CBIS Exam 2022 pt. 2
Brain injury is disease ___, disease ___, and disease ___ -
causative; challenging; accelerating
Cardiopulmonary issues following TBI can due to ___ trauma or ___ trauma -
primary; secondary
Cardiopulmonary issues are related to ___ and ___ -
heart; breathing
When can cardiopulmonary issues post-TBI arise? -
immediately, chronically, or emerge later
Post-TBI cardiopulmonary issues are associated with increased ___ and ___ -
mortality; morbidity
Cardiopulmonary issues that can arise after TBI include: -
orthostatic hypotension
aspiration pneumonia
deep vein thrombosis (DVT)
pulmonary embolism
What is orthostatic hypotension? -
drop in blood pressure due to a sudden change in posture
What is aspiration pneumonia? -
food/drink goes below the VFs
What is deep vein thrombosis (DVT)? -
thrombus (blood clot) forms in one of the deep veins of the body, usually the legs;
can result in leg pain, swelling, or have no signs
What is a pulmonary embolism (PE)? -
starts as DVT, then a chunk of clot (embolic) breaks off and travels to a lung
artery and stops blood flow
PE occurs in what percent of TBI patients? -
54%
Failure of the parts of the sympathetic and parasympathetic nervous systems that contribute
to autonomic (involuntary) nervous system -
dysautonomia or autonomic dysregulation
What does the sympathetic nervous system do? -
control of arousal: increased heart rate, respiration, perspiration, release of
adrenaline and other hormones that characterize body's stress response
1|Page
,What does the parasympathetic nervous system do? -
responsible for de-arousal or relaxed states: lowering heart rate, reducing
adrenaline, etc.
Dysautonomia is also known as what? -
autonomic storming
When does dysautonomia typically resolve? -
early after discovery
Symptoms of dysautonomia include issues with: -
heart rate
respiratory rates
blood pressure
temperature
perspiration
muscle overactivity
posturing
dystonia
rigidity
spasticity
Common musculoskeletal issues after TBI include: -
hyperreflexia
spasticity
contractures
fractures
peripheral nerve damage
etc.
The involuntary increase in muscle tone and exaggerated deep tendon reflexes; overactive
reflexes that are involuntary -
hyperreflexia
Abnormal, usually permanent, condition of joints characterized by decreased ROM, often in a
flexed position, and fixation due to wasting away, shortening of muscle fibers, and loss of
skin elasticity -
contractures
Involuntary, abnormal motoric pattern; may interfere with a person's general functioning,
self-care, and mobility; abnormal muscle tightness due to prolonged contraction -
spasticity
Spasticity and contractures can be treated with: -
ultrasound therapy
exercise
serial casting
When identifying and managing chronic or late TBI complications, you should consider ___ -
normal aging/degeneration
2|Page
, When the regulatory system is damaged, it can cause ___ -
incontinence
UTIs can occur both ___ and ___ in a TBI -
early stages; late stages
What type of changes in a patient are initially indicative of a UTI? -
cognitive, behavioral
How can staff treat a patient with a UTI? -
hydration
minimal caffeine
timed voiding
catheters
Any indwelling catheters should be removed ___ -
ASAP
Bladder training for patients with incontinence means automatically voiding every ___ -
2 hours
UTIs may be ___ in hospitals -
chronic
Causes of incontinence can include ___, ___, ___, and ___ -
-altered bladder sensation
-less capacity
-more urgency
-greater frequency
Issues with incontinence is NOT a ___ issue -
behavioral
Tube feedings and decreased mobility are two factors that can contribute to ___ -
bowel issues and fecal incontinence
To manage bowel/fecal issues, patients need a what? -
predictable bowel routine
Patients with bowel or bladder issues are often not great at ___ -
reporting
What are some treatments for patients with bowel/fecal issues? -
stool softeners
laxatives
fluid intake
Some factors that may complicate nutrition include: -
safety awareness, alertness, dysphagia, other medical issues
