MS 2 Prefinal Tbi, Sci Review Exam

Contusion injuries can indeed lead to damage to both the brain tissue and the blood vessels. A contusion injury refers to a bruise or a localized area of bleeding in the brain, which occurs when the brain tissue is directly impacted or collides with the skull. This can result in damage to the delicate brain tissue as well as the blood vessels that supply oxygen and nutrients to the brain. The severity of the damage can vary depending on the extent of the injury, but it is true that contusion injuries can cause harm to both the brain tissue and the vascular system.

The most common mechanism of spinal cord injury (SCI) is flexion, specifically caused by flexion force. Flexion refers to the bending or forward movement of the spine, while flexion force refers to the external force that leads to this bending. This type of injury occurs when there is excessive forward movement or bending of the spine, causing damage to the spinal cord. It is important to note that there are other mechanisms of SCI as well, such as extension, rotation, and compression, but flexion is the most common.

The correct answer is none because all of the other options (bore-holing, drainage, craniotomy) are potential surgical interventions for a patient with a significant hematoma resulting from a traumatic brain injury. "None" indicates that there is no surgical intervention required in this case.

Spasticity is the correct answer because it is characterized by hypertonicity, hyperactive stretch reflexes, and clonus. Hypertonicity refers to increased muscle tone, hyperactive stretch reflexes involve exaggerated muscle contractions in response to stretching, and clonus is the rhythmic contraction and relaxation of a muscle. These symptoms are all indicative of spasticity, which is a condition characterized by increased muscle stiffness and involuntary muscle contractions. Postural hypotension refers to a drop in blood pressure upon standing, spinal shock is a temporary loss of reflexes and sensation below the level of a spinal cord injury, and sacral sparing refers to the preservation of certain neurological functions in the sacral region of the spinal cord.

Spasmolytic agents are a type of medication used to treat spasticity in patients with spinal cord injuries. These agents work by reducing muscle spasms and promoting muscle relaxation. Examples of spasmolytic agents include diazepam, baclofen, and Dantrium. These medications help to alleviate the symptoms of spasticity and improve the patient's overall mobility and quality of life.

An altered pituitary gland can lead to SIADH (syndrome of inappropriate antidiuretic hormone secretion). SIADH is a condition in which the body produces too much antidiuretic hormone (ADH), causing the kidneys to retain water and dilute the blood. The pituitary gland plays a crucial role in regulating the production and release of ADH, so any alteration or dysfunction in the pituitary gland can disrupt this process and lead to SIADH. Therefore, the statement "Altered pituitary leads to SIADH" is true.

Brown-Séquard syndrome is a neurological condition caused by damage to one side of the spinal cord. It typically results in a loss of sensation and motor function on the same side as the injury, while preserving some sensation and motor function on the opposite side. Kinesthesia, which refers to the sense of body movement and position, as well as pain and temperature sensation, are not preserved in Brown-Séquard syndrome. Therefore, the statement that kinesthesia, pain, and temperature are not preserved in Brown-Séquard syndrome is true.

Post traumatic amnesia is a condition that occurs after a head injury and involves a loss of memory for events that occurred after the injury. It is often used as an indicator for the severity of the head injury, as the duration of post traumatic amnesia can vary depending on the extent of the brain damage. Therefore, the presence and duration of post traumatic amnesia can provide valuable information about the severity of the head injury and help guide treatment decisions.

The correct answer is "all of the above". Central herniation refers to the displacement of brain structures towards the central part of the brain due to increased intracranial pressure. This can lead to compression of various structures including the midbrain, pons, diencephalon, and the ascending reticular activating system. Therefore, all of these structures can be affected in central herniation.

Central Cord Syndrome is a neurological condition associated with congenital narrowing of the spinal cord. It is characterized by damage to the central portion of the spinal cord, resulting in motor and sensory deficits that are more pronounced in the upper extremities compared to the lower extremities. This syndrome is commonly caused by trauma or compression of the spinal cord, leading to impaired function of the nerve fibers that transmit signals between the brain and the body.

Autonomic dysreflexia is a condition characterized by a sudden and dangerous increase in blood pressure that can occur in individuals with spinal cord injuries. Dysuria, which refers to painful or difficult urination, is indeed one of the primary causes of autonomic dysreflexia. When individuals with spinal cord injuries experience bladder distension or urinary tract infections, it can trigger autonomic dysreflexia. This is because the body's autonomic nervous system overreacts to the pain or irritation caused by the urinary issue, leading to a rapid increase in blood pressure. Therefore, the statement "Primary cause of autonomic dysreflexia is Dysuria" is true.

The force directed to the spine can cause flexion force, which can result in an anterior vertebral body fracture.

