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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). Facial Mandible Maxille (2) Zygomatic (2) Nasal. Anatomy of the head & neck - bones. Anatomy of the head & neck - bones.
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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) • Facial • Mandible • Maxille (2) • Zygomatic (2) • Nasal
Anatomy of the head & neck - bones • Cervical Vertebrae
Anatomy of the head & neck – Soft Tissues • Brain • Cerebrum – higher thought processes • Cerebellum – balance and coordinated movement • Brainstem – vital body functions
Meninges- layers of tissue that surround 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 • Cartilagenous 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 • Characterized by immediate and transient post-traumatic impairment of neural function • Mechanism of Injury • Result of direct blow to the head from either a fixed or moving object. • Signs of Injury • Headache • Loss of consciousness • Tinnitus • Nausea • Irritability • Confusion • Disorientation • Dizziness • Amnesia • Concentration difficulty • Photophobia • Sleep disturbances • Vision disturbances • Balance disturbances
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 • What month is it? • What time is it?, etc. • Concentration • 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
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 • 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