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A comprehensive set of 250 questions and answers related to cbis (cerebrovascular and brain injury studies). It covers a wide range of topics, including neuroanatomy, neurophysiology, neuroprotection, neuroplasticity, and traumatic brain injury. Each question is accompanied by a detailed rationale, providing a deeper understanding of the concepts and their clinical relevance. This resource is valuable for students and professionals seeking to enhance their knowledge and prepare for exams in the field of cbis.
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molecules, primarily water, in a person's body non-invasively"
speed, frequently resulting in brain injury"
Pressure may vary due to production and absorption of CSF following injury."
and the arachnoid layers of the meninges"
of the brain"
are stretched and broken, resulting in extensive, widespread damage"
cell death"
-lateral corticospinal tract -rubrospinal tract -tectospinal tract"
-Lissauer's tract -anterior and posterior spinocerebellar tracts -spinothalamic tracts -spinoreticular tract -spinotectal tract"
the rate of neuronal loss over time; refers to the ability of a drug or biological agent to prevent brain cells from dying"
to the environment; refers to the ability of the nervous system to regenerate and reorganize itself, and to form new connections in order to compensate for injury or adapt to changes in the environment"
damage) leads to secondary injury (pathophysiological processes, delayed non-mechanical processes. Phase 1 of secondary injury includes impaired blood flow, tissue damage, metabolic imbalance, membrane permeability--these lead to edema formation, inflammation, and blood-brain barrier breakdown. Phase 2 includes axon terminal depolarization, intracellular breakdown, apoptosis, release of excitatory neurotransmitters, free radical generation, and necrosis--these processes ultimately lead to cell death."
morphology/structure changes; I.e. Hebbian learning, "neurons that fire together wire together""
therapeutic approach"
projections to a brain region is lost, remaining ones sprout and form new synaptic connections onto the partially denervated neurons; this phenomenon supports the idea that the adult injured brain can reorganize and repair itself."
overexcitation; occurs when a neuron is no longer able to maintain its resting potential as a result of impairment of the sodium-potassium pump in combination with large-scale increases in extracellular excitatory neurotransmitters such as glutamate"
steps that tell a cell to terminate itself; cell death"
that occurs between two neurons when they are stimulated simultaneously"
PTA > 7 days GCS = 3-8"
injury"
and disconnected in a violent agitating motion"
an initial concussion and then sustains a second head injury before symptoms from the first have fully resolved; can occur minutes, days, or weeks after the initial concussion; can be fatal or result in severe disability; may occur due to diffuse cerebral swelling or secondary to a subdural hematoma" "How long does it typically take for mTBI symptoms to resolve? What percentage of people experience
About 10%-15% of persons experience persistent problems after that point."
Fatigue Seizure Nausea Numbness Poor sleep Light sensitivity Noise sensitivity Impaired hearing Blurred vision Dizziness/loss of balance Neurologic abnormalities"
Diminished concentration Poor memory Impaired judgment Slowed processing speed Executive dysfunction"
Anxiety Agitation Irritability Aggression Impulsivity"
effectively together, creating difficulty with reading, and triggering headaches"
brain; characterized by disinhibition and abnormal behaviors"
sensitization from recurring central headaches; usually associated with pain in the back of the head that worsens as the day progresses"
treated swiftly, commonly causes both headaches and chronic pain syndromes"
nuclei; extends through the midbrain, pons, and medulla"
standing"
resulting in positional vertigo, causing a spinning sensation; an episode of mild-to-extreme dizziness that is a result of a change of position of the head"
may be side-to-side, up-and-down, or rotary (horizontal/vertical/torsional)"
concussion, lasting for weeks or months, consisting of symptoms such as headaches or dizziness; symptoms lasting longer than 4 weeks post mTBI"
Being female Traumatically injured Low SES History of substance misuse Pending litigation Previous psychiatric diagnoses"
of an injury to the brain"
movements of the particular muscle"
Respiratory issues Bowel/bladder dysfunction Autonomic dysfunction syndrome"
of the vocal folds to provide oxygen-rich air into the lungs, bypassing the mouth and nose"
tone in the structures of the mouth and throat may cause reduced airway opening Central sleep apnea: the injury to the nervous system disrupts the message sent from the brain to the muscles that control respiration, causing disruption in breathing"
respiratory system"
stimulation of nerves." "Neurobehavioral assessments determined to have acceptable standardization for individuals with DOC -
Coma Recovery Scale - Revised (CRS-R) The Disorders of Consciousness Scale (DOCS) Sensory Modality Assessment and Rehabilitation Technique (SMART) Sensory Stimulation Assessment Measure (SSAM) Wessex Head Injury Matrix (WHIM) Western Neurons Sensory Stimulation Profile (WNSSP)"
Tolerance for stimuli or intervention Risk management Caregiver development"
