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82 Cards in this Set
- Front
- Back
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Meninges
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Dura Mater
Arachnoid Mater Pia Mater |
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Frontal Lobe Divisions
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1. Primary motor cortex
2. Premotor cortex 3. Prefrontal cortex |
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Primary motor cortex
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activating and controlling (gross) motor acts
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Premotor Cortex
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-Complex and skilled movements
- speech, hand and finger movement |
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Frontal Lobe Functions
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- how we know what we are doing within environment
- how we initiate activity in response to env. - judgements we make about daily activities - controls emotional response - controls expressive language - assigns meanings to words we choose - involves word associations - memory for habits and motor activities |
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Frontal Lobe Functions
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- how we know what we are doing within environment
- how we initiate activity in response to env. - judgements we make about daily activities - controls emotional response - controls expressive language - assigns meanings to words we choose - involves word associations - memory for habits and motor activities |
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Frontal Lobe Disorders
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-Paralysis-inability to move various parts
-Sequencing-difficulty planning a sequence of cognitive or motor steps -Transcortical Motor Aphasia- loss if spontaneity in communicating with others -Loss in flexibility in thinking |
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Frontal Lobe Disorders cont.
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-Perseveration-persistance of a single thought
-Attending- Inability to focus on a task -Emotionally Labile-Dramatic mood changes - changes in social behavior and personality -Broca's Aphasia- inability to express language |
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Broca's Aphasia
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Production
-Speech is slow, laborious, and halting -Phonetic distortions -Perseveration -Agrammatism or telegraphic speech -Dysprosody -Lots of fillers |
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Broca's Aphasia cont.
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-Relatively good comprehension and reading
-Poor repetition -Writing --They often write as talk --Slow and Laborious --Frequent missspellings and letter omissions --Often slant down across page --Rarely write in cursive |
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Parietal Lobe Functions
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-Gross sensation of pain, temp, touch, etc
-Reading -Naming -Calculations and arithmetic - Cross modal integration of senses |
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Parietal Lobe Disorders
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-Contralateral Neglect
-Motor Apraxia -Tactile agnosia -Inability to judge spatial relationships -Anomia-inability to name an object -Agraphia-difficulties with writing -Alexia-difficulties with reading Dyscalculia-Difficulty with doing mathematics |
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Occipital Lobe Functions
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Visual Processing
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Occipital Lobe Disorders
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-Contralateral visual field neglect
-Difficulty with locating objects in environment -Color agnosia-difficulty identifying colors -cortical blindness-confabulate descriptions and scenes |
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Temporal Lobe
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Structures or areas that are specialized for communication
-Heschl's gyrus -Wernicke's area -Arcuate Fasciculus |
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Heschl's gyrus
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cortical center for hearing
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Wernicke's area
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Language comprehension area
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Arcuate fasciculus
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Axonal bundle connecting Wernicke's area to Broca's area
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Temporal Lobe functions
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-Hearing ability
-Language Comprehension -Lexical categorization -Memory encoding |
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Temporal Lobe Disorders (Left Hemisphere)
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-Hearing/Comprehension deficits
-Aphasia -Demetia (deficits in memory) -Sexual dysfunction -increased aggression and agitation |
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Temporal Lobe Disorders (Right hemisphere)
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-Nonverbal memory
-Loss in ability to discriminate tones/musical ability -deficits in attention -difficulties with humor and inferences -pragmatic impairment (turntaking and code switching) |
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Wernicke's Aphasia
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Production
-fluent -semantically inappropriate -paraphasias are common -sometimes called "cocktail hour speech" |
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Wernicke's Aphasia Production cont.
