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Block 7 Week 5 > Concussion-trong > Flashcards

Concussion-trong Flashcards

1
Q

What is a concussion?

A

defined as brain injury and is a complex pathophysiological process affecting the brain, induced by mechanical forces

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2
Q

What can a concussion be caused by?

A

direct blow to head or elsewhere with impulsive forces transmitted to the head

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3
Q

What does a concussion result in?

A

rapid-onset of short-term neurological symptoms which typically resolve spontaneously

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4
Q

What are risk factors for concussion?

A
  • prior concussions
  • higher in females
  • trauma focused sports
  • young athletes
  • ADD, mood disorders, learning disorders, migraines
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5
Q

(blank) athletes more prone to longer recovery periods and more severe catastrophic injuries

A

younger

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6
Q

What do you do when you see a downed athlete?

A

check ABCs

  • immobilize neck, evauate for C-spine injury or brain injury
  • transfer to EF
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7
Q

Tools that can be used to evaluate at the sideline include,,,,?

A

physical examination, symptom checklist, balance tests, cognitive evaluation

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8
Q

What is the sideline assessment?

A

no same day return to play for athlete diagnosed with concussion

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9
Q

When should you get imaginig?

A

only for those whom pathology is suspected

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10
Q

How do you evaluate concussion?

A

Symptom testing
Cognitive testing
Balance testing (BESS)
Neuropsychological testing

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11
Q

What are the physical signs and symptoms of concussion?

A

Physical symptoms

  • Headache
  • Nausea
  • Vomiting
  • Balance problems
  • Dizziness
  • Fatigue
  • Phonophobia / photophobia
  • Visual problems
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12
Q

What are the congitive signs and symptoms of concussion?

A 
Not “feeling right”
Mental fogginess
Difficulty concentrating
Difficulty remembering things
Confusion about recent events
Answering questions slowly
Repeating questions
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13
Q

What are some other symptoms of concussion?

A 
Other symptoms
Irritability
Sadness
Nervousness
Emotionality
Drowsiness
Sleeping more or less than usual
Difficulty falling asleep
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14
Q

How do you cognitive evaluate for a concussion?

A

orientation
past and immediate memory
learning
concentration

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15
Q

What are the orientations for eval of concussion?

A

Standardized assessment of concussion (SAC)

Maddock questions

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16
Q 
What are these:
Where are we?
What quarter is it right now?
Who scored last in the practice / game?
Who did we play last game?
What was the score last game?
A

Maddock questions

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17
Q

How do you check balance?

A

Balance Error Scoring System
-involves 3 stances
-maintain stance for 20 seconds with hands on hips and eyes closed
(points deducted for open eyes, lifting hands off hi, stumbling)

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18
Q

(blank) impairment after concussion may last longer than subjective symptoms

A

Cognitive

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19
Q

How do you objectively measure occult cognitive impairment?

A

evaluates several domains of cog, focus on memory, cog speed and reaction time -> computerize neuropsychological test

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20
Q

(blank) Should be used as part of comprehensive concussion management strategy and never in isolation to diagnose concussions

A

Neuropsychological testing

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21
Q

What is neuropsychological testing able to detect?

A

postconcussive cog deficits

by comparing to baseline done idealy prior to having concussions

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22
Q

T or F

For the vast majority of the time, neuroimaging not indicated

A

T

Only warranted if concern for intracranial pathology such as bleed, herniation, bony fracture, etc.

23
Q

Can you see a concussion on CT/MRI?

A

no

24
Q

(blank) scan measure cerebral glucose intake and regional cerebral blood flow. How?

A

PET/SPECT

inject radioisotope

25
Q

How do you treat concussion?

A

Should engage in relative physical and cognitive rest

Should avoid physical/cognitive activities that increase symptoms in the early stages of concussion

26
Q

In acute phase (0-10 hrs after injury) shuld avoid (blank) medications

A

mental status altering

27
Q

After the acute phase, what can you do?