management, and caregiver development Person can't participate in goal-setting process and is a passive participant in therapeutic activity
Person does not have volitional control over responses or functioning"
Generalized response (GR) Localized response (LR)"
in the U.S. (over 2 million emergency department visits--81%)"
Young adults age 20- Adults age 65 and older Adults age 75 and older have highest rates of TBI-related hospitalization and death" "Anoxia is an example of a. Traumatic impact injury b. Traumatic inertial injury c. Non-penetrating traumatic injury
age"
"The percentage of female victims of domestic violence with symptoms associated with brain injury is a. 17% b. 37% c. 57%
"Traumatic Inertial injury is caused by a. internal insult
c. metabolic imbalance d. a and b
"The accrediting body of choice for brain injury rehabilitation is a. LTAC b CARF c. JCAHO
"Appropriate treatment strategies for Coma-Emergent Agitation may include a. Consequence or learning based programming b. Medications c. Environmental Management d. Behaviorally Based interventions e. a, b, and c
"The Rehabilitation Act of 1973 is the foundation for a. Vocational Rehabilitation b. Section 504 Accommodation Plans c. Individual Education Plans d. Answer A and B
"The percent of persons with SCI who also have TBI a. 25% b. 40% c. 60% d. 75%
"The limbic system is comprised of a. hippocampus and amygdala b. thalmus and hypothalmus c. frontal and temporal lobes d. occipital and parietal lobes
"A compound or strategy that limits neuronal death following injury and/or enhances recovery a. Apoptosis b. Excitotoxicity c. Neuroplasticity
"This describes when a neuron cannot maintain its resting potential resulting in repeated firing a. apoptosis b. excitotoxicity c. neuroplasticity
"Diagnosing Frontal Lobe Deficits versus Depression has to do with a. the individual's ability to recognize and acknowledge the deficits b. outcomes on the GCS c. results of CT d. thorough family history
deficits" "These medications are typically recommended by Urologists for incontinent bladder management a. anti-biotics b. anti-epileptics c. NSAIDS d. histamine blockers
"Convulsions occur within 7 days following the injury and are purported to occur as a direct result of the trauma , with approximately 50% occurring within 24 hours of impact and is a strong risk factor for post- traumatic epilepsy a. Immediate Post Traumatic Convulsions b. Early Post-Traumatic Seizures c. Status Epilepticus
"C-O-L-D-E-R stands for a. Character-Occurrences-Location-Disorder-Exacerbation-Results b. Coping-Occurrences-Location-Duration-Exacerbation-Results c. Character-Onset-Location-Duration-Exacerbation-Relief d. Character-Onset-Location-Duration-Exacerbation-Results
Location-Duration-Exacerbation-Relief *Refers to the headache review of systems"
variable that temporarily alters the effectiveness of some stimulus or event as a reinforcer" "A psychiatric disorder characterized by short or long term personality disturbance attributed to a brain dysfunction, injury or disease. a. Schizoaffective Disorder b. Organic Personality Disorder c. Bipolar Affective Disorder d. Obsessive Compulsive Disorder
"The amount of people receiving rehabilitation for TBI or treatment for substance misuse who have a history of both TBI and Substance misuse a. 1/ b. 2/ c. 1/
"How much higher is the risk of substance misuse following injury if there was substance misuse prior to
"\Which of the following is most true regarding Person Centered Care? a. All persons are able to direct their own care b. Impaired self-awareness may be a challenge to Person Centered Care planning c. Persons with TBI are generally unable to benefit from Person Centered Care d. Impaired self-awareness limits Person Centered Care only in Acute Rehabilitation
Care planning" "Medical staff discomfort or inexperience in treating certain patients or conditions (without intended malice) best describes the following: a. Staff apathy b. Coping Hypothesis c. Benign Neglect d. Exploitation
"Brown-Sequard Syndrome presents with a. weakness in arms not legs b. loss of muscle control, pain and temperature sensation below site of injury c. muscle control one side (arm and leg) affected
and leg) affected"
"The fastest and most available diagnostic imagery for skull fracture, bleeding and swelling is a. X-ray b. CT c. MRI
"This non-invasive method of stimulating the brain using electromagnetic induction is used as a treatment modality for depression, stroke, migraines and Parkinson's disease a. Constraint induced therapy b. Epley Maneuver c. Magnetic Resonance
"A headache that occurs at least 15 days per month for at least 3 months is considered a. Migraine b. Primary c. Secondary
"Abnormal, usually permanent condition of joints characterized by decreased range of motion, often in flexed position, and fixation due to wasting away and shortening of muscle fibers and loss of skin elasticity a. contractures b. heterotopic ossification c. hyperreflexia
the circulatory system" "The science of prediction and change of socially significant behaviors is a. Neuropsychiatry b. Neuropsychology c. Applied Behavioral Analysis
"This branch of neuropsychology uses specialized testing procedures to relate behavior changes to lesion sites and specific brain mechanisms a. Experimental b. Clinical c. Restorative
"Shaken baby syndrome would be classified as a. Traumatic impact injury b. Traumatic inertial injury c. Open brain injury
