Concussion Pathology And Exam Flashcards
(33 cards)
What are the three components of the Glasgow coma scale
Eyes response, verbal, motor
What are 4 additional red flags that may indicate cerebral edema from meningeal tear (slow bleed)
Worsening dizziness/vertigo
Double vision
Worsening HA
Loss coordination
What time range does mTBI usually improve
7-14 days
What are the 4 main categories of TBI symps
Behavioral, environment, cognitive, motor
What does each tract control:
-lateral vestibular tract
-medial vestibular tract
-vestibulocerebellar tract
-controls LE motor units for balance (flex and ext mus)
-C/S and t/s mus
-coordination
What 3 CN are found in ocular motor systems
CN III: oculomotor
CN IV: trochlear
CN VI: abducens
What does the vestibule-ocular reflex do
Info from vestibular nucleus generates movements that stabilize gaze during head movements
What does the vestibular and ocular-motor systems undergo in TBI? What does it cause?
Chemical distruption
Disrupts timing —> dizziness, vertigo, walking difficulties
What is post-concussion syndrome
Concussion s/s for over 6 weeks
Central issue —> continued neuroinflam
What brain changes occur in post-concussion syndrome (4)
-decreased hippocampal vol (memory)
-increased cell death risk
-smaller thalamus (unable to process sensory info)
-risk limbic atrophy
Symptoms of post-concussion syndrome
HA, dizziness, fatigue, poor coordination, anxiety
Inability to habituate
What is the difference between dizziness and vertigo
-light headed, woozy, off balance (caused by alcohol, OH, not sleeping)
-work spinning; inner ear
Which pathway controls orientation
Medial vestibular pathway
Difference between dizziness and disequilibrium
Dizziness: light headed, woozy, off balance, external causes
Disequilibrium: inner ear imbalance
Specific vestibular s/s of mTBI
N/v, nystagmus (w/ rapid head movements)
What 4 things combined contribute to decreased postural control
Visual, vestibular central and peripheral, and poor integration
What is one big ANS change in mTBI?
BP - loss of auto regulation
Vasorestriction and exercise intolerance
What energy sources decrease in mTBI? What can it lead to?
Glucose and mitochondria
Brain fog/fatigue
2 main common behavioral symps
HA with noise and light sensitivity
Dizziness
3 main symptoms specificity regarding metabolism
Attention, HA, fatigue
What is the King Devick test
-pre and post injury
-rapid # naming
-athletes
3 cards
Assesses eye movement, attention, language, suboptimal brain fxn
When not to perform a graded exertional tolerance exam
If pt has symps at rest
What to keep track of during graded aerobic ex
-time, mode, symp onset
-BP and HR
-RPE
If vestibular involved what form of aerobic exercise to test
Bike
