Transcript Injuries to the Head and Spine

Injuries to the Head and Spine
The Head
• Head
– Skull = cranium, face, and teeth
– Inside the cranium is the brain and primary
neural tissues
Nervous System
• Main components
– Brain
– Cranial Nerves
– Spinal Cord
– Spinal Nerves
– Peripheral Nerves
The Nervous System
• Function = communicate, coordinate, and
regulate
• 2 main divisions
– Central Nervous System (CNS) = brain &
spinal cord
– Peripheral Nervous System = everything
outside the brain & spinal cord
• Function = gathers info and carries info to and from
the CNS
The Nervous System
• 2 Types of Neurons (nerve cells)
– Afferent Neurons = sensory
• Found in skin, muscles, joints, and sensory organs
• Indicates pressure, temperature, and pain
– Efferent Neurons = motor
• Stimulate skeletal, smooth, and cardiac muscle
– Mixed Neurons = combo of sensory and motor
• Located in the brain and spinal cord
Motor versus Sensory
Motor Neuron
Sensory Neuron
The Brain
• Parts of the brain
– Cerebrum
• largest part
• controls willful actions, interprets sensory
messages
• governs thought and speech
– Cerebellum
• Muscle coordination and maintains balance
The Brain
• Parts of the brain
– Hypothalmus
• Regulates body temp and sleep cycles
– Medulla Oblongata
• Controls involuntary actions such as respiration,
heartbeat, blood pressure, swallowing, and
couphing
The Brain
Cranial Nerves
Injuries to the Brain: Concussion
• Concussion – injury to the brain or spinal
cord
• Mechanism of injury – blow to the head or
a fall
• Symptoms –
dizziness
headache
nausea
disorientation
confusion
blurred vision
Grades of Concussions
Grades of Concussions
Grade 1:
1. Confusion
2. No loss of consciousness
3. Symptoms on examination resolve in less
than 15 minutes
Grade 2:
1. Confusion
2. No loss of consciousness
3. Symptoms on examination last more than 15
minutes
Grade 3:
1. Any loss of consciousness
– Brief (seconds)
– Prolonged (minutes
Concussion: Return to Play
• Return Only After Being Asymptomatic with
Normal Neurologic Assessment at Rest and
with Exercise
• Grade 1 -- at least 15 minutes
• Grade 2 -- 1 week
• Grade 3 -- Brief Loss of Consciousness
(seconds) or (minutes)
-- at least 1 month
Regardless of severity, must be cleared by a
doctor
Anatomy of the Ear
Injuries to the Ear
• Cauliflower Ear (Hematoma Auris)
– most common injury of the ear
– caused by extreme friction or repeated trauma
– symptoms: bleeding and fluid accumulation
around the ear
– immediate treatment: ice, compression,
bandage, physician
Injuries to the Ear
• Swimmer’s Ear (Otitis Externa)
– infection of ear canal
– caused by trapped moisture
– symptoms: dizziness, pain, itching, discharge
– immediate treatment: send to physician
– prevention: use ear drops of 3% boric acid
and alcohol solution and keep ears dry
Injuries to the Ear
• Tympanic Membrane (eardrum) Rupture
– caused by sudden change in pressure or
objects inserted too far
– symptoms: loud pop, pain, hearing loss,
nausea and vomiting
– treatment: send to physician immediately
Anatomy of the Eye
Injuries to the Eye
• Contusions (black eyes)
– caused by blow to eye area
– ice immediately
– send to physician if bleeding, severe bruising,
or double vision
Injuries to the Eyes
• Corneal Abrasions or Laceration
– scratch on corneal surface of eye
– caused by dirt, sand, insects, or contact with
another athlete’s finger
– symptoms: pain and watering of the eye
– treatment: do not allow to rub eye, patch eye,
send to physician
Corneal Abrasion
Injuries to the Eye
• Retinal Detachment
– caused by blow to eye
– separation of retina from underlying epithelial
tissue
– symptoms: painless, flashes of light, blurred
vision, “curtain” or something covering field of
vision
– treatment: patch eye and send to physician
Injuries to the Eye
• Fractures – orbital roof & blow out
– caused by direct blow to the eye
– symptoms: swelling, bleeding & double vision
– treatment: control bleeding, patch with sterile
gauze, physician
Orbital Fracture
Injuries to the Eye
• Conjunctivitis (pink eye)
– highly contagious
– symptoms: burning, itching, swollen eyelids,
and discharge
– treatment: wear gloves and wash hands after
examining the athlete, send to physician
Conjuctivitis
Conjuctivitis
Injuries to the Eyes
• Sty