"Which is the most true regarding outcomes for children with AHT/SBS? a. More than 70% survive with long term disability b. More than 50% die as a result of the injury c. Approximately 30% survive with no disability
long term disability" "The specific battery for neuropsychological testing most prescribed by the Department of Defense for service members with a mTBI is a. MACE b. ANAM c. Neurobehavioral Symptom Inventory (NSI)
None. The DoD does not prescribe specific batteries for neuropsych testing" "What percent of service members with mTBI also have PTSD? a. 37% b. 44% c. 56%
"Comprehensive Holistic treatment is most likely provided via a. Polytrauma rehabilitation centers b. Community integrated rehabilitation c. WRAMC
"Cognitive Behavioral Family Theory a. Integrates the primary tenants of A-B-C b. Is grounded in the notion that the whole is greater than the sum of its parts c. Has been widely embraced in the field of childhood disability and pediatric populations
primary tenants of A-B-C" "Family Centered Services
a. Integrates the primary tenants of A-B-C b. Is grounded in the notion that the whole is greater than the sum of its parts c. Has been widely embraced in the field of childhood disability and pediatric populations
embraced in the field of childhood disability and pediatric populations" "Resilience Theory a. Integrates the primary tenants of A-B-C b. Is grounded in the notion that the whole is greater than the sum of its parts c. Has been widely embraced in the field of childhood disability and pediatric populations
set of skills rather than personality traits" "Family Systems Theory a. Integrates the primary tenants of A-B-C b. Is grounded in the notion that the whole is greater than the sum of its parts c. Has been widely embraced in the field of childhood disability and pediatric populations
notion that the whole is greater than the sum of its parts" "Military return to duty may be based on a. Asymptomatic at exertion b. Score on MACE c. Orders from commander d. A and B only
"According to the Congress of Neurological Surgeons, how many more calories will a person require during the acute phase following a head injury, as compared to what he or she needed before the injury?
Level 2: Dysphagia mechanically altered Level 3: Dysphagia advanced Level 4: Regular diet"
increase the risk of developing cardiovascular disease and diabetes. Common in aging adults, metabolic syndrome is marked by abdominal obesity, insulin resistance, high blood pressure, and dyslipidemia.
"In a study looking at long term outcome at 5 years post injury as compared to 2 years post found that a. More people were employed b. Fewer people were employed c. Employment status was unchanged
"What cognitive differences have been found in older adults with TBI compared to age-matched controls
and verbal memory, but no differences in relative cognitive decline, over a 2 to 5 year period"
therapeutic interventions. In addition to medications, OTs and PTs address secondary complications of spasticity such as prevention of contractures and skin breakdown and provide interventions addressing positioning."
by a velocity-dependent increase in tonic stretch with exaggerated tendon reflexes resulting from excitability of the stretch reflex - the faster an individual's extremity is moved the stronger the spasm will be; occurs due to UMN damage Symptoms: increased muscle tone, exaggerated tendon reflexes, clonus Outcomes: weakness and loss of dexterity along with impairment in muscle control, which affects functional independence"
forms in a blood vessel (I.e. a blood clot). An embolus is often a piece of thrombus that has broken free and then circulates within the bloodstream"
below the level of injury Incomplete injury: functioning of sensory and possibly some or much motor sensation below the level of injury"
Agitation/irritability/poor frustration tolerance Apathy Denial of deficits/poor self-awareness Disinhibition Eating disturbances Flat affect/restricted emotions/inability to recognize emotions Impulsivity Lability or emotional instability
Poor initiation Poor judgment and reasoning Psychosis (rare)" "Is consequence (or learning) based programming indicated in the early stages of recovery as individuals
This phase is generally short in duration when medication and environmental based management are provided."
symptoms, which are or resemble symptoms of a known psychiatric disorder. TBI with the addition of subsequent psychiatric disorders would be considered a dual diagnosis."
autonomy, non-discrimination, loyalty, truthfulness, competence, compliance, confidentiality"
unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. This includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Neglect = a failure to provide for the basic needs of a dependent individual Exploitation = the use of a dependent individual's property illegally or without the consent of the individual; includes the expenditure of funds" "This model highlights the progression of an individual in establishing his or her own cultural experiences a. Bio-social b. Racial/cultural identity development c. Socio-political
rehabilitation professional (employment specialist or job coach) to provide intensive individualized assistance to help the person with TBI with gaining and maintaining employment in a real job for real pay in the community. Job coaching can improve work outcomes for persons with TBI."
and Reporting Technique - Short Form (CHART-SF) Mayo-Portland Adaptability Inventory-4 Participation Index (M2P2) Participation Assessment with Recombined Tools - Objective (PART-O)"