Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kin 2236 Athletic Injuries > (3) Lecture 17: Head + Face Injuries > Flashcards

(3) Lecture 17: Head + Face Injuries Flashcards

1
Q

What kind of injury has the most fatalities in sports?

A

Head trauma causes more fatalities than any other sports injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Facial Lacerations

A

Causes
- may be penetrating or blunt trauma causing direct or indirect compressive force

Signs
- pain
- substantial bleeding (especially on sharp bones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Care of Facial Lacerations

A
  • facial lac should be cleaned w/ sterile saline and checked for debris
  • apply pressure to control bleeding
  • RULE OUT SKULL/BRAIN traumas
  • refer to physician if stitches are needed (advocate for plastics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Scalp injuries

A

highly VASCULAR area (bleeds lots)

Causes
- blunt trauma or penetrating trauma
- can occur in conjunction w/ serious head trauma

Signs
- blow to head
- bleeding is extensive and hard to PINPOINT exact site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Care of scalp injuries

A
  • clean w/ antiseptic soap + water (remove debris)
  • cut away hair to expose area
  • apply firm PRESSURE to reduce bleeding
  • wounds larger than 1/2 inch should be referred
  • smaller wounds can be covered w/ protective covering + gauze
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should injuries be sent for stitches?

A
  • tissue adhesive for closure of simple lacerations LESS THAN 4CM that are not at points of high skin tension

Closure w/ stitches when:
- wounds are over 4cm in length of at points of high tension (elbow, knee)
- wound is through ALL skin layers or showing exposed fat, bones, tendons or vessels

place gauze pad over lesion if patient is sent for sutures
- send them within 8-12 hrs MAX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Brain Injuries

A

Caused by
- compressive force
- tensile (negative pressure) force
- shearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CSF

A

mainly help w/ COMPRESSIVE forces

  • converts focal forced into COMPRESSIVE stress dissipated over the brain’s full surface
  • minimal impact on shearing force, especially combined w/ rotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Battle’s Sign

A

Periauricular ecchymosis (bruising around the EAR)

Periauricular: around external ear
Ecchymosis: bleeding under skin

LATE finding (24-48 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Racoon Eyes

A

Periorbital ecchymosis (2 black eyes)

LATE finding (24-48 hrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Battle Sign + Raccoon Eeyes

A

common w/ SKULL fractures + significant head trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Halo Sign

A

CLEAR drainage that separates from blood drainage suggests the presence of CSF

yellow, greeny discharge around blood = SKULL fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Normal pupils

A

Pupils equal and reactive to light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Equal pupils but dilated/unresponsive

A
  • Cardiac arrest
  • CNS injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Equal pupils but constricted/unresponsive

A
  • CNS injury or disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Unequal pupils, one dilated/unresponsive to light

A
  • cerebrovascular accident (CVA)
  • head injury
  • direct trauma to eye
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Epidural hematoma

A

btwn skull + dura

Causes
- blow to head or skull fracture that tears meningeal arteries
- blood accumulation and creation of hematoma and pressure happens RAPIDLY (minutes to hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs of epidural hematoma

A
  • may or may not have brief LOC followed by lucidity
  • GRADUAL progression of signs and symptoms
  • severe head pain, dizziness, nausea, dilation of one pupil (anisocoria) on same side of injury, deterioration of consciousness, depression of pulse and respiration, convulsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Care of epidural hematoma

A
  • needs URGENT neurosurgical care
  • must relieve pressure to avoid disability or death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Subdural hematoma

A

INSIDE DURA

Causes
- result of ACCELERATION/DECELERATION (TENSILE/SHEAR) forces that tear vessels that bridge dura
- CSF doesn’t help much
- VENOUS bleeding (significant bleeding) = can range from little/no damage to cerebellum to cortex damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Signs of subdural hematoma

A
  • athlete may experience LOC in seconds to minutes
  • PUPILLARY ASYMMETRY
  • headache, dizziness, nausea or sleeping if not unconscious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Care of subdural hematoma

A
  • IMMEDIATE EMERGENCY medical attention
  • CT or MRI needed to determine extent of injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Subdural vs epidural hematoma

A

TIMING

subdural is QUICK (seconds to minutes)
epidural is slower (minutes to hours)

24
Q

Recognition and Management of Facial Injuries

A
  1. Assess
    - mental status (conscious vs unconscious)
    - airway and breathing
  2. Manage significant bleeding
  3. Check NOSE and EARS for CSF (halo test) - stick gauze
  4. Take a TOP-DOWN approach to assess
    - facial asymmetry
    - forehead and orbits(eyes)
    - maxilla + nose
    - cheekbones
    - oral cavity + mandible
  5. Symptoms - asymmetry, bony steps, bruising and mobility
25
Q

Forehead fracture

A

Causes
- most common cause is BLUNT TRAUMA
- fairly resistant to fractures
- most superior portions of weaker orbital structures are in forehead

