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BOC > Chapter 26 - Head, Face, Eyes, Ears, Nose, Throat > Flashcards

Chapter 26 - Head, Face, Eyes, Ears, Nose, Throat Flashcards

1
Q

what joints make up the skull?

A

sutures - immovable joints

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2
Q

cranial vault

A

houses brain

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3
Q

bones of skull

A

frontal, ethmoid, sphenoid, 2 parietal, 2 temporal, occipital bones

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4
Q

cerebrum

A

2 hemispheres; voluntary muscle activity

interprets sensory impulse,

controls higher mental functions (memory, reasoning, intelligence, learning, judgement, emotions)

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5
Q

Cerebellum

A

controls synergistic movements of skeletal muscle

coordination of voluntary movements

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6
Q

pons

A

controls sleep, posture, respiration, swallowing, bladder

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7
Q

medulla oblongata

A

lowest part of brain stem, regulates HR, BP, coughing, sneezing, vomiting

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8
Q

Meninges: outer to inner

A

dura mater - subdural space - arachnoid mater - subarachnoid space - pia mater

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9
Q

where is the CSF located?

A

b/w arachnoid mater and pia mater

surrounds and suspends the brain

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10
Q

History: head injury

A

retrograde amnesia - loss of memory of events before injury

anterograde amnesia - loss of memory of events after injury

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11
Q

Observation: head injury

A

disorieneted, blank stare, slurred speech, delayed verbal/motor responses, coordination, unfocused, distracted, memory deficit, normal cognitive functioning

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12
Q

palpation: head injury

A

tenderness, deformity on neck or skull

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13
Q

Special tests: head injury

A

neurologic, eye function, balance tests

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14
Q

neuro exam: head injury

A

cerebral testing (cognitive)

cranial nerve testing

cerebellar testing (coordination of motor function)

sensory testing

reflex testing

motor testing

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15
Q

Eye function exams

A

PEARL, eyes tracking, blurred vision

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16
Q

PEARL

A

pupils equal and reactive to light

dilated or irregular,

inability to accommodate light variance

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17
Q

Eye tracking

A

smooth movement,

rotary movement - nystagmus (possible lesion in posterior fossa of brain)

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18
Q

Balance tests

A

Romberg, BESS, coordination, cognitive tests, neuropsychological assessments

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19
Q

Romberg test

A

stand in double leg, single leg, tandem stances with shut eyes and hands at the sides

(+) tendency to sway or fall

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20
Q

BESS

A

balance error scoring system

double, single (non dominant foot), tandem stances (non dominant food to back) on hard and airex pad.

hands on hips, eyes close, for 20 sec, opposite limb is in 30 degrees of hip flexion and 40-50 degrees of knee flexion

max error score of 10

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21
Q

BESS errors

A

hands lifted off iliac crest, opening eyes, step, stumble, fall, moving angle of hip or knee, lifting forefoot, or heel, can’t stay in position of more than 5 sec

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22
Q

coordination tests

A

finger to nose, heel toe walking, standing heel to knee test

(injury to cerebellum)

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23
Q

Cognitive tests

A

count backwards from 100 by 7s, backwards spelling, naming months in reverse, tests of recent memory

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24
Q

Neuropsychological assessments

A

SAC, SCAT, ANAM

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25
Q

SAC

A

standarized assessment of Concussion

measures of orientation, immediate memory recall, concentration, delayed recall, neurological screening (LOC, amnesia, strength, sensation, coordination)

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26
Q

ANAM

A

Automated Neuropsychological Assessment Metrics

ex. ImPACT

sensitive to measuring cognitive function most susceptible to deficit after concussion

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27
Q

Skull Fx Etiology

A

often from blunt traum

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28
Q

skull fx S/Sx

A

severe headache, nausea, defect or indentation, blood in middle ear/ear canal/nose; ecchymosis around eyes (raccoon eyes); ecchymosis behind the ear (Battle’s sign), cerebrospinal fluid in ear canal and nose

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29
Q

skull fx management

A

complications from intracranial bleeding

bone fragments in brain

infection

immediate hospitalization and referral to surgeon

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30
Q

cerebral concussions

A

mild head injury

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31
Q

concussion etiology

A

immediate and transient post-traumatic impairment of neural functions

direct blow

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32
Q

countrecoup

A

injury to opposite side of initial contact

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33
Q

concussion S/Sx

A

blurred vision, dizziness, drowsiness, excess sleep, easily distracted, fatigue, in a fog, slowed down, headache, irritable, LOC, disorientated, memory issue, poor balance, ringing in ears, sensitive to light or noise, sleep disturbance, nausea/vomiting

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34
Q

post concussion syndrome etiology

A

occurs following a concussion, may be a few hours or a day after the initial impact

