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WorksheetsNeuro - TBI
Total questions: 60
Worksheet time: 30mins
Name
Class
Date
1.
~ Life changing event
~ Behavior and cognitive changes alter every aspect of their lives
~ Other body systems impacted (i.e., orthopedic conditions - fractures)
~ Falls (32%)
~ MVA (19%)
~ Struck by / against (18%)
~ Assaults (10%)
~ Behavior and cognitive changes alter every aspect of their lives
~ Other body systems impacted (i.e., orthopedic conditions - fractures)
~ Falls (32%)
~ MVA (19%)
~ Struck by / against (18%)
~ Assaults (10%)
a)
Traumatic Brain Injury (TBI)
b)
Multiple Sclerosis (MS)
c)
Parkinson's Disease (PD)
2.
Mechanism of Injury;
~ Brain tissue comes into contact w/ an object
~ Rapid acceleration / deceleration of the brain causes shear, tensile and compression forces w/in the brain
~ Diffuse Axonal Injury (DAI)
~ Brain tissue comes into contact w/ an object
~ Rapid acceleration / deceleration of the brain causes shear, tensile and compression forces w/in the brain
~ Diffuse Axonal Injury (DAI)
a)
Primary Injury
b)
Secondary Injury
3.
Mechanism of Injury;
~ Cell death result of a chain of cellular events after tissue damage (hypoxemia, HTN, ischemia, edema, elevated ICP)
~ Hematomas result in elevated ICP
~ Cell death result of a chain of cellular events after tissue damage (hypoxemia, HTN, ischemia, edema, elevated ICP)
~ Hematomas result in elevated ICP
a)
Primary Injury
b)
Secondary Injury
4.
What is normal ICP?
a)
5-20 cm H2O
b)
10-15 cm H2O
c)
5-15 cm H2O
d)
5-10 cm H2O
5.
Blast Injury;
~ U.S. Military
~ Explosive device
~ Transient shock wave causing overpressure on organs
~ U.S. Military
~ Explosive device
~ Transient shock wave causing overpressure on organs
a)
Primary Blast
b)
Secondary Blast
c)
Tertiary Blast
6.
Blast Injury;
~ U.S. Military
~ Explosive device
~ Shrapnel
~ U.S. Military
~ Explosive device
~ Shrapnel
a)
Primary Blast
b)
Secondary Blast
c)
Tertiary Blast
7.
Blast Injury;
~ U.S. Military
~ Explosive device
~ Person flung backward striking object
~ U.S. Military
~ Explosive device
~ Person flung backward striking object
a)
Primary Blast
b)
Secondary Blast
c)
Tertiary Blast
8.
Common Impairments;
~ Paresis
~ Abnormal tone
~ Motor function
~ Postural control
~ Paresis
~ Abnormal tone
~ Motor function
~ Postural control
a)
Neuromuscular
b)
Cognitive
9.
Common Impairments;
~ Frontal lobe involvement
* Arousal level
* Attention
* Concentration
* Memory
* Learning
* Executive Functions
* Great variations
~ Frontal lobe involvement
* Arousal level
* Attention
* Concentration
* Memory
* Learning
* Executive Functions
* Great variations
a)
Neuromuscular
b)
Cognitive
10.
~ Arousal system not functioning
* Eyes closed
* No sleep / wake cycles
* Vent dependent
* Severe injuries may begin w/ this
* Eyes closed
* No sleep / wake cycles
* Vent dependent
* Severe injuries may begin w/ this
a)
Coma
b)
Stupor
c)
Obtunded
d)
Vegetative
11.
~ Pt has basic functions of respiratory and cardiac functions
~ Weaned off ventilator
~ Eyes may be open
~ May startle to sound / visual stimuli
~ Reflexive smiling / crying
~ Startle to stimuli
~ Awareness of surroundings is absent
~ Meaningful communication is absent
~ Weaned off ventilator
~ Eyes may be open
~ May startle to sound / visual stimuli
~ Reflexive smiling / crying
~ Startle to stimuli
~ Awareness of surroundings is absent
~ Meaningful communication is absent
a)
Vegetative State
b)
Minimally Conscious State
c)
Stupor
d)
Obtunded
12.
