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24 Cards in this Set

  • Front
  • Back
What are some of the causes of TBI?
- MVA - 49%
- Assaults
- Falls
- Sports Injuries
- Industrial/Work Related
What are some ways that TBI is Classisfied?
- Blunt
- Sharp
- Compression
- Closed
- Open
- Severity
What are two types of Blunt TBI?
- Deceleration - you hitting something
- Acceleration - something hitting you
What is Closed TBI?
When the brain is traumatized, but it is not penetrated by anything
What is an Open TBI?
When there is an invasion of the Cranium and direct destruction of brain tissue
What is one way of measuring Severity?
By breaking TBI down into
- Mild - PTA 5"-1hr
- Moderate - PTA 1hr-24hrs
- Severe PTA 1day-7days
In relation to classifying severity of TBI, what does PTA stand for and mean?
PTA = Post Traumatic Amnesia
It is the period between the point of injury and when the person has a continuing awareness of surroundings/conciousness
What are the 3 aspects looked at in the Glasgow Coma Scale?
Eye Opening,
Motor Response
Verbal Response
What is the Scale in the Glasgow Outcome Scale?
1- Death
2- Vegetative - unable to follow commands or communicate
3- Concious, but requiring assistance to meet basic needs
4- Moderate Disability - Able to meet basic physical and cognitive needs
5- Good Recovery
What are the symptoms of Concussion?
- Headache
- Nausea
- Difficulty with concentration
- Depression
- Reduced Information processing speed
- Fatigue
- Irritability
What are the 4 Grades of Concussion?
Grade 1- transient confusion, some PTA
Grade 2- increased confusion & PTA
Grade 3- more pronounced confusion, RA & PTA
Grade 4- Classic concussion - brief LOC, variable confusion, RA, PTA
What are the 2 types of effect of TBI?
Direct
&
Secondary
What are the different types of Direct effect that TBI can have?
- Skull Fracture
- Hemorrhage
- Lesions to brain (Contusion, Laceration)
- Diffuse Axonal Injury
What are the Secondary Effects of TBI?
- Cerebral Edema or swelling
- Herniations of brain tissue
- Infarction
- Infection
What is an Extradural (Epidural) Haematoma?
Where there is a swelling of blood outside the Dura of the brain.
Common in MVA and Sports
Often the cause when people 'talk & die'
What is a Subdural Haematoma?
A collection of blood below the dura
It is more common in the elderly, and 50% are associated with skull fracture.
What is Diffuse Axonal Injury (DAI)?
When the axons in the brain have been twisted (pulled away from the synapse), torn or broken.
What is a Contusion
Where there is bruisin on the brain - often in the frontal and temporal regions.
Similar outcomes as concussion, but more marked.
Often contrecoup.
What are the guidelines for Treatment of acute TBI?
- Monitor carefully for subdurals
- Identify & manage comorbidities
- 'Track' clients when primary care is medical, surgical or orthopedic
- Assess function before discharge
- Avoid immobilisation
- Prevent re-injury
What are some Factors that Influence Prognosis of TBI?
- Age - younger better chance of survival and recovery
- Hypotension - 50% increase in mortality with single episode of Hypotension
- Hypoxia
- Delay in Treatment
What are does Recovery look like for TBI?
- Regular and consistent recovery curve
- Younger age associated with less difficulty
- Overlearned skills less disrupted
- Greater severity associated with more difficulty
- Interventions influencing extent and rate of recovery more effective early.
What are some of the Long-Term Consequences of TBI?
- Physical/Motor - usually best recover
- Communication - a fifth have language difficulties, more expressive than receptive
Cognitive - Attention, Memory, Information processing speed, Higher Executive Function
Behaviour - Irritability, Childishness, Reduced Emotional and Impulse Control, Denial/Lack of Insight, Depression - these are often the most difficult to deal with
What are some Factors affecting the Elderly with TBI?
- They have differences in presentation (.e.g delayed presentation, acute medical conditions may obscure it, etc)
- They have differences in pathophysiology - preexisting conditions (e.g. neurological disease)
- They have varied co-morbidities - Dementia, Alcoholism, Frontal Lobe Dysfunction, Prescription Drug Side Effects, Physical Disability, Sensory Impairment
- Need to be careful of falls for the elderly
What is the Grief Adjustment Process that will likely occur after TBI?
Shock - confusion, etc
Expectancy - extreme optimism, etc
Reality - depression, anger, etc
Mourning - awareness of permanence, grieving what might have been
Adjustment - readjust expectations, etc