1. Bones of the Skull and Anatomy of the Head Mr. Brewer

2. The Skull The Skull is composed of 22 bones. All of these bones are joined together through “immovable joints” called sutures. * The only exception is the Mandible Bone aka the “Jaw Bone”.

3. Bones and Sutures

4. Bones Frontal Bone (1) Ethmoid Bone (1) Sphenoid Bone (1) Parietal Bones (2) Temporal Bones (2) Occipital Bone (1)

5. Face Although they are still considered to be part of the skull, the following bones are more specifically referred to as the bones of the face. The Mandible is the only bone that has a moveable joint (Temporal-Mandibular Joint). The Mandible is also known as the “Jaw Bone”. The Maxilla and Zygomatic bones make up the inferior portion of the orbital eye socket. The Zygomatic bones are also known as the “cheek bones”.

6. Skull https://www.youtube.co m/watch?v=Nc5IRj3OJh E -Watch brief clip explaining the bones of the skull.

7. Cranial Injuries Skull Fractures – results from direct blow to the head from impact of falling or being struck by a person or object. Obviously a medical emergency that requires immediate attention by a doctor. * Battle Sign  Subdural Hematoma – can result from a skull fracture or other direct blow to the head that results in blood building up within the meninges region of the brain. Another medical emergency that sometimes can take up to 48-72 hrs. to fully form following the initial blow to the head.

8. Cranial Injuries Orbital Fractures – Fracture(s) that take place to any bone that makes up the orbital cavity. Usually the zygomatic bone, which makes up the “floor” of the orbital socket, is broken. TMJ – “Temporomandibular Joint” dysfunction. http://www.webmd.com/oral- health/guide/temporomandib ular-disorders-tmd

9. Eye Anatomy The eye is a slightly asymmetrical globe, about an inch in diameter. The front part of the eye (the part you see in the mirror) includes: The iris (the pigmented part) The cornea (a clear dome over the iris) The pupil (the black circular opening in the iris that lets light in) The sclera (the white part) The conjunctiva (a thin layer of tissue covering the front of the eye, except the cornea) * The Lens (Sits behind the Iris and adjust to focus sight)

10. Eye Movement -The Eye has several muscles that allow us to intricately move AND control our eyes. -Like most muscles, they are named for their location, shape, and/or position. -https://www.youtube.com /watch?v=vd7OOJ7c1q4https://www.youtube.com /watch?v=vd7OOJ7c1q4 -Movements and how they relate to the nerves. https://www.youtube.com /watch?v=ldiNRvLhQ3A https://www.youtube.com /watch?v=ldiNRvLhQ3A

11. Pathway of Vision Image-> Cornea->Pupil->lens-> Retina-> Rods and Cones(Nerve Cells)->Optic Nerve->Optic Chiasm->Optic Tracts->Occipital Lobe(For interpretation)

12. Eye Injuries Cuts to the Eyelid or surrounding areas of the eye. (Maybe) Corneal Abrasion – Scratch or small cut to cornea. (Maybe) Conjunctivitis – “Pink Eye”; infection of conjunctiva. (Probably)

13. Eye Injuries Detached Retina – A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. (EYE DOCTOR) Hyphema – Buildup of blood in anterior chamber of the eye. (EYE DOCTOR)

14. Treating Eye Injuries In almost all cases when dealing with the eye, it is a good idea to refer the athlete to an eye doctor. (Optometrist or an Ophthalmologist) Steps as an AT: – Stop bleeding if necessary (butterfly/steri strips?) – Determine if eye is functioning correctly both visually and with movement. – Eye Drops? – Eye Patch? Why use an eye patch? – Decide if further attention is needed. – When in doubt, send to eye doctor!

15. Tooth Anatomy Adults typically will have 32 teeth: Incisors (8 total): The middlemost four teeth on the upper and lower jaws. Canines (4 total): The pointed teeth just outside the incisors. Premolars (8 total): Teeth between the canines and molars. Molars (8 total): Flat teeth in the rear of the mouth, best at grinding food. Wisdom teeth or third molars (4 total): These teeth erupt at around age 18, but are often surgically removed to prevent displacement of other teeth.

