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KINESIOL 3K03 > Midterm 1 > Flashcards

Midterm 1 Flashcards

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1
Q

S.C.A.L.P? What is the level at which stitches would be needed?

A 
skin
connective tissue - fat, fibrous tissue, nerves, blood vessels
aponeurosis
loose CT
pericranium
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2
Q

What is the weak point called on the skull? Which plates meet there?

A

pterion

frontal, temporal, parietal, sphenoid

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3
Q

What are the 3 meningeal layers? Describe their features. What could happen if these layers are exposed?

A

dura mater - tough, adheres to skull
arachnoid mater - spongy, weblike
pia mater - delicate, adheres to sulci, gyri

risk of bacterial infection - meningitis

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4
Q

Where is CSF produced? Talk about 2 of its main features/functions.

A

Choroid plexus - occupies subararachnoid space

main features: high turn over rate; 99% water - cleanse, cushion, buoyancy for brain (weigh less in the fluid)

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5
Q

T or F: cranial nerves along with the spinal cord can anchor the brain

A

T

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6
Q

What is a concussion? What’s the main myth? What do you expect in terms of impairments? After recent research, what is the relationship between mechanical insult and concussions?

A

subset of mild traumatic brain injury (mTBI)

myth: unconciousness is not related to concussion
mech: we are seeing less mech damage than expected…so does this mean our tech sucks or maybe we have been expectations are wrong

Note: most concussions are mTBI but not vv.

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7
Q

What is the symptom time frame for concussions?

A

seconds, minutes, days, weeks, months

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8
Q

T or F: a concussion only occurs with a direct blow to the head

A

F - blow to the trunk can also lead to concussion

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9
Q

Differentiate the two types of brain matter and their ability to resist compression and shear deformation

A

grey - compression better than shear

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10
Q

Discuss coup-contrecoup brain injuries. What do you expect to see in terms of deficits?

A

due to linear acceleration, the brain hits one side of the skull and rebounds to hit the other - multiple deficits

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11
Q

T or F: CSF is helpful in resisting angular acceleration.

A

F

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12
Q

Discuss the metabolic problem associated with concussions?

A

After trauma, brain cells “pores” are stretched (mechano-poration), leading to leaking of K = imbalance of the neuronal membrane; excitatory NTs flood in

ultimately causing rapid depolarization and AP firing

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13
Q

What is the double whammy associated with this metabolic problem?

A

We need ATP for the Na-K pumps however…

1) Ca floods IN and impairs fxn of the mitochondria (aerobic system)
2) cerebral blood flow(CBF) also decreases

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14
Q

What are the 4 fundamentals?

A

symptoms checklist
cognitive function
physical function
delayed recall

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15
Q

What are we looking for in Symptom Checklist?

A

subjective data from the athlete - dizziness, nausea, pain, ringing in ears, blurry vision

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16
Q

What are we looking for in Cognitive Function?

A

sense of time, orientation
short term memory
concentration

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17
Q

What are we looking for in Physical Function?

A

gross evaluation of ROM
balance test
coordination test

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18
Q

What are we looking for in Delayed Recall?

A

Their ability to remember the 5 words given in the Cog. Fxn test

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19
Q

What are the 4 risk factors of getting a concussion?

A

sex - F > M (REL) but M > F (ABS)
previous concussion - 3x as likely in the same season
fatigue
nature of sport - aerial or equestrial

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20
Q

How long is the typical recovery time? What are the 4 prognostic factors that will affect RECOVERY with concussions? Note: these do not cause

A

7-10 days

learning disabilities
attention/mood disorders
history of migraines
age - inversely related (children experience more cog issues)

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21
Q

What is NP testing? When is this done? What’s the main limitation?

A

neuropsychological - BEFORE (baseline) and after concussion (when the athlete is SYMPTOM FREE - 48-72 hrs)

test available:

  • imPACT - program that assesses brain function in all aspects - NOT DIAGNOSTIC
  • stroop test

athletes will lie - try to aim for lower scores in order to play post-concussion
other factors: fatigue, sleep, blood sugar, etc

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22
Q

Why do we look at heart rate variability in addition to NP testing?