The statement that the most common and fatal consequences of multiple small hemorrhages is amnesia is false. While multiple small hemorrhages can certainly lead to cognitive impairments, such as memory problems, amnesia is not the most common or fatal consequence. Multiple small hemorrhages can result in a range of neurological symptoms depending on their location, including weakness, numbness, difficulty speaking, and changes in personality. Severe cases can even lead to coma or death. However, amnesia is not specifically associated with multiple small hemorrhages and may be more commonly seen in other conditions such as traumatic brain injury or certain types of stroke.

The given answer, Level IV, suggests that the patient's gait, motor, and postural control are impaired, but their safety with functional mobility tasks and activities of daily living (ADL) skills has improved. This means that although the patient still has difficulties with certain physical functions, they have made progress in their ability to perform daily tasks safely.

The statement that common sites of focal brain injury are the anterior-inferior temporal and parietal lobe is false. Focal brain injuries can occur in various locations depending on the specific circumstances and mechanisms of injury. While the anterior-inferior temporal and parietal lobes can be affected in some cases, they are not universally the most common sites of focal brain injury. The location of a brain injury depends on factors such as the nature of the trauma and the individual's specific anatomy.

Contractures are not a common secondary complication of spinal cord injury (SCI). Contractures refer to the permanent shortening and tightening of muscles and tendons, leading to limited range of motion in joints. While contractures can occur in individuals with SCI, they are not one of the most common complications. The three most common secondary complications of SCI are deep vein thrombosis, pneumonia, and decubitus ulcers (also known as pressure ulcers or bedsores). Deep vein thrombosis is the formation of blood clots in deep veins, pneumonia is a lung infection, and decubitus ulcers are skin breakdown due to prolonged pressure on specific areas of the body.

Sacral sparing refers to the preservation of sensory and motor function in the sacral segments of the spinal cord, while other segments may be affected. In this case, the presence of perianal sensation and external anal sphincter contraction suggests that the sacral segments are spared from damage. This could be due to a lesion or injury higher up in the spinal cord, which affects other segments but leaves the sacral segments intact.

The correct answer is "Uncal and Transitional only." Tentorial notch lesion refers to damage or pressure on the tentorium cerebelli, a membrane that separates the cerebrum from the cerebellum. This can lead to herniation, which is the displacement of brain tissue. In this case, the tentorial notch lesion specifically causes uncal herniation and transitional herniation. Uncal herniation occurs when the uncus, a part of the temporal lobe, is pushed downward and compresses the brainstem. Transitional herniation refers to the displacement of brain tissue through the tentorial notch. Therefore, the answer "Uncal and Transitional only" accurately identifies the types of herniation caused by tentorial notch lesion.

The autoregulatory mechanism of cerebral blood flow is sensitive to the level of CO2. When the level of CO2 in the blood increases, it causes vasodilation of the cerebral blood vessels, allowing for increased blood flow to the brain. On the other hand, when the level of CO2 decreases, it causes vasoconstriction of the cerebral blood vessels, reducing blood flow to the brain. This mechanism helps to maintain a constant blood flow to the brain, ensuring that it receives adequate oxygen and nutrients for proper functioning.

Central herniation refers to the displacement of brain tissue from the central part of the brain towards the brainstem. This can occur due to increased pressure within the skull, often caused by conditions such as traumatic brain injury or brain tumors. Coma is a state of unconsciousness where an individual is unresponsive and unable to be awakened. In central herniation, the compression of the brainstem can lead to disruption of important neural pathways responsible for maintaining consciousness, resulting in coma. Therefore, the statement "Coma" is true in relation to central herniation.

The correct answer is Concave Fracture of Endplate & Teardrop Fracture. This is because the question asks for fractures that are NOT associated with compression force. Concave Fracture of Endplate and Teardrop Fracture are both associated with compression force, while the other options (C4-C7 Fracture and Posterior pendicles Fractures) are not.

Force directed to cause hyperextension of the cervical spine can lead to anterior dislocation of the vertebrae. Hyperextension occurs when the head and neck are forcefully bent backward beyond their normal range of motion. This excessive force can cause the vertebrae to shift forward, resulting in anterior dislocation. This type of injury can be severe and may cause damage to the spinal cord, leading to neurological deficits. It is important to recognize and treat anterior dislocation promptly to prevent further complications.

A spastic bladder is a type of bladder dysfunction that occurs with spinal cord lesions above the conus medullaris. This condition is characterized by increased muscle tone and involuntary contractions of the bladder, leading to difficulty in controlling urination. It can result in frequent urination, urgency, and incontinence. The other options, such as rigid bladder and flaccid bladder, do not accurately describe the bladder dysfunction that occurs with spinal cord lesions above the conus medullaris.

