TBI
A 15 point scale for estimating and
categorizing the outcomes of brain injury. It measures motor response, verbal response, and eye movement response.
What Is Glascow Coma Scale?
Priority intervention for a MVA patient with possible SCI on cervical collar admitted in the ER.
What is airway patency and breathing
Lack of oxygen in the brain for a transient period.
The highest risk factor for CVA/ Stroke.
Other risk factors for CVA
What is TIA?
What is hypertension?
What is smoking, hyperlipidemia, uncontrolled diabetes, AFIB
1) Most severe of the spinal cord injury levels. Paralysis in arms, hands, trunk and legs. Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements.
2) Corresponding nerves control arms and hands. A person with this level of injury may be able to breathe on their own and speak normally.
1) What is High-Level Cervical Nerve Injury (C1-C4). Quadriplegic. Ventilator dependent.
2) What is Low-Level Cervical Nerve Injury (C5-C8)
A swelling in the wall of a weakened blood vessel in the brain, resembling a blister.
Also known as tic douloureux, is a type of chronic pain disorder that involves sudden, severe facial pain. It affects the trigeminal nerve, or fifth cranial nerve, which provides feeling and nerve signaling to many parts of the head and face.
What is brain aneurysm?
What is trigeminal neuralgia?
This abnormal posturing involves adduction and extension of the arms and pronation of the hands and the fingers will be flexed along with extended legs and plantar flexion of the feet. It's the worst posturing in a TBI patient.
What is decerebrate posturing?
T1) This is needed with a Glasgow Coma Scale of 8 and lower.
2) The MOST frequent cause of autonomic dysreflexia AD.
1) What is intubation?
2) What is distended bladder?
1) Sudden or new hemiparesis or unilateral weakness, arm drift, Facial and smile dropping, speech impairment.
2) I have the worst headache of my life and my blood pressure is out of the roof!
3) We need this immediately with onset of CVA symptoms.
1) What is signs/symptoms of Thrombolytic stroke CVA?
2) What is hemorrhagic stroke?
4) What is Brain CT-Scan?
1) Corresponding nerves affect muscles, upper chest, mid-back and abdominal muscles. Arm and hand function is usually normal. Injuries usually affect the trunk and legs(also known as paraplegia). Most likely use a manual wheelchair
2) This patient suffers the above (paraplegia) plus little or no voluntary control of bowel or bladder but can manage on their own with special equipment
1) What is Thoracic T1-T5 Injury
2) What is Thoracic T6-12 Injury
In this neurological disorder, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. This happens in the central nervous system.
A fatal type of motor neuron disease characterized by progressive degeneration of nerve cells in the spinal cord and brain. It's often called Lou Gehrig's disease, after a famous baseball player who died from the disease. it is one of the most devastating of the disorders that affects the function of nerves and muscles. Progression of disease causes trouble breathing, swallowing and paralysis.
What is Multiple Sclerosis?
What is Amyotrophic Lateral Sclerosis (ALS)?
1) In this TBI posturing, there will be adduction and flexion of the arms and the hands will be closed shut (flexed). The legs will be rotated internally and feet flexed.
2) No motor response to painful stimuli, no verbal response and eyes open to pain.
1) What is decorticate posturing?
2) What is GCS 4?
Give this medication within 8 hours of SCI to decrease secondary injury from edema and ischemia. The side effect of medication is hyperglycemia and increase risk for infection and GI bleed from stress ulcers.
What is methylprednisolone?
A field loss deficit in the same halves of the visual field of each eye, often resulting from cerebrovascular injury or tumor or inflammation. This usually occurs as a result of a middle cerebral or posterior cerebral artery stroke and causes. one sided neglect.
What is Homonymous Hemianopsia
Injuries generally result in some loss of function in the hips and legs. Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment. Depending on strength in the legs, may need a wheelchair and may also walk with braces. Flaccid neurogenic bladder and Hypotonia (decreased muscle tone) PRESENT.
What is Lumbar Nerves L1-L5 Injury
This disorder occurs in the peripheral nervous system where the body's immune system damages nerves. The damage to the nerves causes sudden muscle weakness and sometimes paralysis. The syndrome often follows infection with a virus or bacteria. Priority intervention is airway maintenance and respiratory status monitoring.
What is GBS (Guillain-Barré syndrome)?
1) A complication of traumatic brain injury that requires monitoring and precaution.
2) Treatment include hyperventilation, elevation of HOB and mannitol administration.
1) What is Seizures?
2) What is ICP?
