The Head, neck and spine

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The Head, neck and spine
Chapter 10
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Facts

• Brain is protected from trauma by the bones of
  the skull.
• Head has the best blood supply of the body.
• Head weighs about 14 pounds.

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Facts cont

• Neck is seldom injured in daily activity,
  including sports.
• Injuries have the potential to cause serious
  injury, paralysis, or death.
• Spinal cord transmits impulses that control all
  voluntary and involuntary movements of the body.
• 28 bones in the human head.

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Vertebral Column

• Cervical (7)
• Thoracic (12)
• Lumbar (5)
• Sacral (5)
• Coccyx (4 fused)

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Bones of the Head

• 28 bones in the human head.
• 8 cranial bones
• -Parietals -Temporals
• -Frontal -Occipital
• -Sphenoid - Ethmoid
• 14 facial bones
• -Lacrimals -Nasals
• -Zygomatics -Maxillae
• -Palatine -Hyoid
• Vomer - Mandible
• 6 auditory (ear) bones
• -Malleus (Hammer)
• -Incus (Anvil)
• -Stapes (Stirrup)

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Head anatomy
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Cranial Bones

• Paired cranial bones
• Parietals
• Temporals
• Unpaired cranial bones
• Frontal
• Occipital
• Sphenoid
• Ethmoid

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Cranial Bones
-Parietal Bones
-Frontal Bone(Forehead)
-Temporal Bones
-Ethmoid Bone(Nose)
-Sphenoid Bones(Temples)
-Occipital Bone
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Facial Bones

• Paired facial bones
• Lacrimals
• Nasals
• Zygomatics
• Maxillae
• Palantines
• Inferior Nasal Conchae
• Unpaired facial bones
• Vomer
• Mandible
• Hyoid

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Facial Bones
-Mandible(Jaw Bone)
-Maxillea
-Zygomatics (Cheek Bones)
-Vomer
-Palatine(Roof of the mouth)
-Lacrimals
-Nasal
-HyoidA delicate C-shaped bone in the neck that
anchors the tongue muscles to the throat.
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Bones of the Auditory Canal
-Anvil
-Hammer
-Stirrup

• -The bones of the ear transfer vibrations from
  the eustachian tube to the cochlea.
• The hammer (mallus) is the largest bone in the
  ear
• The stirrup (stapes) is the smallest bone in the
  human body (the stapes is also fully developed at
  birth).
• The eustachian tube connects the middle ear to
  the pharynx and respiratory system.

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Sutures

• -Sutures are unique fibrous joints that hold the
  bones of the skull together.
• -During normal human growth sutures expand as the
  head grows.

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Muscle Groups in the Head

• Scalp area
• Consists of long, flat ,smooth muscles that have
  the ability to move forward and backward.
• Other fibers and tissues allow this movement to
  take place with ease.
• Keeping the scalp pliable is very important to
  the nourishment of the skin and hair, as it
   helps keeps the glands and blood vessels
  healthy.

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• Three small muscles are located  in front, above
  and behind the external portion of the ear.
• They have very little movement, but integrate
  with other muscles and tissues and provide
  protection for veins and nerves.

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• Muscles of the eyelid the surrounding orbital
  area and the inside of the eye socket.
• They provide voluntary and involuntary blinking,
  tear duct control as well as movement of the
  eyeball.

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• The nasal region has several small muscles that
  do big jobs.
• They extend and interconnect with other muscles
  all the way from the scalp to the upper lip.
• They operate the nostrils so that we can flair or
  compress them, lift the upper lip and draw the
  brows down at will.
• They also provide some facial features.

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• The mouth is surrounded by 3 muscle groups with
  many muscles that have multiple  functions.
• They can pull the corners of the mouth up or
  down, make us pucker or grin and help other
  muscles with chewing  and numerous other
  necessary duties.
• One of those duties is to give structure and
  expression to the face.