This answer is correct because the statement "Level of Supervision and assistance for task performance is dec." is not true about Pt in Level V and VI in LOCF. The other statements are true, as gait, mobility, and balance are improved, motor control and postural are increased, and tolerance of activities is improved.

The clinical effects of tonsillar herniation include coma, flaccidity, and increased intracranial pressure (ICP). Coma refers to a state of unconsciousness where the individual is unresponsive and cannot be awakened. Flaccidity is the loss of muscle tone, resulting in weakness and limpness. Increased ICP occurs when there is a buildup of pressure within the skull, which can lead to various symptoms such as headache, nausea, and altered mental status. Therefore, the correct answer is that all of these effects are correct in the context of tonsillar herniation.

The statement suggests that a low level of potassium increases the risk of Edema, which is incorrect. Edema is actually caused by an excessive accumulation of fluid in the body's tissues, and low potassium levels do not directly contribute to this condition. Edema can be caused by various factors such as heart or kidney problems, certain medications, or prolonged sitting or standing. Therefore, the correct answer is False.

Cystic cavitation is not a consequence of obstruction. It refers to the formation of fluid-filled spaces or cysts within tissues or organs. Obstruction, on the other hand, refers to the blockage or closure of a passage or duct. While obstruction can sometimes lead to the development of cystic cavities, it is not a direct consequence of obstruction itself. Therefore, the correct answer is False.

The correct answer is Level V, VI. This is because Level V, VI represents a higher level of strength and endurance compared to the other levels mentioned. These levels indicate that the individual has the ability to perform physical tasks related to activities of daily living (ADL), indicating a higher level of functional ability.

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The correct answer is Level 1,2,3 (LOCF). This answer suggests that the improvement in Pt. Postural & Motor control, Physical Fnx, and Tolerance of Activities occurs at levels 1, 2, and 3 as per the LOCF (Last Observation Carried Forward) method. This method is commonly used in clinical trials to handle missing data by carrying forward the last available observation for analysis. Therefore, the improvement in these factors is seen in patients at levels 1, 2, and 3 according to the LOCF method.

The characteristic of Anterior Cord Syndrome is a loss of motor function and a preservation of proprioception and kinesthesia. This means that there is a lack of voluntary movement and muscle control, but the individual can still sense the position and movement of their body parts.

The answer IV suggests that the risk of secondary impairment for the patient is reduced and their tolerance of activity is increased. This implies that whatever intervention or treatment is being discussed in the question, it is effective in minimizing the chances of further complications and improving the patient's ability to engage in physical activities.

Subfalcine herniation occurs when the falx cerebri, a fold of dura mater that separates the cerebral hemispheres, is pushed to one side. This can happen due to a lesion or mass effect in the brain, causing displacement of brain structures. In subfalcine herniation, the cingulate gyrus is pushed under the falx cerebri, resulting in compression and displacement of adjacent structures. This type of herniation can lead to compression of blood vessels and potentially cause ischemia or infarction in the affected brain tissue.

The correct answer is "loose areolar." In cases of a head injury affecting the scalp, the loose areolar tissue is considered the danger zone. This is because the loose areolar tissue contains a rich blood supply and is prone to bleeding. Injuries to this area can result in significant bleeding and potential complications.

A mass lesion in the temporal lobe or middle fossa can cause flaccidity. Flaccidity refers to a loss of muscle tone and weakness, often resulting in limpness or lack of resistance to passive movement. This can occur due to damage to the motor pathways or nerves that control muscle tone and movement. In the case of a mass lesion in the temporal lobe or middle fossa, it can put pressure on these pathways or nerves, leading to flaccidity as a symptom.

When Brown Sequard and Ant Cord Syndrome occur, one of the common symptoms is pain. The affected individual may experience pain in the area where the spinal cord is damaged. Additionally, temperature sensation may be affected, leading to abnormal sensations of hot or cold. Therefore, pain and temperature are both potential losses that can occur in Brown Sequard and Ant Cord Syndrome. The Bambinski Sign, which is a reflex test used to assess the integrity of the corticospinal tract, is not directly related to the loss experienced in these syndromes.

The correct answer is Corpus Collosum and Cerebellum. Diffuse Axonal Injury (DAI) is a type of brain injury that occurs due to the rapid movement or rotation of the brain inside the skull, causing shearing forces that damage the nerve fibers. DAI commonly affects the Corpus Collosum, which connects the two hemispheres of the brain, and the Cerebellum, which is responsible for coordination and balance. The other options mentioned, Corpus Stratium and Cerebrum, are not typically associated with DAI.