CEN Maxillofacial, Ocular, ortho and wound emergencies Flashcards
An adult striked with vehicle bumper would most likely have _______ _______fractures but a child would most likely have _____ fractures too
tibia and fibular fracture; femur
Fast moving potentially fatal infection involving the floor of the mouth and neck is called_______; spreads to _____ ______ ______ as well… _____ should be consulted
Ludgwig’s Angina; pericardium, mediastinum; pleural cavity. ENT
Causes of Ludwig’s angina
untreated dental absess
ABT resistant dental abscess
trauma to the mouth.
Patient with periorbital cellulitis needs to be monitored for ________ , _______, and __________
blindness, intracranial abscess and carvenous sinus thrombosis
Patient with conjunctivitis needs to be monitored for ______ and _______
decreased vision
corneal ulceration
Pt diagnosed with iritis and uveitis you need to monitor for
vision loss
macular edema
Pt diagnosed with glaucoma needs to be monitored for
visual impairments, including blind spots, tunnel vision and total blindness.
What is an avulsion injury?
involve peeling of the skin from underlying tissues
Degloving injury is when the
skin separates completely from the underlying tissue
Degloving injury is common in patients who are on ______ in this case it is important to use __________dressing such as
corticosteroids therapy; occlusive; tegaderm
A tooth fracture involving only the enamel is classified as
Ellis I
A tooth fracture involving the dentin and the enamel is classified as
Ellis II
A tooth fracture involving the pulp, the dentin and the enamel is classified as
Ellis III
During the phalen test, the wrist is flexed for ____minute while the patient is asked to _______
wrist is flexed for one minute, report usual symptoms if precipitated.
Phalen test, what is recorded
the time take for symptoms to appear
When is the Phalen test positive?
When the patient experiences a tingling sensation in the MEDIAL NERVE over the hand.
What is CARPAL TUNNEL SYNDROME
compression neuropathy of the wrist’s median nerve
The outer ear and the medial ear are connected by the
External auditory canal
The external ear and middle ear are divided by
The middle ear and the throat are linked by
The TYMPANIC MEMBRANE
Eustachian tube
Foreign piece embedded to the skin should NOT be
Soaked
What is the waddell triad?
high velocity accidents, chest/abdomen, head and femurs.
What should be used to remove ocular foreign bodies that have rust rings present? if NO RUST RING, what should be used? _______, _______ and _______ and after treatment, you should monitor the patient for a ________ , an _______ or ______
OPHTHALMIC DRILL; moist cotton-tipped swab; sterile needle, foreign body removal instrument; corneal ulcer, infection; scarring.
The maxilla facial bones house the ________sinus and the _____ _____ and forms the ________ ; and the ________cavity
Maxillary; upper teeth; roof of the oral cavity ; nasal
The frontal bone houses the _______sinuses which also forms the roof of the _______sinuses
frontal; ethnoid
The lower teeth are housed by the
Mandible
Patient has injured pelvis , you should initially immobilize the patient by using a
Long spine board
__________is used to initially immobilize a patient with injured clavicle
Figure eight splint
_________is used to initially immobilize a patient who has injured his spine
Stiff cervical collar
___________splint would be used to initially immobilize a patient who has injured his foot, ankle, tibia or fibula
Air
When the patient is standing upright, where should the CANE reach if it is sized appropriate
The patient’s wrist.
The cane should be held in the
opposite the injured site
When walking, the ______ and the ______should move together
cane; injured leg
Bones serves at the primary storage site for which of the following?______ and ______
Calcium and phosphate
Patient with a CENTRAL RETINAL ARTERY OCCLUSION need _______to improve the outflow of aqueous humor
CHOLINERGIC agent
A cholinergic agent would be used to _______The pupils which results in an _________outflow of aqueous humor
constrict; improved/increased
For improving aqueous humor flow, if the patient has light color eyes use _____solution
2%
For improving aqueous humor flow, if the patient has dark color eyes use _____solution
4%
Which type of medications decrease aqueous humor PRODUCTION? Which medications decrease aqueous humor SECRETION
Beta-blockers; CARBONIC ANHYDRASE INHIBITORS
_________ increases the delivery of oxygen to the ischemic tissues and dilate the retinal arterioles
CARBOGEN GAS
2 most important independent risk factors for osteoporosis
age
low bone mineral density
First line of therapies for osteoporosis
Alendronate
Risedronate
When is LDH release?
