1. Injuries to the Head, Neck
PE 236
Juan Cuevas, ATC

2. Anatomy Review Skull The skull has 8 cranial bones & 14 facial bones.
have articulations
called suture joints.

3. Anatomy Review (continued)
Soft tissue
structures
protect the
cranium.

4. Anatomy Review (continued)
The _________
Located underneath cranial bones, consisting the dura, arachnoid, and pia mater.

5. Anatomy Review (continued)
_______________________ (CNS)
Brain and ___________ comprise the CNS.
CNS is protected by meninges, cranium, and vertebrae.
CNS consists of gray and white matter and weighs 3.0 to 3.5 lbs (adult).
Brain has three basic components, the cerebrum, ______________, and brain stem.
Neural impulses travel via ____ pairs of cranial nerves and 31 pairs of spinal nerves.

6. Anatomy Review (continued)
The Neck (cervical spine)
The __ cervical vertebrae provide support for the head and protection for the spinal cord.

7. Anatomy Review (continued)
The first cervical vertebra (C-1) is called _____
Atlas articulates with the occipital bone
The second cervical vertebra (C-2) is called _____

8. Head Injuries in Sports
Even minor head trauma can result in serious injury.
Brain tissue is unable to repair itself; any tissue loss results in some level of ___________ disability.
Severe injuries can result in _________
Coaches can learn to recognize head injuries and render first aid when necessary.

9. Mechanisms of Head Injury
Direct injury to the head involves a blow to the head that causes injury at impact site.
_________________ injury
Coup injury
Indirect injury to the head results from damaging forces traveling to the head from other parts of the body.
Treat every head injury as if there is a neck injury and vice versa.

10. Head Injuries in Sports
Cranial injury:
Involves the bones of the skull.
May be associated soft tissue injury.
_________________ skull fracture:
Involves bone fragments being pushed into the cranial region.

11. Head Injuries in Sports (continued)
_______________ is “a clinical syndrome characterized by immediate and transient impairment of neurologic function secondary to mechanical forces.”

12. Concussion signs and symptoms
____________
Nausea
Balance problems
Double or fuzzy __________
Sensitivity to light or noise
Sluggishness
Felling ____________
Concentration and memory problems
Symptoms may worsen with exertion
Athlete should not return to play until __________________!

13. Head Injuries in Sports (continued)
_____________ Amnesia: forgets events prior to hit
_____________ Amnesia: forgets events after hit.

14. Head Injuries in Sports (continued)
_________________ Syndrome (SIS) can be a serious problem!
Results when an athlete with a head injury receives another head injury before the symptoms of the first injury have resolved.
Involves rapid and catastrophic brain swelling.
SIS can result in __________.
Any athlete sustaining a head injury, no matter how minor, should be monitored by a physician before being cleared to return to participation.

15. Initial Survey Always assume a neck injury has also occurred.
If unconscious, attempt to arouse and note approx. time of injury.
Immobilize head and neck immediately; do not remove athlete’s helmet!!
(Stabilizing the athlete’s head and neck)

16. Initial Survey (continued)
If unconscious, detect ______________by:
Listening near the athlete’s face for typical breathing sounds.
Looking for movements of the thorax and/or abdomen.
If no signs of circulation are present, begin __________ and summon EMS.

17. Physical Examination The physical exam must include assessments of:
________________________ or unconsciousness.
Extremity strength without moving the neck, if conscious.
Mental function, if conscious.
Signs and movements.
Neck _________

18. Physical Exam (continued)
If head injury is suspected:
________ remove helmet.
Don’t move.
___________ arouse someone with ammonia capsules.
If athlete is conscious, use quick neurological tests, such as grip strength and skin sensation.
Examine the eyes, noting ______________, responsiveness to light, and side-to-side movement.
Palpate the neck for deformity.

19. Special Tests Neurologic exam Eye function
Assess cerebral testing, __________________ testing, cerebellar testing, sensory and reflex testing
Eye function
Pupils equal round and reactive to light (__________)
Dilated or irregular pupils
Ability of pupils to accommodate to light variance
Eye tracking - smooth or unstable (_____________, which may indicate cerebral involvement)
Blurred vision

20. Balance Tests Coordination tests __________________
Assess static balance - determine individual’s ability to stand and remain motionless
Tandem stance is ideal
Coordination tests
Finger to nose, heel-to-toe walking
Inability to perform tests may indicate injury to the cerebellum

21. ________________________-
Used to establish impact of head trauma on cognitive function and to obtain objective measures to assess patient status and improvement
On or off-field assessment
Months in reverse order, counting backwards
Tests of recent memory (score of contest, breakfast game, _______________

22. Cervical Spine Injuries
Neck Injuries
Majority occur in football, rugby, ice hockey, soccer, _________-, and gymnastics. Cervical injuries, however, can occur in almost any sport.
________________ injuries are rare--less than 2 in 100,000 of all neck injuries reported in the United States.

23. Cervical Spine Conditions
Mechanisms of Injury

24. Cervical Spine Injuries (continued)
Mechanisms include hyperflexion, hyperextension, rotation, lateral flexion, and _________________.
Neck strains rarely involve neurologic damage.
Serious injuries occur when intact vertebra or fragments of fractured vertebra are displaced or an intervertebral disk ruptures and places pressure on spinal cord or nerve roots.

25. Mechanism of Cervical Spine Injuries
___________ produces most cervical spine injuries.
1976 NCAA enacted the rule barring “spearing.”
Any forced movement of cervical spine can result in injury.
Brachial plexus injuries can produce significant, but transient symptoms.
Coaching personnel must take great care when conducting an examination of an athlete suspected of having a neck injury.