TBI Quiz 1 Flashcards
(72 cards)
1
Q
SAH
A
Subarachnoid hematoma
2
Q
DAI
A
Diffuse axonal injury
3
Q
CHI
A
Closed head injury
4
Q
SBS
A
Shaken baby syndrome
5
Q
ABI
A
Acquired brain injury
6
Q
ICH
A
Intracerebral hemmorage
7
Q
TME
A
Toxic metabolic encephalopathy
8
Q
Interdisciplinary team consists of..
Who is the center of the team
A
Neurologist PT OT SLP social worker psychologist Neuropsychologist Respiratory therapy Rehab therapy Center- patient
9
Q
How many people sustain a TBI during the calendar year?
A
1.7 billion
10
Q
Why are some TBIs not reported?
A
May be an abuse situation, don’t want to report and get in trouble. People may not realize they have a TBI
11
Q
How many deaths are recorded from TBI each year?
A
52,000
12
Q
Do we focus on incidence or prevalence?
A
Incidence
Prevalence is too hard to measure
13
Q
Incidence
A
Amount/frequency it happens within a time period
14
Q
What gender has the highest incidence of TBI?
A
Males- more risk takers, more hands on/dangerous jobs
15
Q
Infant TBIs
A
Shaken baby syndrome, falls
16
Q
Adolescent TBIs
A
Motor vehicle accidents, falls during sports
15-24 have greatest incidence of TBI
17
Q
Elderly TBI
A
Falls, can be more medically compromised which can lead to death
18
Q
SDH
A
Subdural hematoma
19
Q
Highest incidence of falls is
A
Among youngest and oldest people
20
Q
Highest incidence of TBI in youths is cause by
A
Sports injuries- 80% have no change in academic ability after their TBI
21
Q
TBI occurs in how many motor vehicle accidents
A
Over half
22
Q
Intentional TBI
A
street violence, violent crimes, child abuse, domestic abuse, suicide attempts, military actions (harder to prevent these)
23
Q
Unintentional TBI
A
MVAs, sports, job, falls
24
Q
Risk factors of TBI
A
Substance abuse
Per existing medical conditions
Previous brain injury
25
After 2 brain injuries the risk is __ x greater
8
26
When is TBI season? Why?
May through October
| More people playing outside, outdoor activities, riding motorcycles
27
Golden hour
An hour after injury happens prognosis is better and recovery is quicker
28
Acquired brain injury (ABI)
Any injury that occurs after birth
29
Non traumatic ABI are
- tumors
- toxic metabolic encephalopathy (TME)
- anoxia
- hypoxia
30
Toxic metabolic encephalopathy (TME)
brought on by endocrine and metabolic disturbances, toxins, infection and cause changes to cognition and consciousness
31
Anoxia
reduced oxygen supply to the brain
32
Hypoxia
reduced blood supply to the brain (heart attack, clot – wind up with cognitive changes and can end up with TBI)
33
Services for those with TBI
IDEA
| New Jersey state department of human services - has a TBI fund for support for families and those with TBI
34
Translational acceleration
-force travels through the heads center of gravity – linear
35
Coup contra coup injury
Can have it side to side or back to back
36
Rotational acceleration
- force passes at any point other than the center
- you have no idea what’s going to be injured
- can force the head in any direction
37
Diffuse axonal injury (DAI)
- one of the more common CHIs also can be potentially most severe
- cause by movement of the brain within the skull – disrupting nerve cell messages
38
Shearing
Tearing too much to the point that the nerve severs
| More susceptible to shearing where the gray and white matter meet
39
Primary injuries
```
Occur at the time of impact
Shearing
Hemorrhage
Subarachnoid hemorrhage
Intracerebral hemorrhage
Contusion
```
40
Hemorrhage
- typically within brain tissue itself
| - ruptured vessels and bleeding into the spaces between the skulls and brain tissue
41
Intracerebral hemorrhage
Means inside the brain
| Can also be a stroke
42
Contusion
bruising of brain tissue, pooling and swelling of the tissue
43
Secondary brain injuries
```
Hematoma
Subdural hemorrhage
Epidural
Subarachnoid
Intracranial
Cerebral swelling
Cerebral edema
```
44
Hematoma
localized pools of blood found outside the circulatory system
45
Epidural
outside dura mater
-often involves skull fracture
-less dangerous when found quickly does not invade neural tissue
46
Subdural
– between dura mater and arachnoid mater (30% of severe TBIs)
-can compress and shift brain tissue
47
Subarachnoid
-form in the space from a tear of a cerebral artery
| -can be found with a spinal tap- will be blood in spinal fluid
48
Intracranial
-most dangerous – occur in 60% of severe injuries
| -not always diagnosed at first because of brain swelling
49
Cerebral swelling
blood traveling to the injured site
| Can be more problematic for pediatric TBI
50
Cerebral edema
Increase in water content within the brain
-vasogenic – capillaries allow fluid from blood vessels to travel through
Cytotoxic neurons become gorged with liquid content
51
If there is intracranial pressure -pressure has to be removed slowly.. How?
Elevate the head
Draw fluids out with diuretic medications
Increased oxygen (hyperventilation)
High doses of barbiturates (phenobarbital)
Craniectomy
52
Blast injuries (war)
- increase because of active war time
- primary blast injury - atmospheric pressure changes responsible for brain damage (don’t actually have to be right next to the bomb or materials that explode)
- additional research needed on multiple blast injuries
53
Secondary blast injury
shrapnel or debris from blast can strike a soldiers head CHI through blunt force trauma or penetrating head injury that damages brain tissue
54
Tertiary blast injury
energy released by an explosion can accelerate a soldiers body though the air into ground
(ex coup contrecoup)
55
Fourth blast injury
Swelling of the brain
56
CT Scan
- a series of x-ray images that provide cross sectional slices of brain tissue
- can be with or without contrast
- number one way they assess an injury
- does not show contrast as much and it isn’t as clear – things can be missed
57
MRI
- uses large magnets, radiofrequencies, computer
- can pinpoint differences between soft tissue and abnormal tissue
- more contraindications
- if you have metal in your body you CANNOT have an MRI
58
Skull/cranium
- outside is smooth – we can feel that
| - inside is bumpy and jagged – can cause your tearing and shearing
59
More susceptible to skull fractures
- orbital plates of frontal lobe
| - sphenoid and temporal bones around the sinuses and middle ear cavities
60
Meninges
Three layers of membrane that surround the brain
-dura mater-cranial nerves pass through: encases sinuses
-arachnoid mater – delicate and fibrous
-subarachnoid space that contains cerebrospinal fluid
-pia mater-inner most
-thin and tightly around the brain tissue itself
-saran wrap around brain tissue itself
61
Ventricular system
Contains 4 ventricles
- produces CSF
- CSF is another buffer for the brain tissue
62
Cerebral cortex
4 lobes: frontal
temporal
parietal
occipital
63
Frontal lobe
executive function
64
Temporal lobe
Comprehension
| Language on the left
65
Parietal lobe
Sensation
Depth perception
Processing
66
Occipital lobe
Vision
67
Cerebellum
- motor movements, balance
| - very hard to have a TBI that affects this, location is hard to get to
68
Limbic system
- memories, emotion, physical desires
| - deepest part
69
Diencephalon
-nerve damage (maybe DAI injury)
70
Hypothalamus
Memory
71
Brainstem
- midbrain
- pons –swallowing
- medulla
- heartrate, breathing, organs affected
72
How do we predict recovery
```
Extent and location of injury
Length of impaired consciousness
Post traumatic amnesia
Neurological testing scores
Genetics
```
