Concussion Flashcards by Kim Hayden

Describe the basic pathophysiology of concussion

Abnormal exchange of sodium and potassium
Excessive production of glutamate
Interferes with the cells communication
Results in Axonal Dysfunction or Axonal Death

How well did you know this?

Not at all

Perfectly

What is the potential reason for cognitive defects for 7-10 days after concussion?

To restore cerebral homeostasis, the membrane ionic pumps work at an accelerated rate
This requires extra ATP and Glucose
Increased metabolic demand often not met with enough blood flow to support it

How well did you know this?

Not at all

Perfectly

What are signs and symptoms of post concussive syndrome?

Headache
“In a fog”
Emotional changes
Amnesia
Behavioral changes
Sleep disorders (sleeping more or less than normal)
Altered cognition
Diminished reaction time
Dizziness or gait alteration

How well did you know this?

Not at all

Perfectly

What are additional Long Term Symptoms of Post Concussive Syndrome?

Dementia
Parkinsonism
Amyotrophic lateral sclerosis (ALS)
Chronic traumatic encephalopathy

How well did you know this?

Not at all

Perfectly

The severity of Traumatic Brain Injuries is directly related to what?

Amount of force produced by the collision
Ability of anatomical structures to absorb the energy
Ability of the protective equipment to dissipate and absorb the energy produced

How well did you know this?

Not at all

Perfectly

What type of weight training program should all athletes perform to prevent concussion?

Cervical Strengthening

How well did you know this?

Not at all

Perfectly

What percent of acute concussions go unreported?

How well did you know this?

Not at all

Perfectly

What is the primary concern with an athlete who has been recently concussed?

Airway, Breathing, Circulation

- If athlete responding to verbal questioning, not a concern

How well did you know this?

Not at all

Perfectly

How do you treat the unconscious athlete in regards to cervical spine?

Manage as though unstable spine is present
Log roll if necessary to preserve airway
Face mask removed
Transfer to spine board
Do not remove helmet on field unless it prevents stabilization of the spine or face mask cant be removed in reasonable amount of time

How well did you know this?

Not at all

Perfectly

What is the first part of the exam for a conscious athlete who received a concussion?

Eye to Eye contact

How well did you know this?

Not at all

Perfectly

How do you manage the conscious athlete with a concussion on the field who complains with neck pain, spasm or has deformity?

Remain on the field in a supine position
Face mask should be removed
Athlete managed as though an unstable cervical spine is present

How well did you know this?

Not at all

Perfectly

If no indications of unstable C Spine are present, what is initial management of concussion on the field?

Assist to sitting
While palpating c spine, AROM is assessed in all directions while equipment still on
If athlete complains of C Spine symptoms or has “bony block”, return to supine, treat as unstable
If not, Assist to standing and walk off the field

How well did you know this?

Not at all

Perfectly

What is the initial sideline evaluation of the conscious athlete with concussion?

MOI Description
C Spine ROM and palpation performed again
If not painful, remove helmet
If pain during helmet removal, return helmet to head, treat as unstable
Perform MMT and Myotome testing

How well did you know this?

Not at all

Perfectly

Describe the Myotomes/ Myotomal testing done on the sidelines.

C4 - Shoulder elevation
C5 - Shoulder abduction
C6 - Elbow flexion
C7 - Elbow extension
C8 - Grip and thumb extension
T1- Dorsal and palmar interossei

How well did you know this?

Not at all

Perfectly

Describe Cranial Nerves tested on the sidelines

CN II - Optic, Vision
CN III - Occulomotor – eye movement medial/ lateral/superior/inferior
CNIV - Trochlear – eye movement diagonal
CN VII - Facial – control of the musculature of the face

How well did you know this?

Not at all

Perfectly

What are the Cranial Nerves?

Study These Flashcards

Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibular
Glossopharyngeal
Vagus
Spinal Accessory
Hypoglossal

What is the function of the Olfactory Nerve?

Study These Flashcards

Smell

What is the function of the Optic Nerve?

Study These Flashcards

Vision

What is the function of the Oculomotor Nerve?

Study These Flashcards

Innervates ciliary, sphincter pupillae and all the external eye muscles except: superior oblique and lateral rectus

What is the function of the Trochlear Nerve?

Study These Flashcards

Innervates superior oblique eye muscle

- Abduction, depression and internal rotation of the eye

What is the function of the Trigeminal Nerve?

Study These Flashcards

Sensory innervation of the face, sinuses and teeth

What is the function of the Abducens Nerve?

Study These Flashcards

Innervates the lateral rectus muscle of the eye, which retracts the eye within the orbit

What is the function of the Facial Nerve?

Study These Flashcards

Muscles of the face

- Taste sensation to the anterior two thirds of the tongue

What is the function of the Vestibular Nerve?

Study These Flashcards

Innervation to the inner ear

What is the function of the Glossopharyngeal nerve?

- Taste for the posterior third of the Tongue - Sensation to the tonsils, pharynx and middle ear - Motor to the stylopharyngeus muscle and the parotid gland

What is the function of the Vagus Nerve?

- Motor and Sensation for Heart, Lungs, GI and much more | - Parasympathetic fibers to viscera

What is the function of the Spinal Accessory Nerve?

- Upper Trapezius Motor

What is the function of the Hypoglossal Nerve?

- Muscles of the tongue

How should you evaluate the somatosensory system in the conscious athlete with concussion?

- After Cranial Nerve Exam | - Coordination tests such as Finger to nose, Romberg, and Bess

What are some standardized tests given to concussed patients for cognitive functioning?

- Standardized Assessment of Concussion (SAC) | - Immediate Post Concussion Assessment and Cognitive Test (IMPACT)

After the initial sideline evaluation, the acutely concussed athlete should be monitored for what?

- Changes in vital signs (i.e., pulse, respiration, blood pressure) - Increasing complaints related to neurological function (headache, photophobia, dizziness, etc) - If above symptoms change, activate emergency response system and get athlete to ER, could be indication of serious neurological condition

Follow ups after the initial sideline eval for the acutely concussed athlete should be performed at what time points?

- 1-3 hours | - 24 hours

In general, what should return to play criteria be based on after concussion?

- Resolution of physical symptoms (headeache, dizziness, etc) - Return of cognitive status to pre-determined normal levels - No one test should be used as a standard for return to play

What types of medication should not be used to treat headache after concussion?

- Aspirin Products

Describe how to find target heart rate based on Karvonens Formula

- Max heart rate (HR) (220- age) - Resting HR X percent + Resting HR - Max HR - Resting HR; Take that number, multiply by percentage of heart rate you want; then add your resting heart rate back in. - Example: 220-20=200-70(rest) =130 X 50 percent= 65 + 70 = 135 (50 percent THR)

Describe the 5 stages of return to play after concussion and associated target heart rates

- Stage 1 - No activitiy, Absolute rest - THR 30-40% - Stage 2 - Light Aerobic activity - THR 40-60% - Stage 3 - Sport Specific Training - THR 60-80% - Stage 4 - Full Contact - THR 80% - Stage 5 - Return to Play - Full Exertion

Describe Second Impact Syndrome?

- Another concussion before the first one has completely resolved - Potentially Fatal - Because of complete loss of auto regulation of blood supply to brain and causes uncontrolled swelling of the brain - Presentation of rapid deterioration of neurological status and collapse - 50% Mortality

Concussion Flashcards

(37 cards)