1: ENT trauma Flashcards

1
Q

What is the bone most commonly broken in the body?

A

Nose

(Ethmoid bone and Vomer)

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2
Q

What is the usual mechanism of nasal trauma?

A

Fighting

Sport

Falls

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3
Q

What will be disrupted on examination if a patient has nasal trauma?

A

Natural angles of the nose (deviation)

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4
Q

What is the proper name for a nosebleed?

A

Epistaxis

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5
Q

If someone comes in with a bruised orbit, what should you palpate for?

A

Bony orbital trauma

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6
Q

Which nerve are you testing when you palate under the orbits for sensation?

A

Infraorbital nerve

branch of CN V2

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7
Q

What is a septal haematoma?

What do they feel like?

A

Blood within the nasal septum

Soft and boggy - important to differentiate from ?the other one

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8
Q

Why can septal haematoma lead to septal necrosis?

A

Lifting of perichondrium off septum - necrosis

Infection of blood left in septum - abscess - necrosis

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9
Q

What happens if septal necrosis is left untreated?

A

Nose collapses into face

probably a proper name for this

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10
Q

How do you manage a nasal deviation?

A

Manipulate it back into position under anaesthetic within 2 weeks

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11
Q

What artery commonly ruptures in nasal trauma to cause epistaxis?

A

Anterior ethmoidal artery

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12
Q

What can leak through the nasal cavity in significant trauma?

A

CSF

could lead to meningitis

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13
Q

What sense can be lost if the cribriform plate is fractured?

A

Smell

anosmia

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14
Q

Which area of the nose contains the arterial anastomosis which can cause epistaxis?

Where is it?

A

Little’s area

Nasal septum

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15
Q

How is epistaxis managed?

A

ABCDE

squeeze sides of nose and sit forward (so you don’t swallow the blood)

could also use vasoconstrictors or diathermy (cauterisation)

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16
Q

What is a rhino pack?

A

Balloon which can be inflated in the nose to stop epistaxis

17
Q

CSF leaks often settle ___.

When should it be treated?

A

spontaneously

If it hasn’t settled within 10 days

18
Q

What part of the ethmoid bone fractures to cause a CSF leak?

A

Cribriform plate

19
Q

What happens to the cartilage in septal and pinna haematoma?

A

Perichondrium lifted off cartilage by blood

Causes necrosis, calcification, lumpy appearance

20
Q

What is pinna haematoma also known as?

A

Cauliflower ear

21
Q

How are pinna haematomas treated?

A

Incised and drained

22
Q

How are ear lacerations treated?

A

If bit is preserved in ice:

Debride

Reattach with sutures

give antibiotics to prevent infection

23
Q

What are some possible symptoms following a temporal bone fracture?

A

Hearing loss

Vertigo

Facial paralysis

CSF leak (ear/nose)

Pain

24
Q

What is Battle’s sign?

What is it a sign of?

A

Bruising round the eyes or ears

Temporal bone fracture

25
Q

What are the two types of temporal bone fracture?

A

Longitudinal and transverse

26
Q

What are the three types of hearing loss?

A

Conductive

Sensorineural

Mixed

27
Q

What causes conductive hearing loss?

A

Fluid in the ear canal

Tympanic membrane perforation

Disruption of auditory ossicles

Otosclerosis

28
Q

Which auditory ossicle most commonly fractures to cause hearing loss?

A

Incus

29
Q

What is otosclerosis?

A

Hardening of stapes causing it stop moving

> CONDUCTIVE HEARING LOSS

30
Q

What causes sensorineural hearing loss?

A

Damage to CN VIII

which could be caused by damage to the cochlea

31
Q

For the purposes of classifying penetrating neck injuries, the neck is split into ___.

A

zones

Zone I from CLAVICLES to CRICOID

Zone II from CRICOID to ANGLE OF MANDIBLE

Zone III from ANGLE OF MANDIBLE to BASE OF SKULL

32
Q

What is the definition of a proper penetrating neck injury?

A

Penetrates platysma

33
Q

What part of the bony orbit tends to fracture?

A

Floor

orbital blowout fracture due to pressure, floor is the weakest part

34
Q

What is a sign of orbital blowout fracture on a CT scan?

A

Teardrop sign

fat prolapses into maxillary sinus through orbital floor

35
Q

What major eye symptom can trauma cause?

A

Diplopia

due to difference in position of eye

36
Q

What do Le Fort type

a) I
b) II
c) III

fractures look like?

A

a) Horizontal along maxilla

b) Pyramidal (airway obstruction!!!)

c) Transverse (catastrophic)