– infection of the eyelid follicle or subcutaneous
gland
– symptoms: pain, redness, & swelling
– treatment: apply moist heat and physician
Sty
Anatomy of the Nose
Injuries to the Nose
• Epistaxis (nosebleeds)
– cause: direct blow
– treatment:
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control bleeding with direct pressure
athlete sit upright, lean forward, pinch nose
can use noseplugs
ice if swelling is present
do not blow nose once bleeding has stopped
Injuries to the Nose
• Nasal Deviation and Fractures
– cause: direct blow
– symptoms: deformity, pain, swelling, bleeding
– treatment: stop bleeding, send to physician
Nasal Fractures
Injuries to the Mouth and Jaw
• Temporomandibular Joint (TMJ) Dislocation
– cause: side blow to an open mouth
– symptoms:
• locked jaw in open position
• overbite in a normal bite
• deformity
– treatment: ice, physician, do not attempt to
reduce
Normal
Dislocated
Injuries to the Mouth and Jaw
• Jaw Fractures
– cause: direct blow
– symptoms: abnormal movement, loss of
normal bite, pain, point tenderness
– treatment: ice, immobilize, send to physician
Injuries to Mouth and Jaw
• Dislocation of teeth
– cause: blow to mouth
– symptoms:
• bleeding around gums
• loose, displaced or missing teeth
– treatment:
• Knocked out: find tooth, wash it, put back in place
and send to dentist
• If can’t put back in place, wrap it in moist, sterile
gauze and send with athlete to dentist
Anatomy of the Spine
• Composed of 33 vertebrae
– 7 cervical
– 12 thoracic
– 5 lumbar
– 5 sacral (fused together to make 1)
– 5 coccyx (fused together to make 1)
– vertebrae separated by cartilaginous discs
Cervical Vertebrae 1 & 2
1. Dens
2. Transverse foramen
3. Spinous process or spine
4. Anterior arch of atlas
5. Posterior arch of atlas
6. Transverse process
7. Articular facet for base of
skull
The Spine
• ROM of spine
– forward (flexion)
– backward (extension)
– side to side (lateral flexion)
– rotation (cervical & lumbar only)
Injuries to spine and back mostly occur
because of muscular weakness and
imbalances
Functions of the Spinal Column
• Protection
– Spinal Cord and Nerve Roots
– Many internal organs
• Base for Attachment
– Ligaments
– Tendons
– Muscles
Functions Continued
• Structural Support
– Head, shoulders, chest
– Connects upper and lower body
– Balance and weight distribution
• Flexibility and Mobility
– Flexion (forward bending)
– Extension (backward bending)
– Side bending (left and right)
– Rotation (left and right)
Injuries to the Spinal Column
• Herniated disc
– Deteriorated to the point that pushes against
a nerve
Commonly occurs between L-4 and L-5 or L-5
and S-1.
Treatment – Ice and send to physician
Injuries to Spinal Column
• Cervical nerve stretch (burner or stinger)
– Stretching of the brachial plexus nerve
– Occurs when head is pushed to side and shoulder
pushed down
Symptoms:
Pain
Numbness
Muscle Weakness
Treatment:
Ice, neck and shoulder strengthening, problems
persists send to physician
Injuries to Spinal Column
• Contusions
– Caused by direct blow
Treatment
1. Rule out rib fractures and injury to kidney
2. Ice
3. Protect area if possible
Injuries to Spinal Column
• Muscle Spasms
– Uncontrolled, painful contraction of muscle or groups
of muscle
– Caused by traumatic injury, overuse, or improper
lifting
Symptoms:
pain
cramping
decreased ROM
muscle tightness
Treatment: Ice message, stretching, rest
Injuries to Spinal Column
• Back Sprain/Strains
– Caused by sudden twisting motion and
improper lifting
• Sprains – ligaments of facet joints
• Strains – muscles or muscle group
No radiating pain should be present
Treatment: Ice, rest, stretching, back strengthening
exercises
Sprains
Strains
Injuries to Spinal Column
• Spondylolysis – defect in vertebrae
caused by repeated stress from
hyperextension
• Spondylolisthesis – condition where the
disk slips forward caused by muscle
weakness from spondylolysis
Abnormal Curvatures of the Spine
• Kyphosis – exaggerated posterior
curvature of the thoracic spine
• Lordosis – abnormal anterior curvature of
the lumbar spine
• Scoliosis – lateral curve of spine
• Peripheral NerveActionAxillaryFlex and
abduct shoulderMusculocutaneousFlex
elbowRadialExtend elbow, wrist, and
fingersMedianFlex wrist and
fingersUlnarDexterity of fingers