Head, Face and Spinal Injuries Flashcards
two key factors in injury prevention
education and protective equipment
what has been labeled as the silent epidemic
morbidity and mortality associated with brain injury
what kind of trauma results in more fatalities than any other sports injury?
head trauma
what is the neurocranium
holds the brain
what is the viscerocranium
contains the face
what are the meningeal layers?
dura mater - touch layer right underneath the skull
two layers: periosteal layer and meningeal later
arachnoid mater: all the vasculature
pia mater: closest to the Brain proper
what are the meningeal layers for?
providing cushion
five significant sections of the spine and number of vertebra in each
cervical (7), thoracic (12), lumbar (5), sacrum (fused), coccyx (tail bone, sometimes fused)
how many major curves in the spine?
2 : thoracic and lumbar
what to do if you see a specific head injury
call 911 immediately
skull fracture etiology
direct low or force that travels for mandible to skull
skull fracture S&S
severe headache, nausea
palpation may revel defect or deformity
blood in ear canal, nose, battle’s signs, or ecchymosis (racoon eyes)
cerebrospinal fluid appear ing in ear and nose (halo test)
inability to see or smell
unequal pupils
paralysis or convulsions
cerebral contusion etiology
blow to head to skill
in head bleeding
acceleration or deceleration forces
cerebral contusion S&S
worsening headache dizziness, sleepiness, convulsion nausea and vomiting dilation of one pupil alteration and/or deterioration of conciseness disorientation depression of pulse and respiration abnoral posturing
Decorticate posturing is
arms like C's flexion arms flexing towards spinal cord legs internally rotated problem with cervical spinal tract or cerebral hemisphere
decerebrate posturing is
arms like e's extension problem with midbrain or pons arms straight, hands pronated fists head and neck in arched extension
malignant brain edema syndrome etiology
occurs in young population in minutes to hours following a head injury
in adults: intracranial clot resulting in diffuse brain swelling
swelling from hypermedia or vascular engorgement
malignant brain edema syndrome S&S
rapid neurological deterioration progressing to a coma and then possibly death
malignant brain edema syndrome management
with kids closely after a head injury
Facial fracture: nasal S&S
immediate swelling and pain
profuse bleeding
deformity
crepitus
Facial fracture: nasal management
upright sniffing posture
two rolled gauze square and tape
refer for physician for reduction and X-rays
mandibular fracture S&S
deformity loss of occlusion pain with biting bleeding around teeth lower lip anesthesia
mandibular fracture management
temporary immobilization with elastic wrap and ice
refer to hospital for reduction and fixation
orbital fracture etiology
blow to cheek or eyeball forcing it posteriorly
orbital fracture S&S
diplopia restricted eye movement downward displacement of the eye swelling and bruising cheek numbness
orbital fracture management
ice and advice to not blow nose
refer
maxillary and zygomatic fracture S&S
deformity
nosebleed
double vision
numbness
maxillary and zygomatic fracture management
control swelling and maintain airway
manage open wounds
assume potential concussion
physician referral
mandibular dislocation what joint and how occurs?
