NCS Prep - Med bridge
List stages of change - answer1. Precontemplation: no intention to change in next 6
months
2. Contemplation: intend to take action in next 6 months
3. Preparation: intends to take action in next 30 days and has taken some behavioral
steps in this direction
4. Action: has changed overt behavior for less than 6 months
5. Maintenance: has changed overt behavior for more than 6 months
6. Termination: no longer succumb to temptation and has self-efficacy
CN I Olfactory - answer-sensory, smell
-telencephalon
CN II Optic - answer-sensory, vision
-diencephalon
-visual fields, color vision, visual acuity
CN III Oculomotor - answer-somatic and visceral motor
-midbrain
-constricts pupil, up/down and medial eyelid and eyeball movement
CN IV Trochlear - answer-Somatic
-midbrain
-move eye down and out
CN V Trigeminal - answer-Opthalmic (sensory), pons
-maxillary (sensory), midbrain
-mandibular (mixed), pons
Leading cause of brain injury - answerFalls (35%)
Diffuse Axonal Injury (DAI) - answer-shear injury caused by rapid
acceleration/deceleration/rotation
-microscopic diffuse injury to axons
-cortical parasagittal white matter, brain stem and cerebellar peduncles
-frequent cause of vegetative state and morbidity
Pathological grades of DAI - answerI: microscopic axonal injury only
II: I + corpus callosum lesion
III: II + brainstem lesion
Secondary Injury of TBI - answer-Increased ICP, decreased CPP
, -new bleeding, infection, seizure activity
-metabolic cascade (triggered by ischemia or hypoxia)
Intracranial Pressure (ICP) - answer-pressure inside cranium
-lower than 20 mmHg
Cerebral Perfusion Pressure (CPP) - answerthe blood pressure gradient across the
brain.
-about 60 mmHg
-CPP=MAP-ICP
MAP equation - answer1/3 SBP + 2/3 DBP
Complications of TBI - answer-HO
-Seizure risk (80%)
-infection
-hydrocephalus
Coup-Contracoup Injuries - answerDamage to impact site and opposite side of brain as
well
Primary TBI Injuries - answer-skull fracture
-contusion
-hematoma
-laceration
-DAI
-accompanying anoxia or ischemia
Paroxysmal autonomic instability with dystonia - answerA syndrome of intermittent
agitation, diaphoresis, hypothermia, hypertension, tachycardia, tachypnea, and extensor
posturing; a risk factor for increased morbidity after brain injury.
-can occur weeks after injury
-increase in sympathetic nervous system activity
Glascow Coma Scale - mild - answer13-15
Glascow Coma Scale - moderate - answer8-13
Glascow Coma Scale - severe - answer8 or higher
Ranchos Los Amigos - Level I - answerNo response, unresponsive to stimuli
Ranchos Los Amigos - Level II - answerGeneralized response. Nonspecific,
inconsistent, and non-purposeful responses to stimuli usually pain.
List stages of change - answer1. Precontemplation: no intention to change in next 6
months
2. Contemplation: intend to take action in next 6 months
3. Preparation: intends to take action in next 30 days and has taken some behavioral
steps in this direction
4. Action: has changed overt behavior for less than 6 months
5. Maintenance: has changed overt behavior for more than 6 months
6. Termination: no longer succumb to temptation and has self-efficacy
CN I Olfactory - answer-sensory, smell
-telencephalon
CN II Optic - answer-sensory, vision
-diencephalon
-visual fields, color vision, visual acuity
CN III Oculomotor - answer-somatic and visceral motor
-midbrain
-constricts pupil, up/down and medial eyelid and eyeball movement
CN IV Trochlear - answer-Somatic
-midbrain
-move eye down and out
CN V Trigeminal - answer-Opthalmic (sensory), pons
-maxillary (sensory), midbrain
-mandibular (mixed), pons
Leading cause of brain injury - answerFalls (35%)
Diffuse Axonal Injury (DAI) - answer-shear injury caused by rapid
acceleration/deceleration/rotation
-microscopic diffuse injury to axons
-cortical parasagittal white matter, brain stem and cerebellar peduncles
-frequent cause of vegetative state and morbidity
Pathological grades of DAI - answerI: microscopic axonal injury only
II: I + corpus callosum lesion
III: II + brainstem lesion
Secondary Injury of TBI - answer-Increased ICP, decreased CPP
, -new bleeding, infection, seizure activity
-metabolic cascade (triggered by ischemia or hypoxia)
Intracranial Pressure (ICP) - answer-pressure inside cranium
-lower than 20 mmHg
Cerebral Perfusion Pressure (CPP) - answerthe blood pressure gradient across the
brain.
-about 60 mmHg
-CPP=MAP-ICP
MAP equation - answer1/3 SBP + 2/3 DBP
Complications of TBI - answer-HO
-Seizure risk (80%)
-infection
-hydrocephalus
Coup-Contracoup Injuries - answerDamage to impact site and opposite side of brain as
well
Primary TBI Injuries - answer-skull fracture
-contusion
-hematoma
-laceration
-DAI
-accompanying anoxia or ischemia
Paroxysmal autonomic instability with dystonia - answerA syndrome of intermittent
agitation, diaphoresis, hypothermia, hypertension, tachycardia, tachypnea, and extensor
posturing; a risk factor for increased morbidity after brain injury.
-can occur weeks after injury
-increase in sympathetic nervous system activity
Glascow Coma Scale - mild - answer13-15
Glascow Coma Scale - moderate - answer8-13
Glascow Coma Scale - severe - answer8 or higher
Ranchos Los Amigos - Level I - answerNo response, unresponsive to stimuli
Ranchos Los Amigos - Level II - answerGeneralized response. Nonspecific,
inconsistent, and non-purposeful responses to stimuli usually pain.
