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Sport First Responder > Head, Neck and Face Injuries. > Flashcards

Head, Neck and Face Injuries. Flashcards

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1
Q

What is the anatomy of the head and neck?

A
  • Skull: encloses the brain providing it protection, the only major opening is for the foramen magnum (for the spinal cord).
  • Mandible: the lower jaw, the only major moveable bone in the skull.
  • Cervical spine: made up of the first 7 spinal vertebrae.
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2
Q

What are the first 2 cervical vertebrae?

A
  1. Atlas: forms the joint at the base of the skull (atlanto-occipital), ‘yes’ motion occurs here.
  2. Axis: is distinguishable by the odontoid process (fits into the atlas), ‘no’ motion occurs here.
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3
Q

What is the sternocleidomastoid?

A

A muscle that runs from the manubrium of the sternum and the clavicle up to the mastoid process.

When both sides contract at the same time flexion occurs, but when only one side contracts at a time lateral flexion occurs.

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4
Q

What are the scalenes?

A

Composed of 3 muscles on the lateral side of the neck originating from C2-C7. The anterior and medial one attach on the first rib while the posterior one attaches on the second rib.

Function to elevate the first 2 ribs during inhalation.

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5
Q

What is the levator scapulae?

A

A muscles that lies on the posterior side of the neck originating from the transverse process of C1-C4 and attaches on the superior border of the scapula.

Elevates the scapula.

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6
Q

What is the trapezius?

A

A muscle the originates on the medial third of the superior nuchal line, external occipital protuberance, nuchal ligament and the spinous processes of C7-T12.

Attaches on the lateral third of the clavicle, acromion and spine of scapula.

The upper fibres shrug the shoulders, the middle fibres retract the scapula and the inferior fibres depress the shoulders.

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7
Q

What is the brachial plexus?

A

Is the major nerve group that emanates from the cervical spine (C5-T1).

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8
Q

What are the terminal branches of the brachial plexus?

A
  • Musculocutaneous nerve.
  • Radial nerve.
  • Median nerve.
  • Ulnar nerve.
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9
Q

What is the phrenic nerve?

A

Emanates from C3, C4 and C5.

Controles the function of the diaphragm.

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10
Q

What supplies blood to the cervical and cranium?

A
  • Carotid artery: supply to the head and neck.
  • Jugular vein: returns supply from the head.
  • Subclavian artery: supply to the head, neck and upper arm.
  • Meningeal artery: adjacent to the inner surface of the temporal bones.
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11
Q

What movements occur at the neck?

A
  • Flexion.
  • Extension.
  • Lateral flexion.
  • Rotation.
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12
Q

What protects the brain?

A
  • Hair and scalp
  • Skull
  • Meninges: three layers of tissue that surround the brain and spinal cord (dura mater-closest to skull, arachnoid-crossed over by cerebral veins, pia mater-closest to brain).
  • Subarachnoid space: between arachnoid and pia mater that contains cerebrospinal fluid.
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13
Q

What is the function of the frontal lobe?

A
  • Problem solving.
  • Judgement.
  • Planning.
  • Personality.
  • Emotions.
  • Organization.
  • Attention.
  • Concentration.
  • Smell.
  • Movement.
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14
Q

What is the function of the temporal lobe?

A
  • Memory.
  • Hearing.
  • Understanding language.
  • Organization.
  • Sequencing.
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15
Q

What is the function of the parietal lobe?

A
  • Sense of touch.
  • Spatial & visual perception.
  • Sensation.
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16
Q

What is the function of the occipital lobe?

A
  • Vision.
  • Speech.
  • Abstract concepts.
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17
Q

What is the function of the cerebellum?

A
  • Balance.
  • Coordination.
  • Skilled motor activity.
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18
Q

What is the function of the brain stem?

A
  • Breathing.
  • Heart rate.
  • Arousal & consciousness.
  • Sleep & wake cycles.
  • Attention & concentration.
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19
Q

What is a concussion?

A

A complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.

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20
Q

What are some of the common constructs of a concussion?

A
  1. A direct blow to the head, face, neck or elsewhere in the body with a twisting or shearing force transmitted to the head.
  2. Rapid onset of short lived impairment of neurological function resolves spontaneously.
  3. May result in neuropathological changes but the symptoms largely reflect a functional disturbance rather than a structural injury.
  4. May not involve the loss of consciousness.
  5. Typically associated with grossly normal structural neuro-imaging studies.
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21
Q

What are the methods of injury for a concussion?