3|Page
Brain injury is disease ___, disease ___, and disease ___ -
causative; challenging; accelerating
Cardiopulmonary issues following TBI can due to ___ trauma or ___ trauma -
primary; secondary
Cardiopulmonary issues are related to ___ and ___ -
heart; breathing
When can cardiopulmonary issues post-TBI arise? -
immediately, chronically, or emerge later
Post-TBI cardiopulmonary issues are associated with increased ___ and ___ -
mortality; morbidity
Cardiopulmonary issues that can arise after TBI include: -
orthostatic hypotension
aspiration pneumonia
deep vein thrombosis (DVT)
pulmonary embolism
What is orthostatic hypotension? -
drop in blood pressure due to a sudden change in posture
What is aspiration pneumonia? -
food/drink goes below the VFs
What is deep vein thrombosis (DVT)? -
thrombus (blood clot) forms in one of the deep veins of the body, usually the legs;
can result in leg pain, swelling, or have no signs
What is a pulmonary embolism (PE)? -
starts as DVT, then a chunk of clot (embolic) breaks off and travels to a lung
artery and stops blood flow
PE occurs in what percent of TBI patients? -
54%
Failure of the parts of the sympathetic and parasympathetic nervous systems that contribute
to autonomic (involuntary) nervous system -
dysautonomia or autonomic dysregulation
What does the sympathetic nervous system do? -
control of arousal: increased heart rate, respiration, perspiration, release of
adrenaline and other hormones that characterize body's stress response
1|Page
,What does the parasympathetic nervous system do? -
responsible for de-arousal or relaxed states: lowering heart rate, reducing
adrenaline, etc.
Dysautonomia is also known as what? -
autonomic storming
When does dysautonomia typically resolve? -
early after discovery
Symptoms of dysautonomia include issues with: -
heart rate
respiratory rates
blood pressure
temperature
perspiration
muscle overactivity
posturing
dystonia
rigidity
spasticity
Common musculoskeletal issues after TBI include: -
hyperreflexia
spasticity
contractures
fractures
peripheral nerve damage
etc.
The involuntary increase in muscle tone and exaggerated deep tendon reflexes; overactive
reflexes that are involuntary -
hyperreflexia
Abnormal, usually permanent, condition of joints characterized by decreased ROM, often in a
flexed position, and fixation due to wasting away, shortening of muscle fibers, and loss of
skin elasticity -
contractures
Involuntary, abnormal motoric pattern; may interfere with a person's general functioning,
self-care, and mobility; abnormal muscle tightness due to prolonged contraction -
spasticity
Spasticity and contractures can be treated with: -
ultrasound therapy
exercise
serial casting
When identifying and managing chronic or late TBI complications, you should consider ___ -
normal aging/degeneration
2|Page
, When the regulatory system is damaged, it can cause ___ -
incontinence
UTIs can occur both ___ and ___ in a TBI -
early stages; late stages
What type of changes in a patient are initially indicative of a UTI? -
cognitive, behavioral
How can staff treat a patient with a UTI? -
hydration
minimal caffeine
timed voiding
catheters
Any indwelling catheters should be removed ___ -
ASAP
Bladder training for patients with incontinence means automatically voiding every ___ -
2 hours
UTIs may be ___ in hospitals -
chronic
Causes of incontinence can include ___, ___, ___, and ___ -
-altered bladder sensation
-less capacity
-more urgency
-greater frequency
Issues with incontinence is NOT a ___ issue -
behavioral
Tube feedings and decreased mobility are two factors that can contribute to ___ -
bowel issues and fecal incontinence
To manage bowel/fecal issues, patients need a what? -
predictable bowel routine
Patients with bowel or bladder issues are often not great at ___ -
reporting
What are some treatments for patients with bowel/fecal issues? -
stool softeners
laxatives
fluid intake
Some factors that may complicate nutrition include: -
safety awareness, alertness, dysphagia, other medical issues
3|Page
