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Neuromus 1 > exam 2 - concussion > Flashcards

exam 2 - concussion Flashcards

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1
Q

what kind of neuro imaging do we find

A

normal

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2
Q

how long do concussion sympmtom last

A

is it varible depends on the presentation and the pt

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3
Q

cellular what happens during a concuntion

A

K+ leaves the cell

Ca runs in - this leads to a metabolic dysfunction

metabolic dysfuntion - energy crisis

massive release of NT interfere with the cell communication

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4
Q

period after conccusion what are the cells are risk for

A

they are venerable for a undefined amount of time that if they sustain a second insult there could be irreversible damage or death of the cells

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5
Q

who do we diagnosis conculsion

A

clinical diagnosis - there is not specific test that we can do

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6
Q

can we rely on imaging for the diagnosis of a concussion

A

no the result are not stable enough

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7
Q

side line /acute assessments

A

sideline assessment of concussion
SCAT
MACE - military

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8
Q

how do we diagnosis a concussion using clinical information

A

side line assessment
symptoms assessment
neurocognitive testing
vestibular/ocular testing
balance training

many of these tools are only helpful at the time of injury

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9
Q

what can wrong during the recovery of a concussion

A

second impact syndrome
chronic traumatic encephalopathy
post concussion syndrome

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10
Q

what is post concussion syndrome

A

after recovery of concussion the deficts persist after normal window of recoverey

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11
Q

what is the precent of people who have PCS

A

20%

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12
Q

does the hit predict how bad a con will be

A

no

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13
Q

on field signs and symptoms

A

LOC
retrograde
confusion
dizziness
numbness
fatigue
personality chnages
head ache
vomiting
light and noise sensitivity
visual issues

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14
Q

what happen with dizziness is associated with a concusion

A

sole factor that is associated with prolonged recovery

6x more likely to take more then 3 weeks to recover

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15
Q

what did the study show about vomiting and LOC

A

predictive of quick recovery <7days

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16
Q

what acute symptoms are not important for recovery

A

seizure
brief LOC
on-field vomiting

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17
Q

when is imaging and additional test indicated

A

ID serious cerbral injury

ID sersious cervical spine issue

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18
Q

what is a focal neurologic deficit

A

A problem with nerve, spinal cord, or brain function.

It affects a specific location, such as the left side of the face

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19
Q

what to do immediatly following a conccusion

A

remove from play

prohibit activity that would lead to further risk of concus

modify physical and cognitive activity

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20
Q

what does modified physical and cognitive activity look like

A

accomadtions at school and work - moderate workload

moderate high stimulus activity

make sure to provide regular assesments to monitor symptoms and recovery

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21
Q

what was shown when people continued to play with a concussion

A

playing doubled the recovery time

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22
Q

pre-exiting risk factors to concusion

A

female
age (teens and older adults)
migraine history
visual dys
mood disorder
concus hx
learning disablities/adah

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23
Q

injury specific risk factors

A

removal from play
on flied dizziness

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24
Q

post injury risk factors

A

miagraines
visual dys
mood disorders
high initial sym burden
multiple areas involved

