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CBIS EXAM STUDY GUIDE
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CBIS EXAM STUDY GUIDE
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CBIS EXAM STUDY GUIDENuerocognitive Issues Assoicated with Frontal Lobe - answer- Emotional control,
behavioral control, verbal expression, problem solving, decision making, social control,
attention, motivation
Acquired BI - answer- An injury to the brain that is not hereditary, congenital or
degenerative or induced by birth trauma
TBI - answer- An alteration in brain function or other evidence of brain pathology,
casused by an external force
Mild TBI Characteristics - answer- Brief or no loss of consciousness for 0-30mins,
altered state of consciousness is most common and must be <24 hours, account for
75% of TBIs, 13-15 on the GCS, normal imaging, highest prevalence of maltreatment as
16-25% never seek care, often considered a concussion
Moderate TBI Characteristics - answer- Loss of consciousness for up to 24 hours, may
appear on scans, skull fractures and bleeding are common, 9-12 on the GCS
Severe TBI Characteristics - answer- Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury - answer- 1 BI increases risk of 2nd by 3x and 2nd BI
increases risk of 3rd by 8x!
Most Frequent Cause of TBI - answer- Falls
How many people sustain a BI per year? - answer- 2.5 million. 81% visit ED, 16%
hsopitalized, 3% result in death
How many people are living with effects of a TBI? - answer- 13.5 million
Likelihood of BI by gender - answer- Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+ - answer- Falls!
Most common cause of TBI and death by age - 0-3 - answer- AHT!
Most common cause of TBI and death by age - 20-24 - answer- MVAs and Firearms
Most common cause of TBI and death by age - 16-19 - answer- MVAs!
CARF - answer- Accreditation agency for post acute BI programs, residential,
outpatient, vocational, home and community, stroke and pediatric programs - ensures
quality of services through requirements for accreditation and surveys
,Joint Commission - answer- Accreditation agency for hospital based programs, may
accompany CARF accreditation, ensures quality of services through requirements for
accreditation and surveys
Olmsted Decison - answer- Supreme court case stimulated by two women living in a
nursing home in Georgia for community inclusion - resulted in federal and state
initiatives to improve and normalize community living
Model Systems of Care 1987 - answer- Resulted in research projects for TBI by the
NIDDR, established rehab facilities to provide care and complete clinical research in the
process
Symptoms of Mild TBI - answer- Headache, fatigue, seizures, nausea, numbness, poor
sleep, light sensitivity, noise sensitivity, impaired hearing, blurred vision, dizziness, loss
of balance, neurological abnormality, in attentiveness, decreased concentration, poor
memory, impaired judgment, slow proccessing speed, executive dysfunction,
depression, anxiety, agitation, irritability, aggression, impulsivity
Primary causes of Mild TBI - answer- Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI - answer- Relaxation techniques, rest, slow return to
normal activity, and reduction of normal activity if symptoms recur
Peristent Post Concussive Symptoms (PPCS) - answer- Symptoms of Mild TBI last >1
month, occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE) - answer- Often cause by repeated blows to
the head, is a progressive, degenerative condition characterized by broken nuerons
which continually release tau protein cashing dementia over time
Diffuse axonal injury -> tau protein release -> inflammation of the brain -> progressive
dementia
Define Skull - answer- Bony shell that protects the brain, has bony prominences inside
which can worsen brain injury
Cerebral Spinal Fluid (CSF) - answer- Provides cushion to nerve tissue, produced by
ventricles (4) which also store and circulation CSF through the brain
Meninges - answer- Pia Mater - molds around suclhi and gyri, deepest layer
Arachnoid Mater - spiderweb-like, middle layer
Dura Mater - hard plastic, top layer
,Nuerons vs Glial Cells - answer- Nuerons communicate electrical impulses throughout
brain while Glial cells support and nourish Nuerons
Synapse - answer- A junction between the axon of one neuron and the dendrite of
another, allows for passing of communication fro, nueron to neuron
Functions of the Parietal Lobe - answer- Sense of touch; differentiation of size, color,
and shape; visual perception; spatial perception
Functions of the Occipital Lobe - answer- Visual functions
Acquired brain injury (ABI) - answer- injury to the brain that is not hereditary, congenital,
degenerative, or induced by birth trauma
Traumatic Brain injury - answer- an alteration in brain function or other evidence of brain
pathology caused by an external force
Mild brain injury - answer- -AKA concussion
-brief or no loss of consciousness
-its presentation may demonstrate vomiting, lethargy, dizziness, and inability to recall
what just happened
Moderate brain injury - answer- -marked by unconsciousness for any period of time up
to 24 hrs
-will have neurological signs of brain trauma (skull fractures with contusion or bleeding
and may have focal findings on and EEG/CT scan)
Severe brain injury - answer- marked by a period of loss of consciousness of 24 hrs or
greater
Incidence/prevalence - answer- -13.5 million americans, 4.5% of population are living
with brain injury
-TBI is a contributing factor to a third of all injury-related deaths in the US
-75% of TBI's that occur each year are mild TBI
-2.5 million people sustain a TBI yearly
Chronic conditions caused or accelerated by a TBI - answer- -aspiration pneumonia
-seizures
-septicemia
-circulatory problems
Continuum of care - answer- -acute rehab
-post-acute rehab
-long term home and community
, acute rehab - answer- -emergency department
-icu
-acute medical/surgical unit
-specialty neuro trauma polytrauma
post-acute rehab - answer- -comprehensive inpatient rehab hospital
-sub-acute rehabilitation
-transitional residential programming
Long term home and community - answer- -home
-snf
-long term residential programming
-outpatient and day treatment services
-home and community based services
-school and/or vocational rehab
standards for rehabilitation facilities - answer- -person centered practices that focus on
their health and safety
-a robust performance measurement, management, and improvement system that
focuses on continuous improvement of both clinical business practices
-delivery of quality services by competent ad well trained personnel
-accountability to persons served, payers, and regulators
Olmstead decision - answer- -in 1999 the supreme court ruled that the plaintiffs must be
granted the option to live in the community
-uses title II of the american disabilities act to assert that states must administer their
services, programs, and activities "in the most integrated setting appropriate to the
needs of qualified individuals with disabilities"
-resulted in multiple federal and state initiatives that make living in the community a
reality for more persons with disabilities
TBI Model Systems of Care - answer- -established in 1987 by the US department of
educations national institute on disability and rehab research, which moved to the
administration for community living in 2015 as the national institute on disability,
independent living, and rehab research
-conducts prospective, longitudinal research to demonstrate the course of recovery and
outcomes following TBI at 16 centers
-maintains the model systems knowledge translation center
mTBI - answer- mild traumatic brain injury
-traumatically induced physiological disruption of brain function
-alteration of mental state (dazed, confused, difficulty answering questions, unclear
thinking, unable to describe what happened prior to or after injury)
mTBI incidence - answer- -represents 75% of all TBI's that occur in the US
-true incidence may be higher as 16-25% of those injured do not see medical care
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