ENS 265 Final Exam SDSU

How many bones does the head have?

22 bones

What are the immovable joints in the head called?

sultures

What does the cerebrospinal fluid (CSF) do?

Provides cushion for the brain.

What are the meninges?

3 membranes surrounding brain/spinal cord

Name the 3 membranes surrounding the brain (meninges)

-Dura Mater (outermost dense layer)

-Arachnoid (weblike delicate layer)

-Pia Mater (innermost, thin layer that is highly vascularized and adheres closely to brain/cord

What is the most common cause for skull fractures?

direct blows

Raccoon eyes

Bruising around the eyes, indicative of a basilar skull fracture (ecchymosis)

Battle's sign

Bruising behind the ears, indicative of a basilar skull fracture

What is the treatment for a skull fracture?

immediate hospitalization and referral to neurosurgeon

What is an epidural hematoma?

blow to the head or skull fracture which tears meningeal arteries (blood accumulation occurs rapidly- minutes to hours)

What is the period of lucidity?

a period where few signs and symptoms of serious head injury show

What is the treatment for an epidural hematoma?

-requires urgent neurosurgical care (CT)

-must relieve pressure to avoid disability or death

What is a subdural hematoma?

Blood collection under the dura

What are the signs and symptoms of a subdural hematoma?

-headache, dizziness. nausea or sleepiness

-generally a slower onset and progression

What are the bony landmarks of the skull?

-temporomandibular joint (TMJ)

-supraorbital ridge

-zygomatic arch

-nasal bone

-mandible

What is treatment for mandible fractures/dislocations?

-temporary mobilization w/elatic wrap followed by reduction and fixation (fractures)

-follow-up w/soft diet, NSAIDs and analgesics w/ a gradual return to activity 7-10 days following acute period (dislocations)

How to treat a zygomatic fracture

-control swelling and referral to a physician

-healing takes 6-8 weeks

How to treat a maxillary fracture

-airway must be maintained

-must be aware of possible brain injury

-transport to hospital immediately

What equipment is necessary for nasal recovery?

Splint or facial mask (if playing sports)

What are the types of teeth injuries?

fractures, avulsion, subluxations/dislocations

How to treat tooth injuries?

-xray to determine root fracture/damage

-subluxated/dislocated teeth should be perserved

"Cauliflower ear"

auricular hematoma

What is a tympanic membrane rupture?

fall or slap to the unprotected ear or sudden underwater pressure

What is the anatomy of the eye?

cornea, pupil, lens, retina, fovea, optic nerve

What is a orbital hematoma?

black eye

What will the diagnosis of a corneal abrasion require?

fluorescein strip

What is a hyphema?

blood in the anterior chamber of the eye

What is a globe rupture?

blow to the eye by a smaller object than the eye

What is retinal detachment?

detachment of the retina

How to manage neck injuries

-airway integrity

-manage swelling and pain

-severe neck contusion may require stabilization w/ a well-padded collar

What is a concussion described by the NATA?

trauma-induced alteration of mental status that may or may not involve loss of consciousness

Concussion Evaluation

- graded symptom checklist

- eye function tests

- balance tests

- coordination tests

- cognitive tests

- sleep disturbances

What is the balance error scoring system (BESS)?

-quantifiable clinical battery of test that utilizes different stances on both firm and foam surfaces

-errors (patient opening eyes, taking hands off hips, steps/stumbles or falls)

What must an athletic trainer assume if loss of consciousness occurs?

C-spine injury (remove the patient from further evaluation)

How long do persisting concussions last?

weeks to months

What is second impact syndrome?

a 2nd concussion before the 1st concussion is resolved that causes cerebral edema, increased ICP, and possibly death

What is chronic traumatic encephalopathy? (CTE)?

A progressive degeneration, and/or death, of nerve cells caused by repeated head injuries, such as repeated concussions. (similar to Alzheimers)

In the sample of American football players at all levels... who was diagnosed with CTE?

-3/14 highschoolers (21%)

-48/53 college football players (91%)

-110/111 NFL players (99%)

What is traumatic encephalopathy syndrome (TES)?

-New classification under CTE

-Can be diagnosed while person is still alive

-Like a pre-CTE

Why is neuropathology hotly debated when it comes to CTE?

lack of control group, inter-raters, research biases, case controls research and participant biases