Quiz Over Traumatic Brain Injury

Decerebrate posturing refers to a rigid extension of all four extremities, indicating damage to the brainstem. This condition is usually caused by severe brain injury or trauma, and it is associated with a poor prognosis. Decerebrate posturing is characterized by the arms and legs being extended and rotated inward, suggesting dysfunction in the upper brainstem. It is important to recognize and promptly treat this condition as it may indicate significant neurological damage.

The statement is false because rehabilitation should not only focus on measurable impairments. Rehabilitation is a holistic approach that aims to improve a person's overall functioning and quality of life. It involves addressing not only measurable impairments but also psychological, social, and environmental factors that may impact a person's ability to participate in activities and achieve their goals. By considering the broader context and individual needs, rehabilitation can provide comprehensive support and promote optimal outcomes for individuals.

Being aroused, alert, and oriented refers to a state of wakefulness and awareness of one's surroundings. However, awareness goes beyond just being awake and aware of the environment. It includes the ability to understand and comprehend the information received from the surroundings. Therefore, it is possible to be aroused, alert, and oriented without being fully aware or conscious of the situation.

The primary motor cortex is located in the frontal lobe of the brain. This region is responsible for the planning, control, and execution of voluntary movements. It receives information from other areas of the brain and sends signals to the muscles, enabling coordinated movement. The frontal lobe also plays a role in higher cognitive functions such as decision-making, problem-solving, and social behavior.

Personality is not considered an executive function because it refers to the individual's unique traits, behaviors, and patterns of thinking, rather than cognitive processes involved in goal-directed behavior. Executive functions, on the other hand, are cognitive processes that help individuals regulate their thoughts, actions, and emotions to achieve specific goals. These functions include goal setting, planning, carrying out plans, and performance evaluation.

Bruising of the mastoid processes and raccoon eyes are classic signs of a basilar skull fracture. This type of fracture can occur as a result of severe head trauma, and the bruising around the ears and eyes is known as the "battle sign." This sign is indicative of a fracture at the base of the skull, and it is important to recognize and seek medical attention for this condition.

Grade II concussion is characterized by LOC (loss of consciousness) for less than 1 minute, confusion, and post-traumatic amnesia (PTA) lasting between 30 minutes to 24 hours. This means that the person may experience a brief period of unconsciousness, followed by confusion and memory loss for a certain period of time after the injury.

Option II is the correct answer because it states that at this rancho level, there is a generalized response to pain. This implies that the response to pain is not specific to any particular individual or situation, but rather a general response that can be observed in multiple cases. The other options do not provide any information about the response to pain at this rancho level.

A subdural hematoma is a condition characterized by bleeding between the brain and the dura mater, which is the outermost layer of the brain. The correct answer states that a subdural hematoma is mostly venous blood and the bleeding occurs at a slower rate compared to other types of bleeding. This is because subdural hematomas are typically caused by the tearing of veins, which have a lower pressure compared to arteries. The slower bleeding allows for the accumulation of blood over time, which can lead to increased pressure on the brain and potentially life-threatening complications if not treated promptly.

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Vault or basilar fractures are types of skill fractures that can often result in a cerebrospinal fluid (CSF) leak. These fractures occur in the top portion of the skull, known as the vault, or at the base of the skull, known as the basilar region. When these fractures happen, the protective layer surrounding the brain and spinal cord can be breached, leading to a leakage of CSF. This can be a serious condition that requires medical attention and intervention to prevent complications.

Profuse sweating is not a component of Cushing's triad. Cushing's triad is a set of three clinical signs that indicate increased intracranial pressure (ICP) and potential brain herniation. The three components of Cushing's triad are hypertension (high blood pressure), bradycardia (slow heart rate), and irregularities in respiratory patterns. Profuse sweating is not typically associated with Cushing's triad.

The treatment for a subdural hematoma is burr hole drainage. This procedure involves creating a small hole in the skull using a drill (burr hole) to drain the accumulated blood and relieve pressure on the brain. It is a less invasive option compared to craniotomy, which involves removing a section of the skull, or shunt placement, which involves inserting a tube to divert excess fluid. Burr hole drainage is often the preferred treatment for subdural hematomas as it carries less risk and allows for quicker recovery.

The normal ICP (intracranial pressure) for a supine adult is 7-15 mm Hg. This refers to the pressure inside the skull and is an important indicator of brain health. If the ICP is too high, it can indicate conditions such as brain swelling or hemorrhage, while a low ICP may suggest reduced brain perfusion. Monitoring and maintaining normal ICP is crucial for optimal brain function and preventing further damage.

