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- What is the national advocacy organization for persons with brain injury?
The national advocacy organization for persons with brain injury is called the Brain Injury Association (BIA).
- What percentage of firearm-related TBIs result in death?
91% of firearm-related TBIs result in death.
- According to the Interdependence Paradigm, who is the 'power person'?
According to the Interdependence Paradigm, the person with a disability is the 'power person'.
- What is an example of promoting self-determination in the Human Services?
An example of promoting self-determination in the Human Services is developing leadership skills among people with disabilities.
- What is the leading cause of death from TBI?
The leading cause of death from TBI is 'Other', which includes causes such as suicide, homicide, and medical complications.
- What was important about the Olmstead decision?
The Olmstead decision challenged state, federal, and local governments to provide community-based services for individuals with disabilities.
- What percentage of TBIs are due to transportation-related incidents?
25% of TBIs are due to transportation-related incidents.
- What does the TBI Grant Program provide 'seed money' for?
The TBI Grant Program provides 'seed money' for the integration of services and establishment of policy.
- What is the NIDRR website that provides online resources for outcome measures for persons with BI?
The NIDRR website that provides online resources for outcome measures for persons with BI is the Center on Outcome Measurement in Brain Injury (COMBI).
- What percentage of all TBIs are considered moderate injuries?
10-30% of all TBIs are considered moderate injuries.
- Non-accidental trauma is the cause of at least ______ of deaths from head trauma in children under two years old?
80%
- True or False: After one TBI, the risk for a second injury is three times greater. After a second injury, the risk for a third injury is four times greater.
False
- True or False: The creation or prolonging of negatively reciprocal interactions (such as being overly corrective, disempowering or using unnecessarily restrictive comments or actions) is an example of mutually reinforcing interactions.
False
- True or False: The concept of 'no blame' proposes that if people are predisposed to behave in certain situations, then holding them at fault or blaming for unwanted actions makes good sense.
False
- True or False: Staff operating from a stance of 'can versus can't' are not likely to encourage inclusion or support a person's interests.
False
- Self determination builds on the principles of:
Informed consent, right to refuse
- Self-determination revolves around which of the following components:
Freedom, authority, support and responsibility
- The Interdependent paradigm sees the problem of disability as:
Limited or non-existent support for differences
- Five desired interactional components include:
- True or False: Injury to the cerebellum can produce problems with coordination.
True
- The cerebral cortex is made up of two:
Hemispheres
- The four lobes of the brain are:
Frontal, parietal, occipital, temporal
- Each cerebral hemisphere is made up of ______ lobes.
Four
- Which lobe includes the primary visual center?
Occipital
- True or False: Post-concussion symptoms always eventually clear.
False
- True or False: Each sense except smell relays impulses through the thalamus.
True
- This area of the brain monitors impulses from the motor and sensory areas to help control direction, rate, force and steadiness of movements.
Cerebellum
- This part houses basic elemental drives, emotions and survival instincts:
Limbic system
- True or False: Diffuse axonal injuries (DAI) are damaged nerve cells throughout the brain that are stretched and break.
True
- True or False: Tremendous pressure can build up inside the brain after an injury. This is because the skull is closed and has no extra room for swelling or fluid.
True
- A hematoma is:
An accumulation of blood
- The brain stem includes three integral areas called:
Medulla, pons and midbrain
- The system which modulates or changes arousal, alertness and concentration is called:
The reticular activating system
- True or False: When the medulla is injured, life is immediately threatened.
True
- Injury to the limbic system can produce serious problems involving:
Emotional perceptions and feelings
- Each cerebral hemisphere is made up of ______ lobes.
Three
- A child with a frontal lobe injury may go unnoticed because:
Cerebellum
- A subdural hematoma is the result of bleeding into the:
Space between the dura mater and arachnoid mater
- True or False: A coup-contracoup injury means that the back is struck.
False
- The brain sits inside of a rough and bony skull and is bathed in:
Cerebrospinal fluid
- True or False: A decreased amount of oxygen to the brain is called 'hypoxia.'
True
- Two structures associated with the limbic system include:
The hippocampus and amygdala
- Injury to the basal ganglia may result in:
All of the Above (Slowness and loss of movement, Muscle rigidity, Tremor)
- The tiny brain cells making up the nervous system, which are 'communicators' are called:
The function of the cerebellum is to control the direction, rate, and force of movement.
