Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro 2 > Concussion > Flashcards

Concussion Flashcards

1
Q

what level of TBI would a concussion be classified as?

A

mild TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

explain the pathophysiology of a concussion

A

this is a metabolic brain injury

↑ ENERGY DEMAND + ↓ BLOOD SUPPLY → METABOLIC CRISIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list the clinical subtypes of concussion

A
  1. Cognitive/Fatigue
  2. Ocular
  3. Vestibular
  4. Anxiety/Mood
  5. Cervical
  6. Post Traumatic Migraine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the symptoms of the Cognitive/Fatigue Subtype

A

most often seen EARLY ON followinc concussion

  1. Fatigue
  2. HA with cognitive and physical activity
  3. “end of day” symptoms
  4. often see sleep distrubances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

exam findings for Cognitive/Fatigue subtype

A
  1. Vestibular/Ocular screening
    • normal
  2. Neurocognitive Test Results
    • mild, but global/widespread, deficits across all composites
    • deficits with retrieval, encoding intact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

treatment for the cognitive/fatigue subtype

A
  1. incorporate physical/cognitive breaks throughout the day
    • NO NAPS
  2. pharmacological options available if persistent
    • neurostimulants
    • sleep aide
  3. Cog therapy → if symptoms linger more than a few months
  4. Monitored, structured exercise progression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk factors for the Ocular/Visual Subtypes

A

personal/family history of ocular dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

symptoms for the Ocular/Visual Subtypes

A
  1. Frontal HA driven by visual work
  2. Difficulties w/visually-based classes, assignments, or activities
  3. Pressure behind eyes
  4. Visual “focus” issues
  5. Blurry vision
  6. Double vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

exam findings for the Ocular/Visual Subtypes

A
  1. Vision/Oculomotor Exam
    • +Smooth Pursuit, Saccades
    • Convergence difficulties
      • insufficiency
      • spasms/excess
    • Accommodative insufficiency
    • Binocular visual deficits
    • Strabismus
      • Tropias
      • Phorias
  2. Neurocognitive Test Results
    • deficits in reaction time
    • deficits w/visual memory (encoding rather than retrieval)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a strabismus?

A

a misalignment of the eyes or dysconjugate gaze at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a topia?

A

overt deviation of the eye

tend to be present at all time

  • exo → outward (laterally)
  • eso → inward (medially)
  • hyper → upward
  • hypo → downward
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is phoria?

A

ocular deviation occurs when dissociation occurs

tend to show up as the eyes get tired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe what occurs if strabismus is severe or subtle

A
  1. Severe
    • diplopia
    • head tilt (vertical misalignment)
    • noticeable eye turn
  2. Subtle
    • difficulty maintaining focus
    • cosmetically normal
    • ocular soreness
    • HA
    • mental dullness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the difference between convergence and divergence?

A
  1. convergence → ability of eyes to turn inward to focus on a near target
  2. divergence → ability of eyes to move outwards to focus on a further target
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the general symptoms of vergence dysfunction?

A
  1. Asthenopia when reading
  2. Frontal HA
  3. Intermittent/Constant double vision
  4. Squints/closes one eye
  5. Letters appear to float/move on the page
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

list some common vergence problems

A
  1. Convergence insufficiency
  2. Convergence excess
  3. Convergence spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe accommodative dysfunction

A

reduction in ability to focus at near, may prematurely need reading glasses or bifocals

accommodative spasm (over focusing at near)

this is a struggle to coordinate accommodation and vergence, leading to difficulty in spatial awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

accommodative dysfuction will cause trouble with ________

A

spatial awareness

computers/phones/near work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

treatment of Ocular/Visual Subtype

A
  1. Ocular Motor Training
  2. Physical Exertion → generally well tolerated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

risk factors for vestibular subtype

A

PMHx of car sickness/motion sensitivity, migraine, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

symptoms for Vestibular Subtype

A
  1. Vertigo
  2. Dizziness
  3. Nausea
  4. Overwhelmed in visually-stimulating environments
  5. Balance impairments
22
Q

S/S of Vestibular Dysfunction

A
  1. Dizziness
  2. Blurry Vision
  3. Nystagmus
  4. Tinnitus
  5. Vertigo
  6. Hearing Loss
  7. Loss of balance and possible falls
  8. Broad-based stance (to accommodate for imbalance)
  9. Sweating, nausea, and vomiting (due to ANS involvement)
23
Q

list causes of Vestibular Dysfunction in TBI

A
  1. Labyrinthine Concussion
  2. Skull fracture
  3. Hemorrhage into Labyrinth
  4. Hemorrhage into brainstem
  5. Incrased ICP
24
Q

possible manifestation of Labyrinthine Concussion

A

ataxia, imbalance, BPPV may be present

most common vestibular injury due to TBI

25
Q

possible manifestations of skull fracture TBI

A
  1. UVL or BVL (partial or complete)
  2. conductive hearing loss
  3. may have mixed peripheral and central lesions

these are common w/blows to the occiput, temporal or parietal regions

26
Q

possible manifestations of hemorraghes into labyrinth TBI

A
  1. May create post traumatic hydrops (Meniere’s type syndrome)
  2. Damage to labyrinth, may create acute vertigo and unilteral hearing loss
  3. labyrinthine damage may present with S/S similar to acute peripheral vestibular damage
27
Q

possible manifestations of hemorrage into brainstem TBI

A
  1. Oculomotor signs
  2. poor smooth pursuit
  3. vertigo
  4. perception of tilt

this results in damage to vestibular and oculomotor nuclei

28
Q

possible manifestations of increased ICP TBI

A
  1. fluctuating hearing loss
  2. ataxia
  3. imbalance
  4. may cause perilymph fistual
29
Q

