cervical spine neck injuries
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Cervical Spine/Neck Injuries

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Cervical Spine/Neck Injuries. Prevention. strength flexibility proper protective equipment proper sport technique. Contusions - Neck & Throat. blunt trauma baseball, hockey puck larynx - possible fx. of cartilage severe pain hoarse voice difficulty swallowing

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Presentation Transcript
prevention
Prevention
  • strength
  • flexibility
  • proper protective equipment
  • proper sport technique
contusions neck throat
Contusions - Neck & Throat
  • blunt trauma
    • baseball, hockey puck
  • larynx - possible fx. of cartilage
    • severe pain
    • hoarse voice
    • difficulty swallowing
  • contusion to carotid artery
    • causes a clot to form - stroke
cervical nerve stretch syndrome
Cervical Nerve Stretch Syndrome
  • brachial plexus injury
    • stinger, burner, hot-shots
  • 2 mechanisms
    • traction (stretch)
      • head forced one way and pain on other side
    • compression
      • entrapment or impingement of cervical nerve roots
        • at Erb’s Point
slide5
Signs & Symptoms
    • immediate pain
    • numbness or burning sensation down arm
    • arm may be hanging at side or they may be holding it or shaking it
    • decreased strength
    • decreased sensation along dermatomes
  • s & s can last for a short period of time in mild cases, hours, or even days in severe cases
slide6
athletes cannot return to play until:
    • they have full strength compared bilaterally
    • full sensation
    • normal ROM of neck and shoulder
cervical nerve root impingement
Cervical Nerve Root Impingement
  • pressure placed on a cervical nerve root
  • mechanism
    • degenerative disk changes (herniated disk)
    • dislocated cervical facets
    • degenerated facet joints
    • exostosis of vertebral foramen
    • inflammation putting pressure on nerve root
  • pressure causes pain and spasm in cervical areas and possibly pain & sensation loss along affected dermatomes, muscles weakness, altered reflexes, and atrophy
vertebral artery compression
Vertebral Artery Compression
  • can be caused by same mechanisms that cause cervical root symptoms
    • can interrupt blood flow to the brain
  • s & s
    • dizziness
    • confusion
    • nystagmus
  • Vertebral Artery Test
sprains strains fx
Sprains, Strains, Fx.
  • mechanisms of injury
    • compression force (axial force)
    • flexion force - most dangerous when combined with compression – fractures or dislocations
    • hyperextension
    • flexion rotation
    • hyperextension rotation - dislocations
    • lateral flexion
slide10
Always assume the worst!!!!
  • spinal cord function is only inhibited by 1 of 2 mechanisms:
    • impingement or lacerations secondary to bony displacement
    • compression secondary to hemorrhage, edema, and ischemia to the cord
slide11
Evaluation
    • don’t move!!
    • Severe neck pain
    • numbness or tingling
    • muscle weakness and spasm
    • loss of sensation - “can’t feel”
    • unable to move
    • loss of bladder or bowel control
slide12
Other indications of serious injury:
    • Babinski Test
    • Oppenheim Test
    • Decerebrate Posture
      • lesion of brain stem
      • extension of extremities and retraction of head
    • Decorticate Posture
      • lesion of brain stem
      • flexion of elbows and wrists, clenched fists, and extension of lower extremity
    • Flexion Contracture
      • arms flexed across chest
      • spinal cord lesion at C5-C6 level
slide16
an athlete with a cervical fracture or dislocation can walk off of the field
  • any complaint of cervical pain with or without symptoms radiating into the extremities should always be thought of as a catastrophic injury at first
transient quadriplegia
Transient Quadriplegia
  • athlete shows signs of quadriplegia, but symptoms clear within 15 minutes to 48 hours
  • neurapraxia of spinal cord
    • mechanism – blow to head & neck – predisposed by:
      • stenosis of spinal foramen
      • congenital fusion of spinal cervical canal
      • abnormalities of posterior arch
      • cervical instability
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