Head & Neck

Cranium – protects brain. Frontal Parietal (2) Occipital Temporal (2)

Facial Mandible Maxille (2) Zygomatic (2) Nasal

Cervical Vertebrae

Muscle Location Function

Sternocleidomastoid Anterior aspect of the neck

Flex neck; rotate the head

Trapezius Posterior aspect of the neck

Extends neck; adducts scapula

Brain Cerebrum – higher

thought processes Cerebellum – balance

and coordinated movement

Brainstem – vital body functions

Meninges- layers of tissue that surround brain and spinal cord. Has areas of space between each layer

DURA MATER- outer layer made up of arteries and veins

SUBDRUAL SPACE ARACHNOID LAYER- spider web of veins SUBARACHNOID SPACE- contains CSF PIA MATER- inner layer lines brain and spinal cord Cerebrospinal Fluid (CSF) - protects, cushions and

nourishes the central nervous system.

Intervertebral Disks Cartilagenous discs

that lie between the vertebrae.

Act as shock absorbers of the spine.

Cranial nerves 12 pair that branch

off of the brain

Spinal Nerves; nerve root pairs that branch off the spinal cord. Brachial Plexus (C5-T1) –

bundle of spinal nerves that innervate the shoulder and arm muscles

Concussions Characterized by immediate and

transient post-traumatic impairment of neural function

Mechanism of Injury Result of direct blow to the head

from either a fixed or moving object.

Signs of Injury Headache Loss of consciousness Tinnitus Nausea Irritability Confusion Disorientation Dizziness Amnesia Concentration difficulty Photophobia Sleep disturbances Vision disturbances Balance disturbances

Concussions Assessment:

Neuropsychological Testing If possible, preseason testing on a

computerized system (ImPACT). If a concussion occurs, retest injured athlete

following recommended protocols. Thorough evaluation of athlete: (Sport

Concussion Assessment Tool (SCAT 2 – see additional resources) is a tool that can be used to evaluate a concussed athlete.

Physical Examination – evaluation of athletes physical symptoms as listed previously.

Concussions Assessment

Balance/Coordination testing Balance Error Scoring System (BESS – see

additional resources) Romberg Test Finger to Nose

Treatment: Careful removal from

play Thorough physical

and neurological examination

Refer to physician for follow-up examination

Return to Play Guidelines: Depends on the level of play of the

athlete involved. Currently, the NCAA, UHSAA, and a new Utah State law regarding youth sports (HB 204) will dictate a specific plan for concussion management and return to play guidelines. It will include some variation of the following :

Progression through Return-To-Play stages on a case by case basis with final clearance by an approved, licensed health care professional:

Postconcussion Syndrome Persistent symptoms following concussion

- May begin immediately following injury and may last for weeks to months

Persistent headache Impaired memory Lack of concentration Anxiety Irritability Fatigue Depression Continued visual disturbances

Treatment – No clear guidelines Treat symptoms to greatest extent

possible Return athlete to play when all signs

and symptoms have fully resolved

Second Impact Syndrome Rapid swelling of the brain from

additional head trauma; life threatening

Second impact could be minor Could be caused by blow to

chest that accelerates head.

Signs and Symptoms No initial loss of consciousness Rapid worsening leading to:

LOC progressing to coma Dilated pupils Loss of eye movement Respiratory failure

Treatment: Immediate transport to medical facility

Prevention DO NOT LET THIS SITUATION

OCCUR! Careful decision making

regarding return to play following initial head trauma