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55 Cards in this Set
- Front
- Back
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What is a concussion? |
Temporary loss of brain function induced by traumatic biomechanical forces |
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MOI for concussion |
direct blow to skull, coup injury, contra-coup injury, rotational, acceleration/deceleration |
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Brain areas at high risk for concussion (5) |
Frontal lobe, Temporal lobe, Occipital lobe, Thalamus, Cerebellum |
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Body functions measured for concussion testing (7) |
Orientation Immediate memory Concentration Delayed Recall Planning-rate of info processing Balance Vision |
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Diffuse axonal injury |
Can occur with no direct impact to head
Is rapid acceleration / deceleration of the head resulting in rapid flexion - extension movement of neck |
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What causes the shearing mechanisms in diffuse axonal injury? |
Axons in the brain extend over different areas, change in momentum causes acceleration and deceleration at different speeds when a whiplash occurs with biggest impact on thalamus |
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Symptoms of Diffuse Axonal Injury? |
Headache dizzy disorientation confusion nausea fatigue memory motor impairments emotional slurred speech |
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SCAT Examination tests |
examination orientation immediate memory concentration delayed recall exertion |
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Chance of getting another concussion after first? |
4 times |
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When can an athlete be cleared to return after concussion |
when all symptoms have resolved and memory and concentration are restored |
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Grade 1 concussion |
Concussion symptoms lasting LESS than 15 minutes (90%)
No loss of consciousness
Transient confusion
Getting 'bell rung" |
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Grade 2 concussion |
Concussion symptoms lasting LONGER than 15 minutes (90%)
No loss of consciousness
Transient confusion
Getting 'bell rung" |
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Grade 3 concussion |
Loss of consciousness (brief or extended)
amnesia, unsteadiness, severe headache, nausea, tinnitus |
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Grade 1 concussion management |
Removal from game
monitor every 5 minutes for symptoms at rest and under exertion
Return if symptoms clear within 15 minutes |
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Grade 2 concussion management |
Remove from contest and dissalow return next day
Examine frequently for worsening symptoms
Medical professional should examine player
1 week fully asymptomatic at rest and exertion |
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If multiple grade 2 concussions... |
1st 1 week symptom free
2nd minimum 1 month removal and 1 week symptom free
3rd end of season |
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Grade 3 concussion management |
Transport athlete to hospital by ambulance if unconscious or if exhibiting worrisome signs (neck pain)
Thorough neurological test should be administered |
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6 steps to return after grade 3 concussion |
1. no activity until asymptomatic
2. light aerobic
3. sport specific training
4. non contact training
5. contact training
6. game play |
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Do not list for concussions (5) |
Drink alcohol
Left alone
Have nap or fall asleep
Take medication
Return to sport |
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Second Impact Syndrome |
A 2nd head injury before recovering from first
Can cause death |
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What does the Glasgow coma scale test? |
Tests motor response, verbal response, and eye opening response with these values |
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What rates as a score of 1 through 6 for Motor Response of the Glasgow Coma Scale? |
6. Obeys Commands Fully 5. Localizes to noxious stimuli 4. Withdraws from noxious stimuli 3. Abnormal flexion (decorticate posturing 2. Extensor Response (decerebrate posturing) 1. No response |
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What rates as a score of 1 through 5 for Verbal Response of the Glasgow Coma Scale? |
5. Alert and Oriented 4. Confused yet coherent speech 3. Inappropriate speech 2. Incomprehensible sound 1. No sound |
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What rates as a score of 1 through 4 for Eye Opening Response Test of the Glasgow Coma Scale? |
4. Spontaneous eye opening 3. Eyes open to speech 2. Eyes open to pain 1. No eye opening |
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How do you calculate final score of Glasgow coma scale test and what does the final score indicate? |
Add Motor, Verbal and Eye opening scores, 13 - 15 mild head injury, 8 - 12 moderate, 0 - 8 severe injury |
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Can the brain heal after being injured? |
Brain cells themselves do not regenerate however recovery can take place by other areas of the brain accommodating for injured tissue |
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During an assessment, for the present illness what do you ask? |
Chief complaint Pain (PQRST) movements that relieve / aggravate the MOI What PA or recreational sports do you do for fun? (social) Meds? Diagnostic imaging? |
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Red Flags when assessing an athlete (11) |
Severe unremitting pain Pain unaffected by meds or position severe night pain severe pain with no trauma severe spasms bowel / bladder changes changes in vision swallowing or speech changes balance/coordination/falling Short of breath heavy chest |
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What type of pain is cramping/dull/aching? |
muslce |
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What type of pain is dull / aching |
ligament |
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What type of pain is sharp / shooting? |
Nerve root |
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What type of pain is sharp / bright / lightening like? |
Nerve |
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What type of pain is Deep / Nagging / Dull |
Bone |
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What type of pain is sharp / severe / intolerable? |
fracture |
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What type of pain is throbbing / diffuse? |
vascular |
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What can you observe on a patient during an assessment? (5) |
Posture / deformities Abnormal pattern of movement Swelling. edema, colour, atrophy Genu valgrus / vagrum Lordosis / kyphosis |
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During active movement what are you assessing? (5) |
Ability and or willingness to move Restricted ROM Physiological movements which produce symptoms Painful arc Vertebral and or peripheral affections |
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During passive movement what are you assessing? (4) |
Physiological - with overpressure
End range pain?
Accessory - special lig tests
Is AROM and PROM the same? |
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A hard end feel indicates? Soft? Elastic? |
Hard - bone to bone
Soft - tissue approximation
Elastic - tissue stretch, capsular |
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A Springy end feel indicates? |
Intra-articular block |
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A spasm end feel indicates? |
hard twang |
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A empty end feel indicates? |
too much pain to move all the way |
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A boggy end feel indicates? |
Swelling |
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a hard capsular end feel indicates? |
loose body |
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Examples of inert tissue that may be damaged |
Capsules, ligaments, bursa, nerves and nerve sheaths, cartilage, dura mater, fasica |
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Difference between inert and contractile tissue? |
Inert can't contract or relax but can undergo tension during stretching or compression |
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If active and passive movement hurts in same direction what tissue is damaged? |
Inert |
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If active and passive movement hurts in opposite directions what tissue is damaged? |
Contractile |
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Indicators of different non-capsular injuries and what the injury is |
Pain free, full range (no lesion)
Pain and limited range in all direction (arthritis or capsulitis)
Pain and excessive or limited range in some directions (ligament or bursa)
Pain free, limited range of motion in one specific direction (osteophytes) |
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Indicator that a joint capsule is irritated? |
Inflamed capsules contract, producing loss of range of motion |
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Causes of weak muscles (8) |
Muslce strain Pain/reflex inhibition peripheral nerve injury nerve root lesion upper motor neuron tendon pathology avulsion psychological overlay |
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Grade 1, Grade 2, and Grade 3 muscle strains |
1 - strong and painful
2 - weak and painful
3 - weak and pain free |
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What causes sensation of pain in the brain? |
Tissue stimulates nociceptors to transmit via sensory fibers message of pain
Nociceptors in bone/cartilage/ligaments/tendons/fascia/bursa/neural structures
Mechanical means: direct pressure, tension, compression, shear |
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Three structures cause / sense pain |
Inert (joints, bone, synovial, bursa, capsule / ligament)
Muscle (inter/intra muscle fascia, tendons)
Neural structures |
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final part of athlete assessment (3) |
Reflexes
Joint Play
Palpation |
