Unit 3 Content

Question 1

What are the leading causes of TBI

Answer 1

32% from falls
19% from MVA
18% struck by an object

Question 2

What are some primary brain injuries

Answer 2

Coup-countercoup
Polar brain injury
Blast injury
Diffuse axonal injury

Question 3

What are some secondary brain injuries and when do they occur

Answer 3

minutes to hours after an injury

Epidural, Subdural and intracerebral hematomas

Question 4

What is normal ICP and when should you take action if it is abnormal, what should you never do

Answer 4

4-15 mmHg
over 20 mmHg notify nurse and modify activity
Over 30 mmHg stop all exercise
Never invert these patients

Question 5

What are some common neuromuscular impairments that result from TBI

Answer 5

Paresis
Abnormal tone
Motor functions
Postural control

Question 6

What are some common cognitive impairments that result from TBI

Answer 6

Arousal deficits
Attention deficits
Concentration deficits
Memory deficits
Learning deficits
Executive function deficits

Question 7

What are some common behavioral impairments that result from TBI

Answer 7

Agitation or aggression
Disinhibition 
Apathy
Emotional lability
Mental inflexibility
Impulsivity 
Irritability

Question 8

Describe a Coma

Answer 8

Patient’s eyes are closed, they’re not able to respond, they have no sleep wake
cycles
usually pass away or move to another state

Question 9

Describe the Glasgow coma scale

Answer 9

3 - 8 - severe injury
9 - 12 - moderate injury
13 - 15 - Minor brain injury

Question 10

Describe a minimally conscious state

Answer 10

minimal evidence of themselves or the environment

will exhibit localization to stimuli

Question 11

Describe the Glasgow coma scale scoring

Answer 11

Examines eye opening, motor response and verbal responses
3 - 8 - severe injury
9 - 12 - moderate injury
13 - 15 - Minor brain injury

Question 12

What age groups and gender are at the highest risk for TBI

Answer 12

0 - 4 years
and
15 - 19 years
males 1.5 times more than females because if reckless behavior

Question 13

What is a concussion

Answer 13

…a brain injury, and is defined as a complex pathophysiological process
affecting the brain, induced by biomechanical forces

it is a functional disturbance not a structural one

Question 14

What generally can cause a concussion

Answer 14

a direct blow to the head neck or fac

Question 15

What are the 5 acute symptoms

Answer 15

Symptoms - headache, fogginess, emotional liability
Physical signs - LOC, amnesia
Behavioral changes - irritability
Cognitive impairments - slowed reaction times
Sleep disturbances - insomnia

Question 16

What is the pathophysiology of a concussion

Answer 16

Ion channel dysfunction
Metabolic energy crisis
Physiologic axonal stretching

Question 17

Describe a blast related concussion and the injury types

Answer 17

Primary - shockwaves form blast disrupt brain tissue
Secondary - Fragments cause penetrating injury
Tertiary - blunt trauma from striking solid surface

Question 18

What is the most common symptom of a blast concussion

Answer 18

headache

Question 19

If there is a suspected concussion in an athlete what is the protocol

Answer 19

immediate removal from play

Question 20

What are the blood based biomarkers in a concussion

Answer 20

Tau

Question 21

What sports put athletes at the greatest rick for concussion

Answer 21

Football
Rugby
Hockey
Soccer

Question 22

What are some risk factors for sports concussion

Answer 22

prior concussion

3x greater risk in football players

Question 23

Do helmets protect against concussions

Answer 23

no

They do reduce impact forces but do not prevent concussion, neither do soft head protectors

Question 24

Is LOC a measure of concussion severity

Answer 24

if it lasts more than 1 minute

Question 25

What are the return to play guidelines following concussion

Answer 25

Removed from play if concussion is suspected
No play on same day of suspected concussion
Athletes should be symptom free without medications prior to returning to sport
Prior to returning athletes should participate in a stepwise return to play protocol with no return of symptoms

Question 26

What symptoms predict longer recovery periods from concussion

Answer 26

previous concussions
greater number and severity of acute symptoms
acute dizziness
fogginess post injury
cognitive deficits in the first 3 days
Female
history of learning disability
history of migraines

Question 27

What is post concussion syndrome

Answer 27

10 days of persistent symptoms
3 weeks of persistent symptoms in high school athletes

and/or
3 of the following
headache
dizziness
fatigue
irritability
impaired sleep
impaired concentration
impaired memory
impaired tolerance for stress, emotional situations, alcohol use

Question 28

What are the 4 symptom clusters for concussion

Answer 28

Cognitive
Mood disturbances
Sleep alterations
Somatic symptoms

Question 29

What is Chronic traumatic encephalopathy

Answer 29

CTE
generalized atrophy of the cerebral cortex
Frontal and temporal lobe degeneration

Question 30

What are the stages of CTE

Answer 30

1 - headache, loss of attention, and concentration, irritability
2 - depression, explosivity, short term memory loss, increased suicidality
3 - executive dysfunction, cognitive impairment
4 - dementia, word-finding difficulty, aggression, gait and speech abnormalities, parkinsonism may occur in some