~ Minimal evidence of self or environmental awareness
~ Respond to stimuli
~ Visual pursuit
~ Sound localization
~ Sleep / wake cycles present
~ Respond to stimuli
~ Visual pursuit
~ Sound localization
~ Sleep / wake cycles present
a)
Vegetative State
b)
Minimally Conscious State
c)
Stupor
d)
Obtunded
13.
~ Unresponsive state
~ Pt aroused only briefly w/ vigorous stimulation repeated
~ Pt aroused only briefly w/ vigorous stimulation repeated
a)
Vegetative State
b)
Minimally Conscious State
c)
Stupor
d)
Obtunded
14.
~ Frequently sleeping
~ When aroused, decreased alertness
~ Decreased interest in environment
~ Delayed reactions
~ When aroused, decreased alertness
~ Decreased interest in environment
~ Delayed reactions
a)
Vegetative State
b)
Minimally Conscious State
c)
Stupor
d)
Obtunded
15.
~ Agitation
~ Aggression
~ Disinhibition
~ Apathy
~ Emotional liability
~ Impulsivity
~ Irritability
~ Low frustration tolerance
~ Aggression
~ Disinhibition
~ Apathy
~ Emotional liability
~ Impulsivity
~ Irritability
~ Low frustration tolerance
a)
Neurobehavioral
b)
Communication
16.
~ Disinhibited
~ Socially inappropriate language
~ Imprecise language
~ Disorganized
~ Tangential language: train of thought wanders, lack of focus, does not return to initial topic of conversation
~ Socially inappropriate language
~ Imprecise language
~ Disorganized
~ Tangential language: train of thought wanders, lack of focus, does not return to initial topic of conversation
a)
Neurobehavioral
b)
Communication
17.
~ Elevated sympathetic nervous system
~ Overactive
~ Elevated HR
~ Elevated RR
~ Elevated BP
~ Hyperthermia
~ Diaphoresis
~ Decerebrate and decorticate posturing, hypertonia, and teeth grinding
~ Fight or flight system is out of wack
~ Overactive
~ Elevated HR
~ Elevated RR
~ Elevated BP
~ Hyperthermia
~ Diaphoresis
~ Decerebrate and decorticate posturing, hypertonia, and teeth grinding
~ Fight or flight system is out of wack
a)
Dysautonomia
b)
Dysarthria
c)
Dysdiadochokinesia
d)
Dyssynergia
18.
T/F: It is important to pay attention to the signs/symptoms for your patients.
a)
True
b)
False
19.
T/F: Post-traumatic seizures are medically treated with anticonvulsants.
a)
True
b)
False
20.
Which of the following is NOT a secondary impairment?
a)
GI difficulties
b)
DVT
c)
Fractures
d)
Paresis
21.
T/F: The Glasgow Coma Scale is most common, widely used, and is comprised of 3 responses: motor, verbal, and eye-opening.
a)
True
b)
False
22.
Glasgow Coma Scale;
~ 8 or less
~ 8 or less
a)
Severe
b)
Moderate
c)
Mild
23.
Glasgow Coma Scale;
~ 9-12
~ 9-12
a)
Severe
b)
Moderate
c)
Mild
24.
Glasgow Coma Scale;
~ 13-15
~ 13-15
a)
Severe
b)
Moderate
c)
Mild
25.
The Glasgow Coma Scale is a predictor of poor outcomes. They include all of the following EXCEPT:
a)
Pts w/ moderate to severe brain injury
b)
Age, race, lower educational levels
c)
Low initial scores - motor and pupillary reactivity
d)
Visual tracking
26.
