Unit 5.1 Specific injuries Head & Neck Unit 5.1 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 Cervical Vertebrae

Anatomy of the head & neck - Muscles Location Function Sternocleidomastoid Anterior aspect of the neck Flex neck; rotate the head Trapezius Posterior aspect of the neck Extends neck; adducts scapula

Anatomy of the head & neck – Soft Tissues Brain Cerebrum – higher thought processes Cerebellum – balance and coordinated movement Brainstem – vital body functions

Anatomy of the head & neck – soft tissues 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

Common Injuries – Head/Neck Concussions Assessment/Grading: Currently there is debate on whether to or when to grade levels of concussion. Resolution of symptoms should be the focus, rather than the grade of injury.

Common Injuries – Head/Neck If it is decided by the health care professional to grade the injury, the following system is recommended: Concussion Grading System – Cantu 2001 Grade I (mild) Grade II (moderate) Grade III (severe) No loss of consciousness; amnesia lasting less than 30 minutes; other signs/symptoms last less than 24 hours Loss of consciousness less than 1 minute or amnesia lasting more than 30 minutes but less than 24 hours or other signs/symptoms lasting more than 24 hours but less than 7 days Loss of consciousness more than 1 minute or amnesia lasting more than 24 hours or other symptoms lasting more than 7 days

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 is dependent on the following: Physician recommendation Frequency of concussion Severity of concussion Length of time athlete is asymptomatic Prevention strategies Protective equipment Helmet Mouthguard Proper skill technique Following rules of the sport

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