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25
return to play criteria - contact
sym free at rest sym free with exertion normal testing - cog, physical normal testing this is not the same for noncontact activity
26
are all concus the same
no
27
cognitive fatigue profile
fatigue/reduced energy feels best in the am with cognitive and physical activity end of day sym may have sleep deficts cognitive impairment generalized
28
vestibular profile
dizzy nausea/motion sickness ons step behind symptomatic in a busy area off balance
29
ocular/visual profile
frontal headache with visual work hard time with visually based activity in classes pressure behind both eyes visual focus issues blurry vision double vision
30
anxiety mood profile
hypervigilance and rumination overwhlemed hard time going to bed - unable to turn off thoughts hard time staying asleep obsessive thoughts on invertory symptoms limited socialization
31
rumination
a deep or considered thought about something.
32
post traumatic mirgraine profile
varible headache often awake with a headache nausea, photo and phonophobia stress, anxiety, lack of exercise sleep dysregulation ay also present wiht vetsibular migraines
33
do the concus subtype ever occur alone
no, rarely the key is to find the driving subtype
34
what are the three part of concus management
activity modification therapies medication needed?
35
what is the issue with sym checklist
magnifying underreporting
36
what is neurocog testing used for
assist in determining presence of severity of of concus and establishing recovery from concussion
37
do you just use neurocog testing alone when looking at a concus patient
no
38
what is one computerized neurocog test
imPACT
39
what do you do to screen for vestibular and ocular concussions VOMS
SM and saccades NPC horizontal and vertical VOR visual motion sensitivity
40
what does VOMS stand for
vestibular ocular motor screening
41
what is VOMS used for
used with other test to diagnosis a concussion guide referral and treatment
42
what is included in the VOMS - pre and post
5min screen pre test symptoms assessed head ache, dizzy, nausea, foginess post VOMS assessment
43
for VOMS NPC
convergence and sym provocation
44
what is needed for the VOMS assessment
tape measure metranome target with 14 pt font
45
VOMS scoring
individual sx score totaling 2> ID signifgantly for concus score of >5 cm is sig for a concusion
46
is VOMS related to BESS
no
47
visual system deficits with concus
blurred vision double vision jumping image eye strain hard time taking notes in class
48
what does we see with saccades and concussion
undershoot
49
what is a overshooting issue in saccades
cerebellum
50
what are the issues we can see with convergence
convergence spasm 5 cm
51
what is a convergence spasm - concus
spontaneous spasm pupillary constriction inability to abd the eye pt can describe dizziness associated with spasm
52
what is accommodation
the ability of the eye to focus on a near target, moves the focal point of the eye forward
53
what is age dependent accommadation or convergence
accommodation >30 yrs
54
what is an accommodation insufficiency
amp of acc is lower the expected for that age inability to focus or sustain focus for near vision
55
what is accommodation used for
testing that goes beyond VOMS
56
how do you test accommodation
monocular test 14 pt font - bring thsi forward toward pt until it blurs measure from bridge of the nose compare to age related outcomes
57
do you have ocuclar misalignment after concussion yes
strabismus tropia or phoria can be preexisting
58
what is diplopia
double vision
59
PT options for ocular problems
brock pencil push ups 2 dots card smooth pursuits saccades
60
what is part of the peri vestibualr system
SSC otolith organs vestibular ganglion vestibular canal
61
central vestibular system
vest nuclei cere ANS thalamus CC
62
what is the function of the VOR
stablize vision while the head moves
63
what is the function of vestibular spinal reflex - when is it most active
when vision and somosensation is reduced
64
common vest issue following concussion - peri
BPPV labyrinthine concussion
65
common vest issue following concussion - central
brainstem concussion post traumatic migraine
66
common non-vestibular causes of dizziness
cervicogenic dizzy oculomotor autonomic/othrostatic
67
visual motion sensityvity is often associated with
migraine and anxiety
68
is a balance impairment common following a concussion
very common acutely often related to abnormalities in sensory organization
69
what three system do you need to work to have good balance
vest visual somosensory
70
what is a posturgarphy test
sensory orgnaization test
71
what is the BESS
balance tool designed for concussion 3 stance posture - double leg, single leg, and tandem standing
72
as standing test like BESS, ctsib, SOT sensitive to change the first few days after concussion
no
73
what is more sensitive in first few days following concussion
dual task paradigms COBALT, HITMAN
74
treatment for vestibular concussion
1x/week and daily HEP gaze stabilization
75
treatment for migraine concussion
regulated sleep schedule avoid dietary triggers light exertion - walking/stationary bike 20 min a day without symptom reproduction
76
treatment for conginitive concussion
academic accommodations - school breaks - extra time for tests formal extertion rehab - start once base line symptoms improve

Neuromus 1 (15 decks)

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