Lecture 10 Flashcards
Relevant anatomy of head, face and throat
-pharynx
-larynx
-trachea
-esophagus
-sternocleidomastoid
Pharynx
-throat
Larynx
-voice box
-connects throat with trachea, prevents food from getting into trachea while breathing
Trachea
-brings air from throat to lungs
Esophagus
-brings food from throat to stomach
Relevant vessels of the head, face and throat
-carotid artery
-jugular vein
-subclavian artery and vein
-vagus nerve
Bones of the face
-frontal bone
-orbital bones
-nasal bone
-cheekbones
-maxilla bones
-mandible
Frontal bone
-forehead
Orbital bones
-around eyes
-along eyebrows
Nasal bone
-nose
Zygomatic bones
-cheekbones
Mandible
-jaw
Bones of the head and face
-frontal bone
-parietal bones
-temporal bones
-occipital bone
-temporomandibular joint
What is the temporomandibular joint
-joint between temporal bone and mandible
-articular disc within joint
Muscles that act on TMJ
-temporalis
-pterygoids
-masseter
MOI injuries to anterior neck
-blunt force to anterior neck/throat by stick, puck, ball, opponent
What sports are injuries to anterior neck common in
-field hockey
-lacrosse
-hockey
Signs and symptoms injuries to anterior neck
-pressure
-difficulty swallowing “feels thick”
-difficulty breathing
-panicky
What is there a risk of of in injuries to the anterior neck
-larynx fracture
MOI of major bleeds
-skate
-stick
-contact with boards
-laceration of carotid artery, jugular vein, an subclavian vein
What sports are major bleeds common in
-hockey
-figure skating
Acute management of major bleeds
-pressure
-rapid EMS call
-treat for shock
What do major bleeds usually require
-requires vascular surgical team to repair damaged vessels
Prevention of major bleeds
-neck guards
Different types of facial injuries
-eye-poke injuries
-fractures
-auricular hematomas
-lacerations
-TMJ conditions
-dental injuries
What do eye-poke injuries
-subconjunctival hemorrhage
-corneal abrasion
Subconjunctival hemorrhage
-bright red bleeding/spot on white of eye from broken blood vessel
Corneal abrasion
-scratch on surface of eye
Signs and symptoms of eye-poke injuries
-mild discomfort
-irritation
Acute management of eye-poke injuries
-cold compress
-refer for eye exam
When should someone be referred immediately after an eye-poke injury
-any vision changes
-shadows
-floaters
-pressure
-pain
MOI of facial fractures
-direct trauma via opponent
-puck
-ball
What sports are facial fractures common in
-ice hockey
-football
-rugby
-baseball
What type of facial fractures are the most common
-unilateral zygomatic-maxillary-orbital
-isolated mandibular
-nasal fractures
Signs and symptoms
-tender on palpation fracture site
-racoon eyes
-swelling
-divots
-deformities
Acute management of facial fractures
-PIER if tolerated
-refer
MOI auricular hematoma
-blunt trauma
-repetitive friction
What is auricular hematoma
-resulting contusion to ear
Signs and symptoms of auricular hematoma
-pain
-swelling
-bruising
What can auricular hematoma lead to
-necrosis of the cartilage from blood supply being cut off
What is auricular hematoma known as
-cauliflower ear
What sports are auricular hematomas common in
-wrestling
-rugby
-judo
-boxing
Acute management of auricular hematoma
-PIER
-add pressure by packing ear with folded gauze to prevent fluid accumulation
-magnets
MOI lacerations
-blunt trauma
-sharp object
What do lacerations require
-form pressure
Acute management of lacerations of the face
-refer for stiches
-pressure
-steri-strips
What type of joint is the TMJ
-hinge joint
MOI of TMJ conditions
-direct trauma to mandible
-cumulative repeat impacts
What sports are TMJ conditions common in
-contact sports
What can TMJ conditions result in
-dislocations
-fractures
-sprains
-articular disc injuries
-muscle tension/strains
-clicking/altered joint mechanics
-headaches
MOI dental injuries
-direct blow
Common sports related dental injuries
-tooth (crown) fractures
-tooth intrusion
-tooth extrusion
-tooth avulsion
Tooth intrusion
-tooth gets forced into the bone
Tooth extrusion
-tooth gets forced out of the bone
Tooth avulsion
-complete removal from socket
Acute management of dental injuries
-ensure broken teeth removed from mouth
-rule out concussion and C-spine
-refer to dentist
-ER if severe
-rolled gauze to control
-numbing agent
Prevention of dental injuries
-mouthguards
What are types of headaches seen in sport
-dehydration
-cervicogenic
-concussion
What are the different types of cervicogenic headaches
-muscle tension
-joint dysfunction
MOI concussions
-direct blow or indirect
What is a concussion known as
-mild traumatic brain injuries
What is a concussion
-a transient change of neurological function
Cause of concussions
-stretch
-ion exchange
-depolarization of action potentials
-results in an electrical storm
Signs of concussion
-vomiting
-disorientation/confusion
-memory loss
-loss of consciousness
Symptoms fo concussion
-headache, pressure, migraines
-cognitive changes
-vestibular system dysfunction
-nausea
-fatigue
-mood changes
What needs to be ruled out in a concussion
-c-spine injuries
What does assessing a concussion include
-interviews
-physical exams
-testing
Two common assessment tools in concussions
-SCAT6
-ImPACT testing
SCAT6
-standardized tool for evaluating concussions
-sideline or clinical
-designed for athletes over 13 years of age
-takes 10-15 min
What does ImPACT testing stand for
-immediate post-concussion assessment and cognitive testing
ImPACT testing
-computerized objective tool
-requires a baseline test
-measures memory, attention span, visual and verbal problem solving
Components of a SCAT6
-immediate assessment/neuro scan
-off-field assessment
Immediate assessment/neuro scan
-observable signs
-glasgow coma scale
-cervical spine assessment
-coordination and ocular/motor screen
-memory assessment maddocks questions
Observable signs
-athlete position/behaviour/MOI
Glasgow coma scale (LOC)
-eye/verbal/motor responses
Cervical spine assessment
-pain at rest
-TOP
-AROM
-limbs
Coordination and ocular/motor screen
-finger to nose
-follow finger
Memory assessment maddocks questions
-questions re venue
-game
-past games
What is included in off-field assessment
-athlete background
-symptom evaluation
-cognitive screening
-coordination and balance examination
-delayed recall
-decision
What is involved in cognitive screening
-orientation
-immediate memory
-concentration
Post-concussion syndrome
-timeframes vary
-anywhere from 10 days - 3 months
Systems that may be exacerbating symptoms in concussions
-visual
-vestibular
-physiologic
-cervicogenic
-psychological
Post concussion disorder early symptom-limited threshold
-symptom exacerbation
Post concussion disorder no early symptom-limited threshold
-no symptom exacerbation
Chronic traumatic encephalopathy
-progressive degenerative brain disorder caused by repeat head injuries
Signs and symptoms of chronic traumatic encephalopathy
-memory loss
-confusion
-headaches
-irritable mood
-agression
-depression
-slurred speech
-unsteady/altered motor control
Concussion injury prevention
-mouthguards
-proper fitting helmet
-safe technique
-concussion
Safe technique
-no high tackles
-no spearing
Concussion education
-early identification
-no RTP with even 1 symptom
-safe and progressive RTP
