BCS 242 Exam 4

What is Anoxic Brain Injury?

Complete absence of oxygen.

What is Hypoxic Brain Injury?

Reduction in oxygen supply.

What are the environmental causes of Hypoxic Brain Injury?

Reduced oxygen in blood, inadequate blood flow (ischemia), and difficulty metabolizing oxygen by brain tissue.

Which brain structures are most vulnerable to structural damage from hypoxia?

Hippocampus, basal ganglia, thalamus, cerebral cortex, and other areas.

What cognitive symptoms were reported by Caine and Watson (2000) in their study?

54% memory disturbance, 46% personality and behavioral changes, and 31% visuospatial/visual recognition problems.

What are common motor issues associated with Anoxic Brain Injury?

Parkinsonism, dystonia, paralysis, and myoclonus.

What are the mechanisms of injury leading to Anoxia?

Cardiac failure, respiratory failure, anesthesia, near drowning, and self-hanging attempts.

How long can the brain survive without cerebral blood flow before losing consciousness?

20 seconds.

What happens after 3-5 minutes of no cerebral blood flow?

Glucose reservoir is consumed.

What is the outcome after 10-15 minutes of no cerebral blood flow?

Permanent neuronal lesions.

What is the difference in functional outcomes between patients with ABI and TBI according to Cullen & Weisz (2011)?

Patients with ABI found to have worse functional outcomes relative to patients with TBI.

What are some mechanisms of injury leading to Hypoxia?

Chronic obstructive pulmonary disease (COPD), sleep apnea, carbon monoxide poisoning, anemia, high altitude, smoke inhalation, and toxic substances.

What is the hallmark symptom of oxygen deprivation in the brain?

Memory impairment.

What was the condition of Mr. Y upon admission for hypoxic encephalopathy?

PEA arrest due to self-hanging.

What was Mr. Y's score on the Galveston Orientation and Amnesia Test (GOAT)?

44, indicating impairment.

What complications did Ms. X face during her procedure?

Tearing of SVC/inominate veins and a 20-minute CPR interruption.

What is Induction of Hypothermia (IH) in the context of cardiac arrest?

A method to reduce body temperature if consciousness is not regained, typically to 32-34°C (89.6-93.2°F).

What are the effects of Induction of Hypothermia on reperfusion injury?

It stabilizes the blood-brain barrier, decreases cerebral metabolism, and counteracts anaerobic metabolism.

What cognitive issues did Ms. X experience during rehabilitation?

Mild aphasia/apraxia, balance issues, and cognitive impairments.

What psychological issues did Ms. X face post-discharge?

Grief related to vision loss and adjustment to disability.

What is an acquired brain injury?

Any kind of injury to the brain that occurs after birth.

What are some causes of Traumatic Brain Injury (TBI)?

Bump, blow, jolt to the head, or penetrating head injury.

What are the classifications of TBI?

Focal or diffuse, open or closed, and severity.

What counts as an alteration in brain function after a TBI?

Loss of consciousness, memory loss, neurologic deficits, and alteration in mental state.

What is the most common cause of TBI-related deaths in the United States?

Firearm-related suicide.

What percentage of TBI-related deaths occurred in children from birth to 17 years in 2018 and 2019?

Approximately 4.1%.

What is the age-adjusted rate of TBI-related deaths per 100,000 population in males compared to females?

The rate in males was more than three times that of females.

What are the criteria for mild TBI severity?

Normal structural imaging, loss of consciousness less than 30 minutes, post traumatic amnesia 0-1 day, Glasgow Coma Scale (GCS) score of 13-15.

What does a GCS score with a 'T' indicate?

It indicates a TBI with a specific classification.

What is the typical recovery trajectory for mild TBI?

Most often, recovery occurs in days to weeks; >3 months is considered prolonged.

What are common symptoms of mild TBI (concussion)?

Persistent headaches, difficulty concentrating, confusion, fatigue, mood changes, and nausea.

What is the recovery pattern for moderate to severe TBI?

