CNS3

Question 1

Glasgow Coma Scale

Answer 1

Motor
Verbalization
Eye opening

Question 2

Eye opening

Answer 2

Spontaneously – 4
To voice – 3
To pain – 2
No response – 1

Question 3

Verbalization

Answer 3

Orientated – 5
Confused – 4
Inappropriate words – 3
Incomprehensible sounds – 2
No response – 1

Question 4

Motor

Answer 4

Obeys – 6
Localizes – 5
Normal flexion/withdraws– 4
Abnormal flexion (decort)– 3
Extension (decerebrate) – 2
No response – 1

Question 5

Concussion: Definition

Answer 5

immediate and transient impairment of neural function

ex: alteration of consciousness, disturbance of equilibrium, etc., due to mechanical forces

Question 6

MIld GCS

Answer 6

13-15

Question 7

MOderate TBI GCS

Answer 7

9-12

Question 8

Sever TBI GCS

Answer 8

3-8

Question 9

Common Early Symptoms of Concussion

Answer 9

HA
Dizziness, lightheadedness or vertigo
↓ awareness of surroundings
Muddled thinking
NV

Question 10

Common Late Symptoms of Concussion

Answer 10

Persistent HA
Lightheadedness
↓ attention and concentration
Poor memory
Easy fatigability
Irritability
Anxiety or depressed mood
Sleep disturbance*

Question 11

Signs of Concussion

Answer 11

Vacant stare 
Delayed responses 
Inattention
Disorientation
Slurred or incoherent speech

Question 12

dazed, befuddled facial expression

Answer 12

Vacant stare

Signs of Concussion

Question 13

slow to answer questions or follow instructions

Answer 13

Delayed responses

Signs of Concussion

Question 14

easily distracted or unable to track conversations

Answer 14

Inattention

Signs of Concussion

Question 15

exhibited by athlete repeatedly asking a question that has already been answered or exhibiting memory deficits on mental status testing

Answer 15

Memory problems

Signs of Concussion

Question 16

paralytic coma, unresponsiveness to stimuli

Answer 16

Loss of consciousness

Signs of Concussion

Question 17

Damage in TBI

Answer 17

Regardless of the direction of the force, frontal & temporal lobes are most affected

Question 18

Rotational or Translational?

Answer 18

Rotational (angular) forces are more damaging than Translational (linear)

Question 19

MRI or CT

Answer 19

MRI better at picking up lessions

Question 20

contrecoup contusions mechanism

Answer 20

Linear (translational) forces cause skull fractures and contrecoup contusions

Question 21

Biomechanical forces cause: __________ through the hemisphere. Irritation leads to rapid, chaotic electrical depolarization across the cortex

Answer 21

tissue deformation, shearing and fluid wave propagation

Question 22

Irritation leads to __________ across the cortex

Answer 22

rapid, chaotic electrical depolarization.

When big enough causes unconsciousness

Question 23

Rotational injuries lead to:

Answer 23

diffuse shearing of small vessels

Diffuse axonal injury is underlying lesion

Question 24

________ failure and axonal stretch injury lead to Calcium influx and axonal swelling or disintegration

Answer 24

Na – K pump

Question 25

PET concosion

Answer 25

Similar metabolic derangement to what’s seen in coma

Question 26

If hemorrhagic lesions are detected on neuroimaging, _______ is certain

Answer 26

axonal injury

Question 27

Concussion Grading Scales

Answer 27

Grade I: Confusion Only
Grade II: Amnesia, no LOC
Grade III: LOC

Question 28

Grade I

Concussion Grading Scales

Answer 28

Transient confusion, no LOC, abnormalities resolve in less than 15 minutes

Question 29

Grade II

Concussion Grading Scales

Answer 29

Transient confusion, no LOC, abnormalities last greater than 15 minutes

Question 30

Grade III

Concussion Grading Scales

Answer 30

LOC- brief or prolonged

Question 31

Vascular Pathology

Answer 31

Autonomic dysregulation of intracranial vessels causes cerebrovascular congestion (brain swelling) and high ICP

Question 32

Second Impact Syndrome

Answer 32

Catastrophic brain swelling occurring if concussions happen near each other in time.

Intracranial vasodilation and cerebrovascular congestion – vascular autoregulation dysfunction