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NURP 503 - Ex 1 > 1: Head Injuries > Flashcards

1: Head Injuries Flashcards

1
Q

Direct force at point of contact may not be solely responsible for _____ of injury. Especially if there is a high rotational component.

A

Direct force at point of contact may not be solely responsible for severity of injury. Especially if there is a high rotational component.

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2
Q

T/F PE for concussions should include looking for fluid from ears/nose.

A

True

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3
Q

What is the Concussion QuickCheck App?

A

Designed by AAN to help coaches, parents and athletes evaluate for concussion. Includes:
Common signs and symptoms of concussion.
Things the athlete may tell you.
What to do if an athlete has a head injury or concussion during a game.
When an athlete should return to play.
State laws on concussion.
Neurologist GPS search.

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4
Q

Why is postconcussive syndrome controversial?

A

Absence of objective neuro findings.
Inconsistent presentation.
Poorly understood patho.

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5
Q

T/F While a player is on the sidelines with a concussion, repeat exam q 15 minutes until symptoms are cleared.

A

True

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6
Q

Cognitive S/S of concussions (4).

A

Irritability
Nervousness/anxiety
Depression
Emotional lability

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7
Q

The effects of multiple concussions over time remains significant. It can result in long-term neuro and functional deficits. What is this called?

A

Repetitive head injury

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8
Q

Significant sway on Romberg tests suggests _____.

A

Significant sway on Romberg tests suggests persistent injury.

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9
Q

Persistent vomiting, worsening headache, increasing disorientation, and changing LOC are signs of what?

A

Elevated ICP

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10
Q

When should a player be allowed to return to play after treatment for concussion?

A

Must be completely asymptomatic. Have pt jog, sprint, or perform sit-ups to see if symptoms return.

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11
Q

Why are children more susceptible to shear injuries?

A

Brain is unmyelinated in infants and young children.

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12
Q

Amnesia can be present with concussions. _____ is generally very brief. _____ can be seconds to minutes.

A

Amnesia can be present with concussions. Retrograde is generally very brief. Anterograde can be seconds to minutes.

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13
Q

Mechanism of injury:

Direct injury to brain at point of contact (coup).

A

Compressive forces

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14
Q

Why are children more prone to injury from shaking?

A

Children’s brains have higher water content (88% vs 77%). More prone to acceleration-deceleration injuries.

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15
Q

What is the most common type of traumatic brain injury (TBI)?

A

Concussion 75%

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16
Q

Physical S/S of concussions (6).

A 
Headache
N/V
Dizziness
Ataxia
Fatigue
Photo/phonophobia
17
Q

What are the highest-risk sports for concussions by sex?

A

Boys: Football and hockey
Girls: Soccer and basketball

18
Q

When is a CT vs MRI chosen for concussions?

A

CT: Typical in ER. Can quickly r/o bleeds.
MRI: Prolonged symptoms. Detects more subtle changes not seen on CT.

19
Q

T/F Child should be closely monitored for the next 24 hours. Parent should wake the child q 4 hours.

A

False. Parent should wake the child q 2 hours, as neuro deterioration can occur during sleep.

20
Q

Mechanism of injury:

Can result in shearing of axons.

A

Rotational forces

21
Q

With the exception of _____, concussion rates are higher during games than practices. Some sports have higher incidences of concussion based on position played.

A

With the exception of volleyball, concussion rates are higher during games than practices. Some sports have higher incidences of concussion based on position played.

22
Q

What is second-impact syndrome?

A

Second head injury occurs before symptoms from first injury heal. LOC not required for diagnosis.

23
Q

Red flags of concussions (13).

A 
Weakness, numbness, or decreased coordination.
Worsening headaches.
Repeated n/v.
Slurred speech.
Anisocoria (unequal pupils).
Seizures.
Inability to wake pt or drowsiness.
Increasing confusion, agitation, restlessness.
Focal neuro signs.
Inability to recognize people/places.
Neck pain.
Unusual behavior changes.
LOC over 30 seconds.
24
Q

Helmets can help prevent concussions. What is the issue with them?

A

Study found only 15% fit properly.

25
Q

When is a pt sent for imaging with a concussion (4)?

A

Focal neuro signs
Signs of increased ICP
Low Glasgow coma scale score
Seizures related to trauma

26
Q

Postconcussive syndrome is most commonly accepted as occurring within what timeframe after initial injury?

A

Several weeks

27
Q

When should a player be allowed to return to play from the sidelines?

A

If symptoms or physical exam results return to normal within 15 minutes.

28
Q

What age range has the most head injuries with recreational activities?

A

10-14 yo

29
Q

Why can infants and young children tolerate increased ICP better?

A

Unfused sutures

30
Q

Mechanism of injury:

Injury at point opposite contact (contrecoup) because axons and nerves are stretched.

A

Tensile forces

31
Q

When is chronic postconcussive syndrome usually seen?

A

Boxing

32
Q

There is no consensus on return-to-play guidelines, but most agree that symptoms must resolve both at _____ and with _____ before clearance to play is granted.

A

There is no consensus on return-to-play guidelines, but most agree that symptoms must resolve both at rest and with exertion before clearance to play is granted.

33
Q

What is the largest cause of head injuries?

A

MVAs 27-37%

Suspected abuse 30-40% (esp children under 2)

34
Q

What is the risk with second-impact syndrome?

A

SIS can cause cerebral edema and herniation, leading to death.

35
Q

Postconcussive syndrome symptoms (8).

A 
Headache
Dizziness
Fatigue
Irritability
Emotional lability
Impaired memory and concentration
Insomnia
Lower tolerance for noise and light
36
Q

A trauma-induced alteration in mental status that may or may not involve loss of consciousness.

A

Concussion

37
Q

A _____ is a type of mild traumatic brain injury.

A

A concussion is a type of mild traumatic brain injury.

38
Q

Sleep S/S of concussions (2).

A

Sleeping more/less than usual

Trouble falling asleep

39
Q

What is the treatment for postconcussive syndrome?

A

Nonnarcotic analgesics

Antiemetics

NURP 503 - Ex 1 (34 decks)

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