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Upper Eval > Head And Neck > Flashcards

Head And Neck Flashcards

0
Q

Rate of injury to head/c-spine higher in women’s or men’s sports?

A

Women’s sports

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1
Q

Rate of injury to head/c-spine higher in high school or college?

A

Higher in college

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2
Q

________ ________ are difficult to grade due to subjective report and often result in RTP prior to healing.

A

Head injuries

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3
Q

The skull and skin combined has a breaking force of _____ to _____ pounds per square inch; skull alone _____.

A

420 to 490, 40

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4
Q

The most complex and least understood part of the human body?

A

The brain

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5
Q

Motor function, sensory information, special senses (5 senses), cognition, memory are functions of which part of the brain?

A

Cerebrum

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6
Q

The largest section of the brain, the ________ is composed of 2 ________ separated by the ________ ________.

A

Cerebrum, hemisphere, longitudinal fissure

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7
Q

Each hemisphere is divided into what 4 lobes?

A

Frontal, pariatel, temporal, occipital lobes

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8
Q

Balance and coordination, smooth muscle control; reaction time, injury is rare

A

Cerebellum

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9
Q

Body temp regulation, emotional control, water balance control, hormone balance and ANS/CNS(hypothalamus), subconscious brain activity

A

Diencephalon (thalamus, hypothalamus, epithalamus)

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10
Q

HR regulation, respiration regulation, peripheral blood flow regulation

A

Brain stem

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11
Q

Secreted by cells surrounding the cerebrum’s blood vessels

A

Cerebrospinal fluid

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12
Q

A leak with skull fracture and torn dura, opening the inter cranial space to the nose and nasal track

A

Cerebrospinal fluid

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13
Q

At rest the brain demands ____% of the body’s O2 uptake; for each degree increased in core body temp (C), the brain demands an additional ____%.

A

20%, 7%

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14
Q

_____ and _____ of concussions; with repeated injury, increase risk for concussion event, increase in SnSx, increase in days to recovery, increase risk of second impact syndrome.

A

Number, recency

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15
Q

Contusion, skull Fx, intracranial hemmorrhage vs. diffuse (headache)

A

localized head pain

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16
Q

_________ following a blow to the head, probability of skull Fx triples in adults, doubles in kids

A

Vomiting

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17
Q

Reports of ________ in one or more extremities is sign of serious damage to the brain, SC, or N root

A

weakness

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18
Q

PCS

A

Post-concussion syndrome

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19
Q

Persistent SnSx including difficulty concentrating, fatigue, emotional instability

A

PCS

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20
Q

Signs of Brain/C-spine trauma

A

Unconsciousness, Not breathing, no pulse, prone on field (motionless), Nystagmus, Vacant stare, Amnesia, confusion, disorientation, irritability, inability to focus, delayed verbal/motor response, dizziness, headache, blurred vision, tinnitus, slurred speech, nausea, vomiting, unusually fatigued, photophobia, emotional

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21
Q

SnSx for Recurrent Concussions

A

Headache, balance/dizziness, “slowed down”, concentration, sensitivity to light or noise, fatigue, drowsiness, memory

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22
Q

Presence of ________ is more predictive or cognitive deficit as compared to ______.

A

amnesia, LOC

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23
Q

All unconscious athletes must be managed as if they have ________ ________ until ruled out

A

c-spine fracture

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24
Q

Ideal on-field evaluation is done by two responders: 1) __________ _____ _______, 2) ________ ________ & _________ ________.

A

1) stabilizes the head, 2) performs primary & secondary assessments

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25
Q

______ _________ can be difficult; however once you have ________ and _______, no need to move from found position until fracture of c-spine is managed.

A

body positioning,

breathing and pulse

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26
Q

3 pathologic body positions

A

1) decerebrate, 2) decorticate, and 3) flexion contracture (C5-6 lesion)

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27
Q

First priority of Primary Assessment

A

Establish LOC

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28
Q

Primary Assessment

A

Establish LOC; when approaching scene, look for movement; attempt to communicate with athlete while stabilizing the head

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29
Q

If unresponsive, use _______ __________.

A 
AVPU
pain stimuli (pinch fingernail, pinch patient, knuckles to sternum)
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30
Q

T/F

Ammonia inhalants are discouraged due to potential unwanted c-spine movement

A

True

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31
Q

Remove face mask with continued stabilization of helmet and use the ________ ____ ________ to open airway.

A

modified jaw lift

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32
Q

Includes examination of the body for severe bleeding or damage

A

secondary assessment

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33
Q

stationary skull hit by object; one side of the brain is injured

A

coup

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34
Q

skull is moving at high velocity and suddenly stops; damage opposite impact

A

countercoup

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35
Q

Repeated non traumatic blows cause a higher degree of degenerative changes; cumulative neurologic deficits; makes getting an accurate history important at physical time

A

Subconcussive Forces

36
Q

A violent jarring or shaking that results in a disturbance of brain function

A

Concussion

37
Q

Battle Sign

A

Bruising over mastoid process indicative of basilar skull fracture hours post-injury

38
Q

Nystagmus

A

Involuntary Circular movement

39
Q

Anisocoria

A

Unilaterally dilated pupil, can be from intracranial hemorrhage placing pressure on Cranial Nerve III, reactive to light bilateral

40
Q

Determines the presence of cerebrospinal fluid in any fluid escaping from the ears or nose

A

Halo Test

41
Q

Raccoon Eyes

A

Indicative of skull or nasal fracture

42
Q

Palpations should include

A

Spinous & Transverse Processes; skull & facial structures; throat to rule out trauma to the larynx, trachea, & hyoid bone; muscle spasm that was identified on inspection

43
Q

Anterograde Amnesia

A

List of events post-injury; repeated 5 min later

44
Q

Retrograde Amnesia

A

Happenings prior to the injury are prompted for recall

45
Q

Balance & Coordination can be assessed through _____ ________ or the __________ Test.