Fastest gains in the first 6 months, then slower recovery up to 18 months and beyond.

What is a case example of moderate to severe brain injury?

A 29-year-old female with TBI after a skiing accident with multiple chronic micro-bleeds.

What is a diffuse axonal injury?

A type of brain injury where the brain is damaged due to shaking or rotational forces.

What is the Glasgow Coma Scale (GCS)?

A scale used to assess a person's level of consciousness after a brain injury.

What are the signs of confusion after a TBI?

Disorientation, slowed thinking, and difficulty concentrating.

What are some neurologic deficits that may occur after a TBI?

Muscle weakness, loss of balance, vision disruptions, and sensory loss.

What is the impact of falls on TBI-related hospitalizations?

Falls lead to nearly half of the TBI-related hospitalizations.

What are the common symptoms of moderate to severe brain injury?

Symptoms can include severe confusion, prolonged loss of consciousness, and significant neurologic deficits.

What is the significance of post traumatic amnesia in TBI assessment?

It helps determine the severity of the injury based on the duration of memory loss.

What is the typical GCS score range for severe TBI?

A GCS score of 3-8.

What is the primary theme of Pediatric Neuropsychology?

The developing nervous system and its plasticity, including the concepts of 'growing into' deficits and abilities.

What is the leading cause of pediatric death and disability in the United States?

Pediatric Traumatic Brain Injury (TBI).

What is the ratio of boys to girls affected by pediatric TBI?

2:1.

How many children and teens are diagnosed with concussion or TBI each year?

Over 2 million.

What are some common causes of pediatric TBI?

Non-accidental trauma, falls, motor vehicle accidents, pedestrian accidents, and sports-related injuries.

Define concussion.

A mild, non-life-threatening head injury that may or may not involve a brief loss of consciousness.

What percentage of children with TBI have a mild injury?

Approximately 80%.

What are some common outcomes for children with pediatric TBI?

Slower processing speed, difficulty learning new information, less efficient learning, and lower IQ.

What is a significant risk factor for poor recovery from TBI?

Premorbid attention deficits.

What is a common myth about younger children and TBI outcomes?

That younger children have better outcomes due to greater brain plasticity.

What is the Kennard Principle?

The oversimplified idea that younger age leads to better recovery from TBI.

What is the relationship between age at injury and academic achievement?

Children with earlier age of injury tend to have worse academic achievement.

What does developmental resiliency refer to in pediatric TBI?

The ability of children to recover from TBI influenced by various factors such as age, sex, and family resources.

How does sex influence outcomes in pediatric TBI?

Boys tend to engage in more risk-taking behaviors and sustain more severe injuries compared to girls.

What is adrenoleukodystrophy?

A genetic, X-linked disease that disrupts myelination due to the accumulation of very long chain fatty acids.

What is the severe form of adrenoleukodystrophy characterized by?

Progressive neurodegeneration leading to death if untreated.

What are the stages of childhood development in relation to skill acquisition?

Emerging skill in infancy/early childhood, developing skill in childhood/early adolescence, and established skill in adolescence/early adulthood.

What are the implications of having a family with socioeconomic stability for children recovering from TBI?

It can influence recovery and access to resources.

What is the impact of cognitive reserve on recovery from TBI?

General cognitive ability and pre-injury academic level can affect recovery outcomes.

What does the term 'plasticity' mean in the context of pediatric neuropsychology?

The brain's ability to adapt and reorganize itself, which can be beneficial or detrimental after an injury.

What is the significance of the prefrontal cortex in pediatric TBI?

It is particularly vulnerable to the effects of early brain insults.

What is myelin?

A whitish-pink lipid layer infused with capillaries that increases conduction velocity of axons.

What condition is characterized by behavioral changes, cognitive decline, and seizures?

Cerebral-onset Adrenoleukodystrophy (ALD)

What is 'Lorenzo's Oil' used for?

It is a preparation from olive oil and rapeseed oil that might help prevent the buildup of very long-chain fatty acids (VLCFAs) in ALD.