A score less than 8 on the Glasgow Coma Scale (GCS) indicates coma. The GCS is a neurological scale that assesses a patient's level of consciousness. It is based on three components: eye opening, verbal response, and motor response. The scale ranges from 3 to 15, with a lower score indicating a more severe impairment. A score of 8 or less suggests a deep state of unconsciousness, which is commonly associated with coma.

Awareness is the correct answer because it refers to the state of being conscious or having knowledge of one's internal and external environment. It involves being alert and attentive to one's surroundings, thoughts, and emotions. Awareness is essential for perception, cognition, and decision-making processes. It allows individuals to gather information, process it, and respond appropriately to stimuli.

Transportation accidents are the most common cause of Traumatic Brain Injury (TBI). This includes incidents involving motor vehicles, bicycles, motorcycles, and pedestrians. These accidents can result in head injuries due to the impact and force involved in collisions. The high speed and potential for multiple impacts in transportation accidents make them a leading cause of TBI.

Divided attention refers to the ability to focus on multiple tasks or stimuli simultaneously. When walking while finding change in your pocket, you need to divide your attention between the act of walking and searching for the change. This requires the ability to allocate attention to both tasks at the same time. Therefore, the correct answer is divided attention.

Baclofen is the correct answer because it works through presynaptic inhibition at the spinal cord level. It acts as a gamma-aminobutyric acid (GABA) agonist and inhibits the release of excitatory neurotransmitters, reducing muscle tone and spasticity. This mechanism of action allows baclofen to effectively manage muscle tone. Dantrium, boTox, and diazepam do not work through presynaptic inhibition at the spinal cord level and have different mechanisms of action.

A low level brain injury refers to a less severe injury, which may indicate that the patient has a better overall condition and fewer complications. Initiating therapeutic or oral feeds in this case would be considered safe and beneficial for the patient's recovery. In contrast, high level brain injuries are more severe and may require alternative feeding methods or more cautious approaches. Moderate level brain injuries fall in between, and the decision to initiate feeds would depend on the specific circumstances and the patient's condition.

HO, or heterotopic ossification, refers to the abnormal formation of bone in soft tissues such as muscles or tendons. The statement "Occurs most commonly at the elbow" is not true regarding HO. Heterotopic ossification can occur in various joints, including the hip, knee, shoulder, and elbow, but it is most commonly seen in the hip joint.

The textbook presentation of an epidural hematoma can include more than one of the mentioned symptoms. Immediate death can occur in severe cases, while coma can be a result of the brain injury caused by the hematoma. A brief loss of consciousness (LOC) followed by lucidity is also a common symptom. Additionally, contralateral hemiparesis (weakness on one side of the body) and ipsilateral pupillary dilation (dilation of the pupil on the same side as the hematoma) can be observed. Therefore, the correct answer is "more than one of the above."

Sympathetic storming, also known as paroxysmal hypothalamic instability, is characterized by an exaggerated fight or flight response, hypertension, dystonia, sweating, and alterations in consciousness. It usually occurs in individuals with a GCS (Glasgow Coma Scale) of 3-8. However, it is not a good indicator for recovery. This means that the presence or absence of sympathetic storming does not necessarily indicate whether a patient will recover or not. Medications, such as sedatives, can be used to help control the symptoms of sympathetic storming.

When treating someone with a moderate level brain injury, the emphasis is on promoting their safe independence. This means that the focus is on helping the individual regain their ability to perform daily activities and tasks on their own, while ensuring their safety and well-being. The goal is to empower them to live as independently as possible while minimizing the risk of further injury or harm. This may involve providing support, therapy, and assistive devices to help them regain their skills and confidence.

Diffuse axonal injury does not show up immediately on scans. This type of injury is caused by the brain being rapidly rotated or shaken inside the skull, resulting in widespread damage to the axons. The damage caused by diffuse axonal injury is often microscopic and may not be visible on initial scans. The severity of this injury is classified as mild, moderate, or severe, with severe cases being the most serious. Diffuse axonal injury can lead to various complications, including unconsciousness and post-traumatic epilepsy (PVE).

When placing a serial cast, it is important to do so in a submaximal stretch position. This means that the cast should be applied with the joint in a position that allows for some movement, but not to the point of maximal stretch. This position helps to promote healing and prevent stiffness in the joint, while still providing support and stability. Placing the cast in a loose packed or close packed position may limit movement too much or put excessive stress on the joint, respectively.

The given description indicates that the individual can follow simple directions consistently, but has inconsistent orientation to time and place. This suggests that the individual is at a higher level of cognitive functioning compared to individuals at level V, but not as advanced as individuals at levels VII or VIII. Therefore, the correct answer is VI.