26
Q

Signs of forehead fracture

A
  • severe headache and nausea
  • palpation may show defect in skull (flat or sunken in)
  • may be blood in middle ear, ear canal, nose, racoon eyes, Battle’s sign
  • CSF may be in ear and nose (halo sign on gauze)
27
Q

Orbital fracture

A

Caused by DIRECT TRAUMA to eyeball (common in baseball)

Signs
- posterior displacement of eye (enopthalmos)
- diplopia (double vision)
- restricted upward gaze
- downward displacement of eye
- subconjunctival hemorrhaging
- Racoon eyes
- unilateral epistaxis (nosebleed)
- numbness (due to injury to infra orbital nerve)

28
Q

Care of orbital fracture

A
  • ice
  • NO blowing nose
  • NO Valsava maneuvre
  • X-Ray/CT needed to confirm fracture
29
Q

Midface Fracture

A

aka Maxillary Fracture or Le Fort

Signs
- visible lengthening and flattening of face
- mobile maxilla
- nasal bleeding
- ecchymosis of cheek
- malocclusion (alteration of bite) - can’t bring teeth together
- palpation of facial bones - stabilize forehead w/ one hand and gently pull INCISORS

30
Q

Le Fort

A

Midface Fracture

Le Fort I - floating palate
Le Fort II - floating maxilla (pyramidal)
Le Fort III - floating face (transverse)

31
Q

Zygomatic Complex Fracture

A

Caused by DIRECT BLOW to CHEEK

Signs
- deformity, or bony discrepancy
- palpable STEP-OFFS in upper lateral orbital rim and inferior orbital rim
- cheek numbness - due to injury to infra orbital nerve
- nosebleed (on injured side - sinus filling w/ blood)
- diplopia and restricted eye movement
- subconjunctival hemorrhage (eye bleeding) and racoon eyes

32
Q

Care of Maxillary and Zygomatic fractures

A
  • secure airway
  • if conscious, keep in UPRIGHT sitting position to help w/ blood and saliva drainage
  • transport to emergency for definitive diagnosis/imaging
33
Q

Mandible fractures

A

Caused by DIRECT BLOW (often at angle or condyle)

Signs
- pain w/ biting
- (+ ve) TONGUE BLADE TEST

Deformity
- palpate inferior border + mandibular condyle
- loss of occlusion (can they bite down?)
- bleeding around teeth
- lower lip anesthesia

34
Q

Tongue Blade Test

A

Tests for mandible fractures

  • insert a wooden tongue depressor (TD) into both sides of patient’s mouth
  • have patient bite down while you try to pull out TD and rotate TD
  • if you cannot pull TD out, test is NEGATIVE
35
Q

Care of Mandible Fractures

A
  • secure airway
  • temporary immobilization w/ elastic wrap then reduction + fixation
  • emergency medical referral
36
Q

Tooth Fractures

A

Cause
- impact to jaw
- direct dental trauma

Signs
A) UNCOMPLICATED fracture: produces fragments WITHOUT bleeding

B) COMPLICATED: produce BLEEDING w/ tooth chamber being exposed w/ lots of pain + sensitivity to thermal changes, air and touch

C) ROOT fractures: difficult to determine and need X-Ray

37
Q

Care of Tooth Fractures

A
  • find out if they have a dental appliance/fake teeth
  • uncomplicated and complicated crown fractures don’t need immediate attention
  • fractured pieces can be put in MILK or SAVE-A-TOOTH solution
  • DO NOT place avulse tooth portion in ice
  • if not sensitive to air/cold, follow-up within 24 hrs
  • bleeding is controlled by gauze
38
Q

Cause of Tooth Subluxation, luxation, avulsion and intrusion

A

DIRECT blow

39
Q

Subluxed tooth

A

tooth may be LOOSE within socket

40
Q

Tooth luxation

A
  • no fracture but there is DISPLACEMENT

INTRUSION: tooth is driven BACK into socket
- DO NOT try to reposition. dentist immediately

EXTRUSION: tooth is partially OUTWARDLY dislodged
- try to reposition and hold in place by biting down

LATERALLY displaced tooth (fwd, back or side to side)
- do NOT try to reposition. dentist immediately

41
Q

Tooth avulsion

A

tooth is completely removed from oral cavity

TIME-DEPENDENT INJURY
- prognosis is 90% w/ replacement within 30 mins
- after 2 hrs, failure rate is 95%

Care
- locate and protect tooth
- if soiled, rinse lightly w/ MILK or SALINE
- DO NOT RUB. DO NOT USE TAP/DRINKING WATER - could injure periodontal ligament cells`

42
Q

Nasal Fractures

A

caused by DIRECT TRAUMA always

Exam
- palpate for crepitus or bony asymmetries (depression of nasal dorsum OR deviation of septum)
- examine for septal hematoma (breathe through each nostril - plug one side and see if they can breathe)