A

After concussion, there seems to be a shift in the ANS, symp. starts to dominate over parasymp. (ie. the body is “on” all the time). We measure HVR (rest vs max) because it is a objective - no one can alter their results.

due to the increased activity of symp, the athlete would have a high rest HR and a low max HR - resulting into a DECREASED HRV post concussion - evident during/post exercise

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23
Q

6 steps of RTP progression?

A

1) physical/mental rest

2) aerobic exercise only (

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24
Q

What happens if the athletes fails one of the steps?

A

They have to go back to the previous step

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25
What is PCS?
post concussion syndrome (chronic) | - >3 weeks of signs/symptoms
26
What is the BCTT? How does this help PCS patients? What changes do we expect in HRV?
Buffalo concussion treadmill test - progressive exercise (ie. increasing walking rate during) - find the MHR at which their symptoms significantly worsen (threshold) - prescribe 80% MHR - 3x/week for 20 mins - increase in HRV - they can work at a higher level of intensity without experiencing symptoms
27
What is Second Impact Sydrome (SIS)?
If after the initial concussion, the patient experiences a second impact of a high magnitude (WITHIN 1 WEEK)...it could be fatal. Note: 30% concussions are unreported. The second impact and the patient's reaction to the second may not be proportional
28
What ages are at risk of SIS? What are the symptoms and aftermath?
Ages
29
Skull fractures are considered open/compound fractures (fx) - what is the associated risk? In what situations would these types of fractures commonly happen?
risk for infection being struck by an object
30
Intracranial bleeding increases what?
intracranial pressure
31
What are 3 signs of a skull fracture?
CSF fluid from orifices battle signs (discoloration around mastoid process), and raccoon eyes (2-3 days post)
32
Collections of blood within the skull are also called? Which two layers can the blood pool? How Due to the change in ICP, what else can happen to the brain?
Intracranial hematomas subdural (venous) - below the dura - symptoms are slower to appear (up to 1 week post) epidural (arterial) - above the dura - symptoms develop very quickly (within hours); usually associated with change in patient status herniation
33
Due to impaired autonomic fxn, what other symptoms would you expect to see?
changes in... severe, worsening head aches pupil response (equality) repeated vomiting
34
What is CTE?
chronic traumatic encephalopathy those who were involved with contact sports or military, experienced neurodegenerative changes accelerated brain deterioration - AD but too early (around their 40s)
35
What kind of neurodegenerative changes?
aggressive temperament cognitive decline - memory/rationality metal health - anxiety/mood/depressive disorders
36
Do mouth guards prevent concussion?
No
37
How about helmets? What were the 3 types discussed in class?
they protect against lacerations and contusions, but maybe linear...however it does not prevent angular acceleration AIM - normal MIPS - with the slip plane (replicate human body - decreases energy of impact and angular acceleration) Hovding - invisible helmet - detects changes in acceleration to deploy airbag
38
When there are two vertebrae stacked on top of one another...what are the main points of contact?
body | superior/inferior facet joints
39
Talk about spinal canal funnel.
buffer zone/space increases as we descend the spine (spinal cord gets smaller due to branching of the nerves)
40
How do muscles, ligaments and discs act it the spinal structure?
deep muscles COMPRESS & STABILIZE the spine (note: superficial do GROSS movements) ligaments prevent excessive movements in ROM; most ligaments are on the posterior side therefore limiting flexion discs lay between vertebra for shock absorption
41
Differentiate dorsal and ventral roots
dorsal - afferent - sensory in ventral - efferent - motor out
42
Differentiate stable and unstable fx
stable - no deformities or neural disruptions | unstable - deformities - usually due to buckling of the spine due to axial load
43
What are teardrop fx?
unstable fx - worst case scenario usually found Cs - FL + compression of anterior aspect of body = chip; posterior aspect then protrudes into the canal
