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43 Cards in this Set

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  • Back
Define:
Concussion
dizziness, disorientation, blurred vision, difficulty concentrating, alteration in sleep pattern, nausea, headache, loss of balance
Define:
Contusion
bruising on surface of brain because small blood vessels hemorrhage at time of impact
Define:
Epidural hematoma
blow to one side of head or severe trauma from MVA. Period of unconsciousness, then become alert but blood continues to leak therefore will deteriorate when hematoma enlarges
Define:
subdural hematoma
usually in older adults after falls, blood leaks and accumulates slowly. Symptoms mimic CVA and fluctuate
Describe intracerebral hematoma
usually acceleration/deceleration b/c shearing of cortical blood vessels or beneath a fx
Causes of acquired brain injury
airway obstruction near downing, MI with hypoxic events, exposure to toxins, electrical shock (anything that decreases oxygen to brain) present as TBI with more global symptoms
what are the essential components of consciousness
Arousal and awareness
that are mechanisms that can alter consciousness
structural lesion caused by stroke, tumor, abscess, or trauma
Toxic/metabolic abnormalities (drug abuse, liver or renal failure or hypoglycemia or hyperglycemia
medications
anoxia (2nd to cardiac arret, SAH, concussion, DAI)
what are factors influence outcomes for coma
premorbid status= cognitive (intelligence, education, memory)
Personality= close relationships
Pre-exisiting condition
what is primary neurological damage
focal lesion, coup-countercoup injury, diffuse axonal injury, open vs closed
what increases intracranial pressure
cervical flexion, sidelying, excessive hip flexion, coughing, activities that increase blood flow, blood pressure or intrathoracic or abdominal pressure or that decrease venous return (valsalva)
what are the sxs of increased intracranial pressure
vomiting, headache, change in behavior or consciousness. or cushing's triad
what is cushing's triad
decrease HR, increased BP and irregular respiration
Describe what secondary neurological damage is
-increased ICP, with increased change of herniation
-hypoxic ischemia injury= compromised circulation due to shifting structures, or airway obstruction, trauma to chest, massive blood loss, cardiac arrest.
-post traumatic seizures= more common older adults, open head injuries, subdural hematomas
-intracranial infection, cerebral artery vasospasm, obstructive hydocephalus
-neurochemical changes=diffuse axonal injury has a surge or neurotransmitters that destruct neurons
what are events that can trigger seizure
stress, poor nutrition, electrolyte imbalance, missed medications, flickering lights, infection, fever, anger worry and fear
what are PT interventions that are contraindicated with TBI
vesticular stim techniques (fast spinning, irregular movements, acceleration/deceleration)
management of increased intracranial pressure
managing BP, sedation, removing CSF, ventriculoperitoneal shunting, keepig HOB 30-45 to increase cerebral venous drainage
what is midline shift
lateral displacement or falx cerebral b/c lesion occupying space
what is mass effect
midline shift, compressed third ventricle and hydrocephalus
For Ranchos los amigos what does the level indicate:
1
no response
For Ranchos los amigos what does the level indicate:
2
generalized response
For Ranchos los amigos what does the level indicate:
3
localized response
For Ranchos los amigos what does the level indicate:
4
confused-agitated
For Ranchos los amigos what does the level indicate:
5
confused-inappropriate
For Ranchos los amigos what does the level indicate:
6
confused-appropriate
For Ranchos los amigos what does the level indicate:
7
automatic-appropriate
For Ranchos los amigos what does the level indicate:
8
purposeful-appropraite
For Ranchos los amigos what does the level indicate:
9
purposeful-appropriate: stand-by assisstance on request
For Ranchos los amigos what does the level indicate:
10
purposeful-appropriate: modified independent
what are some signs of hydocepahlus
fixed and dialted pupil
how will a patient present if they are decorticate
flexed arms and extended LE
how will a patient present if they are
decerebrate
Extension of UE and LE
what are some cognitive deficits that are possible with TBI
altered consciousness, post traumatic amnesia, orientation, memory deficits, decreased attention spasm, easily distractible with decreased safety awareness, perseveration (repeating a task without know doing) high level function deficits
what are some behavioral deficits that may occur with TBI
sexual dis-inhibition, agitated, aggression, low frustrated tolerance, depression dependent and denial
What are some early goal interventions
increase patients level of arousal, patient function, patient education, family education and prevention of secondary impairment
what are the goals for level I-III management on the ranchos los amigos scale
prevent complications, increase level of interaction with environment, promote meaningful behavioral responses
what are some possible treatment/interventions for level I-III
chest PT, PROM and tone management, positioning, functional mobility, sensory stimulation
what are the goals for level IV management on the ranchos los amigos scale
maintain functional capabilities
what are some possible treatment/interventions for level IV
structure, prevent over stimulation, familiar and desireable activities, high success activities, pt and family education
what are the goals for level V-VI management on the ranchos los amigos scale
maximize functional capabilities
what are some possible treatment/interventions for level V-VI
focus on function and safety, follow command but decompensate if increase difficulty or decrease structure. Limited new learning, working towards consistent patient participation, motor deficits
what are the goals for level VII management on the ranchos los amigos scale
wean from structure and prepare to become part of community
what are some possible treatment/interventions for level VII
involve patients in decision making, emphasize judgment, driving and vocational rehab