1: ENT trauma Flashcards
What is the bone most commonly broken in the body?
Nose
(Ethmoid bone and Vomer)
What is the usual mechanism of nasal trauma?
Fighting
Sport
Falls
What will be disrupted on examination if a patient has nasal trauma?
Natural angles of the nose (deviation)
What is the proper name for a nosebleed?
Epistaxis
If someone comes in with a bruised orbit, what should you palpate for?
Bony orbital trauma
Which nerve are you testing when you palate under the orbits for sensation?
Infraorbital nerve
branch of CN V2
What is a septal haematoma?
What do they feel like?
Blood within the nasal septum
Soft and boggy - important to differentiate from ?the other one
Why can septal haematoma lead to septal necrosis?
Lifting of perichondrium off septum - necrosis
Infection of blood left in septum - abscess - necrosis
What happens if septal necrosis is left untreated?
Nose collapses into face
probably a proper name for this
How do you manage a nasal deviation?
Manipulate it back into position under anaesthetic within 2 weeks
What artery commonly ruptures in nasal trauma to cause epistaxis?
Anterior ethmoidal artery
What can leak through the nasal cavity in significant trauma?
CSF
could lead to meningitis
What sense can be lost if the cribriform plate is fractured?
Smell
anosmia
Which area of the nose contains the arterial anastomosis which can cause epistaxis?
Where is it?
Little’s area
Nasal septum
How is epistaxis managed?
ABCDE
squeeze sides of nose and sit forward (so you don’t swallow the blood)
could also use vasoconstrictors or diathermy (cauterisation)
What is a rhino pack?
Balloon which can be inflated in the nose to stop epistaxis
CSF leaks often settle ___.
When should it be treated?
spontaneously
If it hasn’t settled within 10 days
What part of the ethmoid bone fractures to cause a CSF leak?
Cribriform plate
What happens to the cartilage in septal and pinna haematoma?
Perichondrium lifted off cartilage by blood
Causes necrosis, calcification, lumpy appearance
What is pinna haematoma also known as?
Cauliflower ear
How are pinna haematomas treated?
Incised and drained
How are ear lacerations treated?
If bit is preserved in ice:
Debride
Reattach with sutures
give antibiotics to prevent infection
What are some possible symptoms following a temporal bone fracture?
Hearing loss
Vertigo
Facial paralysis
CSF leak (ear/nose)
Pain
What is Battle’s sign?
What is it a sign of?
Bruising round the eyes or ears
Temporal bone fracture
What are the two types of temporal bone fracture?
Longitudinal and transverse
What are the three types of hearing loss?
Conductive
Sensorineural
Mixed
What causes conductive hearing loss?
Fluid in the ear canal
Tympanic membrane perforation
Disruption of auditory ossicles
Otosclerosis
Which auditory ossicle most commonly fractures to cause hearing loss?
Incus
What is otosclerosis?
Hardening of stapes causing it stop moving
> CONDUCTIVE HEARING LOSS
What causes sensorineural hearing loss?
Damage to CN VIII
which could be caused by damage to the cochlea
For the purposes of classifying penetrating neck injuries, the neck is split into ___.
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
What is the definition of a proper penetrating neck injury?
Penetrates platysma
What part of the bony orbit tends to fracture?
Floor
orbital blowout fracture due to pressure, floor is the weakest part
What is a sign of orbital blowout fracture on a CT scan?
Teardrop sign
fat prolapses into maxillary sinus through orbital floor
What major eye symptom can trauma cause?
Diplopia
due to difference in position of eye
What do Le Fort type
a) I
b) II
c) III
fractures look like?
a) Horizontal along maxilla
b) Pyramidal (airway obstruction!!!)
c) Transverse (catastrophic)
