Understanding Traumatic Brain Injury: Incidence, Effects, and Treatment, Exams of Health sciences

Download Understanding Traumatic Brain Injury: Incidence, Effects, and Treatment and more Exams Health sciences in PDF only on Docsity! CBIS Exam-with 100% verified solutions-2023-2024 * Glasgow Coma Scale (GCS) 3-8 Severe TBI; normal or abnormal structural imaging. LOC over 24 hours, post traumatic amnesia over 7 days * Glasgow Coma Scale 9-12 Moderate TBI; LOC over 30 minutes but less than 24 hours; alteration of consciousness over 24 hours, post traumatic amnesia more than 1 day but less than 7 days * Glasgow Coma Scale 13-15 Mild TBI; normal imaging; LOC 0-30 minutes, alteration of consciousness up to 24 hours, post traumatic amnesia up to 1 day * 3 parts of neuron Cell body Axon Dendrites * 2.5 million TBIs 53,000 deaths (2%) 284,000 hospitalizations (11%) 2,214,000 ED visits (87%) * Coup-contrecoup When the brain accelerates in one directions, it rebounds in the opposite direction * Acquired Brain Injury An injury to the brain that is not hereditary, congenital, degenerative or induced by birth trauma * Traumatic Brain Injury An alteration of brain function or other evidence of brain pathology caused by an external force * Incidence Rate or range of occurrence * Prevalence Number of people with a given condition at a specific point in time * What determines the effects of brain injury? Injury severity Age at injury Alcohol misuse Domestic violence Service in military Participation in sports * Concussion Mild TBI caused by bump, blow or jolt to head that can change the way the brain works (or a fall) Can occur in any sport or recreation activity Memory loss May or may not lose consciousness * 2.5 million people sustained TBI in 2010 ... * Brain Stem Top of spinal column Central point for all incoming and outgoing information and basic life functions * Limbic System Emotions and basic feelings Pia Mater 3rd layer of meninges; molds around sulci and gyri of brain Synapse Junction between cells Action Potential Electrical impulse fired Brain stem areas Medulla Pons Midbrain Cerebellum Lower back section of brain Coordinates, modulates and stores all body movement Occipital Lobes Primary visual center Visual cortex connected to eyes by optic nerves Interprets visual info (recognize size, color, light, motion, dimensions) Occipital Lobe Damage Visual-pereptual-motoric distortions Neuroplasticity Brain can adapt and reorganize due to environment around it or due to cell death Nervous system changes itself, forms new connections and creates new neurons to compensate for injury or adapt to changes in environment Restorative approach Polytherapies The use of more than one treatment method in a combined therapeutic approach; may provide better results Plasticity A change in the expression of genes or proteins related to neuroplasticity Constraint Induced Movement Therapy Contrain unaffected limb for first 2 weeks post injury, plasticity in cortex opposite stroke is eliminated Encourages greater use of impaired limb Axonal Shearing Axons are twisted and disconnected; functional abilities diminished Tension type Headache Bilateral head pain; tight hat or vice clamping around head Tx with NSAIDs and low load craniocervical mobilization Cervicogenic Headache Head pain generated from cervical spine Can provoke headache through movement or manipulation of neck Tx with manual therapies or nerve injections Post-traumatic Migraine Episodes of headaches with different phases Prodrome-> aura -> headache -> post drome Typically unilateral, throbbing, stabbing or sharp pain Tx with triptans, NSAIDs, dark room, quiet environment Neuralgia Pain caused by damage to nerve or structural change in nerve Standard Precautions Hand hygiene, PPE, respiratory hygiene, safe injection and disposal of sharps, cleansing of equipment, isiolation Awareness An individual's ability to receive and process information and use that information to relate to an intentional way to the outside world Regulated by higher cortical areas in cerebrum Costs of Brain Injury Lost productivity Insufficient or inappropriate diagnosis, treatment and care CDC Centers for Disease Control Carries out projects to reduce the incidence of TBI Brain Injury is a silent epidemic Person looks normal Under diagnoses, unreported Problems at work/school, changes in personal relationships, legal problems, homelessness Public Funding of TBI Medicaid Medicare Patient Protection and Affordable Care Act 2010 Engaging in behaviors on impulse without reflecting on potential future consequences Increased lability, social inappropriateness, depression, apathy Fatigue mTBI Common symptom Mental exertion not physical Altered sleep pattern Limit overall activity for 2-4 weeks Vision Changes mTBI Impaired motor control-> blurred vision Convergence insufficiency -> cannot focus Orthostatic Hypotension Drop in blood pressure upon standing Change in balance Benign Paroxysmal Positional Vertigo (BPPV) Vestibular disorder Inner ear and visual/spatial and proprioceptive centers Nystagmus Epley maneuver to correct Sleep Disturbance Management Sleep hygiene education: proper sleep ritual, bedroom environment, diet Neuropsychologists Assess cognitive and psychological functioning EI: education and reassurance Make recommendations for therapies for improved tx Monitor return to work or school Treat emotional problems The management and treatment of mTBI is a serious matter that requires a well rounded diagnostic and treatment approach. A concussion creates changes to the chemical and physical structures of brain which should be monitored to ensure full recovery. Review any lingering symptoms. ... Intrathecal Baclofen (ITB) Severe spasticity Used only when there is a poor response to oral meds Works at level of spine to inhibit excitatory activity at spinal reflexes Pump considered after 1 year Botox Injected into muscles and used to treat increased muscle stiffness (elbow, wrist, fingers typically) Contractures Fixed loss of PROM of joint due to pathology of connective tissue, tendons, ligaments, muscles, joint capsules and cartilage Early mobilization, ROM, positioning, orthotics Heterotopic Ossification Formation of new bone around joints Decreased ROM, increased spasticity, increased pain Commonly occurs on side where spasticity is worse Obesity following TBI During initial recovery and poor nutritional state weight gain is the goal Decreased mobility; unable to burn off calories Weight gain can cause poor fitting equipment Atrophy Due to time without use Decrease in muscle bulk Ataxia Caused by injury to cerebellum Lack of muscle coordination during voluntary movements Movement Dysfunction Bed mobility Transfers Gait Balance Rarely exists in isolation: visual, perceptual, vestibular, and somatosensory symptoms combined Concomitant SCI Cooccurring SCI with brain injury 60% Complete SCI No motor or sensory function below level of injury Incomplete SCI Functioning of sensory and possibly some or much motor sensation below level of injury Pressure Sores Impaired sensation Decreased ability to reposition Perform skin checks frequently-especially bony prominences Hyperreflexia Involuntary increase in muscle tone and exaggerated deep tendon reflexes Osteoporosis Diminished levels of estrogen and testosterone Vulnerable to falls and injuries Incontinence Presence of bilateral central lesions Damage to pedundal nerve and sacral nerve roots UTI Occur early and late post injury Cognitive or behavioral changes Maintain hydration, timed voiding