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35
Q

post concussion symtpoms/signs

A

persisten headache, impaired memory, lack of concentration, anxiety and irritable, giddy, fatigue, depression, visual disturbances, (can be weeks - months long)

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36
Q

second impact syndrome etiology

A

rapid swelling and herniation of the brain after a second head injury that occurs before the first is resolved.

brains blood auto regulatory system causes swelling of brain - increases pressure

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37
Q

second imapct S/Sx

A

no LOC, may look stunned, happens rapidly, dilated pupils, loss of eye movement, LOC –>coma, respiratory failure,

50% mortality rate

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38
Q

second impact management

A

must be noticed within 5 min, send to EMS,

prevention is key to avoiding second impact syndrome

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39
Q

Cerebral Contusion etiology

A

focal injury to brain that involves small hemorrhages or intracerebral bleeding in cortex, brainstem, or cerebellum

impact injury, head strikes immoveable object

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40
Q

cerebral contusion S/Sx

A

LOC, later becomes very alert and talkative, neuro exam will be normal, (headache, dizzy, nausea will persist)

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41
Q

cerebral contusion management

A

hospitalization, CT or MRI tests

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42
Q

Malignant Brain Edema etiology

A

occurs in young athletic population

diffuse brain swelling resulting from hyperemia or vascular engorgement

little to no injury to the brain

raises intracranial pressure, can be life-threatening

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43
Q

hyperemia

A

an excess of blood in the vessels supplying an organ or other part of the body.

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44
Q

Malignant Brain Edema S/Sx

A

rapid neuro detioration to coma and sometimes death

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45
Q

management of malignant brain edema

A

immediate recognition

rapid tx in emergency facility

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46
Q

Epidural hematoma etiology

A

blow to the head or skull fracture can cause tear of meningeal arteries

rapid blood accumulation –> hematoma

(happens in minutes o hours)

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47
Q

Epidural hematoma S/Sx

A

LOC, gradually worsening symptoms,

head pain, dizziness, nausea, dilation of one pupil (same side as injury), sleepiness

later symptoms: deteriorating consciousness, neck rigidity, depression of pulse/respiration, convulsions

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48
Q

management epidural hematoma

A

CT scan to diagnose, pressure must be surgically released

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49
Q

Subdural hematoma etiology

A

more frequent than epidural,

most common cause of death in athletes

acute: progress rapidly, like an epidural hematoma, arterial bleeding, assoc with brain contusion and skull injury
chronic: venous bleeding, low pressure, takes longer to become “serious”

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50
Q

S/Sx of subdural hematoma

A

complicated: LOC, dilation of one pupil (same side as injury)

Uncomplicated and complicated mutual symptoms: headache, dizzy, nausea, sleepiness

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51
Q

management for subdural hematoma

A

immediate transfer, CT scan, MRI needed

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52
Q

Migraine headaches etiology

A

neurological disorder which can last 4-72 hours

common in women
may be genetic

triggers: foods, meds, sensory stimuli, lifestyle changes

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53
Q

migraine symptoms

A

throbbing, pulsating pain on one side of head, nausea, vomiting, sensitive to light/sound/smell, aura, visual changes, tingling sensation, numbness, dizziness

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54
Q

management for migraine

A

prevention - prophylactic meds

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55
Q

where are frontal sinuses housed

A

supraorbital ridges

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56
Q

temporomandibular joint

A

articulation b/w mandibular condyle and mandibular fossa of temporal bone

hinge joint, also glides forward and backward, side-to-side when chewing.

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57
Q

mandible fracture etiology

A

mostly in collision sports;

usually lower jaw frontal angle

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58
Q

mandible fx S/Sx

A

deformity, loss of normal occlusion of teeth, pain when biting, bleeding around teeth, lower lip numbness

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59
Q

mandible fx management

A

temporary immobilization,

reduction and fixation by physician

4-6 week recovery, resume full activity in 2-3 months

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60
Q

mandibular dislocation etiology

A

prone to dislocation,

side blow to open mouth, forces condyle forward out of temporal fossa

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61
Q

mandibular dislocation s/sx

A

locked open position, malocclusion of teeth

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62
Q

managemtn - mandibular dislocation

A

ice, immobilize, reduce

soft food diet, NSAIDs, analgesics,

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63
Q

TMJ Dysfunction etiology

A

usually involves disk-condyle derangement
disk is positioned anteriorly when the jaw closes, when jaw opens condyle translates forward

audible click is heard -

causes deterioration of posterior stabilizing structures and eventually anterior dislocation of disc

64
Q

TMJD s/sx

A

headache, earache, vertigo, inflammation, neck pain - trigger points,

inflammation of synovial capsule, disk derangemetn, malocclusion, hyper/hypo-mobility, msucle dysfunction, limited ROM