Length of time b/w the injury and the time at which the pt is able to consistently remember ongoing events
a)
Post-traumatic Amnesia (PTA)
b)
Physical Therapist Assistant (PTA)
c)
Part-time Associate (PTA)
d)
Post-tickle Action (PTA)
27.
Prognosis; Post-traumatic Amnesia (PTA):
~ 0-1 day
~ 0-1 day
a)
Mild TBI
b)
Moderate TBI
c)
Severe TBI
28.
Prognosis; Post-traumatic Amnesia (PTA):
~ 1-7 days
~ 1-7 days
a)
Mild TBI
b)
Moderate TBI
c)
Severe TBI
29.
Prognosis; Post-traumatic Amnesia (PTA):
~ > 7 days
~ > 7 days
a)
Mild TBI
b)
Moderate TBI
c)
Severe TBI
30.
You are treating a pt w/ a GCS of 13. The pt had PTA (post-traumatic amnesia) for 1 day. You would describe this pt as:
a)
Severe brain injury w/ very poor outcome
b)
Mild brain injury w/ excellent recovery including return to sports and exercise
c)
Moderate brain injury w/ ability to demonstrate good progress w/ therapy
d)
Severe brain injury w/ ability to demonstrate good progress w/ therapy
31.
For PT management of moderate to severe TBI in the acute stage, a clinician would want to consider all of the following after the PT Eval EXCEPT:
a)
ICP - monitor in ICU
b)
ROM restrictions
c)
WB precautions - Ortho
d)
Food status
32.
~ Abnormal Tone and Posturing;
* (B) UE Flexion and (B) LE Extension
* (B) UE Flexion and (B) LE Extension
a)
Decorticate
b)
Decerebrate
33.
~ Abnormal Tone and Posturing;
* (B) UE and LE in extension
* (B) UE and LE in extension
a)
Decorticate
b)
Decerebrate
34.
Which of the following is NOT a way to work towards the PT Goal of preventing secondary complications and prolonged bedrest / immobilization?
a)
Initiate early mobility
b)
Transfers
c)
Head and trunk control
d)
Laying in bed
35.
The Ranchos Los Amigos Level of Cognitive Functioning (LOCF) is used for all of the following EXCEPT:
a)
Used to examine cognitive and behavioral recovery in individuals w/ TBI
b)
When pt has emerged from a coma
c)
Stages of recovery
d)
To assess how many tacos the pt can eat in one sitting
36.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ No response
~ No response
a)
Stage I
b)
Stage II
c)
Stage III
d)
Stave IV
37.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Generalized response
~ Inconsistent / nonpurposeful response
~ Generalized response
~ Inconsistent / nonpurposeful response
a)
Stage I
b)
Stage II
c)
Stage III
d)
Stave IV
38.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Localized response
~ Specific but inconsistent; close eyes, squeeze hands
~ Localized response
~ Specific but inconsistent; close eyes, squeeze hands
a)
Stage I
b)
Stage II
c)
Stage III
d)
Stave IV
39.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Confused Agitated
~ Heightened state of activity, bizarre behavior
~ Confused Agitated
~ Heightened state of activity, bizarre behavior
a)
Stage I
b)
Stage II
c)
Stage III
d)
Stave IV
40.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Confused Inappropriate
~ Consistent w/ simple commands, short periods of time
~ Confused Inappropriate
~ Consistent w/ simple commands, short periods of time
a)
Stage V
b)
Stage VI
c)
Stage VII
d)
Stave VIII
41.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Confused Appropriate
~ Dependent (D) on external direction
~ Confused Appropriate
~ Dependent (D) on external direction
a)
Stage V
b)
Stage VI
c)
Stage VII
d)
Stave VIII
42.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Automatic Appropriate
~ Robot like, decreased rate car
~ Automatic Appropriate
~ Robot like, decreased rate car
a)
Stage V
b)
Stage VI
c)
Stage VII
d)
Stave VIII
43.
