Injuries to the Head and Spine

The Head Head –Bones of the cranium face teeth –Brain –Brain Stem

Bones of the Cranium and Face

Nervous System Main components –Brain –Cranial Nerves –Spinal Cord –Spinal Nerves –Peripheral Nerves

The Nervous System Function –communicate, coordinate, regulate 2 main divisions 1.Central Nervous System (CNS) –brain, cranial nerves & spinal cord 2. Peripheral Nervous System –everything outside brain & spinal cord –gathers and carries info to and from the CNS

Cranial Nerves –12 pairs of nerves –lead from brain to parts of head, neck and torso –involved in senses controlling facial muscles regulate glands

The Nervous System 2 Types of Neurons –Afferent Neurons (sensory) Sends sensory info to CNS –Efferent Neurons (motor) Sends info from CNS Stimulates muscle tissue Stimulates organs and glands –Mixed Neurons (sensory and motor) Located in the brain and spinal cord

Neurons

Major Spinal Nerves Cervical –C1 through C8 –Includes Brachial plexus (C5 – T1) –Phrenic Nerve (breathing) Thoracic –T1 through T12 Lumbar –L1 through L4 Sacral –L4 through S4 –Sciatic Nerve

Spinal Nerve Roots

The Brain Parts of the brain –Cerebrum largest part (2 hemispheres) 4 lobes controls willful actions, interprets sensory messages governs thought and speech –Cerebellum Muscle coordination and maintains balance

Lobes of the Brain Frontal –thinking, personality, behavior Parietal –language Occipital –vision Temporal –language, hearing

The Brain Brain stem –Connects spinal cord with cerebrum –Controls Involuntary autonomic functions Breathing, heart rate, blood pressure, digestion –Consists of: Midbrain Pons Medulla Oblongata

The Brain Brain Stem –Pons communication and coordination center between parts of brain “switchboard” –Medulla Oblongata controls breathing, HR, swallowing ect…..

The Brain Parts of the brain –Hypothalamus Regulates body temp, sleep cycles controls production of many hormones body’s thermostat

Regions of the Brain

Cranial Nerves The 12 Cranial NervesThe 12 Cranial Nerves Assessing Cranial NervesAssessing Cranial Nerves

Injuries to the Brain: Concussion Concussion –injury to the brain or spinal cord MOI –blow to the head or a fall Symptoms –Dizziness –Nausea –Confusion –Headache –Disorientation –Blurred vision

Treatment of Concussions Treatment of concussions –Threw out grading system –If symptomatic, athlete has a concussion –No activity until asymptomatic for 24 hours –More severe symptoms requires no tv, no reading, no video games What is a concussion?What is a concussion?

Concussion: Return to Play No symptoms for 24 hours then: –Day 1 – slow jog; no symptoms, then –Day 2 – sprints/weights; no symptoms, then –Day 3 – practice/no contact; no symptoms, then –Return to physician for clearance –Football HighFootball High –League of Denial: The NFL’s Concussion CrisisLeague of Denial: The NFL’s Concussion Crisis

Concussions Second Impact Syndrome (SIS) –Swelling of the brain –Occurs when suffering 2 nd concussion before 1 st concussion is healed –Very dangerous and sometimes fatal –E:60 - Second Impact SyndromeE:60 - Second Impact Syndrome

Anatomy of the Ear

Injuries to the Ear Cauliflower Ear (Hematoma Auris) –most common injury of ear (wrestling) –caused by extreme friction or repeated trauma –fluid and blood accumulate around outer ear –treat: ice and compress

Cauliflower Ear

Injuries to the Ear Swimmer’s Ear (Otitis Externa) –infection of ear canal –caused by trapped moisture –symptoms: dizziness, pain, itching, discharge –send to physician

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 –send to physician immediately

Tympanic Membrane Rupture

Anatomy of the Eye

Injuries to the Eye Contusions (black eyes) –caused by blow to eye area –ice immediately –send to physician if bleeding or double vision

Injuries to the Eyes Corneal Abrasions or Laceration –scratch on corneal surface –caused by dirt, sand, insects, or contact with another athlete’s finger –symptoms: pain and watering of the eye –don’t rub eye, patch eye

Corneal Abrasion

Injuries to the Eye Retinal Detachment –caused by blow to eye or head –separation of retina from underlying tissue –symptoms: flashes of light, “curtain” covering field of vision –patch eye and send to physician

Detached Retina

Injuries to the Eye Fractures (“blow out”) –caused by direct blow –symptoms: swelling, bleeding & double vision –control bleeding, patch with sterile gauze, physician –Most orbital fractures require surgery

Orbital / Blow Out Fracture

Injuries to the Eye Conjunctivitis (pink eye) –highly contagious –caused by viruses, bacteria or allergens –symptoms: burning, itching and discharge –send to physician

Conjuctivitis

Injuries to the Eyes Sty –infection of the eyelash follicle or oil gland –symptoms: pain, redness, & swelling –treatment: apply moist heat and physician if doesn’t clear up

Sty

Anatomy of the Nose

Injuries to the Nose Epistaxis (nosebleeds) –cause: direct blow –treatment: control bleeding with direct pressure athlete sit upright, lean forward, pinch nose ice if swelling is present do not blow nose once bleeding has stopped

Injuries to the Nose Nasal Deviation & Fx –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

Mandibular Dislocation

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

Mandible Fracture

Anatomy of the Spine Composed of 30 vertebrae –7 cervical –12 thoracic –5 lumbar –5 sacral (fused together to make 1) –coccyx –vertebrae separated by cartilaginous discs

The Spine ROM of spine –forward (flexion) –backward (extension) –side to side (lateral flexion) –rotation (cervical & lumbar only)

Functions of the Spinal Column 1. Protection –Spinal Cord –Internal organs 2. Structural Support 3. Base for Attachment –Ligaments –Tendons –Muscles

Injuries to the Spinal Column Herniated disc –Deteriorated to the point that pushes against a nerve –Commonly 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 –MOI – head pushed to side and shoulder pushed down –Treatment - Ice, neck and shoulder strengthening –Symptoms: Pain Muscle Weakness Numbness

Nerves Affected by Stinger

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 –Caused by injury, overuse or improper lifting Symptoms: pain, cramping, muscle tightness Treatment: Ice massage, stretching, rest –How to Treat Back SpasmsHow to Treat Back Spasms

Injuries to Spinal Column Back Sprain/Strains –Caused by sudden twisting motion and improper lifting –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

Spondylolysis vs. Spondylolisthesis

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