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24 Cards in this Set
- Front
- Back
What are some of the causes of TBI?
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- MVA - 49%
- Assaults - Falls - Sports Injuries - Industrial/Work Related |
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What are some ways that TBI is Classisfied?
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- Blunt
- Sharp - Compression - Closed - Open - Severity |
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What are two types of Blunt TBI?
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- Deceleration - you hitting something
- Acceleration - something hitting you |
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What is Closed TBI?
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When the brain is traumatized, but it is not penetrated by anything
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What is an Open TBI?
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When there is an invasion of the Cranium and direct destruction of brain tissue
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What is one way of measuring Severity?
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By breaking TBI down into
- Mild - PTA 5"-1hr - Moderate - PTA 1hr-24hrs - Severe PTA 1day-7days |
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In relation to classifying severity of TBI, what does PTA stand for and mean?
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PTA = Post Traumatic Amnesia
It is the period between the point of injury and when the person has a continuing awareness of surroundings/conciousness |
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What are the 3 aspects looked at in the Glasgow Coma Scale?
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Eye Opening,
Motor Response Verbal Response |
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What is the Scale in the Glasgow Outcome Scale?
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1- Death
2- Vegetative - unable to follow commands or communicate 3- Concious, but requiring assistance to meet basic needs 4- Moderate Disability - Able to meet basic physical and cognitive needs 5- Good Recovery |
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What are the symptoms of Concussion?
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- Headache
- Nausea - Difficulty with concentration - Depression - Reduced Information processing speed - Fatigue - Irritability |
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What are the 4 Grades of Concussion?
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Grade 1- transient confusion, some PTA
Grade 2- increased confusion & PTA Grade 3- more pronounced confusion, RA & PTA Grade 4- Classic concussion - brief LOC, variable confusion, RA, PTA |
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What are the 2 types of effect of TBI?
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Direct
& Secondary |
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What are the different types of Direct effect that TBI can have?
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- Skull Fracture
- Hemorrhage - Lesions to brain (Contusion, Laceration) - Diffuse Axonal Injury |
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What are the Secondary Effects of TBI?
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- Cerebral Edema or swelling
- Herniations of brain tissue - Infarction - Infection |
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What is an Extradural (Epidural) Haematoma?
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Where there is a swelling of blood outside the Dura of the brain.
Common in MVA and Sports Often the cause when people 'talk & die' |
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What is a Subdural Haematoma?
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A collection of blood below the dura
It is more common in the elderly, and 50% are associated with skull fracture. |
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What is Diffuse Axonal Injury (DAI)?
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When the axons in the brain have been twisted (pulled away from the synapse), torn or broken.
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What is a Contusion
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Where there is bruisin on the brain - often in the frontal and temporal regions.
Similar outcomes as concussion, but more marked. Often contrecoup. |
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What are the guidelines for Treatment of acute TBI?
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- Monitor carefully for subdurals
- Identify & manage comorbidities - 'Track' clients when primary care is medical, surgical or orthopedic - Assess function before discharge - Avoid immobilisation - Prevent re-injury |
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What are some Factors that Influence Prognosis of TBI?
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- Age - younger better chance of survival and recovery
- Hypotension - 50% increase in mortality with single episode of Hypotension - Hypoxia - Delay in Treatment |
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What are does Recovery look like for TBI?
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- Regular and consistent recovery curve
- Younger age associated with less difficulty - Overlearned skills less disrupted - Greater severity associated with more difficulty - Interventions influencing extent and rate of recovery more effective early. |
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What are some of the Long-Term Consequences of TBI?
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- Physical/Motor - usually best recover
- Communication - a fifth have language difficulties, more expressive than receptive Cognitive - Attention, Memory, Information processing speed, Higher Executive Function Behaviour - Irritability, Childishness, Reduced Emotional and Impulse Control, Denial/Lack of Insight, Depression - these are often the most difficult to deal with |
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What are some Factors affecting the Elderly with TBI?
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- They have differences in presentation (.e.g delayed presentation, acute medical conditions may obscure it, etc)
- They have differences in pathophysiology - preexisting conditions (e.g. neurological disease) - They have varied co-morbidities - Dementia, Alcoholism, Frontal Lobe Dysfunction, Prescription Drug Side Effects, Physical Disability, Sensory Impairment - Need to be careful of falls for the elderly |
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What is the Grief Adjustment Process that will likely occur after TBI?
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Shock - confusion, etc
Expectancy - extreme optimism, etc Reality - depression, anger, etc Mourning - awareness of permanence, grieving what might have been Adjustment - readjust expectations, etc |