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- Augmentation- complicating repeated utterance by adding words and paraphrases
-prosody still intact--content of speech sounds normal, if ignoring content - Articulation is normal -Empty speech |
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Empty speech
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-Subts. general words without referents for more specific words
-- ex. patient with moderate W.A. describing shopping trip :"I went down to the thing to do the other one and she was only the last one that ever did it." |
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W.A. Production
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-Empty Speech
-Jargon - Logorrhea or press speech -Circumlocution -Word finding |
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Jargon
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-strings of neoligism with scattered connected words
ex. explaining what the patient had for breakfast "That's frinking the ambuvali binai the frigilator." |
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Logorrhea
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-Phenomenon characterized by continued talking, with little or no turn taking. Clients often have to be interrupted
- Aka: Press Speech |
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Circumlocution
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-Behavior where patient talk's around missing words, knowing the concept but not the word
ex. Breakfast "This morning for-that meal-the first thing this morning-what I ate-I dined on- chickens, but little- and pig-pork-hen frut and some bacon, I guess." |
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Wernicke's Aphasia: comprehension
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-Comprehension is usually impaired. In severe casses patients may not understand single words
-Language spoken or in visual form -May have pure word deafness or blindness |
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Wernicke's Aphasia: repetition
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-Fluent
-Grossly restricted span |
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Wernick'es Aphasia
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-Writing resembles their speech
--the letters are well formed and legible, but it often doesn't make sense. Most use cursive -Paraphasias in speech usually show up in writing, too - logorrhea also occurs in writing |
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Wernicke's Aphasia
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Anosognosia: Patients tend to show a lack of awareness or outward concern about their communication problems
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Limbic Lobe
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Autonomic functions
-food and water intake -body temperature Homone and neurotransmitter release |
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Pathway of Blood #1
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Heart-Aorta-Both sides of subclavian artery-up carotid artery-branches off-internal carotid artery-circle of willis
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Pathway of Blood #2
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Heart-Aorta-Both sides of sublavian artery-vertebral artery up cervical vertebrae- eventually come together at basilar artery
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Neurodiagnostic Techniques
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:X-Ray:
-Structural -Radiation (film) -2-D, not very detailed -Grey scaled according to detail -Inexpensive 0sometimes used with radio-opaque dyes |
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Neurodiagnostic Techniques
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:CT Scan (Computerized tomography):
-Structural -Radiation --narrow rad. beam generators rotate axially around patient --radiation detectors instead of film used to analyze rad. beams --scanner moves up or down body in regualr steps creating series of image "slices" 3D average detail -permits visualization of soft tissues not available from regular X-ray |
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Neurodiagnostic Techniques
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:MRI (Magnetic resonance imaging)
-Structural -No radiation -3-D, high detail -Relatively expensive -Pace-makers and metal objects interfere with scan |
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Neurodiagnostic Techniques
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:PET Scan Positron Emission Topography:
-Functional -Some radiation -glucose is tagged with a radio-isotope -3-D,average -Color coded |
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Neurodiagnostic Techniques
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:EEG (Electroencephalogram):
-Measures brain electrical activity; time varying voltages occurring at different frequencies -functional measure -no radiation -poor spatial resolution, good temporal resolution |
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Neurodiagnostic Techniques
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:ERP (Evoked related potential)
-changes in the electrical activity of the neurons that are temporally associated with physical stimulus or psychological processes -either negative or positive peaks -Hard to tell ERP from EEG, so they average episodes of the same task |
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CNS: Neurons
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-Basic building blocks of the CNS
-15 billion in CNS -Three basic sections --dendrites --cell body --axon |
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Neurotransmitters
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Acetylcholine
-major chemical messenger that controls voluntary movements -acetylcholinestrase -Myasthenai gravis |
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acetylcholinestrase
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breaks down and dissolves acetylcholine in the synaptic gap
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myasthenia gravis
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disease characterized by muscle weakness that becomes worse with exercise
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Dopamine
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-facilitates motor function
-parkinson's disease: tremor, reduced movement, dysarthria -some recreational drugs (LCD) cause excessive dopamine release -El Dopa |
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Norepinephrine
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-regulates sleep, attention, and moods
-treatment of depression |
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Seratonin
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-regulates sleep, emotion, pain
-95% serotonic found in the PNS |
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GABA (glutamate aminobutyric acid)
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regulates pain perception
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Peptides (larger molecules)
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regulates pain perception
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Types of Cells:Neuroglia
