Concussion Flashcards
at rest, ___ is higher outside of the cell and the cell is more ____ inside
Na+
positive
during depolarization, _____ goes in and ____ goes out
Na+ in (3)
K+ out (2)
T/F: repolarization requires energy while depolarization does not
T
there is an influx of ____ during a synapse due to glutamate
Ca+
which structure of the brain is more prone to injury?
white matter
what happens during energy crisis?
Ca+ blocks ATP from mitochondria due to massive release of glutamate and cerebral blood flow decreases
what is phase 2 of concussion called?
spreading depression 2/2 depressive state of ligand-gated channels
_____ metabolism is impaired and can last for 7-10 days
glucose
_____ axons are more prone to injury
unmyelinated
criteria for concussion
MOI
one sx present
common somatic concussion sx
HA
dizzy
fatigue
visual blurring or diplopia
photophobia
balance probs
common cognitive sx of cussion
feeling slowed down
difficulty concentrating
fogginess
memory dysfunction
which assessment is used to assess concussion on field?
SCAT 6
concussion red flags (SCAT 6)
neck pain or tenderness
seizure or convulsion
double vision
loss of consciousness
weakness or tingling/burning in >1 arm or leg
deteriorating conscious state
vomiting
severe or increase HA
increasing restless, agitated, or combative
GSC <15
visible skull deformity
criteria for persistent concussion symptoms
> 3 persistent sx at rest
30+ days following concussion
causes of PCS
autonomic dysregulation
inflammation
visual, vestibular, cervical systems
mental health
the ____ axis is disrupted with concussion and leads to inflammation and confusion
gut-brain
signs of second impact syndrome
dilate pupils (w/ light exposure)
loss of eye movement
unconsciousness
respiratory failure
death
baseline testing for concussion
computerized neurocognitive test
imPACT testing
BESS test
which test should be performed to assess exercise threshold post concussion?
Buffalo concussion treadmill test (do on day 2)
dietary changes post concussion
intake omega-3
water!!! (1/2 BW in oz)
ensure adequate protein intake
what dietary things to avoid post concussion
caffeine and alcohol
processed sugar/foods
artificial sweeteners
fad diets
if concussion sx are greater than ____ , do not do the BCTT
7
BCTT protocol
warm up at 2.5 mph for 2 mins
3.3 mph 0% incline for 1 min
each min increase incline by 1%
continue up to 15 mins (15% incline)
what is considered failing for the BCTT?
increase in overall wellbeing score (worse sx) by 3 or more points
what is considered passing for the BCTT?
reach age adjusted HR max
reach max exertion on Borg scale
no increase of 3+ points
exercise rx post concussion
at least 5 times per week for 20-30 mins at 80-90% of sx threshold (80% non athlete; 90% athlete)
what testing should be done day 3 of post concussion rehab
cervical and VOMS testing
VOMS components
smooth pursuit
convergence
saccades - horizontal & vertical
VOR - horizontal & vertical
visual motion sensitivity (VORc)
a score of ___ or greater is positive for VOMS test
2 (sx rating)
attention and cognition often improve as _____ is addressed in PT
vision
abnormal convergence test
double vision at >10 cm away
normal VOR test
move head 20 deg at 180 bpm for 10 reps
normal VORc
50 bpm for 5 reps
first ____ days should have relative rest
1-2 days
after ___ days, start subthreshold program
2
resistance training not advised but if done should be at ____% 1RM
30%
goal is to exercise ____ mins
30-45
afferents from ____ provide joint position sense of head
cervical region
how is joint position sense tested?
laser on forehead
concussions are a ____ TBI
mild