43
Q

Care for Nasal Fracture

A
  • secure airway
  • control bleeding by external pressure or internal packing
  • protect and transport for X-ray and reduction
44
Q

Septal hematoma

A

Caused by hemorrhage btwn the two layers of mucosa covering septum

Signs
- BLUEISH or DULL RED bulge on septum
- athlete will complain of nasal pain and may have difficulty breathing out of one nostril

45
Q

Epistaxis

A

aka nosebleed

Causes
- DIRECT BLOW in sports
- foreign body or serious facial injury

RULE OUT FRACTURE, NASAL DEPRESSION, SEPTAL HEMATOMA

Signs
- bleeding from anterior aspect of septum (Little’s/Kiesselbach’s area)
- minimal bleeding and resolves spontaneously
- more severe bleeding may need more medical attention

46
Q

Care of epistaxis

A
  • athlete should blow each nostril to clear clots
  • sit upright in HEAD-FORWARD position to avoid blood from pooling/going down throat
  • cold compress over nose = compress vessels of nasal septum
  • if bleeding does not stop in 5 mins, an astringent can be applied w/ gauze to encourage clotting
  • ice to back of head/neck = decreases vagal tone = slows bleeding and helps clotting
  • DO NOT BLOW NOSE FOR AT LEAST 2 HOURS AFTER BLEEDING STOPS
47
Q

Subconjunctival hemorrhage

A

Bright red area in white conjunctiva

Causes
- can happen spontaneously
- due to minor eye trauma or orbital/zygomatic fractures
- Valsalva maneuvers (coughing, sneezing, straining)

Assess for vision issues
- if it covered entire sclera (white part), it may be obscuring a perforation in eye

usually resolves in 2-3 weeks

48
Q

Corneal abrasions

A

scratched eye - happens to most ANTERIOR layer of eye

Causes
- poke to eye
- attempt to remove foreign object from eye by running

Signs
- mild to severe pain
- watering of eye
- photophobia (closes eyes w/ bright light)
- pain w/ blinking
- decreased focusing ability
- spasm of orbicular muscle of eyelid

49
Q

Care of corneal abrasions

A
  • refer to physician (may need to patch)
  • usually heals within 24 - 72 hrs
  • patch may be needed with younger patients to avoid rubbing
  • recent study showed no improvement in pain, symptoms or healing w/ patching
  • return to play is based on decrease in symptoms
50
Q

Hyphema

A

MOST SERIOUS
- injury that leads to serious problems w/ LENS or RETINA

Cause
- anterior chamber injured due to blunt trauma
- HIGH FORCE injury (must RULE OUT penetrating trauma, orbital fracture, abrasion, retinal injury)

Signs
- visible REDDISH tinge (can be pea green) in anterior chamber of eye
- vision is spatially or completely blocked

51
Q

Care of hyphema

A
  • IMMEDIATE referral to an ophthalmologist
  • bed rest for 4 days and elevation; both eyes patched
  • discontinue use of NSAIDs
  • irreversible vision damage if not managed properly
52
Q

Periorbital ecchymosis

A

Black eye

Caused by BLOW to area surrounding the eye

Signs
- swelling and discoloration
- sign of a more serious condition if accompanied by subconjunctival haemorrhage

Care
- apply cold for at least 30 mins
- do NOT blow nose after acute eye injury - may increase hemorrhaging

53
Q

Basic Eye Assessment

A

Chemical injury – Flush immediately for 30 mins

  1. History - determine force + direction of force
  2. Check vision - read in 12 pt font from 16” away
    - diplopia suggests serious injury (closed head/eye)
  3. Pupil/cornea/conjunctiva
    - penlight exam (PEARL)
    - foreign bodies
    - hyphema or subconjunctival hemorrhaging
  4. Eye movements (full mobility … up, down, all around)
54
Q

Airway injuries

A

most DANGEROUS of all maxillofacial injuries

  • airway compromise secondary to laryngotracheal (throat) trauma are second most common cause of death
  • airway obstruction can be caused by any blow to the ANTERIOR neck
  • minor injuries to larynx can worsen due to laryngospasm (closure of larynx) - athlete becomes agitated and panicked
55
Q

Treating laryngospasm

A

move chin fwd and place strong anterior pressure behind angle of jaw

Hold for 45-60 seconds until you hear inspiration

56
Q

Signs and symptoms of larynx injury

A

Cartilaginous fracture to thyroid/cricoid cartilages

  1. athlete initially may be speechless or have hoarse voice
  2. loss of prominence (Adam’s apple) in anteior neck
  3. difficulty breathing - feeling impending doom
  4. pain/tenderness w/ swallowing
  5. crepitation on palpation of anterior neck (subcutaneous emphysema - CRITICAL)
  6. hematoma/hemoptysis - coughing up frothy, pink blood

Kin 2236 Athletic Injuries (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions