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Head & Neck UNIT 8 SPECIFIC INJURIES ANATOMY OF THE HEAD & NECK - BONES Cranium – protects brain. Frontal Parietal (2) Occipital Temporal (2) Sphenoid Facial Mandible Maxille (2) Zygomatic (2) Nasal Lacrimal Ethmoid ANATOMY OF THE HEAD & NECK - BONES ANATOMY OF THE HEAD & NECK - BONES Cervical Vertebrae ANATOMY OF THE HEAD & NECK - MUSCLES Muscle Sternocleidomastoid Trapezius Location Anterior aspect of the neck Posterior aspect of the neck Function Flex neck; rotate the head Extends neck; adducts scapula ANATOMY OF THE HEAD & NECK – SOFT TISSUES Brain Cerebrum – higher thought processes Frontal Lobe Parietal Lobe Occipital lobe Temporal Lobe Cerebellum – balance and coordinated movement Brainstem – vital body functions Pons Medulla Oblongata ANATOMY OF THE HEAD & NECK – SOFT TISSUES Meninges- layers of tissue that surrounds brain and spinal cord Has areas of space between each layer DURA MATER- outer layer made up of arteries and veins SUBDRUAL SPACE ARACHNOID LAYER- spider web of veins SUBARACHNOID SPACE- contains CSF PIA MATER- inner layer lines brain and spinal cord Cerebrospinal Fluid (CSF) - protects, cushions and nourishes the central nervous system ANATOMY OF THE HEAD & NECK – SOFT TISSUES ANATOMY OF THE HEAD & NECK – SOFT TISSUES Intervertebral Disks Cartilaginous discs that lie between the vertebrae Act as shock absorbers of the spine ANATOMY OF THE HEAD & NECK - NERVES Cranial nerves 12 pair that branch off of the brain Spinal Nerves; nerve root pairs that branch off the spinal cord Brachial Plexus (C5-T1) – bundle of spinal nerves that innervate the shoulder and arm muscles COMMON INJURIES – HEAD/NECK Concussions Mechanism of Injury Characterized by immediate and transient post-traumatic impairment of neural function Result of direct blow to the head from either a fixed or moving object. Signs of Injury Headache Loss of consciousness Tinnitus Ringing of the ears Nausea Irritability Confusion Disorientation Dizziness Amnesia Concentration difficulty Photophobia Sleep disturbances Vision disturbances Balance disturbances COMMON INJURIES – HEAD/NECK Concussions Assessment: Neuropsychological Testing If possible, preseason testing on a computerized system (ImPACT). If a concussion occurs, retest injured athlete following recommended protocols. Thorough evaluation of athlete: (Sport Concussion Assessment Tool (SCAT 2 – see additional resources) is a tool that can be used to evaluate a concussed athlete. Physical Examination – evaluation of athletes physical symptoms as listed previously. COMMON INJURIES – HEAD/NECK Concussions Assessment Cognitive testing Immediate memory testing Concentration What month is it? What time is it?, etc. Months of year backward 100-7, continue backward Delayed Recall – have athlete remember words, repeat at later time COMMON INJURIES – HEAD/NECK Concussions Assessment Balance/Coordination testing Balance Error Scoring System (BESS – see additional resources) Romberg Test Finger to Nose COMMON INJURIES – HEAD/NECK Treatment: Careful removal from play Thorough physical and neurological examination Refer to physician for follow-up examination COMMON INJURIES – HEAD/NECK Return to Play Guidelines: Depends on the level of play of the athlete involved. Currently, the NCAA, UHSAA, and a new Utah State law regarding youth sports (HB 204) will dictate a specific plan for concussion management and return to play guidelines. It will include some variation of the following : Progression through Return-To-Play stages on a case by case basis with final clearance by an approved, licensed health care professional: COMMON INJURIES – HEAD/NECK COMMON INJURIES – HEAD/NECK Postconcussion Syndrome Persistent symptoms following concussion May begin immediately following injury and may last for weeks to months Persistent headache Impaired memory Lack of concentration Anxiety Irritability Fatigue Depression Continued visual disturbances Treatment – No clear guidelines Treat symptoms to greatest extent possible Return athlete to play when all signs and symptoms have fully resolved COMMON INJURIES – HEAD/NECK Second Impact Syndrome Rapid swelling of the brain from additional head trauma; life threatening Second impact could be minor Could be caused by blow to chest that accelerates head. Signs and Symptoms No initial loss of consciousness Rapid worsening leading to: LOC progressing to coma Dilated pupils Loss of eye movement Respiratory failure Treatment: Immediate transport to medical facility Prevention DO NOT LET THIS SITUATION OCCUR! Careful decision making regarding return to play following initial head trauma