- Where is the primary sensory cortex located?
The primary sensory cortex is located in the parietal lobe of the brain.
- What is the most common neurological condition reported after brain injury?
The most common neurological condition reported after brain injury is headache, not seizures.
- Paralysis on one side of the body is called:
Paralysis on one side of the body is called hemiplegia.
- What is a twisted position of the neck called?
A twisted position of the neck is called torticollis.
- Which of the following psychiatric manifestations may occur after brain injury?
Psychiatric manifestations that may occur after brain injury include bipolar disorder, major depression, and anxiety disorder.
- What is an important pre-assessment information for brain injury?
An important pre-assessment information includes a pharyngeal tube.
- True or false: Medications to enhance arousal, for behavioral control and mood regulation after brain injury have only a positive effect on recovery.
False. Medications to enhance arousal, for behavioral control and mood regulation after brain injury can have both positive and negative effects on recovery.
- What are the causes of cardiovascular injury following brain injury?
Cardiovascular injury following brain injury may be due to complications from direct trauma and/or damage to the area of the brain that controls the heart.
- True or false: Persons with hypo arousal may benefit from increased environmental stimulation.
True. Persons with hypo arousal (low arousal) may benefit from increased environmental stimulation to help improve their level of arousal.
- What type of seizure involves a transient loss of consciousness for several seconds, with a loss of attention or staring into space?
Absence seizures, formerly known as petit mal, involve a transient loss of consciousness for several seconds, with a loss of attention or staring into space.
- True or false: Difficulty swallowing is called aphasia.
False. Difficulty swallowing is called dysphagia, not aphasia.
- Which domains of function are listed in the text?
The domains of function listed in the text include motor skills, spatial orientation, and the ability to recall information.
- What is anosognosia?
Anosognosia is the lack of awareness of one's own deficits following a brain injury.
- True or false: Limited therapeutic outlets can lead to substance abuse following a brain injury.
True. The text states that limited therapeutic outlets can lead to substance abuse following a brain injury.
- What are the four ways the environment affects behavior?
The four ways the environment affects behavior are rewards, escape, punishment, and extinction.
- What is the definition of executive functioning?
Executive functioning refers to the ability to plan, organize, and problem- solve, not the ability to remember and understand speech.
- What is not part of behavior treatment planning?
Daily memorization tasks are not part of behavior treatment planning, according to the text.
- What is an example of negative reinforcement?
Bethany being removed from therapy and taken to her room, where the TV is turned on to calm her down, is an example of negative reinforcement.
- Which age group has the highest rate of TBI incidence?
Children aged 0-4 have the highest rate of overall incidence of TBI, according to the text.
- What is not an example of an academic accommodation?
The diagnostic indicators for Abusive Head Trauma (AHT) are bleeding of the brain and brain swelling.
- Which law can support a student from preschool through post- secondary education and employment?
Section 504 of the Rehabilitation Act of 1973 can support a student from preschool through post-secondary education and employment.
- What percentage of people experience fatigue and sleep disturbances following a traumatic brain injury?
32-73% of people experience fatigue and sleep disturbances following a traumatic brain injury.
- What percentage of people with blast-related injuries and non- blast injuries experience hearing deficits?
Non-blast injuries: 44% Blast-related injuries: 62%
- How does hearing contribute to cognitive issues following a traumatic brain injury?
Hearing deficits can contribute to attention and memory problems following a traumatic brain injury.
- What percentage of people with traumatic brain injury have personality disorders?
23% of people with traumatic brain injury have personality disorders.
- What type of personality disorder is typically developed following a traumatic brain injury?
Organic Personality Disorder is the type of personality disorder typically developed following a traumatic brain injury.
- What percentage of people aged 16 and older were using drugs prior to their traumatic brain injury?
12% of people aged 16 and older were using drugs prior to their traumatic brain injury.
- What percentage of people were using alcohol prior to their traumatic brain injury?
23% of people were using alcohol prior to their traumatic brain injury.
- Which age group is more likely to develop a substance abuse disorder following a traumatic brain injury?
People who are 5 years old are more likely to develop a substance abuse disorder following a traumatic brain injury.
- How is high-risk drinking defined for men following a traumatic brain injury?
High-risk drinking for men is defined as 4 drinks in a day or 15 drinks per week.
- How is high-risk drinking defined for women following a traumatic brain injury?
High-risk drinking for women is defined as 3 drinks in a day or 7 drinks per week.
- According to the Institute of Medicine, what types of changes, rather than physical changes, are related to disability following a traumatic brain injury?
According to the Institute of Medicine, disability following a traumatic brain injury is related to cognitive, behavioral, and personality changes, rather than physical changes.
- How does caregiver burden increase over time following a traumatic brain injury?
Caregiver burden increases over time following a traumatic brain injury.
- How does caregiver burden relate to cognitive and behavioral issues following a traumatic brain injury?
Caregiver burden is related to the cognitive and behavioral issues experienced by the individual with a traumatic brain injury.
- What social issues do individuals with traumatic brain injury experience following their injury?
Individuals with traumatic brain injury experience social issues following their injury due to unemployment, underemployment, lack of residential options, limited social integration, and the need for supervision.
- What causal evidence did the Institute of Medicine find between traumatic brain injury and other conditions?
The Institute of Medicine found causal evidence between:
- Penetrating traumatic brain injury and unprovoked seizures
- Penetrating traumatic brain injury and premature death
- Moderate or severe traumatic brain injury and unprovoked seizures
- What part of the brain modulates arousal, alertness, concentration, and basic biological rhythms?
The reticular activating system is the part of the brain that modulates arousal, alertness, concentration, and basic biological rhythms.
- What part of the brain is very susceptible to anoxia/hypoxia?
- What is the primary purpose of a valid measurement in healthcare?
A valid measurement is one that consistently measures what it claims to measure across different providers and individuals. This allows for accurate assessment and comparison of a patient's condition or progress.
- Which assessment tool is recommended for early use after a traumatic brain injury?
The Glasgow Coma Scale is the recommended assessment tool for use in the early stages after a traumatic brain injury. It provides a quick and standardized way to evaluate the patient's level of consciousness and neurological functioning.
- What is the typical employment rate reported for individuals after a traumatic brain injury?
The employment rate for individuals after a traumatic brain injury is typically reported to be in the range of 10-40%. This low rate highlights the significant challenges and barriers these individuals face in returning to work and reintegrating into the community.
- Which federal legislation provides funding for comprehensive vocational rehabilitation programs for individuals with disabilities?
The Rehabilitation Act of 1973 is the federal legislation that provides grants to states to operate comprehensive vocational rehabilitation programs for individuals with disabilities, including those with traumatic brain injuries.
- What is the key aspect of community enfranchisement for individuals with traumatic brain injury?
Community enfranchisement refers to the extent to which a person with a traumatic brain injury feels they have control over their own level of participation, feels a part of the community, and feels valued. This sense of empowerment and belonging is a critical component of successful community reintegration.
- What autonomic functions are disrupted in individuals with dysautonomia after a traumatic brain injury?
In dysautonomia following a traumatic brain injury, a variety of autonomic functions can be disrupted, including heart rate, respiratory rate, blood pressure, temperature regulation, and perspiration. This dysregulation of the autonomic nervous system can lead to significant medical complications.
- What are the primary causes of incontinence and bladder issues after a traumatic brain injury?
Incontinence and bladder issues after a traumatic brain injury can occur due to a lack of awareness of the bladder, a greater sense of urgency, and poor tone or tight activity of the bladder sphincter. These neurological and
functional impairments contribute to the high prevalence of bladder problems in this population.
- What is the likelihood of a person with a traumatic brain injury dying from a seizure disorder compared to the general population?
Individuals with a traumatic brain injury are approximately 39 times more likely to die from a seizure disorder compared to the general population. This highlights the significant risk and potential severity of post-traumatic seizures.
- Which type of traumatic brain injury is more commonly associated with post-traumatic headaches?
Post-traumatic headaches are more common in individuals who have sustained a mild traumatic brain injury, also known as a concussion, compared to those with moderate or severe traumatic brain injuries.
- What is the typical incidence of deep vein thrombosis (DVT) in individuals with a traumatic brain injury?
