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PTRS 853 Final > Concussion > Flashcards

Concussion Flashcards

1
Q

Concussion is a _____ TBI

A

mild

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2
Q

Term: Biomechanically induced neurological injury resulting in an alteration of mental status…which may or may not result in a loss of consciousness

A

Concussion

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3
Q

Term: a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces

A

Concussion

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4
Q

PT role in concussion management (3)

A
  1. Acute on-field evaluation
  2. Sub-acute assessment
  3. Rehab/Return to Play/Activity
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5
Q

List the symptoms of concussion (10)

A
  1. Headache (71%)
  2. Feeling slowed down (58%)
  3. Difficulty concentrating (57%)

4.Dizziness (55%)

  1. Fogginess (53%)
  2. Fatigue (50%)

7.Visual blurring/double vision (49%)

  1. Light sensitivity (47%)
  2. Memory dysfunction (43%)

10.Balance problems (43%)

**Difficult to distinguish concussion sx from teenager sx

**Bold symptoms = related to vestibular system

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6
Q

List the key subjective complaints after concussion - cogntive/fatiuge findings (5)

A
  • Headache of 0/10 in the morning, worsens progressively
  • Increasing fatigue as the day goes on
  • Distractibility, poor attention
  • Symptoms with physical activity
  • May have sleep deficits
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7
Q

List the key subjective complains after concussion - cervical findings (6)

A
  • Neck pain/ soreness
  • Limited cervical ROM
  • Symptoms worse with prolonged sitting/ reading postures
  • Headaches (occipital)
  • C/O dizziness and visual symptoms related to cervical ROM
  • May have generalized balance complaints
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8
Q

List the key subjective copmlaints after concussion - ocular findings (4)

A
  • Frontal headache or pressure behind eyes brought on my visual activities
  • Problems in high visual and cognitive demand classes (math/science)
  • Blurry vision, double vision, difficulty maintaining visual focus
  • Fatigue, distractibility
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9
Q

List the key subjective complaints after concussion - anxiety/mood findings (6)

A
  • Hypervigilance, rumination
  • Overwhelmed (poor tolerance of busy environments)
  • Difficulty initiating sleep (unable to turn thoughts off)
  • Difficulty maintaining sleep
  • Excessive focus on/inventory of symptoms
  • Limited socialization
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10
Q

List the key subjective copmlaints following concussion - post-traumatic migraines (6)

A
  • Variable headache and intermittently severe
  • Often wakes with headache
  • Nausea, photo and/or phonophobia
  • Stress, anxiety, lack of exercise
  • Sleep dysregulation
  • May also present with vestibular-migraine symptoms
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11
Q

List the key subjective complaints after concussion - vestibular findings (5)

A
  • Dizziness
  • Nausea
  • “One-step behind”
  • Overwhelmed/anxious in busy environments
  • Off-balance
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12
Q

PT Concussion Subjective: Details of Injury (5)

A
  • LOC (duration)
  • Amnesia
  • Prepared for impact vs. “blindsided”?
  • Removed from play/activity vs. continue to participate
  • On-field symptoms include dizziness?
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13
Q

PT Concussion Subjective: Prior History (5)

A
  • Migraines [Personal History, Family History]
  • Prior Concussion [Length of recovery, Complete recovery]
  • Mood Disorders
  • Learning Disabilities
  • Ocular Motor Problems [Strabismus, “Lazy Eye”, Amblyopia]
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14
Q

PT Concussion Subjective: Current Symptoms (7)

A
  • Headaches
  • Dizziness
  • Visual complaints/difficulty reading
  • Imbalance
  • Neck pain
  • Auditory system complaints (fullness/pressure/tinnitus/loss)
  • Fatigue/Sleep dysfunction
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15
Q

List the Key Factors Related to Recovery (6)

A
  1. Age (younger takes longer to recover)
  2. Exertion (high level of activity after takes longer to recover)
  3. Migraine (hx increases length of recovery)
  4. Amnesia (increases length of recovery)
  5. Dizziness (w/dizziness 6.4x inc risk of protracted recovery)
  6. Repetitive Injury (multiple concussions risk factor for future concussion)
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16
Q

Balance Test BESS (5)

A

Balance Error Scoring System

  1. 3 stance postures [double, single, tandem support]
  2. Firm and foam surface
  3. Eyes closed
  4. Scored based on # postural correction in 20 sec trial
  5. More errors > higher score > worse prognosis
17
Q

Balance Tests (6)

A
  1. BESS
  2. DGI
  3. Functional Gait Assessment
  4. Dual Cognitive Task Paradigms
  5. 5x STS
  6. TUG
18
Q

Term: Maintains stable gaze at slow speeds < 60 d/sec

A

Smooth pursuit

19
Q

Term: Differences in tonic firing rate b/t vestibular nucleii

A

Spontaneous nystagmus

20
Q

Term: Quick movements of eyes b/t targets

A

Saccades

21
Q

Term: Maintains fixed gaze with head movements

A

Slow VOR

22
Q

Test: 2-4 small amplitude, quick movement and observe corrective saccades; peripheral sign- UVL or BVL

A

Head Thrust Test

23
Q

Test: Move head at the rate of 2Hz with 30deg neck flexion and observe nystagmus; horizontal nystagmus- peripheral sign; vertical nystagmus- Central sign

A

Head Shake Test

24
Q

Term: Saccades or nystagmus is a central sign

A

VOR cancellation

25
Q

Test: 2 Move head at 2Hz and if patient loses > 3 lines indicates hypofunction

A

Dynamic Visual Acuity Test

26
Q

Symptoms of Vergence System Deficits (9)

A
  • Trouble reading, focusing
  • Trouble focusing from far to near (taking notes in class
  • Blurred vision
  • Headaches
  • Eye strain
  • Sensitivity to light (w/ excessive vergence response)
  • Pulling sensation around eyes
  • Avoidance of reading
  • Comprehension deficits over time
27
Q

Guidelines for Return to Play Following Sports Concussion (4)

A
  • Gradual return to play program should be implemented once the following conditions are satisfied:
  • Completely asymptomatic presentation
  • Normal neuro-cogntive evaluation
  • Off medications

PTRS 853 Final (10 decks)

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