Transcript Sports Medicine HEAD Injuries

Sports Medicine HEAD
Injuries
CHAPTER 22
Vocabulary:
Encephalon
 Meninges
 Cerebrospinal fluid
 Automatism
 Posttraumatic amnesia
 Retrograde amnesia
 Intracranial
hemorrhage
 Tinnitus
 Rhomberg’s sign
 Cerebral hyperemia
 Cerebral edema

 Occlusion
 Malocclusion
 Epistaxis
 Cauterization
 hyphemia
 Hematoma auris
 Nystagmus
 Keloid
 Photophobia
 External Otitis
 Orbital Hematoma
ANATOMY- HEAD-bones of skull
 scalp is the first line of defense
 Bones of the skull makes up the second line of
defense for the brain
 28 bones in the skull

Frontal, temporal, parietal, occipital
 MENINGES- skull matter
 Protective coverings that enclose the spinal cord and
the brain. Their primary functions are to channel
forces away from the vital structures and provide a
passage way for blood vessels, lymphatic vessels and
nerves
The meninges
Dura mater
– Superficial lines against the skull. It is the
toughest and contains blood vessels and nerves
Arachnoid mater
– Netlike structure, forming a web over the brain
Pia mater
– Deepest and follows all the irregular contours
of the brain
MECHANISM OF INJURY
Direct blow– thin bone produces local trauma in
bending/tensile stress inner table
– Thick bone non trauma local in
bending/tensile stress with peripheral out
bending/tensile stress with peripheral out
bending outer table
– Size of impact smaller more serious than large
surface area
MECHANISM OF INJURY
Coup injury- a forceful blow to the resting
moveable head usually produces maximal brain
injury beneath the point of cranial impact
 Contra coup injury- when a moving head
collides with a nonmoving object producing
maximal brain injury to the opposite site of
cranial impact
Injuries to the Head
 Subdural Hematoma
– Involves veins in the brain.
– Usually tear the bridge between the dura mater to the
brain.
– Contra coup type of an injury.
– Hemorrhage is slow and should be watched very
closely for 24 hours
 Epidural hematoma
– Common with a temporal skull fx.
– Artery- rapid bleeding
– Brief period of unconsciousness followed by
consciousness to coma to death within a period of 1530 min.
Injuries to the Head
Intracerebral bleeding
– Bleeding within the brain itself
– Deterioration of neurological function
occurs rapidly
Skull fractures
– Severe blow to head
– Difficult to determine even by x-ray
– Watch for intracranial bleeding signs
Concussions
Definition of Concussion
Any alteration in cerebral function caused
by a direct or indirect (rotational) force
transmitted to the head resulting in one of
the following acute signs or symptoms:
–
–
–
–
Brief loss of consciousness
Light-headedness
Vertigo (dizziness)
Cognitive or memory dysfunction
Signs/symptoms cont. concussion
 Tinnitus (ringing in the ears)
 Blurred vision
 Difficult concentrating
 Amnesia
 Headache
 Nausea and vomiting
 Photo-phobia
 Balance disturbance
Signs/symptoms cont. concussion
Delayed Signs and Symptoms:
Sleep irregularities
Fatigue
Inability to perform usual daily activities
Depression
Lethargy
Facial Injuries
 Jaw fracture:
 Second to all facial fractures
 Most common fx near jaws frontal angle
 Deformity or malocclusion
 Pain when biting down
 Bleeding around teeth
 Lower lip numbness
 Cheekbone fx. (zygomatic)
 Around the eye, 3rd most common facial injury
 Loss of vision
Facial Injuries
 Teeth injuries
 If dislocated: replace in socket
 Enamel is the hardest substance within the body
 Fractured nose:
 Most common fx. To the face
 RX: control bleeding- x-ray
– Have athlete sit upright
– Cold compress
– Direct pressure to nostril
 Cauliflower ear: hematoma auris
 Cold compress
 Possible drain and cast
 Wear protective ear covering
Eye injuries
Symptoms indicating serious eye
injury:
 Blurred vision not clearing with blinking
 Loss of all or part of the visual field
 Pain that is sharp, stabbing, or throbbing
 Double vision
 RX: cover both eyes but put no pressure on the
eye
 Transport to hospital
Eye injuries
 Blowout fracture
 Hemorrhage occurs around the inferior aspect margins of
the eye
 Diplopia
 Pain while moving eye
 Retinal detachment
 More common with myopia (nearsightedness)
 Seeing specks floating before the eye
 Flashes of light
 Blurred vision
 Curtain falling over the field of vision