Injuries to the Head and Face Athletic Training Unit 5

Anatomy of the Head Brain – is made of billions of cells and requires 20% of the total oxygen and 15% of blood supply. Lobes – the brain is divided into lobes and each lobe is responsible for a specific function. Cerebrospinal Fluid – bathes the brain and spinal cord in chemicals for proper functioning. Scalp – covers the skull and has the ability to decrease the force of impact to the skull.

Bones

Lobes of the Brain Frontal Lobe: voluntary muscle movement, emotion, eye movement. Parietal Lobe: sensation Occipital Lobe: vision Temporal Lobe: hearing, speech Cerebellum: equilibrium, muscle actions, some reflexes.

Cranial Nerves

Preventing Head Injuries Helmets Mouth Guards Proper Skills Communication

Concussions

Concussion – temporary impairment of brain function caused by impact or a rotation force. Post Concussion Syndrome – the signs and symptoms that may follow a head injury from days to months.

Concussion Mechanism

Coup - the result of a sudden, violent stop that causes the brain to accelerate forward and hit the side of the skull Contrecoup - occurs when the brain accelerates forward, hits the side of the skull, and then bounces off the other side of the skull. In both cases, the brain is damaged as it rubs against the inner ridges of the skull

Coup

Countrecoup

Signs & Symptoms (S/S) of Concussion

Signs and Symptoms

Severities of Concussions

Cantu Guidelines

Return to Play

Second-Impact Syndrome

Second Impact Syndrome – an autoregulatory dysfunction that causes rapid and fatal brain swelling. MOI - an athlete is returned to play before symptoms from a previous concussion have subsided. The athlete loses brain function from brain stem swelling and may result in a coma or death. (Mortality rate is high)

Intracranial Hemorrhage

Epidural hematoma – bleeding occurs between the dura mater and skull (from a skull fracture in temporal region). Subdural hematoma – bleeding occurs between the dura mater and brain (subdural space).

Intracranial Hemmorrhage S/S Altered vital signs and consciousness, high blood pressure, decreased pulse, and altered *respiration. *CheyneStroke (hyperpnea – apnea) Pupillary changes (unequal or unresponsive) + Babinski sign (+brain stem injury) Decorticate or Decerebrate Posturing

Skull Fracture

Results from direct impact or from an object such as a ball or bat. s/s: pain, deformity/depression, swelling discoloration, and loss of consciousness. Raccoon eyes, battle’s sign, rhinorrhea, or ottorhea.

Skull Quiz Lobes 12. Reflexes 13. Sensation 14. Hearing, speech 15. Vision

Evaluation of Head Injuries SAC Testing 1. Orientation (Month, date, day, yr, time) 2. Memory and Neurological –Immediate –Delayed 3. Concentration (Digits backward, months reversed) 4. Delayed Recall

Anatomy of the Eye

Injuries to the Eye Preorbital hematoma – ”Blackeye or Contusion” Like any contusion, a blackeye is really caused by the bleeding and discoloration under the skin.

Injuries to the Eye Corneal Abrasion – a finger, foreign body, or embedded object under the eyelid can scratch the outer surface of the cornea. s/s Pain, hyperemia, and watery eye. Flush out the eye with saline

Injuries to the Eye Corneal Laceration – less common than an abrasion but a laceration through the full thickness of the of the cornea from a sharp object. s/s Acute pain, visual impairment, disruption of corneal surface and pupil may appear tear shaped. Tx Refer immediately

Injuries to the Eye Detached Retina – a sudden blow to head or eye cause the pigment layer of retina to tear away from the inner surface. s/s Blurred vision, flashes, floating, or blind spots

Injuries to the Eye Hyphema – hemorrhage (blood) into the anterior chamber of the eye that can be seen under the cornea. s/s Impaired vision, pain, and pressure in the eye. Tx- upright and refer

Injuries to the Eye Orbital Blowout Fracture – a fx to the orbital floor from a blow or trauma to the eye. s/s swelling, discoloration, point tenderness, and eye may sit lower. Diplopia or unable to look up.

Injuries to the Eye Subconjunctival Hemorrhage - rupturing of the small blood vessels in the eye from coughing or contact. It may look painful but there is no pain and no visual impairment.

Injuries to the Eye Orbital roof fracture - a blow to the eye causes a fracture to the roof of the orbit. s/s similar symptoms of a concussion.

Injuries to the Eye Eyelid laceration - an eyelid laceration is similar to most lacerations except the tear duct may also be injured and permanent damage to the tear duct may result.

Injuries to the Eye Conjunctivitis “pinkeye” Infection of the eye that is considered very contagious.

Anatomy of the Ear

Injuries to the Ear Hematoma Auris or “Cauliflower Ear” – the pinna of the ear begins to bleed internally. As the ear heals there is an excessive growth of reparative tissue. Most common in wrestlers

Injuries to the Ear Laceration of the Pinna - similar to other lacerations that tear or lacerate the pinna from earrings, a blow or an object.

Injuries to the Ear Otitis Externa “Swimmer’s Ear” – swimmers can get inflammation of the canal from water causing pain, itching, and a smelly discharge from the ear.

Injuries to the Nose “Epistaxis” is the medical term for “Nosebleed” or bloody nose.

Injuries to the Nose Deviated Septum - the septum is the cartilage that separates the left and right sides of the nose. A deviated septum has moved to one side causing decreased airflow through the nasal passageway.

Injuries to the Nose Nasal Fracture – a direct blow to the nose can fracture one or both of the nasal bones.

Ear Quiz

Injuries to the Jaw/Mouth Jaw Fracture – a direct blow to the jaw can fracture the upper or lower bone.

Injuries to the Jaw/Mouth Temporomandibular Joint Dislocation A blow to the chin or a forceful opening of the mouth can cause a dislocation.

Tooth Dislocation or Fracture – Direct impact may knock a tooth out or fracture it and it must be handled properly. Injuries to the Jaw/Mouth