65
Q

management of TMJD

A

correct mobility issue, strengthening exercises, joint moves,

dental appliance is recommended

66
Q

Zygomatic Complex (Cheekbone) Fx Etiology

A

direct blow to cheekbone,

can be classified as a LeFort Fx

67
Q

Lefort Fx

A

fx of one or more facial bones

68
Q

facial bones

A

zygomatic, maxillary, orbital, nasal

69
Q

Zygomatic Fx - S/Sx

A

obvious deformity, bony discrepancy, nosebleed, double vision, numbness of cheek

70
Q

management zygomatic fx

A

cold application, immediate referral, healing takes 6-8 weeks

71
Q

epistaxis

A

nosebleed

72
Q

diplopia

A

double vision

73
Q

Maxillary fx etiology

A

severe blow to upper jaw

74
Q

maxillary fx s/sx

A

pain with chewing, malocclusion, nosebleed, double vision, numbness in lip and cheek

75
Q

maxillary fx management

A

airway maintained, transportation in upright forward leaning position,

fx reduction, fixation, immobilization

76
Q

crown

A

portion protruding from gum - covered by enamel

77
Q

root

A

portion that extends into alveolar bone of the mouth

covered by cementum

78
Q

dentin

A

beneath enamel and cementum, bulk of tooth

79
Q

pulp

A

lies w/in dentin,

contains nerves, lymphatics, blood vessels that supply entire tooth

80
Q

Preventing dental injuries

A

mouth guards, dental hygiene

81
Q

progression of cavity

A

abscess –> gingivitis (gums inflamed) —> periodontitis (degeneration of dental periosteum, surrounding bone, and cementum)

82
Q

Tooth Fx etiology

A

impact, direct trauma

83
Q

uncomplicated crown fx

A

small portion broken, no bleeding, pulp chamber not exposed,

84
Q

complicated crown fx

A

larger portion broken, bleeding from fx, pulp chamber exposed, great deal of pain

85
Q

root fx

A

occurs below gum line
tooth may appear normal, bleeding from gum,
crown of tooth may be pushed back or loose

86
Q

Tooth Subluxation, luxation, avulsion S/Sx

A

slightly loosened tooth, completely dislodged,

luxated - extremely loose,

87
Q

Tooth Subluxation, luxation, avulsion management

A

sublux - immediate tx not required

luxation - move tooth to normal position if possible, see dentist ASAP

avulsion - rinse tooth, put in save a tooth, re-implant if possible - transport to dentist

88
Q

nose functions

A

clean, warm, and humidify inhaled air

89
Q

nasal fx / chondral separations etiology

A

lateral force causes greatest deformity

90
Q

nasal fx/chondral separation s/sx

A

separation of frontal processes of maxilla, separation lateral cartilage, or combo of 2

profuse bleeding, swelling, hemorrhaging, crepitus

91
Q

deviated septum

A

cause: compression or lateral trauma

s/sx: bleeding, septal hematoma, nasal pain

tx: compression applied, must be drained and packed

92
Q

3 parts of the ear

A

external ear

middle ear

internal ear

93
Q

middle ear

A

tympanic membrane

94
Q

internal ear

A

labyrinth, formed partly by temporal bone of skull

95
Q

eustachian tube

A

aids the organs of hearing and equalizing pressure between the middle and internal ear

joins ear and nose

96
Q

external auditory canal

A

meatus

97
Q

auricle

A

pinna

98
Q

auricle hematoma aka

A

cauliflower ear

99
Q

auricular hematoma etiology

A

compression or shearing to the auricle

causing subcutaneous bleeding

100
Q

auricular hematoma s/sx

A

hematoma,

untreated - keloid formation

101
Q

keloid

A

elevated, rounded, white, nodular, and firm (like a cauliflower)

102
Q

auricular hematoma management

A

petroleum jelly and headgear

cold pack,

aspiration by physician

pack ear with cotton

103
Q

tympanic membrane rupture etiology

A

fall/slap to unprotected ear

sudden underwater pressure variation

104
Q

otoscope

A

inspection device for ear

105
Q

tympanic membrane rupture management

A

heal in 1-2 weeks; infection is possible

106
Q

swimmer’s ear known as

A

otitis externa

107
Q

otitis externa etiology

A

infection of external auditory ear canal

caused by: Pseudomonas Aeruginosa (Bacillus)

108
Q

otitis externa s/sx

A

pain, dizziness, itching, discharge, partial hearing loss,

109
Q

otitis externa management

A

prevent by drying ears, using ear drops, and an alcohol solution

tx with acidification through drops into the ear or antibiotics

110
Q

Otitis media aka

A

middle ear infection

111
Q

otitis media etiology

A

accumulation of fluid in middle ear caused by local and systemic inflammation and infection

