Athletic Injuries ATC 222 Head, Face, Eyes, Ears, Nose, and Throat Chapter 22

Nervous System Central Nervous System –brain –spinal cord Peripheral Nervous System

Brain Anatomy Cerebrum Cerebellum Brain Stem Meninges Dura Mater Arachnoid Mater Pia Mater

Head Injuries Incidence of serious injury has decreased –neck injuries? –protective gear Appr. 250,000 concussions/year Focal vs. Diffuse Injuries

Concussion Definition –clinical syndrome characterized by immediate and transient impairment of normal neurological function Grades Return to Play Criteria Post-concussion Syndrome Second Impact Syndrome

Evaluation Process Primary Assessment? –ABC’s Secondary Assessment –Mental Status –Cranial Nerve Exam –Motor System Exam –Proprioception, balance, and coordination

Cranial Nerve Exam Test for: –Vision –Tracking –Visual Fields –Pupil Reflex –Hearing –Swallowing –Shoulder Shrug –Facial Sensation –Facial Expression –Tongue Protrusion –Mastication

Other Signs and Symptoms headache nausea, vomiting seizures unequal pupils tinnitus unusual drowsiness

Treatment Should be mostly symptomatic in nature Recheck athlete on regular basis Refer if in doubt or in more severe cases Monitor throughout the night No alcohol, aspirin, ibuprofen No activity until asymptomatic Refer if current s/s worsen or if new s/s appear over time

Facial Injuries Mandible Fracture –deformity –malocclusion –malalignment –bleeding around teeth/gums –lower lip anesthesia –pain with biting Treatment

Facial Injuries Mandible Dislocation/Subluxation –commonly from lateral force –malalignment –malocclusion –open, locked jaw

Dental Injuries Types –fracture –dislocation/subluxation Treatment –realign subluxation –replace/preserve dislocation or fracture –30 minute survival rate

Nasal Injuries Fracture or Cartilage Separation –S/S deformity profuse bleeding immediate swelling crepitus –treatment control hemorrhaging referral most return to activity in 3-4 days

Nasal Injuries Epistaxis (nosebleed) –sit upright –ice (nose and ipsilateral carotid) –direct pressure on nostril –cotton/gauze plug –refrain from nose blowing for 2 hours

Ear Injuries Hematoma Auris (cauliflower ear) –causes –S/S swelling redness, warmth pain –treatment ice protection aspirate

Eye Injuries Causes and Prevention S/S or Serious Eye Injury –prolonged blurred vision –loss of part/all of visual field (detached retina?) –sharp, stabbing, throbbing pain –double vision –embedded object –blood in anterior chamber

Treatment of Serious Eye Injury immediate referral cover both eyes with embedded object ice only to surrounding tissue no pressure applied to eyes

Orbital Hematoma “Black Eye” Bleeding in orbit area and poss. Sclera Rule out serious eye injury

Foreign Body in Eye Embedded? Removal –Close eye –eye rinse –removal with gauze pad