Remaining Exam 3 Material [CH 22] Flashcards
anatomy of the head
-skull
-brain
-meninges
skull
composed of 22 bones
brain
-contained within the bony cavity of the cranium
-divided into 4 sections
-cerebrum coordinates all voluntary muscle activities + higher mental functions
-cerebellum = balance + coordination
cerebrum function
coordinates all voluntary muscle activities + higher mental functions
cerebellum function
balance + coordination
meninges
3 membranes that protect the brain + spinal cord
-dura mater, outer
-arachnoid, middle
-pia mater, inner
outer meninges
dura mater
middle meninges
arachnoid
inner meninges
pia mater
assessing head injuries- history
-do you know where you are?
-can you tell me what happened to you?
-does your head hurt?
-do you have any pain in your neck?
assessing head injuries- observation
-is the athlete able to tell where he or she is?
-is there a blank or vacant stare?
-are there delayed verbal + motor responses?
assessing head injuries- palpation
palpation of the skull to identify areas of point tenderness or deformity
special tests for head injuries
-neurological exam
-eye function (PEARL- pupils, equal, accommodate, round + light)
-balance tests
-coordination tests
-cognitive tests (SCAT 5, IMPACT)
what makes brain injuries special
-most of the time brain injuries won’t show up in imaging, so must base diagnosis more off symptoms
-a lot of athletes lie so they can get back into the game- to avoid this, do baseline tests so you can compare after brain injury
skull fx- cause
-blunt trauma
-baseball to the head or fall from a height
skull fx- signs
-severe headache + nausea
-palpation may reveal skull indentation
-racoon eyes or battle’s sign
racoon eyes
bruising in a butterfly pattern on the face
-2 black eyes at the same time
battle’s sign
-bruising on the back of the ear
-indicates baselar skull fx, aka broken base of the skull
-important because a lot of the stuff that keeps you alive goes through the base of your skull
-HIGH DEATH RISK
skull fx- care
-immediate hospitalization
-referral to neurosurgeon
concussion- cause
-a type of traumatic brain injury
-trauma-induced alternation of mental status
-direct blow to the head by some object (ball or other player)
concussion- signs
-headache
-dizziness
-LOC (loss of consciousness)
-feeling “in a fog”
concussion- care
-a concussion is a concussion, there is no such thing as a “mild concussion”
-athlete must be removed from competition
-not allowed to return to competition until cleared by a physician
post concussion syndrome- cause
poorly understood condition
post concussion syndrome- signs
-persistent headache
-impaired memory
-lack of concentration
-irritability
post concussion syndrome- care
-no clear-cut treatment
-athlete shouldn’t be allowed to return to play until all the symptoms of this condition have resolved
school recommendations for return to learning protocol
-cognitive rest 1-3 days- yoga, meditation, no screen use
-light cognitive- listening to music, playing familiar games
-1/2 school days
-full school days
second impact syndrome- cause
result of rapid swelling of the brain following a second concussion occurring before the symptoms of a previous concussion have been resolved
second impact syndrome- signs
-within 15 seconds to several minutes, the condition worsens rapidly
-dilated pupils
-LOC
-coma
second impact syndrome- care
-life-threatening emergency
-must be dealt with within 5 minutes by dramatic life saving measures
cerebral contusion- care
usually results from an impact injury in which the head strikes a stationary immovable object such as the floor
cerebral contusion- signs
-LOC
-neurological exam is normal
-headache
-dizziness
cerebral contusion- care
hospitalization with a variety of imaging tests
epidural hematoma- cause
a blow to the head that can cause a tear of the meningeal arteries embedded in bony grooves in the skull
epidural hematoma- signs
-symptoms worsen quickly
-LOC
-severe head pain
-dizziness
-nausea
epidural hematoma- care
-life-threatening
-CT scan to diagnose
subdural hematoma- cause
-results from acceleration/deceleration forces that tear vessels that bridge the dura mater + the brain
-signs tend to appear more slowly
subdural hematoma- signs
-may be unconscious
-headache
-dizziness
-dilation of 1 pupil
subdural hematoma- care
-life threatening
-CT or MRI necessary
migraine headaches- cause
-exact cause unknown
-may be caused by a vascular disorder
migraine headaches- signs
-flashes of light
-blindness in half of the field of vision
-severe headache
-nausea + vomiting
migraine headaches- care
-best management is prevention
-prophylactic medications to reduce recurrence
mandible fx- cause
-most often occur in collision sports
-direct blow
mandible fx- signs
-deformity
-pain when biting down
-bleeding around teeth
mandible fx- care
-temporary immobilization with an elastic bandage
-full activity can be resumed in 2-3 months with appropriate special headgear + customized mouthguard
zygomatic complex (cheekbone) fx- cause
direct blow to the cheekbone
zygomatic complex (cheekbone) fx- signs
-obvious deformity
-nosebleed (epistaxis)
-seeing double (diplopia)