The incidence of deep vein thrombosis (DVT) in individuals with a traumatic brain injury is approximately 54%. This high rate highlights the importance of preventive measures and close monitoring for this potentially life- threatening complication.
- What is the defining characteristic of severe brain injury?
Severe brain injury is marked by a period of loss of consciousness of 24 hrs or greater.
- What is the incidence and prevalence of brain injury in the United States?
13.5 million Americans, 4.5% of the population, are living with brain injury.
- What are some chronic conditions caused or accelerated by a traumatic brain injury?
Chronic conditions caused or accelerated by a TBI include aspiration pneumonia, seizures, septicemia, and circulatory problems.
- What are the components of the continuum of care for individuals with traumatic brain injury?
The continuum of care includes acute rehab (emergency department, ICU, acute medical/surgical unit, specialty neuro trauma polytrauma), post-acute rehab (comprehensive inpatient rehab hospital, sub-acute rehabilitation, transitional residential programming), and long-term home and community care (home, SNF, long-term residential programming, outpatient and day treatment services, home and community-based services, school and/or vocational rehab).
Persistent post-concussive symptoms (PPCS) refer to slow or incomplete resolution of symptoms following a mild TBI. 10-15% of individuals with mTBI have PPCS.
- What is the function of the brainstem?
The brainstem serves as a control center for involuntary reflexes such as breathing, heart rate, blood pressure, swallowing, vomiting and sneezing. Injury to the brainstem is life-threatening.
- What is the role of the reticular activating system?
The reticular activating system, a collection of nerve fibers within the brainstem, modulates arousal, alertness, concentration, and basic biological rhythms.
- What are the key functions of the thalamus?
The thalamus, located at the top of the brainstem just below the cortex, relays sensory input to the higher levels of the brain. It has many nuclei and all senses (except smell) relay their impulses through the thalamus. Injury to the thalamus causes a wide range of symptoms.
- What are the main functions of the hypothalamus?
The hypothalamus controls the autonomic nervous system, regulates body temperature, hunger and thirst, the endocrine system, and the sleep-wake cycle. It also controls emotional responses and behavior.
- What is the role of the limbic system?
The limbic system is a deep brain structure interconnected with the diencephalon that is involved in emotion, behavior, motivation, long-term memory, and olfaction.
- What are the key functions of the hippocampus?
The hippocampus, located within the temporal lobe, is associated with memory functioning. Injury to the hippocampus causes short-term memory problems, difficulty consolidating short-term memories into long-term memory, and difficulty organizing and retrieving stored memories.
- What is the role of the amygdala?
The amygdala, located near the hippocampus, evaluates sensory input for emotional content and triggers the fight-or-flight response.
- What are the functions of the basal ganglia?
The basal ganglia receive input from the cerebral cortex, process the information, and send it back to the cerebral cortex. Injury to the basal ganglia affects voluntary motor nerves, causing slowness and loss of movement, tremor, and muscular rigidity.
- What are the key functions of the cerebellum?
The cerebellum, located in the lower back section of the brain, coordinates and modulates all body movement. It controls the direction, rate, force, and steadiness of movements. Injury to the cerebellum causes problems with fine motor movement, trajectory of movement, balance, and proprioception.
- What are the main functions of the frontal lobe?
The frontal lobe is responsible for planning, organizing, problem-solving, judgment, impulse control, decision-making, and working memory.
- What are the key functions of the temporal lobe?
The temporal lobe is involved in memory, language, and hearing.
- What are the main functions of the occipital lobe?
The occipital lobe is responsible for visual processing, including the recognition of size, color, light, motion, and dimensions.
- What are the components of the spinal column?
The spinal column consists of the cervical spine (7 vertebrae), the thoracic spine (12 vertebrae), and the lumbar spine (5 vertebrae).
- What is the structure and function of the spinal cord?
The spinal cord is part of the central nervous system, passing through the foramen magnum at the base of the skull into the vertebral canal. It is made of gray matter surrounded by white matter, and contains 31 pairs of spinal nerves.
- What are the main types of neuroimaging used in traumatic brain injury?
The key neuroimaging techniques used in TBI are computed tomography (CT), magnetic resonance imaging (MRI), diffusion tensor imaging, and functional MRI.
- How does computed tomography (CT) work and what is it used for in TBI?
