Cranial Bones and Brain Lobes

• The eight cranial bones are the frontal, parietal, occipital, temporal, sphenoid, ethmoid, zygoma, and nasal bones.

Cranial Bone Locations

• The frontal bone is in the anterior part of the skull.
• The parietal bone is in the superior part of the skull.
• The occipital bone is in the posterior part of the skull.
• The temporal bones are on the lateral sides of the skull.
• The sphenoid bone is on the lateral sides of the skull.
• The ethmoid bone is in the anterior part of the skull.
• The zygoma bone is in the anterior/lateral part of the skull.
• The nasal bone is in the anterior part of the skull.

Brain Lobes and Functions

• The five lobes of the brain are frontal, parietal, temporal, occipital, and cerebellum
• The frontal lobe handles cognitive functions like attention and thinking, emotions, voluntary muscle movement, and smell.
• The occipital lobe is responsible for vision.
• The parietal lobe interprets sensation (pain/touch) and spatial relationships.
• The temporal lobe is responsible for short-term memory, speech, and hearing.
• The cerebellum coordinates voluntary muscle movements and maintains posture, balance, and equilibrium.

Equilibrium and Cerebrospinal Fluid

• Equilibrium involves sensory input from the eyes, muscles, ears, and skin to control body position.
• Cerebrospinal Fluid (CSF) surrounds the brain and spinal cord.
• CSF functions as shock absorption, provides nutrition, and removes waste.
• CSF drainage from the skull, nose, or ears after severe trauma may appear as a yellow halo on gauze.

Traumatic Brain Injury (TBI)

• TBI is caused by a blow or jolt to the head, disrupting normal brain function.
• TBI symptoms include headaches, motor dysfunction, sensory disruption, cognitive issues, and speech difficulties.

Battle's Sign

• Battle's sign is discoloration/bruising behind the ear.
• Battle's sign can indicate a concussion or skull fracture.

Head Injury Mechanisms

• The most common mechanisms of head injuries are impact or rotation.
• The temporal region is the weakest area of the head due to thin bone structure.
• A coup injury occurs when a stationary skull is hit by a moving object, causing trauma on the side of impact.
• A contrecoup injury happens when a moving skull suddenly stops, causing the brain to strike the opposite side of impact.

Neurons and Brain Trauma

• The brain consists of 90 billion neurons.
• Neurons process and transmit information.
• An axon is a long cable that transmits electrical impulses from a neuron.
• Neurons can stretch or tear when the head is jolted or hit.
• Degenerating axons release toxic neurotransmitters that can kill other neurons.

Concussion Symptoms and Recovery

• Concussion symptoms include blackout, headache, blurry vision, balance problems, altered mood/behavior, and memory/sleeping/thinking problems.
• Concussion symptoms usually disappear within days or weeks.
• Recovery includes rest and a gradual return to activity.
• Sleeping is permitted unless a brain bleed is present.

Post-Concussion Syndrome (PCS)

• PCS involves persistent concussion symptoms beyond the normal recovery time.
• PCS symptoms include constant headaches, learning difficulties, and behavioral symptoms.
• Playing through a concussion or returning to activity too early increases the risk of PCS.

Subconcussive Impacts and Chronic Traumatic Encephalopathy (CTE)

• Subconcussive impacts are lower impact jolts to the head.
• Subconcussive impacts can lead to CTE over time.
• CTE is a degenerative brain disease with tau buildup.
• Severe concussion symptoms include nystagmus, anisocoria, increased blood pressure, and decreased pulse rate, and shock.

Nystagmus, Tinnitus, and Amnesia

• Nystagmus is rapid fluttering of the eyes.
• Tinnitus is ringing in the ears.
• Amnesia is temporary memory loss.
• Retrograde amnesia is the inability to recall events before the injury.
• Assessing retrograde amnesia involves asking questions about events leading up to the injury.
• Anterograde amnesia is the inability to remember events after the injury.
• Anterograde amnesia can be determined by asking questions after the injury.

Chronic Traumatic Encephalopathy (CTE) Details

• CTE symptoms include memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and progressive dementia.
• CTE has been compared to Alzheimer's disease.
• Unlike Alzheimer's, CTE includes aggression and lack of impulse control.
• CTE is caused by abnormal tau buildup from repeated low impact hits to the head.
• CTE can only be diagnosed via autopsy.
• 90% former NFL players have been found to have CTE.
• At-risk sports include hockey, football, soccer, and boxing.

Concussion Treatment

• The first step in treating a suspected concussion is removing the athlete from competition.
• Neurological functions should be assessed.
• Monitor symptoms every 15-30 minutes.
• Take the athlete to the ER if symptoms worsen.
• An athlete with stable symptoms can be sent home with a caregiver.
• Athletes are not allowed to drive until re-evaluated by a physician.

Long-Term Concussion Treatment & Recovery

• Long-term treatment includes cognitive rest, no physical activity, no school/studying/video games, and follow-up with a physician for evaluation and cognitive testing.
• Concussion recovery steps for athletes involve gradually increasing activity levels, from regular activity and light aerobic activity to full contact practice and competition.
• Loss of consciousness is not required for a concussion diagnosis.

Baseline Data and Cervical Spine Injuries

• It is important to obtain baseline data on athletes.
• Cervical spine injuries include fractures and dislocations.
• Cervical fractures are caused by axial loading.
• Axial loading is a direct blow to the head with the cervical spine aligned.
• Cervical dislocations are caused by neck flexion with rotation.

Cervical Spine Injury Signs, Symptoms, and Treatment

• Symptoms of cervical spine injuries include pain in the cervical spine, weakness/tingling/numbness in the arms, possible deformity, and rigidity of arms/legs.
• Immediate treatment involves stabilizing the cervical spine, primary survey, determining LOC, and calling 911 if LOC is present, and inspecting ears/nose for CSF leakage.
• Unconscious athletes require calling 911, assessing ABCs, removing the facemask, and initiating CPR/rescue breathing if needed.
• Conscious athletes should be kept calm, a good history taken.
• Perform observation and a neurological exam.

Neurological Exams, Moving Players, and Spine Boarding

• Neurological exams should assess cranial nerves, myotomes, and dermatomes.
• Four to six people should be used to move a player with a cervical spine injury.
• The head, torso, pelvis, and legs are secured on the spine board.

Brachial Plexus Injuries

• The brachial plexus is a branch of nerves running from the cervical region to the shoulder and arm.
• Brachial plexus injuries are caused by traction/stretching or compression.
• Neuropraxia occurs injuries when nerves are stretched.
• A brachial plexus injury is also called a stinger or burner.
• Symptoms include burning/numbness/tingling in the shoulder and arm, limp arms, and loss of control, lasting seconds, hours, or weeks.
• Athletes are more prone after it happens once.

Brachial Plexus Injury Treatment and Return

• Initial treatment includes ice and assessment of neurological function.
• Long-term treatment includes rehab, NSAIDs, and bracing.
• Return to play requires no symptoms, full strength, and full ROM of neck/shoulder.

Facial Injuries

• The maxilla is the upper jaw.
• The mandible is the lower jaw.
• Concussion should always be checked for in an athlete that has sustained a facial injury.
• Blunt eye trauma is sudden forceful impact to the eye or brow.

Overview of the eight cranial bones: frontal, parietal, occipital, temporal, sphenoid, ethmoid, zygoma, and nasal bones including their locations. Also describing the five lobes of the brain, including the frontal, parietal, temporal, occipital, and cerebellum and their functions.