15 - Face and Neck Injuries / Chest Injuries Flashcards
Which part of the ear is a small, rounded, fleshy bulge immediately anterior to the ear canal?
Tragus
Patients with spinal cord injuries at or below C5 may experience what complication? (in conjunction with possible paralysis)
They may lose the ability to use intercostal muscles to breathe. But the diaphragm still will contract alone until C3 or above.
The clear, jellylike fluid near the back of the eyes is called: The clear fluid in front of the lens is called:
Aqueous humor - Water like fluid that liars in from of the lens
Vitreous humor - Gel-like substance that lies behind the lens and in front of the retina
During your treatment of a patient with several sucking chest wounds you only have one vented chest seal in your equipment bag. Describe the most effective way to manage the remaining sucking chest wounds.
Create a seal on each wound by taping an occlusive bandage or other material on three sides of the wound. Leaving the fourth side open to breathe.
In this scenario, you should be observing for the potential to develop into a Pneumothorax
A 22-year-old patient was the victim of an assault. Your assessment reveals a bruise over the sternum with paradoxical motion noted on the left chest and the pulse is irregular. What is your working diagnosis?
Flail chest (1098)
While performing CPR on a 12-year-old cardiac arrest patient your partner tells you that the patient was struck in the chest by a baseball that was traveling at a high rate of speed. What is your working diagnosis?
Commotio cordis
Which muscle adjusts the size of the opening to regulate the amount of light that enters the eye.
Iris
You are performing a reassessment of a patient who was shot in the anterior chest. As you reevaluate your placement of an occlusive dressing, you noticed that the patient is now complaining of increasing respiratory distress and is now showing signs of AMS.
What should your next action be? (explain the patient’s new findings for extra credit)
Give the patient O2 via BVM Rapid transport to the ER
Developing into a Tension Pneumothorax
Remove occlusive dressing and allow air to escape
(1103)
What is the function of the inner ear? What is located in the inner ear?
The inner ear contains that control sound and balance
Cochlea
Vestibular system
What structure, located within the retina, transmits nerve impulses to the brain?
Optic nerve
You are treating a patient who was in a bar fight, there are multiple injuries to the face and head. While examining the eyes you notice the patient states seeing flashing lights and the vision is cloudy. You should suspect:
Detached retina
Which nerves to the diaphragm are responsible for breathing? They exit the spinal cord at what level?
Phrenic nerve
C3 to C5
A 24-year-old was an unrestrained driver of a car that hit a tree at a high rate of speed. The patient is ℅ difficulty breathing and chest pain. Your assessment reveals a bruise over the sternum with crackles on auscultation, a RR of 38, HR of 120, BP of 130/78 and an SpO2 is 93%. You working diagnosis is:
Pulmonary contusion or Simple Pneumothorax
Check answer
The treatment for the above patient should include:
You are treating an unconscious patient who was an unrestrained driver in an MVA. There are multiple injuries to the face and head. The patient is experiencing trismus and central neurogenic hyperventilation, the pupils are unequal, there is epistaxis and blood on the outer part of the ear. What is your working diagnosis? What is your treatment for this patient?
The middle ear contains three small bones, list them:
Hammer
Anvil
Stirrup
As you try to control the bleeding of an open neck wound, you note a crackling sensation in the soft tissue. What is this finding called? What is your treatment for this patient?
Subcutaneous emphysema
Treatment: Call for ALS, Maintain airway as much as you can and provide immediate transport.
(1032)
The thoracic cavity extends from the lower end of the _______ to the _________.
Trachea
Diaphram
About 1” posterior to the external opening of the ear is a prominent bony mass at the base of the skull called the:
Mastoid process
An open neck injury can result in cardiac arrest due to what complication?
Air embolism
Patients with spinal cord injuries at or above C3 may experience what complication? (in conjunction with possible paralysis)
Inability to breathe entirely
Complete interruption of communication between the respiratory centers and the phrenic nerve … causing complete diaphragmatic paralysis.
List four bones of the face?
Nasal bones
Zygoma (2)
Maxilla (2)
Mandible
You are treating a patient who has a sucking chest wound. You do not have a vented chest seal in your equipment bag. Describe the most effective way to treat this injury.
In the scenario above, during your reassessment of the patient, you should be observing for what potential condition to develop?
Use an occlusive dressing, taping three sides and leaving the fourth side open to allow air to leak from the chest cavity
Tension pneumothorax
A 30-year-old male patient was an unrestrained driver of a care that hit a tree at a high rate speed. He has a bruise over the sternum from striking the steering wheel, paradoxical motion is noted on the left chest and his pulse is irregular. What is your working diagnosis? You should also suspect what other condition, in conjuction with your working diagnosis?
Flail chest
Pneumothrorax or other respiratory complications
While performing CPR on a 12 year old cardiac arrest patient your partner tells you that the patient was struck in the chest by a baseball that was traveling at a high rate of speed. What is your working diagnosis?
Commotio cordis
What is the function of the iris?
This muscle acts like a shutter, regulates the amount of light that enters the eye by dilating and constricting the pupil.
You are treating a semi-conscious patient who was assaulted. There are multiple injuries to the face and head. While assessing the eyes you note that they are pointing in different directions? These signs and symptoms are MOST commonly seen with what type of injury?
What is the treatment for the patient in the above scenario?
Brain injury resulting from injury to the head
Address any external bleeding, cover both eyes, tritate oxygen as needed, rapid transport to a trauma center
What is the function of the choroid?
Layer of blood vessels that nourish the retina
You are treating a patient who was involved in a bar fight, with multiple injuries to the face and head. While examening the eyes you notice the patient is unable to follow your finger with both eyes and is complaining of double vision. These signs and symptoms are MOST commonly seen with what type of injury?
Blow-out fracture
What purpose does the eustachian tube serve?
Equilization of pressure in the middle ear when external atmospheric pressure changes
What structure is located in the inner ear? What purpose does it serve?
Cochlea - The organ of hearing
(Hairlike projections that extend into the fluid in the cochlea. Sound causes the cilia and the fluid to vibrate and they send signals the brain to interpret the sound)
Vestibular system - The organ of balance
(Nerves gather information about the position and movement of the head. The brain uses this information to help maintain balance)
Explain how a pulmonary contusion may lead to hypoxia.
The pulmonary alveoli become filled with blood, and fluid accumulates in the injured area, leaving the patient hypoxic
