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PSYCH 377 > Lecture 9: Concussion > Flashcards

Lecture 9: Concussion Flashcards

1
Q

Chronic Traumatic Encephalopathy (CTE)

A

a progressive degenerative disease caused by multiple concussions and other closed-head injuries

characterized by neurofibrillary tangles, plaques, and cerebral atrophy and expanded ventricles due to cell loss

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2
Q

Concussion

A

a common term for mild traumatic brain injury

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3
Q

Tau Protein

A

a protein abundant in the CNS that stabilizes microtubules within neurons

high levels in fluid bathing the brain are linked to poor recovery after head trauma

accumulation in brain tissue is a sign of dementia

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4
Q

Coup

A

a bruise (confusion) at the site of a blow to the head incurred where the brain has been compacted by the skull bone pushing inward

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5
Q

Contrecoup

A

a brain injury caused when a blow to the head impels the brain to strike the skull opposite the primary blow

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6
Q

Shearing

A

a process in which microscopic lesions on nerve fibers throughout the brain, especially in the frontal and temporal lobes, result from twisting movement caused by a traumatic blow to the head

twisting and shearing may also damage major fiber tracks, especially those crossing the midline

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7
Q

Hematoma

A

a local swelling or tumor filled with effused blood

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8
Q

Edema

A

an abnormal accumulation of fluid in intercellular spaces of the body

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9
Q

Coma

A

a state of deep unconsciousness due to brain injury or disease

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10
Q

What are the four purposes for a neuropsychological exam?

A

discriminating psychiatric and neurological symptoms

can give information regarding a patient’s cognitive status and personality characteristics

rehabilitation and treatment evaluation and planning

research related to the study of the organization of brain activity and its translation into behavior

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11
Q

What are common populations for neuropsychological exams?

A

neurological illnesses and injuries

neurodevelopmental disorders

medical illness

toxin exposure

learning disabilities

behavioral and psychiatric conditions

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12
Q

In what why do neuropsychological exams discriminate psychiatric and neurological symptoms?

A

PTSD vs MTBI

both may have similar symptoms but are treated differently

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13
Q

In what why do neuropsychological exams provide information about a patient’s cognitive status/personality characteristics?

A

day to day functioning: the self-perception vs reality difference

ability to meet task demands

OCPD and the workplace: assessment can help understand what types of jobs suit people best

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14
Q

In what why do neuropsychological exams aid in rehabilitation and treatment evaluation and planning?

A

the purpose of rehabilitation: what cognitive supports does patient need? what psychological supports?

barriers to rehabilitation: understanding behaviors/issues that impact a patient’s engagement

defined outcomes: expectations about improvement/timing

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15
Q

In what why do neuropsychological exams aid in research related to the study of the organization of brain activity?

A

recovery from brain injury/strike
example: restraint therapy after stroke

research in the neurosciences
example: assessment of cognitive functioning in driver’s evaluations in seniors

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16
Q

What is assessed in a neuropsychological evaluation?

A

general intellect
higher level executive skills (sequencing, reasoning, problem solving)
attention and concentration
learning and memory
language
visual-spatial perception and construction
motor and sensory skills
mood and personality

17
Q

How does neuropsychological evaluation test for lateralization?

A

left handed people –> more creative; similar scores on motor tasks on right and left

right handed people –> long differences between right and left

if right handed person’s right hand is weak, there is damage

18
Q

How does neuropsychological evaluation test for localization?

A

where is the lesion/injury

stroke in Broca’s area: deficit in speech production

hearing in temporal, vision in occipital, higher order in frontal

19
Q

How does neuropsychological evaluation test for severity?

A

degree of neurological impairment

are they able to do basic activities?

20
Q

What is the Glasgow Coma Scale?

A

measures best response in 3 domains
motor response ( /6)
verbal response ( /5)
eye opening ( /4)

classification
13-15: mild brain injury
9-12: moderate brain injury
3-8: severe brain injury

21
Q

What is post traumatic amnesia (PTA)?

A

refers to the inability of head-injured patients to form new memories

22
Q

What is the classification of post traumatic amnesia?

A

less than 5 minutes: very mild
5 to 60 minutes: mild
1 to 24 hours: moderate
1 to 7 days: severe
1 to 4 weeks: very severe
more than 4 weeks: extremely severe

23
Q

How does neuropsychological evaluation test for acuteness?

A

acute injuries typically have a rapid onset, severe symptoms but improve quickly

examples: migraines, strokes

24
Q

How does neuropsychological evaluation test for chronicity?

A

chronic neurological conditions typically last for a long time or recur

examples: severe traumatic brain injury, Parkinson’s disease, multiple sclerosis

25
Q

How does neuropsychological evaluation test for progressivity?

A

progressive conditions show evidence of deterioration

examples: Multiple sclerosis, dementia, ALS (Lou Gehrig’s disease)

26
Q

What are diagnostic tests for concussions?

A

concussions involve a disruption of brain function rather than structural damage

the majority of time CT scans or MRI tests show no obvious damage

27
Q

What is the neuropathology of concussions?

A

trauma/concussion

diffuse axonal injury: stretching or movement of the brain changes chemistry of the brain

massive release of K+ ions

increase glycolysis for K+ pumps

28
Q

What differences are seen in the fMRIs of concussed patients and unimpacted patients?

A

much more activation in concussed patients

brain had to work a lot harder to do the same task

29
Q

What are the conclusions of concussion education?

A

educational interventions suggest that simply presenting available information may help increase knowledge about concussions, but does not produce long-term changes in behavior among athletes

the most successful education efforts have taken steps to ensure materials are user-friendly, interactive, and multi-modal embedded in mandated training programmes

psychosocial theory-driven methods used to understand and improve “buy-in” from intended audiences have shown promise in changing behavior

30
Q

What is the prosocial mindset?

A

circuits designed to enhance positive social behavior

appetitive: designed to take us closer to an experience and want more

circuits are wired for prosocial versus threat/defensive behaviors

threat circuits (defensive postures; fear responses, backing up) are shut down by prosocial circuits

our default is a defensive circuit; is to be concerned about the future; so we need gratitude practices to feel good

gratitude practices can tilt the sea saw between defensive vs prosocial circuits to dominate

31
Q

How is the anterior cingulate involved in gratitude?

A

link between limbic system and prefrontal cortex

processing of discomforting/bad feelings

the “shame” circuit?

32
Q

How is serotonin involved in gratitude?

A

increases activity of neural circuits that makes you more likely to stay in a positive interaction

33
Q

How is the medial prefrontal cortex involved in gratitude?

A

planning and deep thinking and evaluating your experiences

sets context; defines the meaning of your experience

controls the hypothalamus and other brain regions that positively impact your system; things like dopamine, anti-inflammatory markers, immune system

moderates an individual’s experience

34
Q

What are gratitude practices?

A

heightened sympathetic tone (more alertness); intensity of emotions are enhanced

hearing narratives of other people experiencing positive things/gratitude (i.e. someone help them in the midst of a horrible situation)

story/narrative circuits in the brain are powerful; (decreased activation of the ACC)

35
Q

What are the outcomes of gratitude practices?

A

improved rating of quality of social interactions

improved ratings of feeling more positive/happier

more likely to manage stress

improved emotional regulation

PSYCH 377 (14 decks)

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