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Rec and Care > Final - Concussions > Flashcards

Final - Concussions Flashcards

1
Q

concussion

A

sport related concussion is a traumatic brain injury induced by biomechanical forces

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2
Q

pathophysiology

A

increase in neuronal depolarization - decrease K and increase Ca
increase Na K pump so you need more ATP and increased glucose metabolism
hypermetabolism decreases cerebral blood flow and increase glucose demand
depressed metabolism warrants unchecked Ca accumulation and can lead to cell death

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3
Q

neurochemical changes in brain after concussion

A

will correct on its own within 2-4 days but repeated will not

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4
Q

impairments of neurological function

A

rapid onset and short lived for minutes to days - can be up to 5 days until it comes out

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5
Q

CT and concussion?

A

no - functional not structural unless its a bleed

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6
Q

loss of consciousness and concussion

A

not a lot so dont get reported - less than 2 mins has no bearing of severity but more than 2 is more complex and CT is warranted

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7
Q

how to identify a concusion

A

obersvation of event and B after

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8
Q

when in doubt

A

sit them out for 24 hours for slightest suspicion and y days if one is diagnosed

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9
Q

scat 5

A

5th symposium
sideline assessment and most tested/validated and quick and cheap stand alone tool - health care providers
most effective within first few days - longer the less valid
not sole diagnostic but an aid
standard for 13 and up
child for less than 12 yr - gen maturity

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10
Q

3 red flags

A

vomitting
staggering
slurred speech

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11
Q

6 observable signs

A 
witnessed 
motionless - wind? thoughts? 
balance/gait 
confusion/inappropriate responses 
blank/vacant stares 
facial injuries
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12
Q

maddocks

A

appropriated to environment and make it a convo

  • venue
  • half of game
  • who scored last
  • team played last week
  • did you win last game?
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13
Q

glasgow coma scale

A

best eye response
best verbal response
best motor
15/15 decrease and call an ambulance

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14
Q

cervical spine assessment - 3

A

clear midline neck pain first
AROM
limb strength and sensation

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15
Q

symptom score

A

fill out on their own and watch them
- more honest and fine motor functioning and focus, redo symptoms every time you see them
athlete background - age, gender, ed lvl, concussion hx, confounding things
26 symptoms 0-6

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16
Q

cognitive testing

A

orientation - month, day, year, time
immediate mem - 5-10 unrelated words 3 times and repeat
digits backwards - increasing length
months in reverse order

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17
Q

neurological screen

A

read out loud
PROM cervical
smooth tracking with no double vision
coordination of hand to nose
tandem gait - 10 m - eyes closed if needed
balance - double, single, non dominant, tandem, eyes closed, softer surface, turn your head - only count big errors

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18
Q

delayed recalled

A

what were the 5/10 words i gave you?

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19
Q

decision

A

scores from tests, and clinical judgment - when you decide to do a scat, the decision has been made that you are not going back - 24 hours

20
Q

tough on concussion guidelines

A

parachute canada and rugby

21
Q

no red flags?

A

no ER

22
Q

initial rest - 4

A

`alcohol, med (can be given from med professionals and med supervisions and they are resting , but we weant to know your symptoms), driving, PA

23
Q

treatment

A

detailed assessment - history, cognitive exam, visual and vestibular testing, cervical examination, other as warranted - physical exertiaonal, coordinaton - then do these while PA

24
Q

treatment plan

A

individualized

25
Q

complete vs relative rest

A

24-48 hrs decrease stim and sleep as much as you want - anxiety can mess up things and fck with the chemicals
after 48 do as much as you can as long as you dont increase symptoms - or your brain gets good at doing nothing

26
Q

sleep hygiene

A

after 48 go back to typical sleep pattern - bed and wake up at the same time

27
Q

mental health

A

tell them the recovery rates

28
Q

academic and work

A

up to ind

29
Q

early interventions

A

good - PA after 48 hours 2 20 min walks a day

30
Q

treatmnet

A

cervical, visual, vestibular, cognitive, physiologic, anxiety, migraine - likely to express after concussion when in the family

31
Q

return to learn

A

have a convo - ASAP, breaks as needed, modified days, options on individualized basis, tolerate testing and hw - dont miss school becasue that makes them more anxious

32
Q

return to sport

A 
school/work first 
stage not days 
must be symptom free stage before progress 
cant have 2 stages in 24 hours 
sport specific
33
Q

5 stages of returning to sport

A 
light exertional - 20 min bike 
mod exertional - 20 min jog 
sport specific drill 
full practice without contact 
full practice with contact 
return to sport
34
Q

time line for return to play

A

min 7 days 2 rest and 5 RTP

35
Q

recovery

A

75-85% recover in less than 2 wks, kids 4 wks, 2% that dont recover on their own and have symptoms that go above a year

36
Q

second impact syndrome

A 
sequential concussive blow while experiencing symptoms from prev 
acute metabolic response 
4 days most critical 
long term brain damage possible 
<21 greater chance of sudden death
37
Q

baseline testing

A 
does not change treatment 
<18 not recommended 
>18 limited 
clearing confounders and good hx can play some role in prevention 
- migraine
anxiety and depression 
learning disability 
cervical muscle weakness 
motion sickness 
impaired visual perception
38
Q

the 3 cs

A

cerebral - orientation, concentration, mem
cerebellar - balance and motor
cranial nerves - neurological functioning

39
Q

cerebral main signs

A 
LOC
intellectual 
emotional 
though content 
sensory 
language
40
Q

cognitive tests

A

effect of head injury on cognitive function - status and improvement - serial 7s, months in reverse order

41
Q

how to test for optic nerve

A

blurred vision - read close up and far away - cerebral injury

42
Q

rhomberg test

A

static - normal sway
eye closed and hands at side
one foot, tandem, soft surface

43
Q

coordination - 4

A

finger to nose
tandem walk
standing heel to knee

44
Q

physical exertion - side line RTP

A 
go through the whole thing and wait 15 mins if they only have bad balance, then ask in private if they want to go back 
sports specific 
pushup 
situp 
bear crawl 
burpies
45
Q

how many days for all your symptoms to go away?

A

21

46
Q

when to stop on stationary bike on day 1

A

when you feel bad

Rec and Care (11 decks)

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