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Anatomy and Injuries to the Head. Anatomy of head. 22-28 bones in skull Frontal, ethmoid, sphenoid, lacrimal, parietal (2), temporal (2), zygoma, occipital, nasal (2), maxilla, mandible Bones are joined in immovable joints called sutures Mandible is only movable bone Skull Anatomy Tutorial.
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Anatomy of head • 22-28 bones in skull • Frontal, ethmoid, sphenoid, lacrimal, parietal (2), temporal (2), zygoma, occipital, nasal (2), maxilla, mandible • Bones are joined in immovable joints called sutures • Mandible is only movable bone • Skull Anatomy Tutorial
Brain • Part of CNS • weight= 3 lbs. • Uses 20% of O2 supply & 15% of blood supply • Cells grow/develop until age 18—then they will be destroyed but not reproduced
brain • O2 deprivation results in unconsciousness and death • Pupils will dilate w/in 60 seconds • Brain death occurs in about 4-6 minutes
Sections of Brain • Cerebrum • 4 lobes • Cerebellum • Pons and Medulla oblongata • Make up brain stem
Cerebrum • Coordinates all voluntary muscle activity • Interprets sensory impulses • Controls higher mental functions • Memory, reasoning, intelligence, learning, judgment, emotions
4 lobes of cerebrum • Temporal • Hearing, speech • Parietal • sensation • Occipital • vision • Frontal • Voluntary muscle movement, emotion, eye movement
Cerebellum • Controls movements of skeletal muscles • Plays role in coordination of voluntary muscle movement
Brain stem • Pons • Controls sleep, posture, respiration, swallowing, bladder • Medulla oblongata • Regulates heart rate, breathing, blood pressure, coughing, sneezing, vomiting
Meninges • 3 membranes that protect the brain and spinal cord • Dura Mater • Arachnoid • Pia Mater
Dura Mater • Outer most layer • Separated from bony wall of skull by layer of fat • Contain vital arteries and veins • Forms the epidural space
Arachnoid space • Lines the dura mater
Pia Mater • Membrane that lies directly on the brain • Helps contain the cerebrospinal fluid
Subarachnoid Space • Space between the arachnoid and pia mater
Cerebrospinal fluid • Clear amber in color • Contained in the subarachnoid space • Surrounds and suspends the brain • Has chemicals that assist in proper functioning of brain • Maintains regular pressure around brain • Protects brain from impact
Cerebrospinal fluid • w/ severe injury fluid may drain from ears and nose • Let it drain • Stopping it will increase pressure in skull • Could cause more damage
Scalp • Covers skull • Contains large # of blood vessels, muscles and hair • Skin protects against infection, • keeps dirt and sweat away from eyes • Decreases force of impact due to additional padding • Increases inelasticity created by tension of connective tissue
Thought for the day • To preserve brain function is to maintain quality of life, which depends on how a brain injury is handled.
Prevention of head injuries • Use helmets & mouth guards • Follow the rules of the sport • Learn proper skills and techniques and use them • Use common sense
Injuries • Common mxn is impact and/or rotation • Contra coup occurs when head is moving and receives a blow—brain moves to opposite side of blow and is stopped by skull. That is where the injury occurs • Rotation after impact: causes brain stem to stop functioning normally. Nerve receptors are overloaded which can cause unconsciousness. • Allows for brain to sort out impulses
Skull Fracture • Various kinds • Depressed • Pushes portion of skull in towards brain • Linear • Goes across skull causing tear of vessels on inside of skull • Compound • Results in a portion of skull sticking through scalp • Penetrating • Involves object that has gone through scalp, skull, brain
Skull Fracture • Mxn: • Direct blow to head, blunt trauma to skull • S/S: • severe headache, nausea, defect in skull, bleeding in ears/nose, raccoon eyes, Battle sign, cerebrospinal fluid in ears/nose • Care: • call 911, immobilize head/neck, monitor, perform life saving skills if necessary
Skull Fracture • Complication: • Intracranial bleeding • Bone fragments embedded in brain • infection
Concussion • Temporary impairment of brain function • Alters consciousness • Disturbs vision • Alters equilibrium
Concussion • Mxn: • Direct blow to head • Contra coup injury • Acceleration/deceleration/rotation forces that shake the brain w/in the skull
Concussion • S/S: • Headache • Dizziness • Blurry vision • Double vision • Tinnitus • Nausea • Vomiting • Photophobia
Concussion • S/S: • Unequal or non responsive pupils • Pupils don’t track or “flutter” • Confusion • Disorientation • Loss of balance (equilibrium) • LOC (loss of consciousness) or altered • Amnesia (post traumatic or retrograde) • Difficulty concentrating
Concussion • Care: • Remove from activity until all symptoms clear • With LOC, send to ER • Seek medical attention if symptoms remain • Physician clearance to return to activity
Post concussion syndrome • Persistent symptoms after initial concussion • Symptoms include headache, dizziness, nausea, tinnitus, confusion, inability to concentrate, fatigue • Can last up to a couple weeks or longer • Cannot participate until all symptoms are clear
Second Impact Syndrome • Damage from concussions and brain injury is cumulative • Occurs as result in rapid swelling of brain following a 2nd head injury sustained prior to symptoms of 1st concussion being resolved • 2nd blow can be minor • Most likely to occur in athletes under 20 years old
Second impact syndrome • S/S: • “stunned” • Walk off field on own power • Lose consciousness soon after—lead to coma • Dilated pupils • Loss of eye movement • Respiratory failure • MORTALITY rate----50%
Second impact syndrome • Care: • Call 911 • Life threatening emergency that should be dealt with w/in 5 minutes in an ER • PREVENTION is the best care
Intracranial Hematoma • Severe bleeding w/in the brain • Intracerebral bleeding • Hematoma caused increase in pressure on brain • Rapid death can occur • Mxn: direct blow to head or head striking an immoveable object • Temporal or parietal regions are more vulnerable
Intracranial hematoma • S/S: will vary • LOC • Headache • Dizziness • Nausea • Possible paralysis • Increased blood pressure • Decreased pulse rate
Intracranial hematoma • Care: • Call 911 • Monitor athlete • Perform any life saving skills necessary until EMS arrives