16. Tooth Anatomy Enamel: The hardest, white outer part of the tooth. Enamel is mostly made of calcium phosphate, a rock- hard mineral. Dentin: A layer underlying the enamel. Dentin is made of living cells, which secrete a hard mineral substance. Pulp: The softer, living inner structure of teeth. Blood vessels and nerves run through the pulp of the teeth. Cementum: A layer of connective tissue that binds the roots of the teeth firmly to the gums and jawbone. Periodontal ligament: Tissue that helps hold the teeth tightly against the jaw.

17. Injuries to the Teeth Chipped Tooth – Can occur while eating/chewing, but in sports often times happens a result of a direct blow to the mouth. Preserving a tooth: The tooth must not be left outside the mouth to dry. If it cannot be replaced in the socket, put it in one of the following: 1. Emergency tooth preservation kit (such as Save-a-Tooth®) 2. Milk 3. Mouth (next to cheek) Fractured Mandible – In sports, usually a result of an extreme amount of force to the jaw by either an object(baseball), or equipment(Baseball bat, sticks, etc.) – Rarely they can occur due to a fall where a player was unable to brace themselves. *Normally Jaw will need to be wired shut due to the strong muscles of the jaw causing problems if they could move the jaw.

18. Ear Anatomy The ear is broken down into the Outer, Middle and Inner ear.

19. Ear Anatomy The Outer Ear is simply made up of the Auricle and the External Auditory Meatus(Ear Canal). Cuts and other external injuries can occur to the Auricle. The “Outer Ear” ends at the end of the canal where the Tympanic Membrane is located. Tympanic Membrane is better known as the “Eardrum”. How the Ear works: – https://www.youtube.com/watc h?v=qgdqp-oPb1Q https://www.youtube.com/watc h?v=qgdqp-oPb1Q

20. Ear Anatomy The Malleus, Incus and Stapes are three bones of the middle ear. They are more commonly known as the Hammer, Anvil and Stirrup because of their shape. These 3 bones are considered to be the 3 smallest bones in the human body (technically 6 because there are 2 sets of these 3 bones, one for each ear. Their main function is to amplify sound, and relay that sound to the inner ear for the brain to interpret.

21. Ear Injuries Otitis Externa (Swimmer’s Ear): The Ear Canal can cause what is known as “Swimmers ear” if water entered the canal and stayed there for an extended period of time. In those type of dark, warm and moist conditions, bacteria forms causing an infection known as Otitis Externa aka “Swimmer’s Ear. Ruptured Tympanic Membrane: Rupture to the “Ear Drum” - Can result from direct blow from object or air OR loud violent sound causing the ear drum to rupture.

22. Ear and Nose Injuries Hematoma Auris: “Cauliflower Ear” – Most common in wrestlers. – Ears being hit repeatedly by mats/hands. – Rubbing on mats or other surfaces. Epistaxis: “Nosebleed” – Most common occurrence is following a directly blow. – Frequent Nose Bleeds: Can also happen commonly in wrestlers if hit in the face on consecutive days. Cauterization? Sometimes done to prevent ongoing nosebleeds from occurring.

23. Throat Anatomy The throat has 2 functions: – To Provide a passageway for food to reach the Esophagus for digestion. – To provide a passageway for air to reach the Trachea(wind-pipe), which eventually allows oxygen to get to the lungs.

24. The Hyoid Bone The Hyoid Bone is a sesamoid (Free-floating) bone located in the throat. The function of the Hyoid Bone is to provide additional support for surrounding structures located in the throat

25. Throat Functions There are some key parts of throat that have important roles in the human body. One of the most important roles the throat has to play, is allowing food and air to get where they need to be during breathing and eating. Food in the lungs can be very detrimental, just as too much air in the GI tract can cause problems such as distension as well. I.E. Swallowing vs. Inhaling. The Epiglottis plays a large role in keeping food out of the lungs. https://www.youtube.com/wat ch?v=pNcV6yAfq-g https://www.youtube.com/wat ch?v=pNcV6yAfq-g

26. Concussions Where to begin….

27. Resources WebMD Principles of Athletic Training Textbook