Whenever there is muscle injury
ALKALINE PHOSPHATASE in increased when?
A patient’s metabolic bone activity has increased
When force is applied to a large surface areal; it results in ______ (more or less) tissue damage than if would if the same force was applied to a small surface area
less
4 types of collision occur during a vehicular collision (ABCD)
Auto
Body
Cavity contents
Debris
Cold therapy does what?
It increases the patient’s pain threshold
The decrease of muscle spasms, inflammation and blood flow for the use of cold therapy limits _____ and ______
hemorrhage; swelling.
Which time frame for injury can you apply cold therapy to prior to splint applications?
occurred less than 24 to 48hours
In traumatic amputation: APPROPRIATE INTERVENTION FOR AMPUTATED PART is to ?
Place in a WATERTIGHT container over an ICED SALINE BATH
Amputated part should be kept_____and never be put directly on
Dry; ice
Infection that developed near root of eyelash is _______and it is an infection of the eyelid _____
HORDEOLUM (STY) : oil gland;
When the eyelid has a small circumscribed cysts formed by retention of meibomian gland secretions?
Chalazion
3 clinical manifestations of TRIGEMINAL NEURALGIA
- Facial grimacing during episodes
- Painful paroxysmal tic
- little to no sensory loss along the trigeminal nerve
For neurologic disorder, bleeding gum is symptom of
Temporal arteritis
For neurologic disorder, increased sensitivity to noise is symptom of
Bell’s PALSY
For neurologic disorder, ______ ________ are a clinical presenation for herpes zoster oticus symptom of
Herpetiform vesicles
The diagnostic test that provides the best view of a patient’s inferior orbital rims/maxillary sinues and the nasoethmoidal bones
Water’s view
The diagnostic test that provides the SIX LANDMARK FOR EVALUATION of facial symmetry
SUBMENTAL VERTICAL VIEW
The diagnostic test that provides view of the frontal sinus and the superior orbital rim
CALDWELL VIEW
To view the ZYGOMA and ZYGOMATIC ARCH use
zygomatic radiography
In regards to spider bites
All spiders are poisonous
The 2 spiders humans need to be wary of
Black widow spider
Brown recluse spider
The black widow spider bite may cause severe pain within _______the brown recluse spider bite may cause pain _____ ____after the bite. Black widow spider bite will _______WBC, brown secluse spider will _______WBC
15mns; 3-4 hours; increase; decrease
What is the normal intraocular pressure______ and it is measured by a _________
10-21 mmhg ; tonometer
The higher the intraocular pressure, the greater the risk for _________
compression of optic nerve
It is important to examine the optic nerve regardless of the
Intraocular pressure.
Retinal artery occlusion is associated with -______ ______ ______and is a ________. Circulation must be restored within _)____ to ______ to prevent blindness
SUDDEN, PAINLESS, UNILATERAL BLINDNESS ;, medical emergency 60-90
When a patient is bitten by venomous snake you should:
Immobilize the bitten area below the level of the heart.
Which of 2 bones are connected by cartilaginous joints?
RIBS and SPINE>
Bones connected by fibrous joings
skull, pelvis, ulnar.
The radius and ulna are ______Which is a type of fibrous joints.
syndesmoses
Heat therapy
- not used that are less than 48 hours old
- used to relax tight muscles
- used for injury that do not include inflammation or swelling
- not used when bleeding disorder are present.
Comprised of 80% of adult’s bone mass______ and _____account for 20% of total bone mass and is rod and plate like elements
Cortical bone: Trabecular bone
A hard splint is best described as _________Ex:
A soft splint is best described as ______Ex:
An air splint is best described as _______Ex:
A traction splint is best described as _____Ex
Firm and rigid; (elbow injury)
nonrigid
inflatable (foot injury)
ability to support factors while providing traction. (femur and hip injury)
Gout causes joint pain in ankles wrist, elbows, heels NOT in ______recurrent gout can lead to _______
Shoulders; gouty arthritis.
What are the 3 stages of gout
Symptomatic hyperuricemia
acute
tophaceous
Electric shock sensation is a sing of which condition?
