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Department
Kinesiology
Course
Kinesiology 2236A/B
Professor
Dave Humphreys
Semester
Winter

Description
1Midterm2Lecture7ConcussionsacomplexpathophysiologicalprocessaffectingthebraininducedbytraumaticbiomechanicalforcesvaguebcwedontknowthatmuchaboutconcussionseducateppltoknowaboutthingsotherthanwhattheyseeinthemediascarystuffLinearforcebothsideInjuryatimpactsitebrainstrikesskullonoppositesideRotationalforceworsespinjelloinhandsomestaysomespinstearBrainstrikesskullonothersideBrainrotatesstretchesortearsstructuresvesselsasitshearsonitselfaxonsandBVMixtureofsymptomsEmotionalmoreemotionalsadnervousirritableCognitiveattentionproblemmemorydysfunctionfogginessfatiguecognitiveslowingSleepdisturbancecantfallasleepsleeplessthanusualSomaticsymptomsbwvisualproblemsdizzinessbalanceproblemsheadacheslightsensitivitynauseaCommonsymptomsHSUniathleteswithin3daysofinjuryheadache71willmiss310concussionsifgoingbyheadachesaloneslowed58concentrationdizzinessfogginessfatiguevisualblurringdoublevisionlightsensitivitymemorydysfunctionbalanceproblemskeyknowwhatyouarelookingforlookforALLsymptomsgoldenretrieverscanttellyouyoudontneedtobehitintheheadtohaveaconcussion60fromdirectblowheadimpactfaceneckbutconcussionsmayalsobecausedbyelsewhereonthebody40withanimpulsiveforcetransmittedtotheheadbodystopsheadkeepsgoingwhiplashinjuryimpactthresholddontneedtobehithardnoagreeduponbiomechanicalthresholdforinjury60168ginbooksbutdoesntmatterforcedoesnotfactorinonsymptomseveritycannottellhowlongonewillbeoutfordependingonhowhardtheyarehiteveryonesbodyreactsdifferentlysmallimpactsthataddupcanmaketheeffectofalighterimpactworsehardlighthitcanbeoutlongershortercantbasereturntoplayonimpactgwillstillhaveconcussionwgoodequipmentrotationalwhiplashinjuryhelmetandmouthguardmaterialofdesignidealforpreventinghighenergyimpactforcesassociatedwcatastrophicheadinjuriesskullfracturesbutlessidealforreducingthelowerimpactrotationalforcesconcussionsaretypicallyrelatedpreventcrackingtheeggbuteggmightstillbescrambledNOstrongscientificevidencethatmouthguardsreducedconcussionriskmouthguardsonlyhelpwhenforceisfromchinforcetransmittedtoskullotherthanthatwonthelpconcussionalsohelpsteethtostayinConcussionsarenotgettingworsewerejustgettingsmartercanidentifywhentheyhavethemlengthoftimemissedhasdoubledintheNFLoverthepast10years255days35concussionseverityscaleshavebeenpublishedbutnonehavebeenscientificallyvalidatednosuchthingasaminorsevereorgrademuscleswhenitjusthappenedonlyknowwhentheyparticipateforalengthoftimeandareokayhowlongofatimemissed2TypetextConvulsioncannotalwayspredictabadconcussionnotamodifyingfactorModifierssymptomsfactorsthatmighttellusifitwilltaketorecovermanagementpersistenceofsymptoms1minutedurationtakelongeramnesiaaloneretrogradeandanterogradetonicposturingorconvulsivemovementsnotamodifierdontmemorizeMedicalManagementABCsifunconsciousloadandgoknowyourathletedotheyliketoughingitouttofigurethingsoutfastInitialassessmentchildSCAT3memorizingneuraltestfullpicaskingallsymptomsstandardorientationquestionsalonearenotreliabletimeplacedaytogiveyoufullpictureiehowmanyfingersamIholdingupSomeonemustmonitorfordeteriorationoverthenextfewhourscommonly4hrshomewadultatnightwakethemuptocheckuponthemcouldbegoodbutthenpressurebuildsupNeedmonitoringbcwontknowtheyareconcussedbctheyareconcussedWorseningsymptomsisamedicalemergencygoesdownhillfastIfindoubtgetitcheckedoutGetbigpicturedontwanttosetthembackChildrenunder13samesymptomsasadultsbutdifferentbrainsdevelopingbrainismorevulnerabletoinjuryyoungeryouarethelongerittakesforrtpneverreturntoplayonthesamedayReturntoplayafterclinicallycompletelysymptomfreeHighschoolathletesthemildconcussionwasexaminedinHSathletes1317yearsold15minlessonfieldsymptomsrequired7daysbffullneurocognitivesymptomrecoveryjustbctheyaregoodinthemomentnotgoodtogobackinsuggestallHSathletesdiagnosedwconcussionshouldnotreturntoplayonsamedayoftentakeanaverageof30daystoreturntobaselinelevelofcognitivefunctionhigherupthelevelofplaytheshortertherecoverytimeProsbacksamedayifasymptomatic15minnd2weeksofvulnerabilitypostinjury2impactsyndromemetrateforglycogenandBFdropsbutdemandforglucoseincreasesandsinksagainmismatchbcglycogennotbrokendownandbloodcannotdelivertosupplydemandofglucosendndifunder21w2hitcouldbefatalevenif2impactisminorneurochemicalprocessesappeartodifferindevelopingbrainreturntoplaybfcompleteresolutionofsymptomscatastrophicincreaseinintracranialpressurelooseconsciousnessandeventuallydie3Midterm2ReturntoplaywhosjobtestedonTABLE1ifsymptomsreturngobacktopreviousstagewsymptomsdoctorsmaysayitisokaystationarycyclingheadnotbouncingtalktest24hoursbweachrehabilitationstagebestscenarioapprox1weekrtpPracticalquestionspulloutwillplayersbehonestDoplayersalwaysknowtheyhaveaconcussionDotheyknowthesymptomsAretheythinkingstraightWilltheymakegooddecisionsbctheyhaveabraininjuryexternalpressureswillyouhavetodealwithparentscoachesteammatesManydontreportsymptomsbctheydontthinkheadinjuriesareimportantdidntwanttoleavegamedidntrealizeaconcussionwascontinueddidnotwhattoletdowntheirteammatesLessreportedtheyhadaconcussion15butmanyreportedthesymptomsofaconcussion50CantaskiftheyhadaconcussionaskbydescribingpossiblesymptomsTakehomepracticalmanagementteachgoodtechniquehelmetisnotaweaponprimarypreventionknowyourathletesdotheyusuallycryandtaketimetofindouthowtheyarehavebaselineSCAT3forcomparisonlinesofcommunicationexpectationsiftheymighthaveaconcussiondontquestionmeathletescoachesparentswewillgetthemthroughthereturntoplaystepsbepreparedforinjuryknowhowtoassessatthetimetertiarypreventionfollowupwsportmedicinephysiciangotoaspecialistScenario12yearoldhitshisheadonthegroundInitiallyheisdazedbutsoonwantsbackinthedrillsHeanswersalltheimportantquestionsbuthasa710headacheNextdaygamedayWakesupwaheadachebuthasfeltOKsincelunchheadacheduetofoodParentsareenthusedaboutthegamewhatdoyoudoCantplayuntilgoingthroughallthestepsdefnotrtponsamedayLecture8CervicalSpineInjuriescspineandnonemergencyforsidelinestAssessment1aidshowtodealwiththemfirstaidsprimarysecondaryexamreturntogamecspineinjuryhowtodealwthemEverythingtodaywillbedoneunder5minboardingisfasttooEmergencyManagementknowwhattodohowtodoitproperlyandwhywedothemrememberstepsbetterskillstoaccomplishitproperlywminerrorlifedeathspine3thingstoaskyourselfFASTwhengoingonthefieldforANYinjuryexam1IstheathleteatriskLifecardiacarrestbleedingalotlimbfracturecouldlooselimbifnottreatedrightYeswcspinefracture2IstheanatomicalareaphysicallystablefortransportneckkneeareligamentsholdingittogetherNowcspinefracture3HowdoIgetathleteoffthefieldtosidelinesWalkassistnonweightbearinglegkneenotstableimmobilizeboardNowcspinefracture
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