44
What are burst fx? What is a burst fx of C1?
unstable fx - worst case scenario shattering of the vertebrae - usually C1 but it can happen at any level; C1 = JEFFERSON usually "neat"
45
Differentiate dislocation and subluxation
dislocation - GROSS displacement - can happen with or without fx subluxation - minimal displacement - within mm - still in contact
46
Discuss the other types of fractures, more stable - process, clay shoveler's, (some) lumbar compression
Note all of these are outside of the spinal canal process (SPs, TPs) breaks off SP broken due to fascial pull from traps/rhomboids around C6/C7 - power lifters and linesmen compression - aerial sports, axial load crushes anterior aspect of the lumbar vertebrae
47
Compare/contrast lumbar and cervical fx
Cs - more severe because they are smaller, less protected | Ls - protected by trunk, more space in spinal canal
48
When it comes to fx, we have to consider the nature of the sport and movement. What 3 specific sports behaviours put the C spine at risk?
spearing hitting from behind diving
49
What is transient quadriplegia (TQ)?
transient - short term NEUROPRAXIA of C spinal cord - disruption to the SC's ability to send messages (motor and/or sensation) TQ - short term (5mins - 3-4 days) - may appear severe at first
50
Briefly list the 4 main components of primary.
safety check - for yourself and others C-spine LOC ABCs
51
When would you do a spinal assessment (even if they are mobile), for sure?
change in sensation- tingling, weakness, paralysis, spine pain
52
Above all, what is the greatest concern?
VITALS - ABCs!
53
Would you remove their helmets and face masks?
face mask - yes | helmets - no because you can move the c-spine
54
Spinal assessments include what two things?
palpation neurological scan
55
What are dermatomes and myotomes? How are they in terms of variability?
dermatomes - sensory - VARIABLE | myotomes - motor - less variable - note: SMALL MOVEMENTS
56
What are we looking for during palpation?
muscle tone, heart, muscle spasm
57
Brachail plexus - nerves? Pathway?
C5-T1; squeeze through scalenes, under clavicle, below the GH joint
58
What is neuropraxia? What is the other term for neuropraxia of the brachial plexus?
transient conduction block (neural messages) - usually not associated with structural failure (motor and/or sensation) burner or stinger
59
Repeated neuropraxia injury may result in what?
greater neurological damage axonotmesis and neurotmesis
60
Neuropraxia of the BP - what are the symptoms and signs?
- burning, stinging in upper extremity (shoulder --> hand) - paresthesia (change in sensation) - numbness - unilateral (usually on the same side of trauma) - may have muscular weakness (dropped shoulder) (motor and/or sensation)
61
What are the 3 ways the BP can be affected? How would this happen?
1) tensile/traction mechanism; c-spine - lateral flexion (opposite side), shoulder girdle - depression (tackle, slammed to the ground) 2) compression mechanism; c-spine - lateral flexion (same side), c-spine - extension; closing of the intervertebral foramen 3) direct impact - compression mechanism - strike to Erb's point (2-3 cm above clavicle)
62
How would age predispose us to the 3 mechanisms of BP neuropraxia or burner/stinger?
younger (20s) -TENSILE; adults (30s) - COMPRESSION (stenosis of IVF)
63
Burner/stinger - what other injuries should we rule out, and keep at the back of our heads?
broken clavicle | shoulder dislocation
64
How do we prevent injury to the c-spine?
better shoulder pads protective neck rolls tackling technique resistance training
65
What is an auricular hematoma? Short term? Long term?
the ear is composed of a cartilagenous auricle that is wrapped with perichondrium (blood supply) due to high friction/shearing forces (acute or chronic) - it separates these two components and increases the sub-perichondrial space where blood can pool Short term = necrosis - disrupted blood supply causes tissue death Long term = hematoma + necrosis = fibrosis - cauliflower ear deformity; body tries to repair the ear by filling the space with fibrous tissue; may block auditory canal
66
What is the TMJ? features?
temporomandibular joint - beside tragus, open jaw ball = mandible, socket = temporal bone; with meniscus; may be asymmetrical due to hypertrophy open mouth - mandible anteriorly translates
