SMED UNIT 6- HEAD AND NECK

pupil equal and reactive to light

12 nerve pairs that begin in areas of the brain. They are designated by number and name

study the effects of head trauma on cognitive function (mental processes that allow us to carry out common tasks)

awake and responds immediately and appropriately

impaired memory, disorientation and confusion

drwosy yet easily arouswed, oriented to persono, place and time

asleep most of the time, difficult to arouse, responds inappropriately

no response to verbal stimuli, some response to painful stimuli

no response

bloody nose

length of time from injury until conscious memory returns

loss of memory of events that occurred before the injury

can recite 4-5 words or numbers right after you say them

ringing in the ears

balance testing for intracranial damage

double vision

On Old Olympus Towering Tops, A Finn And Greek Viewed Some Hops

Smell (I)

vision (II)

eye movement, constriction of pupil (III)

eye movement (IV)

head and face sensation (V)

lateral movement of the eye (VI)

taste, facial movements (VII)

hearing and equilibrium (VIII)

swallowing (IX)

speech (X)

movement of neck and spine (XI)

movement of the tongue (XII)

Blunt trauma to head.

S/S- blood and/or CSF in ear or nose, severe headache, nausea, skin indentation

T/X- 911

Direct or indirect trauma to head

S/S- confusion, headache, dizziness, trouble concentrating, abnormal pupil response

T/X- take out of play, determine LOC, watch for symptoms to worsen

Blow to head (may be a slow bleed)

S/S- show signs of mild headache but then has sever head pains, dizziness, nausea, unequal pupils.

TX- referral to the ER

blow to the head

S/S- extremely fast bleeding, arterial. (in 10-20 min the athlete will go grom fine to having major symptoms

TX- ER, surgery

Veins are torn that bridge the dura mater to the brain (Contrecoup)

S/S- bleeding is slow, s/s may not appear for hours

TX- 911 after s/s appear

occurs at site opposite of impact

Force trauma to being (bleeding within the brain)

S/S- deterioration of neurological function

TX- 911, ER

Happens after head injury

s/s- impaired memory, lack of concentration, anxiety, depression

TX- may not return to play until symptoms are gone and have been cleared by a health care provider

Second head injury before S/S of initial injury go away ( caused 50 deaths over the last decade)

S/S- appear stunned, within short time athlete may collapse, dilated pupils, loss of eye movement, respiratory failure.

TX- prevention

Repetitive blows to the head (progressive degenerative brain disease

S/S- depression, mood changes, impulse control problems (eventually causes dementia)

TX- no cure

Motor function, balance, posture

Voluntary movements

Sensory

Motor functions

Consciousness depends on excitation of the cerebral cortex

between arachnoid and pia mater (subarachnoid space)

-Suspends brain

-Cushions it from shock

Dura Mater- Dense, inelastic, outermost matter

Arachnoid membrane- thin, delicate membrane, attached to the spinal cord by small tissue strands

Subarachnoid space- in between the arachnoid and the pia mater. Helps contain the spinal fluid

Pia Mater- innermost layer

Frontal, Occipital, 2 Sphenoid, 2 Parietal, 2 Temporal

Medulla- heart, lungs motor

Pons and midbrain- reflexes

Note length of time unconscious for

Alert-comatose

Headache- Location, type

Memory- immediate recall, recent memory

QUESTIONS-

• Do you know where you are

• What happened

• Does your head hurt

• Do you have pain in your neck

• can you move your hands and feet

obvious deformity

slurred or incoherent speech

gross disturbance in coordination

length of time athletes affects abnormal

swelling or bleeding from scalp

discoloration

disorientation

delayed verbal and motor responses

-skull deformity

-open wounds

-palpate both neck and skull

BALANCE TESTS-

Rhomberg (stand with eyes closed, single leg and tandem stance)

BESS (balance error scoring system)

COORDINATION TESTS-

finger to nose

heel-to-toe walk

heel to knee test

CONGITIVE TESTS-

count backwards from 100 by 7

spelling a word backwards

3 word recall

name the months in reverse order

Cerebral testing- cognitive function

Cranial nerve testing- rule out isolated injury

Cerebellar testing- coordination and motor function

Sensory testing- dermatomes

Reflex testing

Cognitive Activity Monitoring Log

the institution of both physical and cognitive rest

no school attendance, no home/school work, no reading, no video games, no texting, no computer time, and no television

mild traumatic brain injury

return to learn

after mild symptoms develop and before severe symptoms develop

577

1. NO activity

2. Gradual reintroduction of cognitive activity

3. Homework at home before schoolwork at school

4. School re-entry

5. Gradual reintegration into school

6. Resumption of full cognitive workload

ice pack for head and neck, eat light diet, go to sleep, rest, tylenol

check eyes with flashlight, wake up every hour, test reflexes, stay in bed

drink alcohol, eat spicy foods, drive

Step 1- light aerobic exercise

Step 2- Sport specific exercise

Step 3- noncontact training drills and resistance training.

Neurocognitive test=

PASS- non contact training drills and resistance training

FAIL- retake in 48 hours

Step 4- full contact practice

a full 24-hour period. if symptoms return athlete drops back one level

bump of knowledge

between arachnoid and pia mater

suspends brain, and cushions it from shock