Head, Face, and Spinal Injuries Flashcards
ecchymosis
bruising
epistasis
nose bleeds
signs and symptoms of skull fracture
- severe headache and nausea
- palpation may reveal defect or deformity
- may be blood in the ear canal, nose
- ecchymosis around the eyes (raccoon eyes)
- ecchymosis behind ears (Battle’s sign)
- CSF may appear in ear and nose (halo test)
- inability to see or smell
- unequal pupils
- paralysis, or convulsions
cerebral contusion - etiology
focal brain injury which involves small hemorrhages within cortex, stem or cerebellum
true or false; head traumas result in more fatalities than other sports injury
true
from most superficial to least superficial, what are the brain mater? (3 points)
Dura mater
Arachnoid mater
Pia mater
How many cervical, thoracic, lumbar, sacrum, and coccyx vertebra are there?
Cervical - 7 Thoracic - 12 Lumbar - 5 Sacrum - 5 (but not in all people) Coccyx - 3-5
define skull fracture
direct or indirect force that travel from the mandible to the skull
S&S Skull Fractures (7 points)
1) bad headache/nausea
2) bleeding from ear, nose, ecchymosis around eyes, behind ear
3) CSF in ears, nose
4) cannot see or smell
5) unequal pupils
6) paralysis or convulsions
true or false; concussions mean there was a skull fracture
false
true or false; skull fractures require immediate hospitalisation
true
define cerebral contusion
- small hemmorages in the cortex, cerebellum, or brain stem
S&S of Cerebral Contusions (3 points)
- headache/nausea
- dizziness
- LOC -> talkative state
define intracranial haemorrhages
blow to the head or skull #
- acceleration/deceleration forces most common cause of athlete death
which of the following is the most common cause of athlete death?
a) cardiac arrest
b) acceleration/deceleration forces of head
c) lack of education
d) malignant brain edema syndrome
B
S&S Intracranial haemorrhages (7 points)
- worsening headaches
- dizziness, sleepiness, convulsion
- nausea/vomiting
- dilation of one pupil
- alteration of and/or deterioration of consciousness; disorientation
- decrease pulse and respiration
- abnormal posturing
true or false; intracranial haemorrhages does not require immediate medical attention
false; it DOES require immediate medical attention
Problems with cervical spinal tract or cerebral hemisphere will result in _______ abnormal posturing
decorticate
Problems within midbrain or pons will result in ______ abnormal posturing
decerebrate
Decorticate posture
- stiff body
- bent arms
- clenched fist pulled into chest
- legs rigidly extended
- plantarflexion
Decererbate posture
- arms and legs stiffly extended
- forearms and hands in pronated fists
- head and neck arched into extension
- plantar flexion
Cause of Intracranial Haemorrhages - Malignant Brain Edema Syndrome in Young Population and Adults
- young population - within minutes to hours
- adults - intracranial clot resulting in diffuse brain swelling with little or no brain injury
- swelling result of hyperemia or vascular engorgement -> result in increased pressure
S&S Intracranial Haemorrhages - Malignant Brain Edema Syndrome
- rapid neurological deterioration -> coma -> death within minutes to hours
Life threatening condition!
What is the most common facial fracture?
a) mandible
b) TMJ
c) nasal
d) orbital
e) maxillary/zygomatic
nasal
S&S Nasal fractures
- profuse bleeding IF underlying tissue is formed
- deformity if lateral blows; crepitus
true or false; nasal fractures require immediate hospitalization
false; refer to physician for X ray, examination, and reduction
from most frequent to least frequent, what are the facial # (4 points)
1) nasal
2) mandibular
3) orbital
4) maxillary and zygomatic
S&S mandibular fracture (4 points)
- cannot bite down
- lower lip anesthesia
- bleeding around teeth
- pain with biting
S&S Orbital fractures
- diplopia, restricted eye movement, downward displacement of the eye,
- swelling and bruising
- cheek numbness
true or false; in the case of orbital #, you must ask the athlete to blow their nose for the Halo test
false; do NOT ask them to blow their nose; increased pressure can worsen fracture
S&S facial fractures (4 points)
- deformity
- nosebleed
- double vision
- numbness
how would you manage maxillary and zygomatic #?
