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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 • 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 Nerves • Assessing 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? 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 High – League of Denial: The NFL’s Concussion Crisis Concussions • Second Impact Syndrome (SIS) – Swelling of the brain – Occurs when suffering 2nd concussion before 1st concussion is healed – Very dangerous and sometimes fatal – E: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 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 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