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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 System • Main components – Brain – Cranial Nerves – Spinal Cord – Spinal Nerves – Peripheral Nerves The 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 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 Brain Cranial Nerves 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 headache nausea disorientation confusion blurred vision Grades of Concussions Grades 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 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 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 Injuries 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 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 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 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. Dens 2. 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 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 Numbness Muscle Weakness 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 cramping decreased ROM 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