Ranchos Los Amigos Level of Cognitive Functioning (LOCF);
~ Purposeful Appropriate
~ Purposeful Appropriate
a)
Stage V
b)
Stage VI
c)
Stage VII
d)
Stave VIII
44.
~ Used for plantarflexor or biceps contractures
~ Due to increased tone or prolonged shortening of the muscle
~ i.e. ankle stretch into maximal amount of dorsiflexion ROM
~ Short leg version of this is applied
~ Removed in 2-5 days
~ **Risk of skin breakdown - important to monitor skin integrity**
~ Due to increased tone or prolonged shortening of the muscle
~ i.e. ankle stretch into maximal amount of dorsiflexion ROM
~ Short leg version of this is applied
~ Removed in 2-5 days
~ **Risk of skin breakdown - important to monitor skin integrity**
a)
Serial Casting
b)
Splinting
45.
Which of the following is NOT an outcome measure for TBI?
a)
Functional Independence Measure (FIM)
b)
Berg Balance Scale (BBS)
c)
High-Level Mobility Assessment Tool (Hi-Mat)
d)
Self-reports
46.
T/F: With Motor (re)learning strategies:
~ pts experience mental and physical fatigue
~ practice is distributed w/ frequent rest periods
~ random practice schedules are possibly beneficial, but difficult at first
~ pts experience mental and physical fatigue
~ practice is distributed w/ frequent rest periods
~ random practice schedules are possibly beneficial, but difficult at first
a)
True
b)
False
47.
PT tx for TBI includes all of the following EXCEPT:
a)
BWSTT
b)
FES
c)
Aerobic / Endurance Conditioning
d)
Sitting for more than 2 hours
48.
T/F: Consistency and behavior planning is important.
a)
True
b)
False
49.
T/F: With a mild TBI, self-reports of blurred vision, nausea, light sensitivity, sleep disturbances, and ringing in the ears can be expected.
a)
True
b)
False
50.
What % of people w/ mild TBI experience post-concussive syndrome deficits months to years after the initial injury?
a)
10-20
b)
15-25
c)
5-15
d)
25-30
51.
T/F: Each step in the rehab stage for mTBI should take 24 hours.
a)
True
b)
False
52.
T/F: If any changes / symptoms occur post-mTBI, progress to next stage -- rest 24 hours.
a)
True
b)
False, step back to previous stage
c)
False, rest 12 hours
d)
False, return to play
53.
Which of the following is NOT an outcome measure listed for TBI?
a)
Dizziness Handicap Inventory (DHI)
b)
Activities-specific Balance Confidence Scale (ABC)
c)
Post-Concussion Scale
d)
HiMat
54.
~ Abnormal growth of bone in non-skeletal tissues including muscle, tendons, or other soft tissue
~ Results in jagged, painful joints
~ Results in jagged, painful joints
a)
Heterotopic Ossification
b)
Heterotopic Calcification
55.
T/F: PT tx for heterotopic ossification frequently includes PROM, AAROM, transfers, positioning, and splinting.
a)
True
b)
False
56.
T/F: Heterotopic Ossification commonly occurs in the hips, and is more prevalent in women than men in their 20s and 30s.
a)
True
b)
False, in the knees
c)
False men > women
d)
False, 30s and 40s
57.
T/F: Joint mobility is crucial when HO is detected early.
a)
True
b)
False
58.
Which duo in our class has been named Thunder Buddies?
a)
M&M
b)
Tanny & Sammy
c)
Mireya & Ryne
d)
Letty & Chels
59.
What does LA stand for?
a)
Los Angeles
b)
Las Atrioventrucula
c)
Los Astros
d)
Letty A...
60.
Who almost fell into the toilet performing a WC transfer in the lab restroom?
a)
TCo
b)
Ryann
c)
Ryne
d)
Sammy Quinn
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