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-to suppor and protect the neurons
-40-50 times the number of neurons -4 types in the CNS 1. Astrocytes 2.Oligodendrocytes 3. Microglia 4. Ependymal cells |
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Astrocytes
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-form supporting network in brain
-form blood vessel to provide the blood-brain barrier -form scar tissue around dead brain cells |
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Oligodendrocytes
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myelinate axons in the CNS
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Microglia
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-Scavengers of the CNS
-Engulf dead brain tissue and remove it form the lesion site |
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Ependymal Cells
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-contribute to blood-brain barrier
- form lining inside the ventricles where the choroid plexus secrete CSF |
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Brain's Protective Systems
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-scalp
-skull -dura mater -blood-brain barrier -cerebral spinal fluid (CSF) -collateral circulation |
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Brain's Vulnerabilities: Acute events and processes
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Brain requires constant supply of oxygen and glucose
- especially intolerant of sudden decreases in Oxygen, which are often signaled by a rapid decrease in cognitive functioning |
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Fact
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Without oxygen, brain tissue can become necrotic (dead) in 3-5 minutes
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Necrosis:
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death of tissue
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Infarct
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Necrosis of brain tissue caused by lack of oxygen (sometimes used to refer to a specific type of stroke)
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Stroke or Cerebrovascular accident (CVA)
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-500,000 per year
-3rd leading cause of death in US -2 million people living stroke survivors in the US -85% usually return to their pre-stroke living environment, most with some impairment of the ADL's (activities of daily living) |
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1st major classification of CVA
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Ischemic 80%: Occlusion within an artery causing decreased overall blood flow; artery walls stay intact.
1. Thrombosis 2. Embolism 3. TIA (transient ischemic attack) |
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Thrombosis
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Insidious process: gradual occlusion of artery, usually by plaque or fatty buildup in areas of slowed blood flow or bifurcation
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Embolism
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Acute process: artery is occluded by a mass flowing in the bloodstream, often a distrubed piece of plaque or fatty buildup
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TIA
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transient ischemic attack (AKA Mini clots)
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2nd major classification of CVA
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Hemorrhagic (20%): decreased overall blood flow caused by a rupture in the vessel wall
1. intracerebral ---aneurysm ---elevated BP ---Arteriovenous malformation (AVM) 2. extracerebral ---epidural hematoma ---subdural hematoma |
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Intracerebral
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often regions of brainstem
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Aneurysm
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Ballooning or weakness in vessel wall, usually genetically determined
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arteriovenous malformation (AVM)
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malformed or tangled mass of arteries and veins, usually genetically determined
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Extracerebral
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bleeding into the spaces between the meninges, often casued by traumatic brain injury or TBI
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Epidural Hematoma
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bleeding between the dura mater and the skull
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subdural hematoma
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bleeding between the dura mater adn teh arachnoid membrane
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TBI: Traumatic Brain Injury: Incidence
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-7 million incidents each year in the US
-2/3 caused by MVA (motor vehicle accident, most of rest by falls and assault |
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TBI: Traumatic Brain Injury: Prevalence
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Males>Females
-Most commonly occurs with individuals who are 15-25 yrs. of age |
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Risk Factors for TBI
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-Alcohol and drug abuse
-school adjustment and social history -socioeconomic status -personality type: A>B -Previous history of TBI -Participation in Sporting events |
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Present high risks for TBI
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1. Boxing
2. Motorcycling 3. Bicycling 4. Rock-Climbing 5. Horse-riding 6 Hockey 7. Football |
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First Major classification of TBI
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Penetrating:Perforates or fractures the skull and penetrates brain tissue
- damage focal in nature - mortality rate high if in brainstem area - if survival, good prognosis for recovery |
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Second major classification of TBI
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Non-penetrating (closed head): skull stays intact
1. non-acceleration injury 2. acceleration injury |
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Non-acceleration injury
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head is not moving at the time of impact
--impression trauma: skull deforms at point of impact |
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Acceleration injury
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Head undergoes a sudden increase or decrease in motion
a. linear acceleration injury b. angular acceleration injury |
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linear acceleration injury
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linear path acceleration though center axis
- coup/contre-coup |
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angular acceleration injury
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off center acceleration causing a rotation of skull nad brain
--diffuse axonal injury (DAI) |