1) DVT, SPINAL SHOCK, NEUROGENIC SHOCK, AUTONOMIC DYSREFLEXIA AND RESPIRATORY FAILURE.
2) This complication results from autonomic nervous system disregulation following injury above T6. This is because of loss of sympathetic nervous system activities with increased unopposed parasympathetic nervous system activities leading to Bradycardia, hypotension, flushed and warm skin. Tx includes IV Fluids, vasopressors and atropine.
3) In this complication extreme HTN is seen after SCI due to excitation of a stimuli in the body that causes a sympathetic response and the parasympathetic nervous system is unable to abate it. Tx; seat patient up, foley catheterization to remove bladder distention and removal of fecal impaction. Avoid kinks in foley and wrinkled sheets to prevent complication.
1) What Is SCI complication?
2) What is Neurogenic Shock?
3) What is Autonomic Dysreflexia?
1) No aspirin, no heparin, no warfarin, no thrombolytics, bedrest, neuro-checks and seizure precautions, prevent sensory overload, cluster care.
2) Thrombolytics first 4 hours from the onset of symptoms.
3) Speak in a normal tone/voice, do not complete task and allow time for completion, NPO till able to swallow, soft diet not regular, PT/OT, dress weak area first.
1) What is hemorrhagic stroke interventions?
2) What is priority intervention for thrombolytic stroke?
3) What is convalescent/Post stroke interventions?
1) This spinal cord injury level MOST likely will be able to walk.
2) Steroids, analgesics, muscle relaxants (decrease muscle spasms), laminectomy, spinal fusion, therapeutic hypothermia, spine stabilization, airway maintenance, halo- traction device (move as a unit), monitor for complications herrmorage, neurogenic shock and autonomic dysreflexia), screw driver attached to vest with pt on halo.
What is Sacral Nerves S1-S5 Injury?
What is SCI multidisciplinary interventions?
1. This is a chronic autoimmune disorder in which antibodies destroy the acetylcholine receptors at the neuromuscular junction inhibiting communication between nerves and muscle, resulting in extreme weakness of the skeletal muscles. It affects the voluntary muscles of the body, especially those that control the eyes, mouth, throat and limbs. Tensilon test used to differentiate it from cholinergic crisis. Characterized by periods of exacerbation and remission. Tension makes it better BUT makes pt with cholinergic crisis worse. Thymus gland removal helps.
2. A disorder of the central nervous system that affects movement, often including tremors. Nerve cell damage in a part of the brain causes dopamine levels to drop, leading to the classic triad (motor features) - resting tremor, “cogwheel” rigidity, and bradykinesia. Also results impaired posture and balance.
What is Myasthenia Gravis (MG)?
What is Parkinson’s Disease (PD)?
1) This refers to a set of signs that are indicative of increased intracranial pressure (ICP), or increased pressure in the brain. It consists of bradycardia (also known as a low heart rate), irregular respirations (Cheyne Stokes breathing), and a widened pulse pressure (Hypertension).
2) This medication is given to decrease gastric irritation due to stress response of the body during TBI.
1) What is Cushing's triad?
2) IV Famotidine (Pepcid)-Histamine H2 Receptor Antagonist
1) Bed in low position with side rails up and padded, suction machine readily available, maintain low stimulus environment.
2) Anticoagulants, antiplatelets, hydration, pneumatic compression devices, antiembolic stockings, early ambulation/ROM exercises.
1) What is seizure precaution?
2) What is DVT prophylaxis?
2) This is a non-fluent aphasia in which the output of spontaneous speech is markedly limited and there is a loss of normal grammatical structure.Patient can comprehend but cannot express.
1) This aphasia causes you to speak in a jumbled “word salad” that others can't understand. Patient cannot receive interpretation of words/phrases from brain.
1) What is Broca's aphasia?
2) What is Wernicke's aphasia?
Injuries generally result in some loss of functionin the hips and legs. Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment. Most likely will be able to walk.
What is Sacral Nerves (S1 – S5) Injury?
J1) Multiple Sclerosis (MS) has periods of relapsing and remission. True or False?
2) Guillain-Barré syndrome (GBS) has unilateral muscle weakness. True or False?
3) This medication is given to determine myasthenia gravis crisis or cholinergic crisis.
4) A neurological disorder that causes paralysis or weakness on one side of the face. One of the nerves that controls muscles in your face becomes injured or stops working properly. Symptoms include: Sudden weakness or paralysis on one side of your face. A drooping eyebrow and mouth. A viral infection is the MAIN cause.
1) True
2) False- Have symmetrical muscle weakness
3) What is tensilon or edrophonium?
4) What is Bell's palsy?