Injuries to the Head and Spine

The Head

• Head– Bones of the

• cranium • face• teeth

– Brain– Brain Stem

Bones of the Cranium and Face

Nervous SystemNervous System

• Main components– Brain– Cranial Nerves– Spinal Cord– Spinal Nerves– Peripheral Nerves

The Nervous SystemThe Nervous System

• Function– communicate, coordinate,

regulate

• 2 main divisions1.Central Nervous System (CNS) – brain, cranial nerves & spinal cord

2. Peripheral Nervous System– everything outside brain & spinal cord – gathers and carries info to and from the

CNS

Cranial Nerves

• Cranial Nerves– 12 pairs of nerves– lead from brain to

parts of head, neck and torso

– involved in• senses• controlling facial

muscles• regulate glands

The Nervous SystemThe Nervous System

2 Types of Neurons– Afferent Neurons (sensory)

• Sends sensory info to CNS– Efferent Neurons (motor)

• Sends info from CNS

• Stimulates muscle tissue• Stimulates organs and glands

– Mixed Neurons (sensory and motor)

• Located in the brain and spinal cord

Neurons

Major Spinal Nerves

Cervical– C1 through C8– Includes Brachial plexus (C5 – T1)– Phrenic Nerve (breathing)

Thoracic– T1 through T12

Lumbar– L1 through L4

Sacral– L4 through S4– Sciatic Nerve

Spinal Nerve Roots

The Brain

Parts of the brain– Cerebrum

• largest part (2 hemispheres)• 4 lobes• controls willful actions,

interprets sensory messages• governs thought and speech

– Cerebellum• Muscle coordination and

maintains balance

Lobes of the Brain

• Frontal– thinking, personality,

behavior

• Parietal– language

• Occipital– vision

• Temporal– language, hearing

The Brain• Brain stem

– Connects spinal cord with cerebrum

– Controls• Involuntary autonomic

functions• Breathing, heart rate, blood

pressure, digestion

– Consists of:• Midbrain• Pons• Medulla Oblongata

The Brain• Brain Stem

– Pons• communication and

coordination center between parts of brain

• “switchboard”

– Medulla Oblongata• controls breathing, HR,

swallowing ect…..

The Brain

• Parts of the brain– Hypothalamus

• Regulates body temp, sleep cycles

• controls production of many hormones

• body’s thermostat

Regions of the Brain

Cranial Nerves

• The 12 Cranial Nerves

• Assessing Cranial Nerves

Injuries to the Brain: Concussion

• Concussion – injury to the brain or

spinal cord

• MOI – blow to the head or a fall

• Symptoms– Dizziness– Nausea– Confusion– Headache– Disorientation– Blurred vision

Treatment of Concussions

• Treatment of concussions– Threw out grading system– If symptomatic, athlete has

a concussion– No activity until

asymptomatic for 24 hours– More severe symptoms

requires no tv, no reading, no video games

• What is a concussion?

Concussion: Return to PlayConcussion: Return to Play

• No symptoms for 24 hours then:

– Day 1 – slow jog; no symptoms, then

– Day 2 – sprints/weights; no symptoms, then

– Day 3 – practice/no contact; no symptoms, then

– Return to physician for clearance

– Football High – League of Denial: The NFL’s

Concussion Crisis

Concussions

• Second Impact Syndrome (SIS)– Swelling of the brain– Occurs when suffering

2nd concussion before 1st concussion is healed

– Very dangerous and sometimes fatal

– E:60 - Second Impact Syndrome

Anatomy of the Ear

Injuries to the EarInjuries to the Ear

Cauliflower Ear (Hematoma Auris)– most common injury of ear

(wrestling)– caused by extreme friction or

repeated trauma– fluid and blood accumulate

around outer ear– treat: ice and compress

Cauliflower Ear

Injuries to the EarInjuries to the Ear

Swimmer’s Ear (Otitis Externa)– infection of ear canal– caused by trapped

moisture– symptoms: dizziness,

pain, itching, discharge– send to physician

Injuries to the EarInjuries to the Ear

• Tympanic Membrane (eardrum) Rupture– caused by sudden

change in pressure or objects inserted too far

– symptoms: loud pop, pain, hearing loss

– send to physician immediately

Tympanic Membrane Rupture

Anatomy of the Eye

Injuries to the EyeInjuries to the Eye

• Contusions (black eyes)– caused by blow to eye

area– ice immediately– send to physician if

bleeding or double vision

Injuries to the Eyes

Corneal Abrasions or Laceration– scratch on corneal surface– caused by dirt, sand,

insects, or contact with another athlete’s finger

– symptoms: pain and watering of the eye

– don’t rub eye, patch eye

Corneal Abrasion

Injuries to the Eye

• Retinal Detachment– caused by blow to eye or

head– separation of retina from

underlying tissue– symptoms: flashes of

light, “curtain” covering field of vision

– patch eye and send to physician

Detached Retina

Injuries to the EyeInjuries to the Eye

• Fractures (“blow out”)– caused by direct blow– symptoms: swelling,

bleeding & double vision– control bleeding, patch

with sterile gauze, physician

– Most orbital fractures require surgery

Orbital / Blow Out Fracture

Injuries to the Eye

• Conjunctivitis (pink eye)– highly contagious– caused by viruses,

bacteria or allergens– symptoms: burning,

itching and discharge– send to physician

Conjuctivitis

Conjuctivitis

Injuries to the Eyes

• Sty– infection of the eyelash

follicle or oil gland– symptoms: pain, redness,

& swelling– treatment: apply moist

heat and physician if doesn’t clear up

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

• ice if swelling is present• do not blow nose once

bleeding has stopped

Injuries to the Nose

• Nasal Deviation & Fx– 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

Mandibular Dislocation

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

Mandible Fracture

Anatomy of the Spine

• Composed of 30 vertebrae– 7 cervical– 12 thoracic– 5 lumbar– 5 sacral (fused

together to make 1)– coccyx– vertebrae separated

by cartilaginous discs

The SpineThe Spine

• ROM of spine– forward (flexion)– backward (extension)– side to side (lateral

flexion)– rotation (cervical &

lumbar only)

Functions of the Spinal Column

1. Protection– Spinal Cord– Internal organs

2. Structural Support

3. Base for Attachment– Ligaments – Tendons – Muscles

Injuries to the Spinal Column

• Herniated disc – Deteriorated to the point

that pushes against a nerve

– Commonly 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– MOI – head pushed to side

and shoulder pushed down– Treatment - Ice, neck and

shoulder strengthening– Symptoms:

• Pain• Muscle Weakness• Numbness

Nerves Affected by Stinger

Injuries to Spinal Column

• Contusions– Caused by direct blow

• Treatment1. 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– Caused by injury,

overuse or improper lifting

• Symptoms: pain, cramping, muscle tightness

• Treatment: Ice massage, stretching, rest

– How to Treat Back Spasms

Injuries to Spinal Column

• Back Sprain/Strains– Caused by sudden

twisting motion and improper lifting

– 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

Spondylolysis vs. Spondylolisthesis

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