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Chapter 8 - Head Injuries

Chapter 8 - Head Injuries. Greatest danger to our physical well-being due to head structures controlling life sustaining processes. Head Anatomy. Skull 29 bones 8 cranial 14 facial 7 ear Hyoid. Head Anatomy. Brain Cerebrum two hemispheres Frontal parietal temporal occipital

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Chapter 8 - Head Injuries

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  1. Chapter 8 - Head Injuries Greatest danger to our physical well-being due to head structures controlling life sustaining processes

  2. Head Anatomy • Skull • 29 bones • 8 cranial • 14 facial • 7 ear • Hyoid

  3. Head Anatomy • Brain • Cerebrum • two hemispheres • Frontal • parietal • temporal • occipital • Meninges • Dura matter • Arachoid: Sub arachoid space (CSF) • Pia

  4. Head Anatomy • Brain stem (relays sensory and motor information and life supporting reflex center, cranial nerves) • Midbrain • Pons • Medulla oblongata • Cerebellum • Subconscious movements • Equilibrium & posture • Motor error detectors • Movement patterns • Emotional: pleasure & anger

  5. Head Injuries • Causes • Sudden forces to head • Direct • Indirect (inertial) • acceleration & deceleration mechanism • Head Motion • translation • rotation

  6. Head Injuries • Mechanical Properties • Skull: stiff yet compressible • Brain: compliant • Internal stresses • Strain exceeds capacity to withstand load • Close vs. Open • Primary and Secondary • Severity: internal damage to neural structures • Boxing: CTBE or dementia pugilistica

  7. Chapter 8 - Trunk Anatomy & Injuries Largest segment of the body (40-50% body mass).

  8. Trunk Anatomy • Bone: Axial Skeleton • Ribs • Sternum • Vertebrae

  9. Trunk Injuries • Vertebral fractures • Major Health concern • Proximity to spinal • Potential to cause severe neural damage, including death • Axial compressive loads • T11-L3 minimal curvature, transition zone

  10. Trunk Injuries • Three Column model • Burst fracture: compression force causing vertebrae to shatter from within • High loading rates: intrusion • Disk degeneration • Healthy: more intrusion • Old: less intrusion

  11. Trunk Injuries • Spinal Deformities • abnormal distributions patterns or pathological tissue adaptations • Associated with cardiopulmonary dysfunction • Scoliosis: Lateral

  12. Kyphosis Sagittal plane: hunchback Common in women Osteoporosis Prevention: exercise Scheuermann’s kyphosis: changes in endplates of growing vertebrae Lordosis: abnormal extension (swayback) Lumbar area tilting lumbar area luumbosacral angle above 30 deg Trunk Injuries

  13. Spondylolysis defect of the vertebrae lamina (pars articularis) Spondylosthesis translation or slippage between adjacent segments Five types Dysplastics Isthmic degenerative Traumatic Pathological Young athletes Isthmic: repeated loading of pars region, fractures Trunk Injuries

  14. Trunk Injuries • Spondylolisthesis • older: L4-L5 degeneration due to arthritis • Young: L1-S5, end plate lesions

  15. Trunk Injuries • Loads of the spinal column • comples • compression • torsional - shearing • tensile - excessive spinal motion • Lumbar region highest forces

  16. Trunk Injuries • Disks • viscoelastic • annulus fibrosus • fibrocartilage • criss-crossed orientation • nucleus pulposus • 70-90% water • mucoprotein & fibers • intrinsic pressure • High tensile stress (Poisson’s) • cartilaginous end plate

  17. Trunk Injuries • Loading during exercise • Sit-up versus curls

  18. Trunk Injuries • Lifting • Weight belts • IAP

  19. Trunk Injuries • Bulging disks: • nucleus pulposus is displaced from its normal position • Rotation stress

  20. Trunk Injuries

  21. Trunk Injuries • Mechanism • Compressive loads • Hyperflexion with lateral bending • nerve root disturbance • posterolateral displacement • Low Back Pain • 85% undiagnosed

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