The neck is not designed to be a weight-bearing part of the body.

The neck is not designed to be a weight-bearing part of the body.

IT IS IN THE SPORT

MOBILITY

Facet Joint

(Controls mov’t.)

Spinous ProcessFacet Joint

Vert. Body

Disc

LATERAL

C7

T1

Craniocervical Ligaments

Spinous Process

MUSCLESTrapeziusScalenes

Sterno-mastoid

TYPES OF NECK INJURIES

• Strains

• Sprains

• Fractures/ Disloc.

• Nerve

MECHANISMS OF CERVICAL

INJURY

AXIAL LOADING

FLEXION

FLEXION AND ROTATION(Most fractures)

EXTENSION

IN

BURNER OR STINGER

MECHANISM OF INJURY

Head tilted away.

Head rotated away.

Shoulder depressed.

Posture of the arm after a burner. Pain is burning and it radiates down to the arm. Tenderness on Brachial Plexus

BRACHIAL PLEXUS

PINCHED NERVE

Mechanism of Injury (M.O.I.) ….

Axial loading to the extended, side-flexed neck.

LO AD

STRETCH

PINCH

ASSESSMENT OF THE HEAD-NECK

INJURED ATHLETE ON THE PLAYING

SURFACE

NEUROLOGICAL SIGNS

Disruption of nerve functionWeakness

Reduced Sensation

Reduced Reflexes

Muscle Atrophy

PAIN IS NOT A

NEUROLOGICAL

SIGN!!!!!

NerveCover

Touching Nerve

FIELD APPROACH

TO

THE INJURED ATHLETE

BLOCK THE HEAD

No Helmet

Removal

C.P.R.

Look Listen Feel

ANY UNCONSCIOUS ATHLETE MUST BE

TREATED AS A POTENTIAL SPINAL

CORD INJURY!!!

Athlete unconscious.

Athlete conscious with loss of movement or sensation. Complains of central neck pain.

FIELD MONITORING

Re-check vitals.

Reassure athlete.

Observe for Shock.

Be prepared to treat for shock.

SHOCK

Collapse of the c.v. system, or failure of the system to provide an adequate blood supply to all body tissues.

CAUSES OF SHOCK

Blood vessels dilated so widely that there is a

poor venous return.

There is loss of blood.

Heart fails to circulate the blood properly.

TYPES AND CAUSE OF SHOCK

Hemorrhagic – Internal and/or External Bleeding

Respiratory – reduce O2 in blood. (sucking wound, airway obstruction, spinal cord injury).

Neurogenic – loss of control by the nervous

system.

Psychogenic – reaction of nervous system to fear, bad news etc.

Cardiogenic – inadequate function of

the heart

Septic – severe infection resulting in vasodilation.

Metabolic – loss of fluids through diarrhea, or urination.Anaphylactic – caused by allergic reactions. Extreme emergency.

SIGNS AND SYMPTOMS

Eyes dull, lackluster

Pupils dilated

Face pale

Shallow, irregular respirations

Pulse rapid and weak 2

… 2

Skin cool and clammy

May have nausea, fainting, anxiety, thirst

Blood pressure is low

TREATMENT FOR SHOCK

Control bleeding.

Elevate lower extremities if no chest or head injury.

Prevent loss of body heat.

Lie athlete down. N.P.O.

Primary Survey

Initial scan done by the ‘at head’ person. Feeling for deformity etc.Secondary Survey

Someone else holds head and you check lower ext.

Initial Questions

What happen?

Pain? Present or after accident.

Feelings: burning/tingling

Head pain/ache?

Orientation to time and place.

Observations of pupils.

Observe for any CSF or blood coming from nose or ears.

Look for bruising.

Test motor and sensory of upper extremity.

Do gross motor of feet.

Test grip strength of the upper extremity.

Continue to ask about headache and nausea.

Removal from FieldSupine lying. Sitting.

Four Point Kneeling. Three Point Kneeling. Standing (with support). Slowly walk to sideling.

Sideline Testing.

SIDE LINE TESTING

Subjective

Question about their feelings (headache, tingling, nausea)

ObjectiveMotor skills, verbal skills

HEEL TO SHIN

1 2

EYE MOVEMENTS(Nystagmus)

BALANCE TANDEM WALK

DECREASED STATUS

GUIDELINES FOR CONTINUED

MONITORING

Grade II should be sent to the hospital.

Grade I monitored at home. We give instructions.

No A.S.A. One drink!

MINOR NECK TRAUMA

SIDELINE MANAGEMENT

Minor Neck Trauma is an injury that has no arm pain, no loss of neck motion and no central pain during movement. The following should be tested……

General test of the myotomes (specific

nerves that innervate specific muscles) to determine if there is gross weakness. If

weakness; no return.

SIDE LIGHT… ‘Motion Talk’

..ors – muscles doing the movement.

..ion – direction of mov’t.

..ed – end position.

SHOULDER ELEVATION

C3,4

“Lift your shoulders up, hold and do not let me push them down”.

“ Don’t let me push your arms down”.

SHOULDER ABDUCTORS

C5

ELBOW FLEXION

C6

“Bend your elbow”

ELBOW EXTENSION

C7

“Straighten your elbow.”

THUMB EXTENSORS

C8

“ Do not let me pull your thumb down”.

FINGER ABD/ADDUCTORS

T1

“Do not let me push your fingers together”.

If the neck motion is good, there is no neck/arm pain and the strength in the extremities is good, it is decision time!

If in doubt, don’t!

If the tests are good and you tested long and often enough, then do!

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