The focus when developing a seating system is not to use a flexible seat to decrease support. This means that a flexible seat is not considered as a solution to reduce the amount of support provided by the seating system. The other options mentioned in the question, such as accommodating fixed deformities, focusing on pelvis position, and using gravity to counteract hypotonicity, are all important factors to consider when developing a seating system.

Perseveration refers to the uncontrollable repetition of a particular response. It is a cognitive symptom that often occurs in neurological disorders, such as dementia or traumatic brain injury. Individuals with perseveration may continue to repeat a word, phrase, or action even when it is no longer relevant or appropriate. This repetitive behavior can be disruptive and interfere with daily functioning.

On day one of the rehabilitation process, patients should be instructed in an out of bed (OOB) schedule and rest schedule. This means that right from the beginning of their rehab journey, they should be taught when to get out of bed and engage in activities, as well as when to rest and take breaks. This early instruction is important for setting the foundation of the rehabilitation program and ensuring that patients understand the importance of balancing activity and rest for their recovery.

The correct answer is VIII. At this Rancho level, the patient is alert and oriented, able to recall and integrate past and present events, and is skilled in home and community. This suggests that the patient has a high level of cognitive functioning and is able to function independently in their daily life.

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At this rancho level, responses are non-purposeful and random, there is difficulty learning new tasks, and verbalizations can be inappropriate. This suggests that the individual is at a very low level of cognitive functioning and may have severe impairments in their ability to understand and communicate. Level V is the correct answer because it accurately reflects these characteristics.

Obtundity refers to a state of reduced alertness, disinterest, and slow responses. It is a condition where a person appears dull, apathetic, and lacks the ability to respond quickly or engage in activities with normal enthusiasm. This term is often used to describe a state of mental dullness or decreased cognitive function. It is different from other options such as stupor, delirium, and coma, which have their own distinct characteristics and levels of consciousness impairment.

Damage to the thalamus can lead to permanent coma. The thalamus is a vital part of the brain that acts as a relay station for sensory information, controlling the flow of messages between various parts of the brain. It plays a crucial role in regulating consciousness and alertness. Damage to the thalamus can disrupt the transmission of signals, leading to a loss of consciousness and potentially resulting in a coma.

The goal of "Tolerated stander for 2 min x 2 times/day" is appropriate for someone with a low level brain injury because it focuses on improving their ability to tolerate standing for a specific duration of time. This goal is important as it helps to improve their overall strength, balance, and endurance, which are often affected after a brain injury. Additionally, using a stander can also help prevent complications such as muscle contractures and pressure sores.

After the 1st brain injury, someone is 3 times more likely to suffer another. This means that their chances of experiencing a second brain injury are three times higher compared to someone who has not had a brain injury before. After the second brain injury, they are 8 times more likely to have even another. This indicates that their likelihood of experiencing a third brain injury is eight times higher compared to someone who has only had one brain injury.

TBI, or traumatic brain injury, commonly occurs in various age groups. However, the age group of 20-25 is not typically considered a common age group in which TBI occurs. TBI is more prevalent in younger age groups, such as 0-4 and 15-19, as well as in older individuals above the age of 75.

A bone scan is the best test to determine if HO (heterotopic ossification) is present. This is because a bone scan uses a radioactive tracer to detect areas of increased bone activity, which can indicate the presence of abnormal bone growth. Other options like observation of painful, limited range of motion and elevated serum alkaline phosphatase can be suggestive but are not definitive tests for HO. A radiograph may show the presence of abnormal bone growth, but it may not be as sensitive as a bone scan in detecting early stages of HO.

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In level V of Rancho, behavior begins to become goal directed. This suggests that at this level, individuals start to exhibit purposeful actions and demonstrate intentionality in their behavior. It indicates a higher level of cognitive functioning and the ability to plan and execute actions towards achieving specific goals.

Currently, 2% of the US population are living with problems from a TBI. This means that out of every 100 people in the US, 2 of them are experiencing difficulties resulting from a traumatic brain injury. TBIs can result from various causes such as accidents, falls, or sports injuries, and can have a significant impact on a person's physical, cognitive, and emotional functioning. It is important to raise awareness about TBIs and provide support and resources for those affected by them.

Males are 1.5 times more likely to sustain a Traumatic Brain Injury (TBI) compared to females. This means that the risk of males experiencing a TBI is 1.5 times higher than that of females.

The average number of people in West Virginia who die as a result of Traumatic Brain Injury (TBI) per year is 25.

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Each year, approximately 50,000 people die from a traumatic brain injury (TBI), while around 1.4 million TBIs occur annually. This indicates that TBIs are a significant cause of mortality, with a high number of incidents resulting in death. The figures highlight the importance of addressing and preventing TBIs to reduce the number of fatalities associated with this type of injury.