TBI

Question 1

The incidence of TBI is highest in males ages _____ and then children ages _____.

Answer 1

Highest in males 15-20 years

Children 6-10 years

Question 2

Mortality rates of TBI are highest in children younger than ____ and older than _____.

Answer 2

Younger than 6

Older than 15

Question 3

List 2 reasons why children are more susceptible to damage secondary to TBI.

Answer 3

1. Higher number of synapses, immature myelinization

2. Skull and brain more compressible

Question 4

List 2 causes of TBI in younger children and 2 causes of TBI in older children.

Answer 4

Younger children

1. Falls
2. Abuse

Older Children

1. MVAs
2. Sports and recreation

Question 5

List 6 residual deficits in cognitive/social domains following a TBI.

Answer 5

1. Hyperactivity/distractibility
2. Low tolerance for frustration
3. Poor judgment/problem solving
4. Aggression
5. Memory deficits
6. Auditory and visual perception deficits

Question 6

List 3 determinants of prognosis after TBI relative to age.

Answer 6

1. Infants have increased vulnerability
2. Before 5 years-more severe language deficits
3. 15-21 yrs-greater behavioral and emotional deficits than adults

Question 7

List 4 things that used to determine prognosis following a TBI.

Answer 7

1. Age
2. Duration of coma
3. Depth of coma
4. Duration of post traumatic amnesia

Question 8

______ pediatric scales are used to asses children younger than ______ years post TBI.

Answer 8

RANCHO pediatric scale (reversed # from adult scale)

12 years

Question 9

List 2 impairment measures and 3 functional measures used to assess children post TBI.

Answer 9

Impairment: MMT and ROM

Functional: GMFM, PEDI, and WeeFIM

Question 10

List 5 motor impairments associated with TBI.

Answer 10

1. Spasticity
2. Ataxia
3. Paralysis/weakness
4. Decreased ROM
5. Deconditioning

Question 11

Spasticity peaks at _____ months then decreases over ______ years. Coma for greater than _____ could result in bilateral moderate/Severe spasticity.

Answer 11

Peaks at 2-3 months then decreases over 2 years.

Coma > 1 month

Question 12

Age greater than _____ years is a risk factor for heterotopic ossification. _______ treatment is typically delayed for this condition.

Answer 12

Age > 11 years = risk factor

Surgery is delayed

Question 13

List 3 signs of heterotopic ossification.

Answer 13

1. Decreased ROM
2. Pain with testing
3. Swelling, erythema, increased warmth

Question 14

List 4 intervention considerations used to treat children with TBI in Rancho levels 3-5.

Answer 14

1. Avoid interventions that alter physiologic parameters (work within guidelines set my physician)
2. Gentle ROM
3. Positioning
4. Sensory stimulation

Question 15

List 4 precautions to be aware of in patients with increased intracranial pressure (ICP).

Answer 15

1. Lateral neck flexion
2. Increased hip flexion
3. Full supine
4. Trendelenburg

Question 16

Children in Rancho pediatric level _____ require constant supervision because of impaired ______ and ______.

Answer 16

Level II

Impaired judgement and problem solving

Question 17

List 3 intervention used to treat agitation in Rancho pediatric level II.

Answer 17

1. Decrease distractions
2. Provide structure and routine
3. Simplify commands/complexity of the task

* able to follow 1 step commands with cueing*

Question 18

______ is the easiest AD to use.

Answer 18

WALKER