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Summer 2025 - WJ, AL, AT > Week 2 DaSilva TBI lecture > Flashcards

Week 2 DaSilva TBI lecture Flashcards

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1
Q

What is the first thing that one needs to when a patient just suffered a TBI?

A

Establish the an open airway

also make sure that the vitals are stable and establish electrolytes

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2
Q

Before the vitals are established how often do you need to do neuro checks

A

every 15 mins

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3
Q

What scale is used at the
- Scene of the accident
- Used in research
- Used as a predictor of outcome
- used in throughout Acute care

A

Glasgow Coma Scale

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3
Q

T/F
a patient can score a 2 on the Glasgow Coma Scale

A

False
The lowest possible score is three

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4
Q

After the vitals are established how often do you need to do neuro checks

A

every 30 mins

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5
Q

What is the scale of the Glasgow Coma Scale

A

3-15

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6
Q

In the Glasgow Coma Scale what score is considered a SEVERE injury (coma)

A

3-8

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7
Q

In the Glasgow Coma Scale what score is considered a MOD injury

A

9-12

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8
Q

In the Glasgow Coma Scale what score is considered a MILD injury

A

13-15

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9
Q

what are some limitations for the GCS

A

aphasia
alcohol or medications
pre existing conditions

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10
Q

what is a localized brain injury

A

localized to the site of impact on the skull

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11
Q

what is a diffuse brain injury

A

widely scattered shearing of axons

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12
Q

a diffuse brain injury typically occurs in what type of MOI

A

Car collision
falling high surface
basically any high speed collision

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13
Q

what is the normal intracranial pressure when a patient is lying down

A

0-10 mm hg

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14
Q

what is the intracranial pressure number that is a clear contraindication for PT?

A

20 mmHg or higher

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15
Q

between 20-40 mmHg of intracranial pressure what can occur ?

A

neurological disease

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16
Q

If a patient has a velocity over __________ of their cerebral arterial blood flow you are not allowed ________ activities

A

100
Out of Bed

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16
Q

if a patient reaches 60 mmHg what can occur ?

A

almost always results in death

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17
Q

If I have too much CSF in the ventricles that is considered what ?

A

Hydrocephaly

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18
Q

If a person has too much swelling of the brain tissue that is considered what ?

A

Brain Edema

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19
Q

How many types of hematomas are there and where are they located ?

A

Epidural
(outside of the dura mater)

Subdural
( inside the dura)

Intracerebral
( within the brain)

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20
Q

Because of the brains viscoelastic properties what can occur when someone has a TBI?

A

Distortion
Midline shift
Herniation through the Foramen Magnum

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21
Q

what is the definition of hypoxia ?

A

Dec of oxygen due to O2 within the TISSUE

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22
Q

what is the definition of ischemia ?