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• The last 2 muscle groups of the face are the jaw
  and temporal areas.
• There are 3 main muscles that give us the ability
  to chew.
• They are very strong and can produce a great
  amount of pressure. These connect to all the
  muscles around the mouth eyes and nose area.

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Neck and Spine muscles

• Sternocleidomastoidius
• Trapezius
• Levator scapulae
• Deltoid
• Coracobrachialis
• Teres major
• Latissimus dorsi
• Supraspinatus
• Subscapularis
• Pectoralis major
• Erector spinae

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Muscles of the Tongue

• The muscles of the tongue have names ending in
  glossus, the Greek word for "tongue."
• Palatoglossus, styloglossus, genioglossus,
  hyoglossus
• These muscles, move the tongue in patterns
  necessary for speech, and they manipulate food
  within the mouth in preparation for swallowing.

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The Brain

• The brain is divided into main functional
  sections, called lobes
• Frontal Lobe
• Temporal Lobe
• Parietal Lobe
• Occipital Lobe
• The Cerebellum
• Brain Stem

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Frontal Lobe

• Initiation
• Problem-Solving
• Judgement
• Personality
• Emotions
• Organization
• Attention/Concentration
• Inhibition of Behavior
• Self-monitoring
• Speaking (expressive language)

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Temporal Lobe

• Memory
• Hearing
• Understanding language
• Organization
• Sequencing

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Parietal Lobe

• Sense of touch
• Differentiation (identification) of size, shapes,
  and colors
• Spatial perception
• Visual perception

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Occipital Lobe

• Vision
• Located at the back of the brain
• Any significant trauma to the brain could produce
  subtle changes to our visual-perceptual system

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Cerebellum

• Balance
• Coordination
• Skilled motor activity
• Relatively well protected from trauma
• Cerebellar injury results in movements that are
  slow and uncoordinated
• Individuals with cerebellar lesions tend to sway
  and stagger when walking.

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Brain Stem

• Breathing
• Heart rate
• Arousal and consciousness
• Sleep and wake cycles
• Attention and concentration
• All information to and from our
• body passes through the brain
• stem on the way to or from
• the brain.

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Head Injuries

• Head injuries fall into two categories
• 1) external (usually scalp) injuries and
• 2) internal head injuries, which may involve the
  skull, the blood vessels within the skull, or the
  brain.
• Most childhood falls or blows to the head result
  in injury to the scalp only
• (which is usually more frightening than
  threatening.)
• An internal head injury could have more serious
  implications because the skull serves as the
  protective helmet for the delicate brain

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External Scalp Injuries

• The scalp is rich with blood vessels
• Even a minor cut to the scalp can bleed profusely
  
• The "goose egg" or swelling that may appear on
  the scalp after a head blow results from the
  scalp's veins leaking fluid or blood into (and
  under) the scalp
• It may take days or even weeks to disappear.

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Internal Scalp Injuries

• The brain is cushioned by cerebrospinal fluid
• a severe blow to the head may knock the brain
  into the side of the skull or tear blood vessels
• Any internal head injury - fractured skull, torn
  blood vessels, or damage to the brain itself -
  can be serious and possibly life threatening.

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Common Injuries

• Cervical Nerve Stretch Syndrome (Stinger)
• Common in football. Stretching of one or more of
  the brachial plexus nerves. When they become
  stretched or contused a burning sensation is
  produced that extends from the point of Injury to
  the arm.
• Cervical Fractures and Dislocations
• Pain in cervical region or back, muscle spasm,
  inability to move neck, numbness and decrease in
  strength of the limbs, paralysis below site of
  injury.

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• Epidural
• Crack in the skull occurs when arteries located
  in the brain are torn and a blood clot will
  rapidly form.
• Subdural
• Veins connecting the duramatter to the brain are
  ruptured, may take hours or days to develop
  symptoms.
• Intracerebral
• Bleeding within the brain. Usually has a fast
  onset and requires immediate hospitalization.

