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57 Cards in this Set
- Front
- Back
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most common causes of TBI |
falls MVA assults or sports men ages 1-2 15-24 elderly6 |
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what are the ways to classify brain injury |
open closed primary secondary blast |
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what causes primary injury |
conact with an object or rapid acceperation causing cortical disruption causing shear tensile and compression forces lstabbing or shooting |
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blast injury |
military explosive tetinates shockwave |
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secondary injurt |
what happens because brain tissue got injured swelling cerebral edema ICP hypoxia hypo hypertension |
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drownings or heart attacks lightening toxins |
aquired brain injury or noxic lack of oxy or brain tissue all over the brain |
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brain contusion |
where the brain hit the skull |
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coup and couter coup |
coup initial hit counter where brain rebounds |
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complete paralysis of all voluntary muscles except eyes |
locked in can happen after TBI |
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secondary symptoms |
ICP seizures het oss, PSH or storming, cerebral spinal fluid leak |
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normal and not for ICP |
5-10 mmhg normal >20 ab |
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hings that increase icp |
cervical flex coughing vibration or percussion techniques |
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ICP leads to |
less artierial blood to the brain and brain tissue comprimised |
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signs of icp |
headache sleepy pupil bp increase hr decrease rr decrease |
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seizures more common with what |
open head injurysubdural hematoma older people |
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paroxusmal sympathetic hyperactivity storming |
sympathetic response overactive tachycardia hyperthermia postures teeth grinding |
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cerebral spinal leak |
clear drainage from ears or nose change in vision or hearing dramatic difference in function |
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TBI treatment |
steroids, antibiotics, surgery for ICP |
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tbi diagnostic tests |
ct mri doppler cerebral angiography etc |
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glascow coma scale where they dont survive |
3-4 |
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8 or less on glasgow |
severe TBI |
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13 or higher on glascow |
mild tbi |
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9-12 glascow |
oderate |
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high number of crs-r means what |
cognitively mediated behaviors |
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lower numbers on crsr |
reflex mediated behaviors |
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why is crsr more acurate |
picks up small meaningful changes |
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rancho 4 5 6 |
awake but confused agitated or inappropriate |
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rancho 123 |
coma vegiie minimal conscious |
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rancho 7 8 |
back in community on own |
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level one rancho |
coma |
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rancho 2 |
veggie sleep wake cycle |
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rancho 3 |
wake up but groggy |
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what do for rancho 123 |
orient tell whats going on like theyre awake make them do things to wake them up |
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rancho four |
confused agitated awake but not safe angry toddler |
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What are the six subscales for CRSR |
auditory, visual, motor, verbal, communication, arousal |
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CRSR high scores mean what |
cognitively mediated behaviors |
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what is rancho scale used for |
measure and describe a patinets level of cognitive function |
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what level: coma no response total assistance no sleep wake cycles no eyes opening |
level one |
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level: vegitiative state generalized response total assistance general pain response |
2 |
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level minimally conscious/ localized response total assistance follows a moving object with eyes on and off awake may recognize family and friends turns away from pain |
3 |
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level confused agitated max assist heightened state of activity poor attention span mood swing agression fighting |
4 |
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level: confused; inappropriate non agitated maximal assistance alert but not agitated can become agitated no goal directed problem solving may perseverate |
5 |
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level: confused appropriate mod assist inconsistently oriented able to use assistive memory aid may be able to pay attention unaware of impairments |
6 |
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level automatic appropriate minimal assistance able to pay attention for 30 minutes demonstrated carryover of new learning minimal supervision needed unaware of others needs and feelings aware of their impairments kindof but still not safe |
7 |
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level: purposeful appropriate SBA to modified independent consistently oriented able to recall past aware of issues and can self correct thinks about consequences acknowledges others’ feelings still can be easily angered |
8 |
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what do you work on in rancho 123 |
talk to them like normal tell them what you are doing orient them family bring pictures |
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what to focus on rancho 456 |
orient the patient room quiet and calm repeat things simple commands personal items |
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things to focus on with 7 and 8 rancho |
encourage patient to be independent as possible provide guidance and assistance Dual tasking motor learning |
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what are the cognitive deficits of TBI |
disorientation attention span loss of memory loss of executive function poor planning and organizational skills inability to control emotional response |
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motor deficits for TBI |
decerebrate decorditate weak, abnormal tone difficulty with motor sequence ataxia and bad balance |
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communicaton deficits with TBI |
aphasia reading comprehension written comprehension language skill deficits dysarthria |
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neurobehavioral deficits |
anxiety psychosis sexual disinhibition aparthy, iritability lability agression impulsive mental inflexibility persoality changes |
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what are these contractures, skin breakdown, HO, DVT decreased bone density atrophy enduracne infection pneumonia |
complications of TBI |
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what is important about positioning with tbi |
dependent on resting posture, mm tone present, presence of primitive reflexes, respiratory status tilt in space wc as soon as medical status is stable, get them up |
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important things ab range of motion |
prevent contracture or HO functional positions serial casting |
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activities to increase awareness |
important even when patient is in a coma sume they can hear you and orient them explain what youre doing refer to stuff they are familiar with |
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how to pace strength and endurance stuff with tbi |
head and trunk control emphasis at first progress to distal extremitites start functional |
