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Sports Medicine HEAD Injuries. CHAPTER 22. Vocabulary:. Occlusion Malocclusion Epistaxis Cauterization hyphemia Hematoma auris Nystagmus Keloid Photophobia External Otitis Orbital Hematoma. Encephalon Meninges Cerebrospinal fluid Automatism Posttraumatic amnesia
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Sports Medicine HEAD Injuries CHAPTER 22
Vocabulary: • Occlusion • Malocclusion • Epistaxis • Cauterization • hyphemia • Hematoma auris • Nystagmus • Keloid • Photophobia • External Otitis • Orbital Hematoma • Encephalon • Meninges • Cerebrospinal fluid • Automatism • Posttraumatic amnesia • Retrograde amnesia • Intracranial hemorrhage • Tinnitus • Rhomberg’s sign • Cerebral hyperemia • Cerebral edema
ANATOMY-- • HEAD-bones of skull • scalp is the first line of defense • Bones of the skull makes up the second line of defense for the brain • 28 bones in the skull • Frontal, temporal, parietal, occipital • MENINGES- skull matter • Protective coverings that enclose the spinal cord and the brain. Their primary functions are to channel forces away from the vital structures and provide a passage way for blood vessels, lymphatic vessels and nerves
The meninges • Dura mater • Superficial lines against the skull. It is the toughest and contains blood vessels and nerves • Arachnoid mater • Netlike structure, forming a web over the brain • Pia mater • Deepest and follows all the irregular contours of the brain
MECHANISM OF INJURY • Direct blow- • thin bone produces local trauma in bending/tensile stress inner table • Thick bone non trauma local in bending/tensile stress with peripheral out bending/tensile stress with peripheral out bending outer table • Size of impact smaller more serious than large surface area
MECHANISM OF INJURY • Coup injury- a forceful blow to the resting moveable head usually produces maximal brain injury beneath the point of cranial impact • Contra coup injury- when a moving head collides with a nonmoving object producing maximal brain injury to the opposite site of cranial impact
Injuries to the Head • Subdural Hematoma • Involves veins in the brain. • Usually tear the bridge between the dura mater to the brain. • Contra coup type of an injury. • Hemorrhage is slow and should be watched very closely for 24 hours • Epidural hematoma • Common with a temporal skull fx. • Artery- rapid bleeding • Brief period of unconsciousness followed by consciousness to coma to death within a period of 15-30 min.
Injuries to the Head • Intracerebral bleeding • Bleeding within the brain itself • Deterioration of neurological function occurs rapidly • Skull fractures • Severe blow to head • Difficult to determine even by x-ray • Watch for intracranial bleeding signs
Definition of Concussion • Any alteration in cerebral function caused by a direct or indirect (rotational) force transmitted to the head resulting in one of the following acute signs or symptoms: • Brief loss of consciousness • Light-headedness • Vertigo (dizziness) • Cognitive or memory dysfunction
Signs/symptoms cont. concussion • Tinnitus (ringing in the ears) • Blurred vision • Difficult concentrating • Amnesia • Headache • Nausea and vomiting • Photo-phobia • Balance disturbance
Signs/symptoms cont. concussion • Delayed Signs and Symptoms: • Sleep irregularities • Fatigue • Inability to perform usual daily activities • Depression • Lethargy
Facial Injuries • Jaw fracture: • Second to all facial fractures • Most common fx near jaws frontal angle • Deformity or malocclusion • Pain when biting down • Bleeding around teeth • Lower lip numbness • Cheekbone fx. (zygomatic) • Around the eye, 3rd most common facial injury • Loss of vision
Facial Injuries • Teeth injuries • If dislocated: replace in socket • Enamel is the hardest substance within the body • Fractured nose: • Most common fx. To the face • RX: control bleeding- x-ray • Have athlete sit upright • Cold compress • Direct pressure to nostril • Cauliflower ear: hematoma auris • Cold compress • Possible drain and cast • Wear protective ear covering
Eye injuries • Symptoms indicating serious eye injury: • Blurred vision not clearing with blinking • Loss of all or part of the visual field • Pain that is sharp, stabbing, or throbbing • Double vision • RX: cover both eyes but put no pressure on the eye • Transport to hospital
Eye injuries • Blowout fracture • Hemorrhage occurs around the inferior aspect margins of the eye • Diplopia • Pain while moving eye • Retinal detachment • More common with myopia (nearsightedness) • Seeing specks floating before the eye • Flashes of light • Blurred vision • Curtain falling over the field of vision