zygomatic complex (cheekbone) fx- care
-cold application for edema control
-healing takes 6-8 weeks
-proper protective gear when returning
facial laceration- cause
direct impact to the fact with a sharp object
facial laceration- signs
-obvious tearing of the epidermis, dermis, + often the subcutaneous of the skin
-substantial bleeding
facial laceration- care
-refer to physician for suturing
-systemic antibiotics to avoid infection
what is a tooth made of
a composite of mineral salts
-calcium + phosphorus
crown
portion protruding from the gum
-top part of tooth
root
-extends into the alveolar bone of the mouth
-nerves + blood vessels below the root
tooth fx- cause
-any impact to the upper or lower jaw
-direct trauma
tooth fx- signs
-depends on depth of the fx
-uncomplicated crown fx no bleeding
-root fx has bleeding in the gum
tooth fx- care
-athlete referred to a dentist for further eval
-x-ray
tooth subluxation, luxation, + avulsion- cause
direct blow to the mouth
tooth subluxation, luxation, + avulsion- signs
-tooth loosened
-tooth totally dislodged
-may not have pain
-avulsion- tooth knocked completely out of the mouth
tooth subluxation, luxation, + avulsion- care
-for subluxation + luxation, no immediate treatment required…see dentist within 48 hours
-for avulsion, the athlete should be referred immediately
-the sooner the tooth can be re-implanted the better the prognosis
nasal fx- cause
direct blow to the nose
-from the side or straight frontal force
nasal fx- signs
-obvious deformity
-swelling
-bleeding
nasal fx- care
control bleeding + refer athlete to a physician for an x-ray + reduction of the fx
septal hematoma- cause
-due to the fx of the cartilaginous portion of the nasal septum
-forceful blow to the nasal tip
septal hematoma- signs
-persistent low-grade pain in the septal area
-persistent nasal congestion
-symptoms don’t show for at least 24-48 hours after nasal injury
septal hematoma- care
hematoma must be drained
another name for nosebleed
epistaxis
nosebleed (epistaxis)- cause
-direct blow to the nose
-sinus infection
-high humidity
-nasal dryness
nosebleed (epistaxis)- signs
obvious bleeding
nosebleed (epistaxis)- care
-sit upright with cold compress placed over nose
-control bleeding
external ear (2)
-pinna
-external auditory canal
middle ear (1)
tympanic membrane
internal ear (1)
cochlea
another name for auricular hematoma
cauliflower ear
auricular hematoma (cauliflower ear)- cause
-compression
-shearing
auricular hematoma (cauliflower ear)- signs
-hemorrhage
-fluid accumulation
-fibrosis outer ear
auricular hematoma (cauliflower ear)- care
-headgear reduces chances of developing hematoma
-cold pack immediately
-aspiration may be required
tympanic membrane rupture- cause
-fall or slap to the unprotected ear
-sudden underwater pressure variation
tympanic membrane rupture- signs
-athlete c/o loud pop followed by ear pain
-nausea + vomiting
-dizziness
tympanic membrane rupture- care
usually heals within 1-2 weeks
another name for swimmers ear
otitis externa
swimmers ear (otitis externa)- cause
-bacterial infection of the ear canal
-water trapped in ear
swimmers ear (otitis externa)- signs
-itching
-discharge
-partial hearing loss
swimmers ear (otitis externa)- care
-drying ears with a soft towel
-ear drops
-referral to physician
middle ear infection (otitis media)- cause
inflammation + infection
middle ear infection (otitis media)- signs
-intense ear pain
-fluid draining from the ear canal
-transient loss of hearing
middle ear infection (otitis media)- care
antibiotics
cornea
transparent covering of pupil
pupil
central opening of the eye
iris
colored portion of the eye
lens
converts light to image via optic nerve
orbital hematoma- cause
direct contact to the eye
orbital hematoma- signs
-subconjunctival hemorrhage
-faulty vision
orbital hematoma- care
-cold application
-athlete should not blow nose (might increase hemorrhaging)
orbital fx- cause
blow to the eye (ex: baseball)
orbital fx- signs
-diplopia (double vision)
-eye stuck in an upward gaze
-soft tissue swelling + hemorrhage
orbital fx- care
-antibiotics to decrease likelihood of infection
-may be treated surgically
hyphema- cause
blunt blow to the anterior aspect of the eye
hyphema- signs
-reddish tinge in the anterior chamber
-blood starts to settle inferiorly
-blood may turn pea green
-vision partially blocked
hyphema- care
-immediate referral to a physician
-bed rest with head elevated 3-45 degrees
-patching of both eyes
retinal detachment- cause
blow to the athlete’s eye separating the retina from its underlying attachment
retinal detachment- signs
-painless
-seeing specks floating before the eye
-flashes of light
-blurred vision
retinal detachment- care
-bed rest with patches on both eyes
-referred to ophthalmologist to determine if surgery is necessary
another name for acute conjunctivitis
pink eye
acute conjunctivitis (pink eye)- cause
-various bacteria or allergens
-dust, pollen, smoke or air pollution
acute conjunctivitis (pink eye)- signs
-eyelid swelling
-redness
-itching
-yellow green discharge for bacteria
-clear color for viral infection
acute conjunctivitis (pink eye)- care
referred to physician