exam findings for vestibular subtype

A
  1. Vestibular/Ocular Screen
    • VOR dysfunction (vertical and/or horizontal)
    • VOR suppression
    • Can see +smooth pursuit, saccades
    • **not sig enough to see +skew
  2. Neurocognitive Test results
    • difficulty w/visual motor speed, reaction time
30
Q

the vestibular subtype frequently coexisits with ____________

A

Migraine and/or Anxiety Subtype

31
Q

Treatment for vestibular subtypes

A
  1. Vestibular Rehab Therapy (VRT)
  2. Pharmacological (as needed)
    • Meclizine
    • Tricyclic antidepressants
    • Melatonin
    • SSRIs
32
Q

risk factors for anxiety/mood subtype

A

personal/family hx of anxiety, migraine, vestibular disorders

33
Q

symptoms for anxiety/mood subtype

A
  1. ruminative thoughts
  2. hyper-vigilant
  3. fastidious
  4. easily overwhelmed
  5. difficulties initiating/maintaining sleep
34
Q

exam findings for anxiety/mood subtype

A
  1. Vestibular/Ocular Screen
    • normal
  2. Neurocognitive Test Results
    • normal
35
Q

anxiety/mood subtype treatment

A
  1. treat vestibular and/or migraine subtype, if present
  2. supervised exertion therapy
  3. cognitive behavior training
  4. regulated schedule
    • sleep, exercise, diet, hydration, etc
  5. Psychotherapy
  6. Pharmacology
    • antidepressants
    • benzos
36
Q

risk factors for post-traumatic migraine subtype

A

personal or family hx of migraine, ice-cream HA, motion sensitivity, vestibular disorder, anxiety

37
Q

symptoms for post-traumatic migraine subtype

A
  1. variable HA
    • often wakes with HA
  2. nausea, photo and/or phonophobia
  3. stress, anxiety, lack of exercises
  4. sleep dysregulation
38
Q

what is a migraine?

A

a neurovascular event that is a failure of central modulation of trigeminovascular system

  • 1/3 of pts will experience preceding aura
    • visual, sensory, language, motor
  • high genetic predisposition
39
Q

exam findings for post-traumatic migraine subtype

A
  1. vestibular/ocular screen
    • normal
  2. neurocognitive test results
    • verbal and visual memory deficits
40
Q

treatment for post-traumatic migraine subtype

A
  1. medications
    • pain, sleep regulation
  2. diet
  3. stress management
  4. avoid migraine “triggers”
    • alcohol, caffeine, poor sleep
  5. NO PT
41
Q

risk factors for cervical subtype

A
  1. prior c-spine injury
  2. high-velocity injury
  3. strong rotational component to injury
42
Q

symptoms for cervical subtype

A
  1. neck pain, stiffness, soreness
  2. HA radiating forward from upper C/S
    • precipitated/aggravated by specific neck movements or sustained postures
43
Q

exam findings for cervical subtypes

A
  1. vestibular/ocular screen
    • normal
  2. Neurocognitive test results
    • normal
    • cervical screen
44
Q

treatment for cervical subtype

A
  1. obtain imaging
  2. cervical stabilization exercises
  3. medication
    • muscle relaxants, analgesics
  4. injection/nerve block
  5. massage, acupuncture
45
Q

most commonly reported symptoms in post-concussive athletes

A
  1. HA
  2. feeling slowed down
  3. difficulty concentrating
  4. dizziness
  5. fogginess
  6. fatigue
  7. visual blurring/double vision
  8. light sensitivity
  9. memory dysfunction
  10. balance problems
46
Q

sideline concussion assessments

A
  1. SCAT5
  2. Sideline Impact Test
  3. NFL Sideline Tool
  4. Standarized Assessment of Concussion (SAC)
  5. King-Devick Test
47
Q

what is the purpose of the Buffalo Concussion Treadmill Test

A
  1. to investigate exercise tolerance in pts w/post-concussive symptoms >3 weeks
  2. to help establish appropriate levels of exercise to aid in return to play/activity
  3. to aid in differentiating between possible diagnoses for concussive symptoms
  4. to ID physiological variables associated with exacerbation of symptoms and pt’s level of recovery
48
Q

stopping criteria for the Buffalo Concussion Treadmill Test

A
  1. symptom exacerbation
    • an increase of 3 or more pts on the VAS scale from resting VAS score
  2. voluntary exhaustion
    • an RPE >17 w/o sig symptom exacerbation
  3. pt demo’s rapid progression of complaints, pt appears faint, has stopped communicating, or continuing the test constitutes a sig health risk for the pt
  4. pt reaches 90% or more of age-predicted HRmax
    • with or w/o any increase in symptoms and still reporting low RPE
49
Q

BCTT Exercise prescription

A
  1. 80% of the max HR reached w/o symptom exacerbation
  2. 20 min daily w/o exceeding the time or HR constraints
  3. swimming, walking or stationary cycling → do not attempt resistance training
50
Q

describe typical recovery for concussion

A
  1. 85-90% concussions show signs of recovery in first 10-14 days
    • may be more like 21-28 days for full biophysiological process
  2. Recovery from sports-related concussion in children is ~4 weeks
  3. early ID of impairments aids in return to activity/sport w/o prolonged sequelae
51
Q

predictors of prolonged recovery for concussion

A
  1. Initial symptoms
  2. sex
  3. age
  4. loss of consciousness
  5. amnesia
  6. premorbid comorbidities
    • pysch dx, migraines, vestibular dysfunction

Neuro 2 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions