tbi quiz 11/17

Question 1

A non-congenital or non-degenerative insult to the brain caused by an external force

Answer 1

The definition of TBI

Question 2

Children under 4
adolescents 15-19
Adults over 75
people with previous tbi
persons with history of drug/alcohol use

Answer 2

High risk groups for a tbi

Question 3

Object penetrates the skull and brain

Answer 3

Open brain injury

Question 4

Acceleration, deceleration, and rotational forces

Answer 4

Closed brain injury

Question 5

Direct hit on the head

Answer 5

Coup

Question 6

The result of the brain moving inside the skull from the coup impact

Answer 6

Contrecoup

Question 7

Occurs at the time of the trauma and is caused by localized contusions

Answer 7

Primary injury

Question 8

Results from stretching and shearing forces occuring in the tissues of the brain

Answer 8

Diffuse axonal injury

Question 9

Results from a series of chemical reactions in the brain that can occur immediately after the injury, his or days later, and significantly worsen the damage caused by primary injury

Answer 9

Secondary injury

Question 10

Stabilize the patient medically
treat for shock or respiratory arrest
assess for other injuries
spinal or soft tissue injuries, wounds, internal injuries
Immobilization: halo, cast, traction
Craniotomy if needed to decrease intracranial pressure or bleeding
Meds for pain or seizures
meet nutritional needs with IV fluids or NG tube PRN
in the ICU the neurologic status is frequently reassessed

Answer 10

Medical management

Question 11

Baseline cognitive status
address areas of basic ADLs
ensure the practice of basic hygiene skills
bed and sitting position
maintain ROM
facilitate responses to stimuli
increase endurance for activity

Answer 11

OT in the ICU

Question 12

Decreased ability to recall information from before the brain injury

Answer 12

Retrograde amnesia

Question 13

Decreased ability to recall new information

Answer 13

Anterograde amnesia

Question 14

A confusional state with prominent ongoing difficulty laying down new memories. Best way to monitor the impact and course of tbi

Answer 14

Post traumatic amnesia

Question 15

Loss of consciousness for 5 minutes or less
initial Glasgow coma scale (GCS) of 13 or 15
post traumatic amnesia of less than 1 hour

Answer 15

Mild tbi

Question 16

Loss of consciousness for greater than 5 minutes but less than 6 hours
initial gcs of 3 to 8
post traumatic amnesia of 1 to 24 hours

Answer 16

Moderate tbi

Question 17

Loss of consciousness of 6 hours or more
initial gcs of 3 to 8
post traumatic amnesia for more than 24 hours

Answer 17

Severe tbi

Question 18

Total the scores for eye opening, motor response, and verbal response
15 is normal
13-14 is associated with mild head injury
8-12 is associated with moderate head injury

Answer 18

Glasgow Coma Scale

Question 19

Level 1- no response:total assistance
level 2- generalized response: total assistance
level 3- localized response: total assistance
level 4- confused/agitated: maximal assistance
level 5- confused, inappropriate non - agitated: maximal assistance
level 6- confused, appropriate: moderate assistance
level 7- automatic, appropriate: min assist of ADLs
level 8- purposeful, appropriate: stand-by assistance
level 9- purposeful, appropriate: stand-by assistance on request
level 10- purposeful, appropriate: modified independence

Answer 19

Rancho los amigos

Question 20

Motor problems
abnormal reflexes (atnr) and (stnr)
abnormal muscle tone
muscle weakness

Answer 20

Impairment after tbi

Question 21

Posturing is an indicator of the severity of brain damage

Answer 21

Not a question just a hint

Question 22

Elbows, wrists, and fingers flexed; legs extended and rotated inward

Answer 22

Decorticate

Question 23

Head arched back, arms extended by sides, and legs extended. Patient is rigid with teeth clenched

Answer 23

Decerebrate

Question 24

Caused by imbalance muscle tone, deficits in righting reactions, impaired muscle control, or deficits in vision, cognition, and perception

Answer 24

Postural dysfunction

Question 25

Dulling or loss of light touch, sharp-dull discrimination, proprioception, kinesthesia, or stereognosis

Answer 25

Sensory changes

Question 26

Sensory changes, decreased functional endurance, and dysphagia

Answer 26

Additional impairment after tbi

Question 27

``` Double vision reduced gaze stability Poor attention poor visual memory glare sensitivity impaired balance visual-spatial misperception Loss of coordination ```

Answer 27

Post traumatic vision syndrome

Question 28

``` Visual agnosia right-left discrimination figure-ground discrimination Topographic perception depth perception tactile agnosia body scheme left unilateral neglect apraxia ```

Answer 28

Perceptual impairments

Question 29

``` Disorientation reduced attention and concentration impaired initiation impaired memory decreased safety awareness delayed processing of information impaired executive function & abstract reasoning ```

Answer 29

Cognitive dysfunction

Question 30

Reduced frustration tolerance refusal to cooperate tasks that are too difficult can increase agitation Combativeness disinhibition lack of social awareness emotional liability exaggerated emotional response affective mental functions social support is a strong predictor of success Premorbid psychiatric or emotional problems may be worsened by tbi reactive depression to losses associated with tbi family structure is disputed client and family may benefit from counseling

Answer 30

Behavioral dysfunction