Head injury

Question 1

What is the most common type of TBI?

Answer 1

Acute subdural hematoma

Question 2

What is a coup injury?

Answer 2

Forceful blow to resting head producing max brain injury below point of impact

Question 3

What is a count recoup deceleration?

Answer 3

Moving head impacting against an unyielding object producing max injury opposite the side of imapct

Question 4

What is the implication of a shearing force injury in concussion?

Answer 4

Force applied parallel to surface is the least tolerated by neural tissue, which can produce atonal injury which has no predictable pattern of injury or recovery

Question 5

What is the most common type of intracranial hemorrhage injury type and leading cause of death in athletic head injury?

Answer 5

Acute subdural hematoma

Question 6

What % is SCI of all sports injury?

Answer 6

2-3%

Question 7

What is relationship between recovery and compression force?

Answer 7

Inversely proportional to time of compression

Question 8

What is on field management for SCI?

Answer 8

No movement induced on field

Question 9

What is the clinical syndrome definition of a concussion?

Answer 9

Immediate and transient post traumatic impairment of neural function: altered consciousness, visual disturbances, equilibrium disturbances

Question 10

What are two important cognitive predictors of protracted recovery on concussion?

Answer 10

Amnesia (post-traumatic)

Loss of consciousness

Question 11

What are three important cognitive predictors of protracted somatic recovery in concussion?

Answer 11

Headache
disequilibrium/dizziness
visual disturbances

Question 12

What are the 4 neurocognitive domains evaluated in concussion?

Answer 12

orientation
memory
concentration
delayed recall

Question 13

of all concussed patients, how many will have a prolonged recovery?

Answer 13

1 in 5

Question 14

what are three reasons that hs age athletes are more likely to have protracted neurocognitive effects compared to college athletes?

Answer 14

incomplete myelination of white matter
ongoing neurocognitive development
greater head to body ratio

Question 15

what are symptoms of postconcussion syndrome?

Answer 15

transient episodes of symptoms: exertional headache, fatigue, impaired memory and concentration

Question 16

what are the 3 phases of PT management of protracted concussion recovery?

Answer 16

vestibular-ocular rehab, cervical rehab, physical exertion progression

Question 17

what are the 4 stages of chronic traumatic encephalopathy?

Answer 17

1: headache, loss of attention, concentration
2: depression, explosive reactions, short-term memory loss
3: loss of executive functions, cognitive impairment
4: dementia, word-finding, aggressiveness

Question 18

what is second impact syndrome?

Answer 18

patient typically has mild post concussive symptoms after initial concussion, but after 2nd concussion 15-several min collapses into semi-comatose state

Question 19

what are the 3 tenets of lystedt law for concussion?

Answer 19

1. immediate removal of suspected injured athlete from athletic event
2. education of coaches, parents, and athletes on concussion symptoms and risk of rts
3. return to play only with written clearance of approved healthcare provider that trained in this specific area

Question 20

what is the most important tenet of cervical spine injury?

Answer 20

avoid head impact

Question 21

what is cervical cord neuropraxia?

Answer 21

transient neurological deficit which may involve complete paralysis but can resolve immediately or rapidly allowing activity to be cont. lasts from 10min-48 hr

Question 22

what kind of imaging is used to establish a “central reserve” of CSF around the spinal cord?

Answer 22

MRI

Question 23

is a “stinger” peripheral or nerve root?

Answer 23

peripheral

Question 24

what is a common symptom of a stinger?

Answer 24

burning dysesthesias unilaterally from shoulder through arm to hand

Question 25

difference in numbness bet brachial plexus and nerve root lesion?

Answer 25

brachial plexus has numbness and burning over entire UE, nerve root is definable dermatome

Question 26

difference in sensation loss dermatomal pattern bet brachial plexus and nerve root lesion?

Answer 26

brachial plexus: 2 or more dermatomes lose sensation | nerve root: definable dermatome

Question 27

difference in paralysis in brachial plexus vs. nerve root lesion?

Answer 27

brachial plexus: complete transient paralysis of UE | nerve root: partial transient paralysis of UE

Question 28

where would one expect tenderness in a brachial plexus lesion?

Answer 28

tenderness at brachial plexus no tenderness over posterior neck increase in symptoms w passive head and neck movement to opposite side

Question 29

where would one expect tenderness in a nerve root lesion?

Answer 29

no tenderness at brachial plexus tender over posterior neck hyperflexion, extension, or lateral flexion of neck to same side causes symptoms

Question 30

how does one differentiate bet brachial plexus and nerve root lesions in terms of downward pressure on head w chin in the supraclavicular fossa on same side as lesion

Answer 30

brachial plexus: symptoms do not occur | nerve root: symptoms do occur

Question 31

what is the definition of a cervical radiculopathy?

Answer 31

numbness, tingling, loss of sensation at correlating disc level

Question 32

what is the element that eventually damages the mitochondria involved in a concussion?

Answer 32

Ca

Question 33

what is the protein released in submax exercise? what is it's role in concussion healing?

Answer 33

BDF: brain derived neurotrophic factor | improves neuronal connections

Question 34

What is the physiologic process resulting in concussion?

Answer 34

cell membrane ruptures causing a depolarization of cell with a release of glutamate->K and Mg go out and Ca comes in->energy emergency of hypobolic state of cell->Ca cont to influx cell->cell death