CT is an X-ray procedure that combines multiple X-ray images with the aid of a computer to produce cross-sectional views and 3D images of internal structures. In TBI, it is used to identify anatomical changes like fractures, swelling, blood clots, and hemorrhage.
- How does magnetic resonance imaging (MRI) work and what are its advantages over CT in TBI?
MRI uses a magnetic field, radio frequency pulses, and a computer to produce detailed pictures of organs, soft tissues, bone, and other internal
- Also known as dysautonomia - Autonomic functions such as heart and respiratory rates, blood pressure, temperature, and perspiration are disrupted - May also present with muscle overactivity, posturing, dystonia, rigidity, and spasticity - Usually resolves in early recovery
- DVT
- Deep vein thrombosis - Occur when a blood clot forms in one or more of the deep veins in the body, usually in the leg - Can cause swelling, redness, or fever but can occur without symptoms - Often occurs after immobility - Without the use of prophylaxis, a PE may occur and lead to death
- PE
- Pulmonary embolus - Clot in the lungs
- Bladder issues
- The brain is the control center for bowel and bladder function, and when injured, the regulatory systems in eliminating may be disturbed, resulting in incontinence or accidents
- TBI and spinal cord overlap
- SCI annual incidence is 12,000 - TBI is present in 60% of individuals with SCI
- Early post-traumatic seizures
- Detection and treatment of EPTS are necessary in order to minimize the potential for secondary brain damage - Occurrence of EPTS is a strong risk factor for the development of LPTS
- What is autonomic dysfunction syndrome?
Autonomic dysfunction syndrome occurs in 15-33% of persons with severe TBI. It is an imbalance in the autonomic nervous system, with signs such as dystonia, agitation, tachycardia, diaphoresis, hyperthermia, hypertension, and tachypnea.
- What is fatigue?
Fatigue is the awareness of a decreased capacity for physical and mental activity due to imbalance in the availability, utilization, and restoration of resources needed to perform activity. It is a phenomenon that is not well understood, so there are no well-established treatments.
- What is primary fatigue?
Primary fatigue is caused by injury or disease which affects the brain centers that control arousal, attention, and response speed.
- What is secondary fatigue?
Secondary fatigue occurs from factors that exacerbate fatigue, such as sleep disturbances, pain, stress, anxiety, and depression.
- What are some measures of fatigue?
Some measures of fatigue include the Visual Analogue Scale for Fatigue (VAS-F), Fatigue Severity Scale (FSS), Barrow Neurological Institute Fatigue Scale (BNI Fatigue Scale), Global Fatigue Index (GFI), and Causes of Fatigue Questionnaire (COF). These assess different aspects of fatigue, such as severity, impact on daily function, and causes.
- What are some causes of sleep disruptions after brain injury?
Causes of sleep disruptions after brain injury include daytime napping, pain, depression, anxiety, possible disruption of the circadian rhythm and melatonin synthesis, and changes in REM sleep.
- How can sleep disturbances be treated after brain injury?
Sleep disturbances after brain injury can be treated through lifestyle modifications, relaxation training, sleep hygiene education, medication, and devices for sleep apnea.
- What is psychological fatigue?
Psychological fatigue is a state of weariness related to reduced motivation, prolonged mental activity or boredom that occurs with chronic stress, anxiety or depression. This is relevant as a high proportion of people with brain injuries experience depression and anxiety.
- What are some interfering factors with cognitive function after brain injury?
Interfering factors with cognitive function after brain injury include medical instability, such as metabolic, pulmonary, endocrine, and sleep dysfunction, as well as impairments of emotional and behavioral control resulting from damage to the brain, difficulties adjusting to deficits, pre-existing factors, or a combination of these. Depression is also a common co-morbid condition.
- What are the principles of cognitive rehabilitation after brain injury?
The principles of cognitive rehabilitation after brain injury include: 1) Viewing cognitive skills and their remediation as hierarchical and inter- related, with basic cognitive skills addressed before higher-level ones. 2) Ensuring less complex treatments supersede those of greater complexity. 3) Targeting attention, perception, categorization, abstract thinking, and memory to restore or reorganize impaired cognition in a hierarchical approach.
- What is the compensatory approach to cognition after brain injury?
