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Neurology II: Midterm > Module 5 > Flashcards

Flashcards in Module 5 Deck (34)
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1
Q

_ _ _ is an alteration in brain function , or other evidence of brain pathology, caused by an external force.

A

Traumatic brain injury (TBI)

2
Q

Symptoms of TBI can be _ or _ depending on the?

A

Temporary or permanent depending on the extent of the neurological damage

3
Q

_ includes non traumatic insults to the brain.

A

ABI- acquired brain injury

4
Q

Average age of onset, gender usually affected and incidence (ER and Hospital), and mortality rate of TBI

A

Age on onset 15-24 year old Males

1.7 million to ER, 300,000 to hospital

Mortality: 50k

5
Q

Computerized tomography (CT), MRI, Positron EMission Tomography (PET), Diffusion Tensor Imaging (DTI), Single-Photon emission computerized tomography (SPECT), Functional MRI, and MR spectroscopy are all?

A

Diagnostic procedures used to identify TBI

6
Q

Which diagnostic procedure is best for viewing white matter (reveals the extent of the damage)? Which uses gamma rays in order to detect brain activity?

A

DTI- Diffusion Tensor Imaging: White matter

Single-Photon emission computerized tomography (SPECT)

7
Q

Which diagnostic procedure uses neurochemical profiles? 3 types of neurochemicals that are profiled? And associated structures involved?

A

MR spectroscopy

Neurochemicals:

  • N-acetyl aspartate (NAA): Brain cells
  • Lactate: Indicates cell death
  • Choline: RElated to cell membrane phospholipids
8
Q

MR spectroscopy is up to _ accurate by itself in predicting disability. Up to _ when combined with?

A

84% accurate by itself

90% when combined with Evoked Potentials

9
Q

Focal injury, diffuse axonal injury (DAI), coup-contrecoup, and blast injury are common forms of?

A

Primary Injuries that can contribute to TBI

10
Q

_ _ is a cascade of injuries that occurs due to primary injuries.

A

SEcondary injuries

11
Q

Examples of secondary injuries: chain of _ _, - injury, _ _, elevated _, _ and _.

A
Chain of cellular events
Hypoxic- ischemic injury
Intracranial hematoma
ICP- inter rainfall pressure
Edema
Seizures
12
Q

What is the difference between secondary injury and secondary impairment?

A

Secondary injury
- can happens in concert with a primary injury, that is directly related to the primary injury

Secondary impairment
- is indirectly related, can happen down the line

13
Q

DVT, heterotrophic ossification, pressure ulcers, chronic pain, contractures, muscle atrophy and pneumonia are examples of?

A

Secondary impairment

14
Q

Spinal cord injury, fractures, open wounds, soft tissue damage, peripheral nerve injury, and internal organ injuries are examples of?

A

Concurrent/ concomitant injuries (secondary injury0

15
Q

What scale uses a patient’s responses (eye opening, verbal response, motor response) in order to classify the extent of brain injury?

A

Glasgow Coma Scale

16
Q

What is the scale/ point that classify a patient as severe, moderate, and mild using the Glasgow coma scale?

A

Severe: less than or equal to 8

Moderate: 9-12

Mild: 13-5

17
Q

The Glasgow coma scale is not _ _, but is? Most valid in?

A

Not very valid

But is commonly used in the field in an emergency situations

Most valid in the early stages

18
Q

90% of patients with a Glasgow coma number of the less than 8? 50% of those?

A

90% are in a coma (long-term)

50% of those people die

19
Q

What scale do we as PT use to classify a patient who has had a TBI?

A

Rancho Los Amigos levels of cognitive functioning

20
Q

A coma is described as a patient that has some _ _, and may _ or have _ _ or other types of _ _, and is otherwise non-responsive.

A

A coma is described as:

  • patient has some wake/ sleep cycles
  • may have reflexive crying or other types of emotional outbursts
21
Q

How many levels exist in the Rancho Los amigos scale?

A

10

22
Q

Which levels of Rancho Los amigos scale are described and general definition of each:

  • No response
  • Generalized response
  • localized response
A

Level I: no response (comatose)

Level II: Generalized response
- patient exhibits same response no matter what the stimulus

Level III: Localized Response
- patient exhibits varying responses depending upon stimulus

23
Q

Rancho Levels I-III general description: _ functioning, _ _ care needs, _ _ engagement with?

A

Low Functioning, high acuity care needs, minimal cognitive engagement with their environment

24
Q

What level of Rancho Los Amigos scale is being described and give a general description: Confused Agitated, and confused and inappropriate

A

Level IV: Confused agitated (confused, edgy)

Level V: Confused Inappropriate (Less agitated but still confused)

25
Q

General Description of Rancho Levels IV-V: _ _ care needs, _ _ is needed for _, _ _ with their environment.

A

High acuity care needs
Constant supervision is needed for safety
Challenging interactions with their environment

26
Q

What is the description of Rancho Los Amigos levels VI and VII?

A

Level VI: Confused Appropriate

Level VII: Automatic appropriate

27
Q

General description of Rancho levels VI-VII: progressing with - and _, _ _ with their environment, _ _and _ is often still needed.

A

Progressing with self-care and mobility

Improving interactions with their environment

Frequent cues and assistance is often still needed (greater independence)

28
Q

Corresponding description and assistance levels for Rancho levels VIII-X

A

Level VIII: Purposeful Appropriate (Stand-by Assistance)

Level IX: Purposeful Appropriate (SBA on request)

Level X: Purposeful Appropriate (Moderate Indepence)

29
Q

General description of Rancho levels VIII-X: _ their own _ to _ _, often become _ as they become more aware, _ with _ _ to develop - skills.

A

Developing their own strategies to manage deficits

Often become depressed as they become aware

Progressing with all interactions to develop life-long skills

30
Q

What are the 3 main factors that affect rehabilitation?

A

Pre-morbid status

Family support and involvement

Insurance/ financial resources

31
Q

Cryotherapy, medications, maintaining blood flow and oxygen to the brain, and assignment of Glasgow coma scale are all?

A

Life-sustaining medical techniques used at the scene to minimize the extent of damage

32
Q

What are two common medical techniques to used reduce edema and inter cranial pressure in a patient with a TBI

A

Ventriculostomy or external ventricular drain

Craniectomy/ surgical decompression

33
Q

What are the following medications used for in patients with TBI: Dilantin, baclofen/ Botox, Haldol, Ritalin/ adderall, and Valium/ Paxil

A

Dilantin- seizures

Baclofen/ Botox- spasticity

Haldol- Antipsychotics

Ritalin/ Adderall- Psychostimulants

Valium/ Paxil- anti-anxiety/ anti-panic

34
Q

What are these medications used for in patients with TBI: Atenolol, Tramadol, Ambien, Paxil/ Prozac, Reglan, Lithium

A

Atenolol- dis inhibited behavior

Tramadol- pain

Ambien- sleep

Paxil/ Prozac- anti-depressant

Reglan- nausea/ gastric stasis

Lithium- mood stabilizer