A
  • Direct blow: causes focal brain damage (ex. injury localized to the area hit by an object. AKA coup.
  • Indirect blow: the outside force causes the mobile brain to accelerate then decelerates with impact on the opposite side of the skull. AKA contra-coupe.
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22
Q

What occurs to the brain during a concussion?

A
  • Swells.
  • Decreased blood flow.
  • Changes in cerebral metabolism.
  • Loss of the ability to auto regulate.
  • Changes in EEG activity.
  • Changes in higher cortical function such as impaired memory.
23
Q

What are the signs and symptoms for a concussion?

A
  • Momentary or prolonged loss of consciousness.
  • Disoriented (person, place, time).
  • Amnesia.
  • Dizziness.
  • Headache.
  • Nausea.
  • Ringing in ears.
  • Blurred/double vision.
  • Nystagmus.
  • Poor balance.
  • Loss of coordination.
24
Q

How do you manage on field care of a head injury?

A
  1. Safety.
  2. Consider C-spine immobilization.
  3. Check responsiveness: level of consciousness (alert, voice, pain, unconsciousness).
  4. Consider activation of EMS.
  5. Maintain ABC’s
25
Q

How do you preform an evaluation of a concussion?

A
  1. Get athlete to stay still and stabilize the head (in the position found).
  2. Ask if there is any pain in specific area.
  3. If wearing a helmet, do not remove or undo chin straps.
  4. Ask if there is any numbness or tingling.
  5. If head/neck injury suspected get them to try and slowly move extremities.
  6. If unsure of neck injury call EMS.
  7. Do a SAMPLE survey.
  8. Only if completely sure of no neck injury slowly get them to stand up.
26
Q

How do you progress to getting an athlete with a possible concussion to stand?

A
  1. Sit up (reassess signs and symptoms).
  2. Sitting to kneeling on one knee.
  3. Kneeling to standing.
27
Q

How do you assess mental wellbeing on the field?

A
  • Person.
  • Place.
  • Time.
  • All questions asked should require the athlete to think.
28
Q

What is retrograde amnesia and how do you assess it?

A

A loss of memory access to events that occurred before an injury.

Ask the athlete to recall the events leading up to the blow. (“what did you have for breakfast?”, “ how did you get to the game?”)

29
Q

What is anterograde amnesia and how do you assess it?

A

A loss of the ability to create new memories after an injury.

Ask the athlete to remember 3-5 words and get them to repeat them back to test immediate recall and then again 5 minutes later to test short term memory.

30
Q

How do you assess mental wellbeing on the sidelines?

A
  1. Repeat signs and symptoms questions.
  2. Repeat tests of pupil accommodation.
  3. Cognitive function: word association, number recall, months backwards.
  4. Coordination tests: finger to nose, heel toe walking.
  5. Balance tests: stork stand.
31
Q

What should parents do/watch for when their child may have a concussion?

A
  • Wake the child every 1 and a half to 2 hours.
  • Don’t give medication without medical consultation.
  • Sudden mood swings.
  • Changes in consciousness.
  • Headaches.
  • Confusion.
  • Vomiting.
  • Visual disturbances.
32
Q

What are the steps to returning to play after a concussion?

A
  1. No activity for at least 24 hours including TV, video games, etc.
  2. Light exercise such as walking or stationary cycling.
  3. Sport specific activity (ex.skating in hockey).
  4. “On field” practice with no body contact.
  5. “On field” practice with body contact.
  6. Play the game.
33
Q

What are the signs and symptoms of post concussion syndrome?

A
  • Persistance headaches.
  • Anxiety and irritability.
  • Fatigue.
  • Depression.
  • Inability to concentrate.
  • Impaired memory.
  • Visual disturbances.
34
Q

What can you do to prevent concussions?

A
  1. Wear the appropriate protective equipment.
  2. Ensure adequate physical fitness.
  3. Adere to the rules of your sport.
  4. Respect your opponent.
35
Q

What are the typical methods of injury for a spinal injury?

A
  • Hyper-extension.
  • Hyper-flexion.
  • Hyper-rotation.
  • Whiplash motion.
  • Axial loading.
36
Q

How do you manage a spinal injury?

A
  • Do not move or remove any equipment unless necessary.
  • Check for any numbness or tingling and see if they can move their fingers and toes.
  • Keep the athlete warm, comfortable and calm.
  • If absolutely sure of no spinal injury slowly get them to their feet.
  • If unsure call EMS, always reason on the side of caution.
37
Q

What are the signs and symptoms of a mandible fracture?

