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Anatomy and Injuries to the Head

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Anatomy and Injuries to
the Head
Anatomy of head
пЃ® 22-28 bones in skull
пЃ®
Frontal, ethmoid, sphenoid, lacrimal, parietal
(2), temporal (2), zygoma, occipital, nasal (2),
maxilla, mandible
пЃ® Bones are joined in immovable joints called
sutures
пЃ® Mandible is only movable bone
пЃ® Skull Anatomy Tutorial
Skull
skull
Skull inferior view
Brain
пЃ® Part of CNS
пЃ® weight= 3 lbs.
пЃ® Uses 20% of O2 supply & 15% of blood
supply
 Cells grow/develop until age 18—then they
will be destroyed but not reproduced
brain
пЃ® O2 deprivation results in unconsciousness
and death
пЃ® Pupils will dilate w/in 60 seconds
пЃ® Brain death occurs in about 4-6 minutes
Sections of Brain
пЃ® Cerebrum
пЃ®
4 lobes
пЃ® Cerebellum
пЃ® Pons and Medulla oblongata
пЃ®
Make up brain stem
Sections of Brain
Cerebrum
пЃ® Coordinates all voluntary muscle activity
пЃ® Interprets sensory impulses
пЃ® Controls higher mental functions
пЃ®
Memory, reasoning, intelligence, learning,
judgment, emotions
4 lobes of cerebrum
пЃ® Temporal
пЃ®
Hearing, speech
пЃ® Parietal
пЃ®
sensation
пЃ® Occipital
пЃ®
vision
пЃ® Frontal
пЃ®
Voluntary muscle movement, emotion, eye
movement
Cerebrum
Cerebellum
пЃ® Controls movements of skeletal muscles
пЃ® Plays role in coordination of voluntary muscle
movement
Brain stem
пЃ® Pons
пЃ®
Controls sleep, posture, respiration,
swallowing, bladder
пЃ® Medulla oblongata
пЃ®
Regulates heart rate, breathing, blood
pressure, coughing, sneezing, vomiting
Brain Stem
Meninges
пЃ® 3 membranes that protect the brain and
spinal cord
пЃ®
пЃ®
пЃ®
Dura Mater
Arachnoid
Pia Mater
Dura Mater
пЃ® Outer most layer
пЃ® Separated from bony wall of skull by layer of
fat
пЃ® Contain vital arteries and veins
пЃ® Forms the epidural space
Arachnoid space
пЃ® Lines the dura mater
Pia Mater
пЃ® Membrane that lies directly on the brain
пЃ® Helps contain the cerebrospinal fluid
Subarachnoid Space
пЃ® Space between the arachnoid and pia mater
Meninges
Cerebrospinal fluid
пЃ® Clear amber in color
пЃ® Contained in the subarachnoid space
пЃ® Surrounds and suspends the brain
пЃ® Has chemicals that assist in proper
functioning of brain
пЃ® Maintains regular pressure around brain
пЃ® Protects brain from impact
Cerebrospinal fluid
пЃ® w/ severe injury fluid may drain from ears and
nose
пЃ® Let it drain
пЃ® Stopping it will increase pressure in skull
пЃ® Could cause more damage
Scalp
пЃ® Covers skull
пЃ® Contains large # of blood vessels, muscles
and hair
пЃ® Skin protects against infection,
пЃ® keeps dirt and sweat away from eyes
пЃ® Decreases force of impact due to additional
padding
пЃ® Increases inelasticity created by tension of
connective tissue
Thought for the day
пЃ® To preserve brain function is to maintain
quality of life, which depends on how a brain
injury is handled.
Prevention of head injuries
пЃ® Use helmets & mouth guards
пЃ® Follow the rules of the sport
пЃ® Learn proper skills and techniques and use
them
пЃ® Use common sense
Injuries
пЃ® Common mxn is impact and/or rotation
пЃ® Contra coup occurs when head is moving and
receives a blow—brain moves to opposite
side of blow and is stopped by skull. That is
where the injury occurs
пЃ® Rotation after impact: causes brain stem to
stop functioning normally. Nerve receptors
are overloaded which can cause
unconsciousness.
