CBIS Exam 2 2025 – Certified Brain Injury Specialist Comprehensive
Review with Verified Questions, Rationales, and Flashcards | Study
Guide for BIAA Certification | Neurorehabilitation, Cognitive
Recovery, and Clinical Practice Prep
Nuerocognitive Issues Assoicated with Frontal Lobe
Emotional control, behavioral control, verbal expression, problem solving, decision making, social control,
attention, motivation
Acquired BI
An injury to the brain that is not hereditary, congenital or degenerative or induced by birth trauma
TBI
An alteration in brain function or other evidence of brain pathology, casused by an external force
Mild TBI Characteristics
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
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
Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury
1 BI increases risk of 2nd by 3x and 2nd BI increases risk of 3rd by 8x!
Most Frequent Cause of TBI
Falls
How many people sustain a BI per year?
2.5 million. 81% visit ED, 16% hsopitalized, 3% result in death
How many people are living with effects of a TBI?
13.5 million
Likelihood of BI by gender
Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+
,Falls!
Most common cause of TBI and death by age - 0-3
AHT!
Most common cause of TBI and death by age - 20-24
MVAs and Firearms
Most common cause of TBI and death by age - 16-19
MVAs!
CARF
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
Accreditation agency for hospital based programs, may accompany CARF accreditation, ensures quality of
services through requirements for accreditation and surveys
Olmsted Decison
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
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
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
Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI
Relaxation techniques, rest, slow return to normal activity, and reduction of normal activity if symptoms recur
Peristent Post Concussive Symptoms (PPCS)
Symptoms of Mild TBI last >1 month, occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE)
, 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
Bony shell that protects the brain, has bony prominences inside which can worsen brain injury
Cerebral Spinal Fluid (CSF)
Provides cushion to nerve tissue, produced by ventricles (4) which also store and circulation CSF through the
brain
Meninges
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
Nuerons communicate electrical impulses throughout brain while Glial cells support and nourish Nuerons
Synapse
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
Sense of touch; differentiation of size, color, and shape; visual perception; spatial perception
Functions of the Occipital Lobe
Visual functions
Functions of the Frontal Lobe
Planning; organizing; problem solving; working memory; impulse control; decision making; personality;
behavior; initiation; anticipation; self-monitoring; motor planning; emotions; awareness of abilities; attention;
concentration; mental flexibility; speaking - all executive functions
Functions of the Temporal Lobe
Hearing functions, memory, understanding language, organization and sequencing
Functions of the Brain Stem
Breathing, HR, arousal, consciousness, sleep/wake functions, attention, concentration
Transmits all sensory information from body to brain and movement signals from the brain to the body
Contains sensory centers for hearing, touch, taste, and balance
Even if the cerebral cortex is gravelly damaged, the brain stem can keep someone alive - or in a vegetative state
Review with Verified Questions, Rationales, and Flashcards | Study
Guide for BIAA Certification | Neurorehabilitation, Cognitive
Recovery, and Clinical Practice Prep
Nuerocognitive Issues Assoicated with Frontal Lobe
Emotional control, behavioral control, verbal expression, problem solving, decision making, social control,
attention, motivation
Acquired BI
An injury to the brain that is not hereditary, congenital or degenerative or induced by birth trauma
TBI
An alteration in brain function or other evidence of brain pathology, casused by an external force
Mild TBI Characteristics
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
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
Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury
1 BI increases risk of 2nd by 3x and 2nd BI increases risk of 3rd by 8x!
Most Frequent Cause of TBI
Falls
How many people sustain a BI per year?
2.5 million. 81% visit ED, 16% hsopitalized, 3% result in death
How many people are living with effects of a TBI?
13.5 million
Likelihood of BI by gender
Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+
,Falls!
Most common cause of TBI and death by age - 0-3
AHT!
Most common cause of TBI and death by age - 20-24
MVAs and Firearms
Most common cause of TBI and death by age - 16-19
MVAs!
CARF
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
Accreditation agency for hospital based programs, may accompany CARF accreditation, ensures quality of
services through requirements for accreditation and surveys
Olmsted Decison
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
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
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
Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI
Relaxation techniques, rest, slow return to normal activity, and reduction of normal activity if symptoms recur
Peristent Post Concussive Symptoms (PPCS)
Symptoms of Mild TBI last >1 month, occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE)
, 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
Bony shell that protects the brain, has bony prominences inside which can worsen brain injury
Cerebral Spinal Fluid (CSF)
Provides cushion to nerve tissue, produced by ventricles (4) which also store and circulation CSF through the
brain
Meninges
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
Nuerons communicate electrical impulses throughout brain while Glial cells support and nourish Nuerons
Synapse
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
Sense of touch; differentiation of size, color, and shape; visual perception; spatial perception
Functions of the Occipital Lobe
Visual functions
Functions of the Frontal Lobe
Planning; organizing; problem solving; working memory; impulse control; decision making; personality;
behavior; initiation; anticipation; self-monitoring; motor planning; emotions; awareness of abilities; attention;
concentration; mental flexibility; speaking - all executive functions
Functions of the Temporal Lobe
Hearing functions, memory, understanding language, organization and sequencing
Functions of the Brain Stem
Breathing, HR, arousal, consciousness, sleep/wake functions, attention, concentration
Transmits all sensory information from body to brain and movement signals from the brain to the body
Contains sensory centers for hearing, touch, taste, and balance
Even if the cerebral cortex is gravelly damaged, the brain stem can keep someone alive - or in a vegetative state