TMJ joint, generally a blow to open mouth form the side
mandibular dislocation S&S
locked open position w?ROM minimal long with poor bite contact
mandibular dislocation management
cold, elastic wrap, immobilization and reduction
activity again 7-10 days later
dental fractures uncomplicated is
broken tooth, no bleeding
dental fractures complicated is
bleeding and lots of pain, root fracture must be cleared with an x ray
dental fractures management
dental attention 24-48hrs afterward
fractured pieces in a bag
manage bleeding with gauze
in sensitive to air and cold, root exposed, if not can continue playing
tooth subluxation is
loose within socket, little or no pain
tooth luxation is
displacement without fracture
inward = refer to dentist immediately
tooth avulsion is
what to do
completely knocked out
place tooth in milk or saline
eye injuries what they look like
swelling
discolouration
penetrating objects
movement of the lid
what to inspect for in eye injuries
look at globe for abnormalities or foreign bodies
inspect conductive and sclera for haemorrhaging, deforming or foreign body
check for nine eye movements
what are the nine eye movements
cross then and x then cross eyes
up, down, side, side, bottom right, bottom left, top right, top left, cross eyed
orbital hematoma is
black eye
orbital hematoma S&S
blood collecting in anterior chamber of eye within first 2hrs
reddish tinge in anterior chamber, blood may turn pea green
vision partially or completely blocked
photophobia
drowsiness
acute conjunctivitis is and caused by
pink eye
bacteria/common cold
acute conjunctivitis S&S
redness, discomfort, eyelid swelling, discharge
itching
acute conjunctivitis management
avoid contact and no contact lens wearing
isolate towels and washcloths
eye drops prescribed
ruptured tympanic membrane causes
fall or slap to unprotected ear
pressure variations
ruptured tympanic membrane S&S
loud pop heard pain in ear nausea vomiting dizziness hearing loss visible rupture through otoscope
ruptured tympanic membrane management
refer to physician
Auricular Hematoma – Cauliflower ear cause
compression or shear injury to the auricle
Auricular Hematoma S&S
tearing of overlying tissue away from cartilage
hemorrhaging and fluid accumulation
coagulation and fibrosis occur is there is no treatment
Auricular Hematoma management
wear proper ear protection
ice and elastic wrap to minimize bleeding
if swelling, refer to physician for aspiration
prevention of cervical spine injuries
strengthening of cervical or paraspinal musculature
maintain functional ROM
using correct techniques
prevention of thoracic and lumber spine injuries
avoid repetitive stress
correct biomechanics abnormalities
correct lifting technique
core stabilization
common injuries of the spine occur when and are
when normal ROM is exceeded strains (muscle/tendons) sprains (joint associated -capsule or ligament) fracture dislocation fo joint dice rupture burner (neural)
muscle strains occur with what two movements
hyper flexion or rotation
muscle strains S&S
pain by be diffuse or localized
pain may be activated with stretching
spasms
potential deferment in the muscle belly
muscle strains management
PIER/RICE acitivity modification gentle ROM/stretching exercises NSAIDS/muscle relaxants
ligamentous strains how?
same as sprains, just more violent
snapping of head or neck
ligamentous strains S&S
longer lasting symptoms same as sprains
localized pain and tenderness over the transverse and spinous processes
pain usually arise day after trauma
decrease active and passive ROM
ligamentous strains management
rule out fracture or further injury
RICE for first 48-72 hrs
Cervical fracture MOI
over ROM
Axial load: driving right into top of skull
Flexion, hyperextension, rotation and flexion, rotation and hyperextension, lateral flexion
how does a cervical fracture occur
generally an axial load with some degree fo cervical flexion
cervical fracture S&S
neck point tenderness restricted motion cervical muscle spasms cervical pain pain in the chest and extremities numbness in the trunk or limbs loss of bladder or bowel control
cervical spine fracture management
stabilize, collared and spine boarded regardless of level of consciousness
use extreme caution and care
Brachial plexus neuropraxia (burners) cause
result of stretching or compression fo teh brachial plexus
disrupts peripheral nerve function without degenerative changes
Brachial plexus neuropraxia S&S
burning sensation numbness tingling pain radiating to all the fingers some loss of function of the arm and hand for seconds to several minutes
Brachial plexus neuropraxia management
return to activity once returned to normal
strengthening and stretching program
paddling to limit neck ROM during impact
disc herniation - lumbar happens in what two vertebra most commonly and from what
L4 or L5
poor mechanics
typically chronic
flexion and twisting
disc herniation - lumbar S&S
sharp centrally located pain
radiates unilaterally across the back, glute and down leg
pain typically worsens after being stationary
forward bending and sitting increases pain, side bending away from pain
disc herniation - lumbar management
ice
ROM
core strengthening
Spondylolysis what is it
degeneration of the vertebra due to congenital weakness (stress fracture results)
associated with reported spinal hyperextension
what is spodylolisthesis
occurs after Spondylolysis
when one vertebrae above or below extends bilaterally
S&S of spodylolisthesis and Spondylolysis
pain and persistent aching low back stiffness with increased pain after activity
frequent need to change position
full ROM with some hesitation towards flexion
localized tenderness and some possible segmental hypermobility
step of deformity may be present
spodylolisthesis and Spondylolysis and management
strengthening and stabilization exercises
increased susceptibility to lumbar strains and strains
what sports at highest risk for spodylolisthesis and Spondylolysis
aesthetic sports and collision sports