67
If there was a blunt trauma to one side of the mandible, describe one would happen on one side. They other?
distraction/dislocation - trauma side | compression - opposite side
68
What are signs and symptoms or other problems of a TMJ dislocation?
may happen on both sides ``` inability to close mouth spasm of the lateral pterygoid muscle local bruising and swelling teeth breakage fx damage of meniscus ```
69
Are TMJ injuries considered head injuries?
sure,...if it jaw is fractured...imagine the brain
70
What is the orbit composed of? What is an OBF?
orbit: prismatic cone shape, 7 bones, extra-ocular muscles, fat orbital blowout fracture: the orbit is composed of multiple bones (multiple points failure); due to direct trauma to the eye or the orbit, pressure within the orbit increases and shatters the inferior-medial floor of the orbit; medial wall may break as well
71
What's the signs/symptoms of OBF? What may happen to their gaze and why?
bruising, swelling diplopia - 2x vision sensation impairment - numbness through upper cheek area eye looks droopy, like it's withdrawn into skull impaired gaze/tracking - if the inferior floor blows out, the interior oblique muscle can get caught - patient cannot look up in one eye OR they are STUCK looking down
72
What are the two components or layers of bone?
cancellous/cortical bone | porous spongy bone
73
Describe the periosteum. How can it affect injury?
membrane wrapping the bone it's usually the cause of pain "bruised" bone - internal bleeding of the bone, blood trapped under the membrane
74
What is the articular cartilage?
covers the full end of the bone - differs from meniscus which only covers small area
75
Other than the site of impact, where else can the fx occur?
failure at.... points of changing direction/shape points of small x-sectional area (shaft)
76
What 4 forces can cause fx and bone failure?
bending compression (axial) tensile twisting
77
Differentiate the two types of bone fractures - acute trauma vs. stress/repeated fx
acute trauma - one time, recent/new | stress - repeated over time
78
What are are oblique, comminuted, spiral, and horizontal fx?
comminuted - smashed
79
What are some signs & symtoms of a fx?
localized pain bleeding, bruising, swelling muscle spasm - body's natural way of splinting impaired function maybe...deformity
80
First 4 steps when dealing with a fx?
monitor LOC, ABCS reduce risk of SHOCK immobilize check integrity/access of distal circulation
81
In what cases are fx are absolutely an emergency?
compound femur spinal rib (risk to thoracic region - lungs)
82
What 4 complications can occur with fx?
infection compartment syndrome deep vein thrombosis pulmonary embolism - note: usually in lower extremities
83
What is compartment syndrome and what are the signs & symptoms?
compartment = muscles of common function, nerves, blood supply during a fracture, the blood can pool and increase the intracompartimental presure leading to possible compression & cut off of the artery signs - hot, puffy, distal regions are not getting circulation
84
What is a DVT? What increases the risk of DVT?
deep vein thrombosis - fx in lower extremities blood might clot after splinting/casting; blood clot dislodges and travels through venous pathway appearance - puffy, swollen oral contraceptives
85
What can happen, secondary to a DVT? Symptoms?
pulmonary embolism the dislodged blood clot travels and gets trapped in lungs chest pain, shortness of breath, pale
86
What is the expected healing time of a fx?
6 weeks; femurs take longer, fingers 3-4 weeks
87
Side fx of splinting/casting?
sores, itchiness, bacterial growth, skin peeling after removal
88
What happens during the first 10 day after the fracture is casted? Then after?
bone knit together and form a callous - the patch then gets filled up Ca, collagen, and other materials for repair
89
What is ORIF?
Surgical process of adding metal to repair fx open reduction internal fixation
90
What is anterior cord, central cord, syndrome? (motor, sensation)
anterior 2/3- loss of motor, incomplete loss of sensory central - upper > lower limb in motor deficit, mixed sensory
91
What's the difference between tetraplegia and quadraplegia?
same thing - loss of motor/sensation ability of all limbs

KINESIOL 3K03 (3 decks)

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