пЃ® Allows for brain to sort out impulses
Skull Fracture
пЃ® Various kinds
пЃ® Depressed
пЃ®
пЃ®
Linear
пЃ®
пЃ®
Goes across skull causing tear of vessels on
inside of skull
Compound
пЃ®
пЃ®
Pushes portion of skull in towards brain
Results in a portion of skull sticking through scalp
Penetrating
пЃ®
Involves object that has gone through scalp, skull,
brain
Skull Fracture
пЃ® Mxn:
пЃ®
Direct blow to head, blunt trauma to skull
пЃ® S/S:
пЃ®
severe headache, nausea, defect in skull,
bleeding in ears/nose, raccoon eyes, Battle
sign, cerebrospinal fluid in ears/nose
пЃ® Care:
пЃ®
call 911, immobilize head/neck, monitor,
perform life saving skills if necessary
Skull Fracture
пЃ® Complication:
пЃ®
пЃ®
пЃ®
Intracranial bleeding
Bone fragments embedded in brain
infection
Skull Fracture
Skull Fracture
Concussion
пЃ® Temporary impairment of brain function
пЃ®
пЃ®
пЃ®
Alters consciousness
Disturbs vision
Alters equilibrium
Concussion
пЃ® Mxn:
пЃ®
пЃ®
пЃ®
Direct blow to head
Contra coup injury
Acceleration/deceleration/rotation forces that
shake the brain w/in the skull
Concussion
Concussion
пЃ® S/S:
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
Headache
Dizziness
Blurry vision
Double vision
Tinnitus
Nausea
Vomiting
Photophobia
Concussion
пЃ® S/S:
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
Unequal or non responsive pupils
Pupils don’t track or “flutter”
Confusion
Disorientation
Loss of balance (equilibrium)
LOC (loss of consciousness) or altered
Amnesia (post traumatic or retrograde)
Difficulty concentrating
Concussion
пЃ® Care:
пЃ®
пЃ®
пЃ®
пЃ®
Remove from activity until all symptoms clear
With LOC, send to ER
Seek medical attention if symptoms remain
Physician clearance to return to activity
Concussion
Concussion
Post concussion syndrome
пЃ® Persistent symptoms after initial concussion
пЃ® Symptoms include headache, dizziness,
nausea, tinnitus, confusion, inability to
concentrate, fatigue
пЃ® Can last up to a couple weeks or longer
пЃ® Cannot participate until all symptoms are
clear
Second Impact Syndrome
пЃ® Damage from concussions and brain injury is
cumulative
пЃ® Occurs as result in rapid swelling of brain
following a 2nd head injury sustained prior to
symptoms of 1st concussion being resolved
пЃ® 2nd blow can be minor
пЃ® Most likely to occur in athletes under 20 years
old
Second impact syndrome
пЃ® S/S:
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
“stunned”
Walk off field on own power
Lose consciousness soon after—lead to coma
Dilated pupils
Loss of eye movement
Respiratory failure
MORTALITY rate----50%
Second impact syndrome
пЃ® Care:
пЃ® Call 911
пЃ® Life threatening emergency that should be
dealt with w/in 5 minutes in an ER
пЃ® PREVENTION is the best care
Intracranial Hematoma
пЃ® Severe bleeding w/in the brain
пЃ®
пЃ®
пЃ®
Intracerebral bleeding
Hematoma caused increase in pressure on
brain
Rapid death can occur
пЃ® Mxn: direct blow to head or head striking an
immoveable object
пЃ®
Temporal or parietal regions are more
vulnerable
Intracranial hematoma
пЃ® S/S: will vary
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
LOC
Headache
Dizziness
Nausea
Possible paralysis
Increased blood pressure
Decreased pulse rate
Intracranial hematoma
пЃ® Care:
пЃ®
пЃ®
пЃ®
Call 911
Monitor athlete
Perform any life saving skills necessary until
EMS arrives
Intracranial hematoma
Epidural Hematoma
пЃ® Tear in meningeal arteries that are embedded
in bony grooves of skull
пЃ® Formation of hematoma very quickly due to
arterial blood pressure
Epidural hematoma
пЃ® Mxn:
пЃ®
пЃ®
Blow to head
Results of skull frature
Epidural hematoma
пЃ® S/S:
пЃ®
пЃ®
пЃ®
пЃ®
LOC
After regaining consciousness, may appear
completely lucid w/ no symptoms of head
injury
Symptoms of concussion can appear and
gradually worsen
Later---decreased level of consciousness,
neck rigidity, decreased respiration & pulse
rate, convulsions
Epidural Hematoma
пЃ® LIFE-THREATENING
пЃ® Care:
пЃ®
пЃ®
пЃ®
Call 911
Monitor athlete
Live saving skills as necessary
Epidural Hematoma
Subdural Hematoma
пЃ® Occurs more frequently
пЃ® Involves venous bleeding
 S/S will appear more slowly—after hours or
even days
Subdural hematoma
пЃ® Mxn:
пЃ®
Acceleration/deceleration forces that tear
blood vessels that bridge the dura mater and
brain
Subdural hematoma
пЃ® S/S:
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
пЃ®
LOC
Dilation of one pupil (unequal) usually on
same side as injury
Headache
Nausea
Sleepiness
Other concussion symptoms
Subdural hematoma
пЃ® Care:
пЃ®
пЃ®
пЃ®
Call 911
Monitor athlete
Life saving skills as necessary
Subdural hematoma
Comparison of the 3 hematomas
Scalp injuries
пЃ® Lacerations
пЃ® Abrasions
пЃ® Contusions
пЃ® hematomas
Scalp Injuries
пЃ® Mxn:
пЃ®
Blunt or penetrating trauma
пЃ® S/S:
пЃ®
Complaints of being hit, bleeding, open
wound, deformity (bump)
пЃ® Care:
пЃ®
пЃ®
Control bleeding, clean wound, refer for
sutures if more that ½” long and 1/8” deep
Watch for infection
Scalp wounds
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