- maintain airway and control swelling
- manage open wounds
- assume potential concussion
- refer to physician
mandibular dislocation involves the _____ joint
TMJ
S&S Mandibular dislocation
- locked-open position w/ minimal ROM and poor occlusion
true or false; when wrapping a person with mandibular dislocation, you wrap horizontally around the neck
false; you wrap vertically to maintain airway
S&S dental fractures
uncomplicated - broken tooth, no bleeding
complicated - bleeding, lotta pain
in the event of a dental fracture, the athlete can resume to playing if there is no pain (eg., no sensitivity to air or cold)
true; keep playing!! Just make sure you rule out any mandibular # or concussions
how would you manage:
subluxed tooth
luxated tooth
avulsed tooth
subluxed tooth - refer within 48 hours
luxated tooth - normalize if possible; immediate follow up
avulsed tooth - re implant if possible or in a bag of milk or saline; follow up ASAP
define:
tooth subluxation
tooth luxation
avulsion
tooth subluxation - tooth loose in socket with little or no pain
tooth luxation - tooth displaced in socket but no fracture
avulsion - tooth completely knocked out
S&S laceration
- profuse bleeding
- localized swelling
- localized pain
how would you manage laceration?
- RED to control bleeding
- clean wound to prevent contamination
- look for foreign objects and presence of skull fractures
- if no fracture sign, apply sterile dressing -> steri strips
- refer to physician for suturing
true or false; in the event of an eye injury (impaled object), you must keep the athlete in a neutral seated position and stabilize the object
false; recumbent position
what is the medical name for black eye
orbital hematoma
S&S orbital hematoma
- swelling and discoloration
- signs of a more serious condition may be displayed as a subconjunctival hemorrhage or reduced vision
how long should you apply cold compress for in the even of orbital hematoma?
a) 15 min or longer
b) 30 min or longer
c) 45 min or longer
d) all day
B
how long of a rest will a person need for orbital hematoma and their vision is distorted?
a) 6-12 hours
b) 12-24 hours
c) 24 hours
d) 24-36 hours
e) 48 hours
C
true or false; you should monitor an athlete for concussions after an eye injury
true
S&S hyphema
- blood collect in anterior chamber of the eye within first 2 hours
- visible reddish tinge in anterior chamber (blood may turn pea green)
- vision is partially or completely blocked
- photophobia, drowsiness
how would you manage hyphema?
- do not get them to lie down
- refer to physician immediately
- rest and limited physical activity
- rule out concussion
S&S acute conjunctivitis
- itchy (associated with allergen)
- redness
- discomfort
- swelling
- discharge
true or false; a ruptured tympanic membrane cannot heal and thus lead to profound hearing loss
false; usually heals spontaneously within 1-2 weeks
S&S ruptured tympanic membrane
- hearing loss
- loud pop -> pain in ear
- nausea
- vomiting
- dizziness
how would you manage ruptured tympanic membrane?
- refer to physician
- small to moderate perforations usually heal spontaneously within 1-2 weeks
- infection can occur -> monitor continually
S&S auricular hematoma
- tearing of overlying tissue away from cartilage
- hemorrhaging and fluid accumulation
- if unattended, coagulation and fibrosis occur
how would you prevent auricular hematoma?
- wear proper protection or use friction-reducing agent
- ice and elastic wrap to minimize hemorrhaging
what is the most common spinal injury?
a) cervical
b) thoracic
c) lumbar
d) sacrum
e) coccyx
lumbar
which lasts longer, strains or sprains?
sprains
S&S muscular strain
- diffused or localized pain
- pain w/ stretching
- decreased activity of mm belly
- potential deformity of mm belly
- no radiating pain/no neurological involvement
S&S ligamentous sprains
- similar to strains but lasts longer
- localized pain & tenderness over transverse and spinous process
- pain will usually arise the day after trauma (result of mm spasm)
- decreased active and passive range of motion
How long should you RICE after a ligamentous sprain ?
first 48 - 72 hours
S&S cervical fracture
- neck point tenderness
- restricted motion
- cervical mm spasms
- cervical pain
- pain in chest and extremities
- numbness in trunk or limbs
- weakness in trunk or limbs
- loss of bladder and bowel control
how would you manage a cervical #?
- should be stabilized and collared regardless of LOC
in the event of a cervical fracture? When should you roll the person?
a) always
b) if they are unconscious
c) if they are not breathing
d) You should never roll the person if they have a cervical fracture
C
S&S Brachial plexus neuropraxia
- burning sensation
- numbness/tingling/pain radiating down to fingers
- some loss of function of arm and hands from seconds to several minutes
which vertebrae is most affected for disc herniation
L4-5
stress fractures can lead to _____ of the vertebra which can worsen into slipped vertebra known as ______
spondylosis; spondylolisthesis
S&S spondylosis and spondylolisthesis
- pain and persistent aching
- low back stiffness with increased pain after activity
- frequent need to change position
- full ROM w/ some hesitation in regards to flexion
- localized tenderness and some possible segmental hypermobility
- step off deformity may be present
