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 SystemNervous System

• Main components– Brain– Cranial Nerves– Spinal Cord– Spinal Nerves– Peripheral Nerves

The Nervous SystemThe 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 SystemThe 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 BrainThe Brain

Cranial Nerves

http://en.wikipedia.org/wiki/Image:3DScience_male_nervous_system_labeled.jpg

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 nausea confusion

headache disorientation blurred vision

Grades of ConcussionsGrades 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 PlayConcussion: 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 EarInjuries 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

http://images.google.com/imgres?imgurl=http://www.techsideline.com/columns/2005/faustear.jpg&imgrefurl=http://avilella.blogspot.com/&h=171&w=254&sz=13&tbnid=jWLQpuIqhS87wM:&tbnh=75&tbnw=111&prev=/images%3Fq%3Dcauliflower%2Bear%2Bimages%26um%3D1&start=3&sa=X&oi=images&ct=image&cd=3

Injuries to the EarInjuries 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 EarInjuries 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 EyeInjuries 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 EyeInjuries 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:

• 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. Dens2. 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 SpineThe 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 Muscle WeaknessNumbness

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 decreased ROMcramping 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