A

Dec of blood flow to that area or tissue

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22
If someone suffers secondary damage because of hypoxia or ischemia what are the structures more often affected ?
Hippocampus Basal ganglia Cerebral cortex Cerebellum
23
True or False A craniotomy requires a part of the skull to be completely removed to relieve ICP ?
False silly. There just needs to be a while then the hematoma is suctioned out to relieve that pressure
24
what is a craniectomy ?
remove part of the skull to relieve ICP and is later placed back once the swelling has gone down
25
what is the landmark used when making sure that the EVD is at the correct level?
External meatus
25
if someone has a high ICP what are some treatments used ?
sedative/hypnotic drug therapy Skeletal muscle paralytics Core temp regulation (not used much )
25
When a person has an EVD ( External Ventricular Drain ) what is something that you need to be cognizant of ?
The level at which the EVD is at when they are moving
26
what are common medications used for ppl with recent TBI Name 3
anticonvulsants Sedatives/anesthetics Narcotic analgesics skeletal muscle relaxants cardiovascular medications
27
what are the 3 type of feedings tube that one might see if one suffers from TBI ?
Nasogastric tube Gastrostomy tube Jejunostomy tube
28
If someone suffers from Neurogenic fever what structure is likely damaged ?
Hypothalamus
29
A fever can cause what effects ?
Inc calorie demands Inc metabolic demands of the brain
30
true or false a fever can be a sign of brain herniation ?
True
31
systemic arterial hypertension can be caused _______ stimulus
Noxious
32
the most common side effect that one needs to consider when working with someone with a TBI is what ?
Tachycardia
32
HR is controlled by various regions in ________ caudally to __________
diencephalon, medulla
33
The Disability Rating scale Craig Handicap Assessment and Reporting Technique Discharge all measure what aspect of the ICF model ?
Participation
33
The Disability rating scale is used to track what ?
used to track individuals from coma to community
34
The FIM and FAM outcome measures that measure what aspect of the ICF model ?
Activity
35
The JFK Coma Recovery Scale Rancho Levels of Cognitive Function Moss attention Agitated behavior scale Measure what aspect of the ICF model
Body structure function
36
The Craig Handicap Assessment and Reporting Technique (CHART) measures what 6 aspects
Physical ind. Mobility Occupation Social integration Economic self sufficiency Cognitive ind.
37
The Pops measures what 5 categories
1 Domestic life 2 Major life activities 3 Transportation 4 Interpersonal interactions and relationships 5 Community recreational and civic life
38
If a patient requires 24/7 supervision and have to be within the same room that is considered what type of supervision ?
Full Time Direct Supervision
38
The FIM and FAM are additional items to be assessed only for what conditions ?
TBI/CVA
39
If a patient requires 24/7 supervision and have to be within the same building that is considered what type of supervision ?
Full time indirect supervision
39
What assessment defines minimum mobility req as being able to ind. walk 20 meters without a gait assistance but orthoses are allowed ?
Hi level Mobility Assessment Tool
40
what are some factors that affect the prognosis
Age Post traumatic amnesia Degree and duration of loss of consciousness first TBI vs Previous ones premorbid intelligence / enrichment
41
is a person has NO response what is that considered in the rancho level ?
Level 1 No response
41
what is a Level 2 (Generalized response) in Rancho classification
Limited non purposeful responses often for pain only ex. inc breathing rate inc BP reddening of the face
42
If a patient is able to have a localized response. They may be able to follow simple commands what is that considered in the rancho classification ?
Level 3 Localized response
43
if a patient with a score of 1-3 what might be some characteristics that they may resent with ?
might be asleep or awake are at inc risk of seizure To be Nothing by mouth show extreme levels of hypertonicity
44
what is a maximum amount of time that someone can be in a persistent vegetative state
there is no limit
45
If there is no eye opening no vocalization no movement what is that considered ?
A coma
46
If a patient can open their eyes can move spontaneously has sleep wake cycles but cant follow commands that is considered what ?
Persistent Vegetative state
47
True or False Glasgow coma scale is more sensitive than both the JFK coma scale and Rancho scale ?
False the JFK coma scale is the most sensitive scale it can detect minimally conscious state
48
Why is the JFK scale so important ?
is allows for a better diagnose and has a HUGE implication with patient discharge
49
What is PTA ? Post traumatic amnesia
a period of time from the event to the time that the patient has an ongoing short memory problem
50
How long does PTA typically occur and what does it mean if last longer than that?
3-4 times the amount of length that they are unconscious If it last longer it means that there is some other complication
51
The Galveston Orientation and Amnesia Test ( Goat) Requires how many consecutive test equal to or greater than 75 to be considered out of a PTA?
3 consecutive score
52
If a patient is aggressive unable to do self care confused and disorientated what rancho level are they considered ?
Level 4 Confused, agitated
53
where are some areas of the brain that could lead to increased agitation ?
Temporal lobe (psychomotor) Seizures Fronto orbital anterior temporal lobes sylvian fissure
54
What could be some causes of agitation ?
Sensory Overload Deprivation Sleep Deprivation Electrolytes Seizures
55
if a patient appears to be alert is verbally inappropriate or does not learn new information confused is non agitated what level is that considered at Rancho?
Level 5 Confused, inappropriate, non agitated
56
If a patient has good directed behavior has serious memory problems some self awareness of self and others what is that considered at Rancho?
Level 6 confused, appropriate
57
if a patient is Alert Oriented Has abstract reasoning persist but still has many function at reduced levels in society what is that considered within the Rancho Classification ?
Level 8 Purposeful, Appropriate
58
if a patient has poor insight into condition poor judgement has robot like behavior with minimal confusion what is that considered in Rancho Classification?
Level 7 automatic, appropriate
59
What is considered a mild TBI ?
traumatically induced disruption of brain function by at least any period of LOC any memory post or pre event any change of mental state when the accident occured focal neuro deficits
59
If a person scores an 8 within the Rancho classification are they back to their baseline before the event ?
NO
60
Broca's aphasia and drop foot are considered to be a ______ deficit
Focal Neuro deficit
61
What are the physical symptoms of a Mild TBI
Headache Fatigue Lethargy Tinnitus blurred vision
62
Cognitive symptoms of a Mild TBI
concentration perception memory
63
Behavioral symptoms for a mild TBI
Disinhibition Emotional Lability Irritability
64
What is the most common symptom of a mild TBI?
Headaches
65
what amount of time is considered a period of rapid recovery ?
Up to 1 year after event
66
To be considered a mild TBI what are the req
LOC of 30 min or less PTA no greater that 24 hrs

Summer 2025 - WJ, AL, AT (11 decks)

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