A

treat symptomatically

28
Q

Is there any particular med for treatment of acute symptoms of concussion? What should you do?

A

no

  • can use acetaminophen for headaches
  • could have risk for bleed
  • relax, ice, massage
29
Q

If headaches linger past (blank) days may consider abortive medications

A

3-4

30
Q

With concussions, sleep disturbances are common but you shouldnt use (blank)

A

sleep promoting meds or stimulants

31
Q

(blank) disturbances also common as well, but again, medications not indicated in acute setting

A

Mood

32
Q

What is the return to play protocol?

A
  • Athlete should be symptom free at rest and at exertion before full participation in sports
  • should have norm cognitive and balance exam
  • stepwise increase in phys demand
  • may take days to months before final clearance
33
Q

If an athlete has symptoms at any step of the return to play protocal what should you do?

A

make them stop and rest until asymptomatic at which time may begin the protocal again at the previous step

34
Q

Prior to clearance, athletes should be (blank)

A

evaluated by licensed healthcare professional

35
Q

Is there a guidline for when an athlete should return to school?

A

no

if they have cognitive difficulties you should give them extra time in school and such

36
Q

What happens if you return an athlete to play before readY, thus what are the short term sequelae of concussion?

A

at risk for second impact syndrome (resulting in death)

or decreased reaction time leading to prolongation or increased risk for recurrent concussion

37
Q

In postconcussion syndrome-the majority of symptoms (80-90%) resolve in (blank) days. Occasionally, symptoms do last from (blank) to (blank)

A

7-10

weeks to years

38
Q

What are the symptoms of postconcussion syndrome?

A

Headache, dizziness, insomnia, cognitive dysfunction, depressed mood, irritability, anxiety, fatigue, noise/light sensitivity

39
Q

Is there a correlation b/w severity of concussion and likelihood of development of postconcussion symptoms?

A

NO!

40
Q

What is the treatment of postconcussion syndrome?

A

time

41
Q

How should you approach post-concussion syndrome?

A

Comprehensive neuropsychological evaluation
Cognitive therapy, neurorehabilitation programs
Supervised progressive exercise programs

42
Q

What is second impact syndrome?

A

Diffuse cerebral swelling thought to be secondary to dysregulation of blood supply to brain, leading to increase in intracranial pressure, brain herniation, and possibly coma/death

43
Q

What is the long-term sequelae of concussions?

A

Chronic traumatoc encephalopathy (CTE) and chronic neurocognitive impairment

44
Q

What is this:
neurodegenerative disease associated with repetitive brain trauma and characterized pathologically by accumulation of tau protein in specific areas of the brain
Associated with memory impairment, depression, poor impulse control, cognitive dysfunction

A

Chronic Traumatic Encephalopathy

45
Q

CTE is a neurodegenerative disease associated with repetitive brain trauma and characterized pathologically by accumulation of (blank) in specific areas of the brain

A

tau protein

46
Q

How can you diagnose CTE?

A

Diagnosis can only be definitively made by confirmatory histopathology after death

47
Q

T or F

not all athletes diagnosed with CTE have reported concussions during play. SO why CTE then?

A

T

Proposed effect of subconcussive blows and/or other factors, including possibly genetic predisposition

48
Q

What is this:
May present with postconcussion syndrome, but may manifest years afterwards
Can be demonstrated by neuropsychological testing
Higher incidence of mild cognitive impairment and depression in former NFL players with concussion compared to those without

A

Chronic Neurocognitive Impairment

49
Q

When is a permanent disqualification due to concussion warrented?

A

no really evidence based quidelines, must be evaluated and determined on a case-by-case basis

50
Q

How do you prevent concussion?

A

No real way

51
Q

DO mouth guards or helmets help prevent concussion?

A

No

52
Q

What is secondary prevention for concussion?

A

may be possible with good return-to play managment

53
Q

Where can you get info on concussions?

A

CDC
NCAA
NFL

Block 7 Week 5 (8 decks)

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