A

Most common site of injury is anterior to the angle.

  • Acute pain on palpation and with movement.
  • Deformity.
  • Loss of normal occlusion.
  • Bleeding around the teeth and possible tooth damage.
38
Q

How do you treat a mandible fracture?

A
  • Ice, support and medical referral.
  • Will require reduction and about 6 weeks to recover.
  • Prevention on return to activity includes proper headgear and mouth guard.
39
Q

What are the signs and symptoms of a mandibular dislocation?

A

Occurs most frequently at the temporomandibular joint.

  • Jaw locked open and cannot move.
  • Imperfect positioning of the teeth when the jaw is closed.
40
Q

How do you treat a mandibular dislocation?

A
  • ICE (ice, compress, elevate).
  • Medical referral.
  • Rest 7-10 days before returning to activity.
41
Q

What is are the signs and symptoms of a nasal fracture?

A

Method of injury: direct blow resulting in a separated cartilage or broken bone.

  • Generally profuse bleeding.
  • Lateral deviation of the septum.
42
Q

How do you treat a nasal fracture?

A
  • Get athlete to pinch nostrils to control bleeding.
  • Ice to control pain and swelling.
  • Medical referral to ensure proper reduction.
43
Q

How do you treat a epistaxis (bleeding nose)?

A

Method of injury: direct blow, sinus infection, dry nasal membrane, foreign bodies.

  • Pinch the nostrils to control bleeding for a minimum of 5 minutes.
  • Do not lean the head backwards.
  • Do not let them blow their nose for 2-3 hours.
  • Medical referral may be needed if bleeding lasts longer than 10 minutes.
44
Q

What are the different components of a tooth?

A
  • Crown: the part above the gums and is covered in enamel.
  • Root: the part below the gum and into the alveolar fossa (covered by cementum).
  • Pulp: the inner portion that contains all the nerves and blood vessels.
  • Dentin: located below the enamel and cementum.
45
Q

What is a tooth dislocation?

A

Generally the result of a direct blow to the teeth or indirect via the jaw.

A tooth that is avulsed from its socket can usually be saved.

46
Q

How do you treat a tooth dislocation?

A
  • Keep patient calm.
  • Pick tooth up by the crown (if dirty was with cold water for 10 seconds).
  • Try to encourage them to replant the tooth (can bite on gauze to hold it down.
  • Place tooth in a suitable storage medium (ex.milk)
  • Can be transported in the mouth (between molars and the cheek).
  • Seek emergency dental treatment.
47
Q

How do you treat a tooth fracture?

A
  • If the crown is damaged there is little chance of saving it.
  • Place gauze pad soaked oil over the tooth.
  • Cover with skin lube or vaseline.
  • Apply commercially available anaesthetic ointment.

Prevention: use a properly fitted mouth guard.

48
Q

Where are the most common places to get a facial laceration?

A

Places with underlying boney prominences (ex. over the eye, zygomatic process).

49
Q

How do you treat a facial laceration?

A
  • Wear gloves
  • Control bleeding with direct pressure.
  • Butterfly bandages or steri-strips can be used to temporarily seal the wound.
  • Seek out medical care.
50
Q

What are eye contusions and how do you treat them?

A
  • Caused by a direct blow.
  • Results in severe swelling and possible orbital fracture.
  • Treat with a cold compress.
51
Q

What are corneal abrasions and how do you treat them?

A
  • Results from direct contact with the cornea by a finger or projectile.
  • Treat with an eye patch to protect against further insult and antibiotics to ward off infection.
52
Q

What is a hyphema and how do you treat it?

A

Pooling of blood into the anterior chamber of the eye.

  • Refer to medical care.
  • Treat with bed rest with the head elevated 30-40 degrees and both eyes patched.
  • Blood will resorb in 3-4 days with little damage to vision.
53
Q

How do you treat a foreign body in the eye?

A

Can use plain water to irrigate the eye and flush the particles out for about 15-20 minutes.

54
Q

What is a Haematoma of the pinna (cauliflower ear) and how can it be treated?

A

Caused by excessive friction over the auricle which can lead to subcutaneous bleeding into the auricular cartilage and subsequent keloid scarring.

-Manage the ear trauma with ice packs, compression and if needed aspiration by a doctor (prevention is usually the best bet).

Sport First Responder (14 decks)

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