A

tandem walking, Romberg

46
Q

Bones of the face

A
  1. Frontal
  2. Nasal
  3. Zygomatic
  4. Maxilla
  5. Mandible
47
Q

Tandem walking

A

Pt walks heel-to-toe along straight line for ~10 yards; pt returns to starting position by walking backward

48
Q

Romberg Test

A

Pt shuts eyes and abducts arms to 90 degrees with elbows extended; pt tilts head backward and lifts one foot off ground while attempting to maintain balance; pt is asked to touch the index finger to the nose with eyes remaining closed.

49
Q

The temporary cessation of breathing

A

Apnea

50
Q

Monitor and record pulse rate immediately and every _____ min (for_____min)

A

5, 20

51
Q

T/F

BP should decrease across your evaluation of the injury; if it remains high, SN of brain hemorrhage

A

True

52
Q

Cranial Nerve I (name and Function)

A

Olfactory - Smell

53
Q

Cranial Nerve II

A

Optic - Vision (test peripheral vision)

54
Q

Cranial Nerve III

A

Oculomotor - Pupil reaction to light, elevation of upper eyelid

55
Q

Cranial Nerve IV

A

Trochlear - Depress and adduct eye

56
Q

Cranial Nerve V

A

Trigeminal - Face sensation and muscles of mastication (clench teeth)

57
Q

Cranial Nerve VI

A

Abducens - Lateral eye movement (test ability to abduct eye past midline)

58
Q

Cranial Nerve VII

A

Facial - Muscles of expression (smile) and taste

59
Q

Cranial Nerve VIII

A

Vestibulocochlear - Equilibrium, hearing

60
Q

Cranial Nerve IX

A

Glossopharyngeal - Pharyngeal muscles (swallow, voice) and taste

61
Q

Cranial Nerve X

A

Vagus - Muscles of pharynx and larynx (swallow, voice, gag reflex)

62
Q

Cranial Nerve XI

A

Accessory - Trapezius and sternocleidomastoid muscles (shrug shoulders)

63
Q

Cranial Nerve XII

A

Hypoglossal - Tongue movement

64
Q

Spearing

A

cervical flexion associated with axial loading of the c-spine: highly dangerous

65
Q

Although illegal, spearing still occurs in over ____% of all football plays; cervical dislocations primary occur at the level of _____; lordotic curve is 0 at ____ degrees of c-spine flexion

A

19, C4-6, 30 degrees

66
Q

Second-impact syndrome

A

A second blow to the head following a recent concussion; risk for sudden death or serious brain injury as high

67
Q

Subdural Hematoma

A

Caused by venous bleeding between the Dura mater and the brain

68
Q

This injury accounts for a majority of head-injury deaths in sport; symptoms may take longer to develop (30 days after trauma) due to slower venous bleeds, making detection harder

A

Subdural Hematoma

69
Q

Epidural Hematoma

A

Caused by arterial bleeding between the Dura mater and the skull; usually rapid onset of symptoms

70
Q

The outermost meningeal covering of the brain

A

Dura mater

71
Q

A fold in the dura mater in the longitudinal fissure between the two cerebral hemispheres

A

Falx cerebri

72
Q

If arterial blood flow to the brain is obstructed/damaged, the design of the ________ ____ __________ permits at least a partial supply of blood to the affected area

A

Circe of Willis

73
Q

Cerebral Spinal Fluid (CSF) originates from the

__________ ___________

A

Choroid Plexuses

74
Q

Should be used in conduction with on field testing

A

Standardized Assessment of Concussion Instrument (SAC)

75
Q

Measures the magnitude of brain injuries;scores of 11 - 15 have good prognosis

A

Glasgow Coma Scale

76
Q

Serial 7s test

A

Neurological function test that assesses analytical skills; athlete is asked to count backwards from 100 x 7

77
Q

Pulse pressure of ___ mmHg is normal: greater than him ___ mmHG is indicated of increased intracranial bleeding

A

40, 50

78
Q

Importance of vomiting with head injury is a likely indicator of school fracture: __ times likely and children, and ___ times likely in adults.

A

2x children

3x adults

79
Q

Three types of school fractures

A
  1. Linear (crack)
  2. Depressed (debt)
  3. Comminuted (crushed)
80
Q

When do we refer to a physician following a concussion (3)

A
  1. Any loss of consciousness
  2. Amnesia lasting longer than 15 min
  3. Worsening of symptoms
81
Q

Post-concussion syndrome (PCS) symptoms that persist for more than ____ months after injury represent disruption of the brain, especially the ______ _____, ________ lobe, and _______ lobe.

A

3, brain stem, frontal , temporal

82
Q

BESS (balance error scoring system)

A

Firm surface bout: double leg stance, single leg stance, tandem leg stance; soft surface about: double leg stance single leg stance tandem leg stance

83
Q

Jefferson’s fracture

A

A fracture of a circular bone in two places similar to breaking a doughnut in half

84
Q

Cervical stenosis

A

Narrowing of the spinal canal with hyperflexion or hyperextension of the neck, transient quadriplegia can result when the ratio of the diameter of the spinal canal and I am in of the vertebral body is .80 or less, higher risk

85
Q

True/false: the football helmet has been implicated in increasing the number of injuries to the cervical spine

A

True

86
Q

Individuals who have suffered trauma to the are recognizable by their uncovering; segmental, robotlike movement

A

Cerebellum

87
Q

Formed by the medulla oblongata and the pones

A

Brain stem

88
Q

Sympathetic nervous system

A

The part of the central nervous system that supplies the involuntary muscles

Upper Eval (5 decks)

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