Term
| What is the big difference between TBI motor involvement, and stroke probs? |
|
Definition
| TBI more likely to be B and strokes are usually unilateral. |
|
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Term
| What are the major risk factors for TBI? (5) |
|
Definition
| Age, gender, socioeconomic status, alcohol use, high impact activities |
|
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Term
| What age groups are most at risk for TBI? |
|
Definition
|
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Term
| Which gender is most likely to sustain TBI? |
|
Definition
| males (engage in riskier behaviors) |
|
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Term
| How is socioeconomic status and TBI risk correlated? |
|
Definition
| Lower socioeconomic status ~ increased risk for TBI |
|
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Term
| What is the leading cause for TBI? |
|
Definition
|
|
Term
| What are the prognosticators (who will do better after TBI)? (5) |
|
Definition
| Gender (F), Severity of initial injury (glasgow coma scale high score), Post traumatic amnesia (shorter duration), duration of unconsciousness following injury (shorter), physiologic measures (lower ICP). |
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Term
| What is retrograde amnesia? |
|
Definition
| Loss of memory of events that happened just before the injury. It's common for these memories never to return. |
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Term
| What is the difference between open head and closed head injuries? |
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Definition
| In an open head injury there is a skull fracture involved. CHI = no skull fracture. |
|
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Term
| What is a depressed skull fracture? |
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Definition
| Bony fragments go into brain tissue ie: hit w/ hammer. |
|
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Term
| What is a puncture skull fracture? |
|
Definition
| Something goes cleanly through the bone. ie: stabbing |
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Term
| What are the three major types of CHI pathology? |
|
Definition
| Acceleration-dececeleration, vascular injury, hypoxic injury. |
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Term
| Describe acceleration-decceleration injury. Describe the type of damage it causes within the brain tissue. |
|
Definition
| The skull stops, but the brain keeps going and gets pounded on the front/back/side of the inside of the skull. It causes sheer force on neurons and axons, and pulls on axons and vessels causing tearing. |
|
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Term
| Describe the damage caused by vascular CHI. |
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Definition
| When there is bleeding in the brain, there is an ischemic response which causes vasospasm and further injury. You can also have compression injury from the blood volume, and shift in tissue can increase damage. |
|
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Term
| how does hypoxic CHI occur? |
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Definition
| Blood doesn't get to where it has to go - either by blood damage in the brain or major blood loss in another part of the body, and causes hypoxic damage. |
|
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Term
| What is diffuse axonal injury? |
|
Definition
| Diffuse degeneration of white matter; the damage is not localized to any one area. |
|
|
Term
| What are the three types of head injury? |
|
Definition
| Open head, closed head and traumatic injury to extracranial blood vessels. |
|
|
Term
| what are the major additional complications from brain injury? (2) |
|
Definition
| swelling in the brain and increased intracranial pressure. |
|
|
Term
| What causes increased intracranial pressure? |
|
Definition
| fluid in the brain, caused by the normal response of swelling. |
|
|
Term
| what is a normal icp value? |
|
Definition
|
|
Term
| Over what pressure is icp abnormal? |
|
Definition
|
|
Term
| An ICP of >40mmHg results in what? |
|
Definition
| Impairment in electrical activity. |
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Term
|
Definition
|
|
Term
| At what ICP do you absolutely stop PT Tx because of potential damage? |
|
Definition
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|
Term
| You're Txing a pt, and their ICP goes up higher than you are comfortable with. What is the first step you should take? What if that doesn't work? |
|
Definition
| First step - raise the head of the bed. 2nd step - get nurse immediately. |
|
|
Term
| high ICP can result in herniations. where? |
|
Definition
| foramen magnum, tentorial hernia, csf spaces. |
|
|
Term
| What is a tentorial hernia? |
|
Definition
| hernia in tissue above the cerebellum |
|
|
Term
| describe what csf space herniation looks like. |
|
Definition
| on MRI or CT - ventricles are squished or non-visible b/c tissue pushes into that space. |
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