APPROACH TO FACIAL TRAUMA

Question 1

Elements of the facial trauma history and physical

Answer 1

History
Inspection
Palpation
Eye Exam
Nose Exam
Ear Exam
Oral Exam

Question 2

When during trauma survey facial trauma is evaluated

Answer 2

Secondary Survey

Question 3

3 key questions in the History

Answer 3

How is your vision?
Do any parts of your face feel numb?
Does your bite fit togeather normally?

Question 4

Inspection

Answer 4

Lateral view for dish face with Le Fort III fractures
Frontal view for donkey face with Le Fort II or III fractures
Bird’s Eye View for exophthalmos with retrobulbar hematoma
Worm’s View for enophthalmos with blow-out fracture or flattening of malar prominence with zygomatic arch fractures
Raccoon eyes (bilateral orbit ecchymosis) and Battle’s Sign (mastoid ecchymosis) associated with basilar skull fracture

Question 5

Palpation

Answer 5

Palpate entire face
Intraoral palpation of the zygomatic arch
Rock the hard palate to assess for LaFort fracture

Question 6

Eye Exam

Answer 6

Exam prior to eye lid swelling or with retractors
loss of visual acuity
diplopia and limitation with upward gaze
telecanthus
Tear drop sign
Hyphema
Fat through wound

Question 7

Nose

Answer 7

Inspect for septal hematoma &
CSF leak
Palpate for Crepitus

Question 8

Ears

Answer 8

Auricular Hematoma
Hemotypanum
CSF leak

Question 9

Oral

Answer 9

Jaw deviation
Malocclusion
Dental injuries
Mucusal injuries
Tongue blade test