What is the established treatment option for cerebral ALD?

Bone marrow (blood stem cells) transplantation.

What factors influence the success of bone marrow transplants in ALD?

Timing of the transplant, matching donor compatibility, and the severity of the disease.

What is the significance of Performance IQ in ALD treatment outcomes?

A Performance IQ greater than 80 at transplant indicates a higher probability of survival.

What is the gene therapy product name for ALD?

Elivaldogene autotemcel.

What is the FDA-approved drug for early-stage ALD in children?

Skysona.

What are the criteria for adding a disease to newborn screening?

Availability of a suitable test, early diagnosis benefits, accepted treatment availability, known natural history, and cost-effectiveness.

What is dyslexia?

A specific reading disability characterized by unexpected difficulty in reading, not primarily due to visual processing issues.

What core deficits are involved in dyslexia?

Phonemic processing, sound recognition, and mapping sounds to written letters.

What is the prevalence of dyslexia in the population?

Dyslexia occurs in 5-15% of the population and is familial and heritable.

What brain regions are associated with dyslexia?

Posterior superior temporal gyrus, angular gyrus, inferior frontal gyrus, and occipital-temporal regions.

How can brain activation patterns in dyslexics be normalized?

Through successful, intensive reading interventions.

What are some characteristics of poor readers with dyslexia?

Over-reliance on anterior systems for sound recognition and compensatory use of visual recognition patterns.

What is the role of plasticity in dyslexia?

Plasticity can be beneficial, but may require intervention to help normalize brain function.

What is a common misconception about dyslexia?

That it involves seeing letters or words backwards or upside down.

What is music therapy?

Clinical & evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional.

What degree is required to become a Board Certified Music Therapist (MT-BC)?

A BS or BA in Music Therapy from an accredited program.

How many clinical rotation hours are required for music therapy education?

180 clinical rotation hours.

What is the purpose of music therapy?

To improve & sustain patient functioning through individualized, patient-directed music therapy treatment planning and implementation.

What is creative arts therapy?

Uses active engagement in the arts to address mental, emotional, developmental, and behavioral disorders.

What are the education requirements for a Licensed Creative Arts Therapist (LCAT)?

An MS or MA in Creative Arts Therapy, a graduate-level internship, and 1500 hours of post-graduate supervision.

What part of the brain processes music first?

The Brain Stem.

What does the Auditory Cortex do?

It perceives tone and pitch, aiding in recognizing melodies, intervals, and frequencies.

Which brain area is associated with emotional reactions to music?

The Nucleus Accumbens.

How does music affect the hippocampus?

Music increases neurogenesis in the hippocampus, allowing the production of new neurons.

What role does the Motor Cortex play in music therapy?

It is involved in movement, foot tapping, and instrument playing, increasing the size of grey matter.

What is the significance of the Basal Ganglia Loop in music therapy?

It processes beat and rhythm, which is beneficial for aphasia and Parkinson's treatment.

What is the function of the Prefrontal Cortex in music processing?

It creates expectations, violations, attention, and satisfaction of expectation.

What are the treatment goals addressed by music therapy?

Neurological, cognitive, social, emotional, psychological, early mobility, physical rehabilitation, and end of life.

What is the required continuing education for MT-BC every five years?

100 hours of mandated continuing education.

What is the role of the Amygdala in music therapy?

It regulates emotional responses and processes emotions elicited from music stimulation.

What is the educational requirement for a PhD in Music Therapy?

Completion of a doctoral program in Music Therapy.

What does the Cerebellum regulate in relation to music?

It regulates rhythm, timing, and physical movement, storing physical memory.

Who were some early pioneers in music therapy?

Eva Augusta Vescelius, Isa Maud Armstrong, Stickney Ilsen, and Willem van de Wall.

What is the role of Wernicke's Area in music processing?

It is involved in musical imagery and encodes music timbre.

What is the significance of the Occipital Lobe in music therapy?

It is involved in reading music and visual cues given in groups.