Trigeminal neuralgia
Hearing loss, and loss of sensation of one side of the mouth
TEMPORAL ARTERITIS
Collection of purulent material around the tonsils consistent with
Peritonsillar abscess
There are 3 types of bone cell, which one is responsible for BUILDING NEW BONES>
osteoBLASTS
The bone cell responsible for MAINTAINING BONE TISSUE
osteoCYTES
The bone cell responsible for MAINTAINING BONE RESORPTION
osteoCLASTS
Group I Laryngeal trauma
Group II laryngeal trauma
Group III laryngeal trauma
Group IV laryngeal trauma
no fracture, simple hematomas and lacerations
Minor mucosal disruption, hematoma, swelling
Exposed cartilage, vocal cord immobility, massive swelling
Disruption of anterior larynx, unstable fracture, severe mucosal injuries.
What does the cornea relies on for nourishment_______. Does it contain blood vessels?
TEARS
AQUEOUS HUMOR
No it doesn’t
What is the eye first and most powerful lens
CORNEA
Inflammation of the CORNEA is called______
KERATITIS
2 things that increases the risk of Keratitis
Use of contact lenses
Exposure to UV light.
what should be considered for complex facial wounds
Plastic surgery consultation
For face, wound closure can be delayed for up to
and Laceration should be closed within
20 hours
4-6 hours
Inflammation of a rib and sternal junction
Costochondritis.
Sinus pressure around the forehead , sinuses most likely responsible are
Frontal sinuses.
Where are the ETHMOID sinuses located__________
Where are the SPHENOID sinuses located
Bridge of the nose
behind the nose
A second degree sprain is when a patient has a partial
A first degree sprain is when a patient little
LIGAMENT TEAR
Tearing with good stability
Where are the Maxillary sinuses located
around the cheeks.
Aching and throbbing pain is
tinging and burning sensation pain
NOCICEPTIVE pain
NEUROPATHIC
When removing a stinger (bee stinger) from a patient, you should do so by _________and it should be done by scrapping in the _____________ of the angle of the penetration
Scraping the skin; opposite direction of the angle of the penetration.
Fluid buildup in the inner ear in an area known as the labyrinth
Meniere’s disease
What is the most disabling symptom of Meniere’s disease
Vertigo
____________ examination is used to evaluate cornea
_________Examine intraocular structures of the eye
________Examination is to magnified eyes structure
fluorescein examination
Ocular sonography
SLIT LAMP
Which nerves controls the act of swallowing_____
Which nerve control the tongue’s MOTOR function
VAGUS
Hypoglossal
Scaphoid injury patient should be fitted for _____
Severe wrist injury patient should be fitter for ______
Carpal fracture or dislocation for ______
SPICA splint
COAPTATION splint
radial gutter splint.
Create a high pressure wound_____
Causes a projective missing wound_______
Paint gun
Nail gun
Ocular emergency characterized by increased intraocular pressure leading the COMPRESSION of the OPTIC NERVE
Acute angle closure glaucoma
wound that is 5 centimeters deep and 2 cm wide
PUNCTURE WOUND , not a laceration
__________linked to equilibrium , balance and hearing
ACOUSTIC NERVE
_________Links to One’s face and taste of the anterior 2/3 of tonge
FACIAL nerve
Patient wearing only _________would have bladder rupture, bowel perforation, lower thoracic fracture
LAB BELTS.
Which of the medications should NOT BE RECOMMENDED for gout?________Recommended meds ______and _____
ASPIRIN; Ibuprofen, prednisone.
Pupil allow for__________
Optic nerve responsible for _______
light to enter the eye
transfer for visual information
The VOCAL CORD are contained in which part of the pharynx?
LARYNX
Prevents food and irritants from entering lung
EPIGLOTTIS
If an infant’s cry cannot be explained,_______Could be a result
CORNEAL ABRASION
Has three lateral processes medial, inferior, posterior?
ZYGOMA
Responsible for mastication and speech
MASSETER muscle
Muscle to bone connection
Bone to bone connection
TENDONS
Ligaments
The only mobile bone in the facial skeleton
MANDIBLE
Tetanus infection managed with
Antitoxins
ABT
Vaccination
Patient with tetanus presents with
lock JAW
hypertonia, painful muscle contractions of jaw and neck
In regards to using CRUTCHES the patient should NOT
rest weight on axillary area.
