Concussion

Question 1

at rest, ___ is higher outside of the cell and the cell is more ____ inside

Answer 1

Na+
positive

Question 2

during depolarization, _____ goes in and ____ goes out

Answer 2

Na+ in (3)
K+ out (2)

Question 3

T/F: repolarization requires energy while depolarization does not

Answer 3

T

Question 4

there is an influx of ____ during a synapse due to glutamate

Answer 4

Ca+

Question 5

which structure of the brain is more prone to injury?

Answer 5

white matter

Question 6

what happens during energy crisis?

Answer 6

Ca+ blocks ATP from mitochondria due to massive release of glutamate and cerebral blood flow decreases

Question 7

what is phase 2 of concussion called?

Answer 7

spreading depression 2/2 depressive state of ligand-gated channels

Question 8

_____ metabolism is impaired and can last for 7-10 days

Answer 8

glucose

Question 9

_____ axons are more prone to injury

Answer 9

unmyelinated

Question 10

criteria for concussion

Answer 10

MOI
one sx present

Question 11

common somatic concussion sx

Answer 11

HA
dizzy
fatigue
visual blurring or diplopia
photophobia
balance probs

Question 12

common cognitive sx of cussion

Answer 12

feeling slowed down
difficulty concentrating
fogginess
memory dysfunction

Question 13

which assessment is used to assess concussion on field?

Answer 13

SCAT 6

Question 14

concussion red flags (SCAT 6)

Answer 14

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

Question 15

criteria for persistent concussion symptoms

Answer 15

> 3 persistent sx at rest
30+ days following concussion

Question 16

causes of PCS

Answer 16

autonomic dysregulation
inflammation
visual, vestibular, cervical systems
mental health

Question 17

the ____ axis is disrupted with concussion and leads to inflammation and confusion

Answer 17

gut-brain

Question 18

signs of second impact syndrome

Answer 18

dilate pupils (w/ light exposure)
loss of eye movement
unconsciousness
respiratory failure
death

Question 19

baseline testing for concussion

Answer 19

computerized neurocognitive test
imPACT testing
BESS test

Question 20

which test should be performed to assess exercise threshold post concussion?

Answer 20

Buffalo concussion treadmill test (do on day 2)

Question 21

dietary changes post concussion

Answer 21

intake omega-3
water!!! (1/2 BW in oz)
ensure adequate protein intake

Question 22

what dietary things to avoid post concussion

Answer 22

caffeine and alcohol
processed sugar/foods
artificial sweeteners
fad diets

Question 23

if concussion sx are greater than ____ , do not do the BCTT

Answer 23

7

Question 24

BCTT protocol

Answer 24

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)

Question 25

what is considered failing for the BCTT?

Answer 25

increase in overall wellbeing score (worse sx) by 3 or more points

Question 26

what is considered passing for the BCTT?

Answer 26

reach age adjusted HR max reach max exertion on Borg scale no increase of 3+ points

Question 27

exercise rx post concussion

Answer 27

at least 5 times per week for 20-30 mins at 80-90% of sx threshold (80% non athlete; 90% athlete)

Question 28

what testing should be done day 3 of post concussion rehab

Answer 28

cervical and VOMS testing

Question 29

VOMS components

Answer 29

smooth pursuit convergence saccades - horizontal & vertical VOR - horizontal & vertical visual motion sensitivity (VORc)

Question 30

a score of ___ or greater is positive for VOMS test

Answer 30

2 (sx rating)

Question 31

attention and cognition often improve as _____ is addressed in PT

Answer 31

vision

Question 32

abnormal convergence test

Answer 32

double vision at >10 cm away

Question 33

normal VOR test

Answer 33

move head 20 deg at 180 bpm for 10 reps

Question 34

normal VORc

Answer 34

50 bpm for 5 reps

Question 35

first ____ days should have relative rest

Answer 35

1-2 days

Question 36

after ___ days, start subthreshold program

Answer 36

2

Question 37

resistance training not advised but if done should be at ____% 1RM

Answer 37

30%

Question 38

goal is to exercise ____ mins

Answer 38

30-45

Question 39

afferents from ____ provide joint position sense of head

Answer 39

cervical region

Question 40

how is joint position sense tested?

Answer 40

laser on forehead

Question 41

concussions are a ____ TBI

Answer 41

mild