

CONFUSED, APPROPRIATE; MOD ASSIST - inconsistently oriented - able to attend to familiar tasks for 30 minutes - able to use assistive memory aide with max assist - mod assist to problem solve - unaware of impairments - verbal expressions are appropriate

Answer 56

AUTOMATIC, APPROPRIATE; MIN ASSIST - consistently oriented - min supervision with new learning and with safety in routine at home and community - overestimates abilities - unable to recognize inappropriate social-interaction behavior - unaware of others needs and feelings

Answer 57

PURPOSEFUL, APPROPRIATE; STAND BY ASSIST - consistently oriented - independently attends and completes task for 1 hour - uses assitive memory devices to recall schedule - thinks about consequences - aware and acknowledges impairments - over or under estimates abilities - able to recognize inappropriate social interactions - self centered and uncharacteristically independent/dependent

Answer 58

rare neurological disorder that results after TBI - complete paralysis of all voluntary muscles except those that control eye movement - pt. remains conscious and possesses cognitive function but is unable to move