The crutches should be ______inches in front of the body walking. There should be ___ to ___- inches between the axilla and the top of the crutches. The crutch’s hand rests should b positioned so that the user’s elbow are bent at a ____degree angle
12; 1-1/2 inch ; 30
The BIGGEST concern with nasal foreign bodies in pediatric patients
ASPIRATION
What are the four Rs of fractures
The six Ps of neurovascular assessment
Ortho management RICE
Reduction
Recognition
Retention
Rehabilitation
Pain, pallor, paresthesia, paralysis, pulses, polar
Rest Ice Compression elevation
Which parts of the INNER EAR contains balance receptors
Vestibule
Semicircular canal
Where does the auditory transduction, the conversion of acoustic energy to electrochemical energy takes place______
which one contains the hearing nerve________
Labirynthine cavity
Cochlea
To look for calcific deposits in tendinitis, what tests should be used______sensitivity ______
Xray; 90%
Seeing FLOATERS and LIGHT FLASHES in the visual fields__________
RETINAL DETACHMENT
Abnormal high fluid pressure causing the patient to experience headaches, eye redness, decreased vision or HALOS or excessive TEARING
Glaucoma
Patient cannot move MUSCLES on one side (Paralysis of one side of face) of his face it is _________and it is caused by trauma to which nerve
BELL’S PALSY; 7th
Facial nerve disorder in which the face experiences excruciating pain that recurs and increases its frequency and severity
Trigeminal Neuralgia
Common systemic vasculitis of the facial area is known as
Temporal arteritis.
What are the 2 sets of sinuses that are present at birth
Ethnoid and maxillary sinuses
Frontal sinus develops before the age of
seven
Patient on ciprofloxacin, or any fluroquinolones should be watch for _________also if they are receiving direct steroid injections to tendons
Achilles tendon rupture.
When a clot becomes dislodged following tooth extraction, it is known as_______and it is the result of _________ appears about 3-4_______after tooth extraction.
ALVEOLAR OSTEITIS or
Dry socket ; osteomyelitis.
During bicycle collision, the handlebars generally causes _______and_______injuries generally occur due to straddling the bike during a collision
Blunt trauma; perineal
The frontal facial bone forms_________and also the roof of the ______, the orbit and the ________sinuses
Cranium’s anterior portion; nose, ethnoid.
Tennis elbow aka _______ _______ is an elbow tendinitis, and is caused by _______
Lateral Epicondylitis; overuse of elbow
Shoulder tendinitis aka_________ Patellar tendinitis aka ________is also referred to as ___________
Rotator cuff tendinitis; knee tendinitis ; Jumper’s knee
Le FORTE II FRACTURE is characterized by
facial elongation
anterior cheek paresthesia
CSF leakage
Diminished EOM
Le FORTE I FRACTURE is characterized by
Upper lip numbness Epistaxis bruising malocclusion Crepitus
Le FORTE III FRACTURE is characterized by
Facial elongation and flattening with MASSIVE EDEMA An anterior open bite Free floating SEGMENT RHINORRHEA Epistaxis
Why is visual acuity done before manual examination________________ and chart should be _____Ft away and for non-english patient use the _____chart
Because manipulation increase blurring and decrease acuity;20; E chart
A patient with MENIERE’S Disease, to decrease the inner ear volume , which medication most likely give to the patient_____
For VESTIBULAR REPRESSION use ________
And to suppress conduction in the vestibular cerebellar pathways use________
DIURETICS; antihistamines; ANTICHOLINERGIC
Compartment syndrome is the result of ______ ______within a ______body space. Most often occurs following
Excessive pressure; closed
fractures, soft tissue injury, snake envenomation, vascular injury , external compression
If an infant/small child is admitted with an eye injury which of the following MOST likely occur
the infant/child was shaken
STRAIGHT-leg raise test is an accurate predictors of ________and if the patients pain increased when you move the patient’s knee back in a full extension during a straight leg raises, it indicates
Herniated disc; Nerve root or Sciatic nerve irritation
Ice should not be placed on a patient with compartment syndrome because it causes_______We should remove______ and arm should not be
VASOCONSTRICTION; constrictive clothes; elevated
Patient with HYPOGONADISM, or decreased__________levels are at risk for developing ________
Testosterone; osteoporosis
Precipitation of calcium sets on the corneal surface, may indicates________ and blue sclera indicate that may have________
Hyperparathyroidism: OSTEOGENESIS IMPERFECTA
Caused by cellulitis, osteomyelitis, or pleuritis is ________ _____
Caused by crush injury or major trauma ________
Caused by hx of minor trauma or intestinal or gallbladder surgery_______
Pasteurella Multocida
Wound botulism
Gas gangrene
_______provides pathway for afferent and efferent impulses to travel
White matter