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• Concussions
• Shaking of the head that results in temporary
  impairment of brain function.
• Forceful blows to the head or other parts of the
  body can cause concussions.
• An athlete does not have to suffer loss of
  consciousness to suffer a concussion.
• Three types of concussions
• Mild
• Moderate
• Severe

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Concussion cont
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Concussion cont
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Mild concussion

• No loss of consciousness!
• Possible loss of memory (temporary).
• Some mental confusion.
• Unsteadiness.
• Ringing in the ears.
• Minor dizziness.
• Dull headache.
• Rapid recovery from all symptoms!
• No athletic participation as long as athlete has
  a headache, or any other symptoms.

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Moderate Concussion

• Loss of consciousness for up to 2-3 minutes.
• Inability to remember events that occurred before
  losing consciousness.
• Nausea.
• Dizziness.
• Ringing in the ears.
• Disturbance of balance.
• Frequent headaches after symptoms have subsided.
• Immediate referral to physician.
• Continuous observation for 24 hours to be aware
  of worsening symptoms.

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Severe concussion

• Loss of consciousness for more than two or three
  minutes (may result in a coma).
• Lack of response to painful stimuli in the
  extremities.
• Possible wandering eye movements.
• Severe amnesia.
• Inequality of pupil size.
• Possible convulsions.
• Athlete should be transported to the hospital by
  emergency personnel (ambulance).
• Quick action is mandatory!
• Always suspect that the athlete has also suffered
  a neck injury in addition to the concussion.

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Muhammad Ali

• Diagnosed with Parkinsons disease in 1984.
• Punch Drunk syndrome.
• Repetitive trauma to the head led to a life of
  medication.

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• Epistaxis (Nosebleeds)
• Result of a direct blow and is a common minor
  injury.
• Lean individual forward (NOT BACKWARDS).
• Pinch the affected nostril closed.
• Use cold pack if necessary.
• Use a barrier (kleenex, gauze, finger, tampon,
  etc) to stop the bleeding.
• Bleeding should stop in about 5 minutes.

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What to look for

• There are different levels of injury that require
  different levels of concern
• Call an ambulance if your child shows any of the
  following symptoms
• -unconsciousness
• -abnormal breathing
• -obvious serious wound or fracture
• -bleeding or clear fluid from the nose, ear, or
  mouth
• -disturbance of speech or vision
• -pupils of unequal size
• -weakness or paralysis
• -dizziness
• -neck pain or stiffness
• -seizure
• -vomiting more than two to three times
• -loss of bladder or bowel control

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Prevention

• It's impossible to prevent anyone from ever being
  injured, but there are some things you can do to
  take caution. Make sure
• always wears appropriate headgear and safety
  equipment when biking, in-line skating,
  skateboarding, snowboarding or skiing, and
  playing contact sports.

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Unique Information

• In 1904, Theodore Roosevelt threatened to outlaw
  football after 19 college players were killed or
  paralyzed from brain or spinal cord injuries.
• The weight of the human brain triples during the
  first year after birth, going from 300 to 900
  grams.
• One baby, child or adult gets hurt by a traumatic
  brain injury every 15 seconds.
• Each year, more people will suffer a traumatic
  brain injury than will be diagnosed with breast
  cancer, HIV/AIDS, spinal cord injury and Multiple
  Sclerosis combined.
• ...Your brain consists of about 100 billion
  neurons! 
• That's about 166 times the number of people on
  the planet! 
• It would take you approximately 3,171 years to 
  count them all!

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• ...your brain is capable of having more ideas
  than the number of atoms in the known universe!
• Human jaw muscles can generate a force of 200
  pounds (90.8 kilograms) on the molars.
• If you received a penny for each thought, you'd
  earn 40 each day
• The only jointless bone in your body is the hyoid
  bone in your throat
• It takes the interaction of 72 different muscles
  to produce human speech.
• The entire length of all the eyelashes shed by a
  human in their life is over 98 feet (30 m).