112
Q

otitis media s/sx

A

intense pain, fluid drainage, loss of hearing, systemic infection which could cause fever, headache, irritability, loss of appetite, and nausea

113
Q

otitis media management

A

analgesics, antibiotics

114
Q

Impacted Cerumen etiology

A

excessive amounts of earwax

115
Q

impacted cerumen s/sx

A

muffled hearing, little to no pain

no infection

116
Q

impacted cerumen management

A

remove earwax with irrigation, do no use a q-tip,

may need a physician to remove with a curette

117
Q

sclera

A

tough, white outer layer covering the eye

118
Q

cornea

A

transparent portion of the sclera, covers pupil

119
Q

how do we see

A

light passes through the cornea, then the anterior chamber, past the iris and the lens, and through the vitreous body - which focuses the image on the retina, where it is detected by the optic nerve

120
Q

when dealing with the eye what injuries would require immediate referral

A

retinal detachment

perforation of the globe

foreign object embedded in cornea

blood in anterior chamber,

decreased vision

loss of visual field

poor pupillary adaptation

double vision

laceration

121
Q

Testing pupillary reaction

A

pupil dilation and accommodation by covering eye then exposing it to full light

122
Q

testing for visual acuity

A

snellen eye chart

123
Q

ophthalmoscope

A

instrument for observing interior of the eye (especially the retina)

124
Q

Orbital Hematoma aka

A

black eye

125
Q

orbital hematoma etiology

A

blow to eye may initially injure the surrounding tissue & produce capillary bleeding into tissue spaces

126
Q

orbital hematoma s/sx

A

ecchymosis, pain

more serious: subconjunctival hemorrhage or faulty vision

127
Q

oribtal hematoma management

A

ice, do not blow nose

128
Q

orbital fx etiology

A

blow to eyeball that forces it posteriorly, compresses the orbital fat until a blowout or rupture occurs to the floor of the orbit

129
Q

orbital fx s/sx

A

diplopia, restricted eye movement, downward displacement of the eye, pain accompanied by soft tissue swelling and hemorrhage

130
Q

orbital fx management

A

prophylactic antibiotics

treated surgically

131
Q

corneal abrasions and lacerations etiology

A

caused by rubbing of a eye where there is a foreign body

132
Q

corneal abrasion s/sx

A

severe pain and watering eyes, photophobia, spasm of the orbicular muscle of the eyelid

133
Q

corneal abrasion management

A

eye patch

diagnose with fluorescein strip

antibiotics

134
Q

hyphema etiology

A

collection of blood within the anterior chamber,

caused by being struck in the eye (by a ball)

135
Q

hyphema s/sx

A

referral to physcian, hospitialize, bed rest, patch both eyes, sedation,medication

136
Q

globe rupture etiology

A

blow to eye by a small object (golf ball)

137
Q

globe rupture s/sx

A

pain, decreased visual acuity, diplopia, irregular pupils, increased intra-ocular pressure, orbital leakage

138
Q

globe rupture management

A

immediate rest, eye protection, antiemetic medication to avoid increasing intra-ocular pressure

139
Q

retinal detachment etiology

A

blow to the eye that partially or completely separates the retina from underlying retinal pigment epithelium

common among those with myopia or nearsightedness

140
Q

retinal detachment s/sx

A

specks floating in the eye, flashes of light, blurred vision

as it progresses, may notice a ‘curtain’ closing over the field of vision

141
Q

retinal detachment management

A

immediate referral to ophthalmologist

142
Q

acute conjunctivitis etiology

A

usually caused by various bacteria or allergens,

143
Q

acute conjunctivitis s/sx

A

eyelid swelling, purulent discharge, itching, burning

144
Q

acute conjunctivitis management

A

highly infectious; 10% solution of sodium sulfacetamide

145
Q

hordeolum (sty) etiology

A

infection of the eyelash follicle or the sebaceous gland at the edge of the eyelid;

caused by staphylococcal

146
Q

hordeolum s/sx

A

erythema of the eye, localized into a painful pustule within a few days

147
Q

hordeolum management

A

application of hot, moist compresses and 1% yellow oxide or mercury;

may need surgery

148
Q

throat contusion etiology

A

getting “clotheslined”

could injure carotid artery, causing a clot to form that occludes blood flow to the brain or it becomes dislodged and migrate to the brain

149
Q

throat contusion s.sx

A

severe spain, spasmodic coughing, hoarse speaking voice, difficult to swallow and breathe, inability to breathe, expectoration of froth body, cyanosis

150
Q

throat contusion management

A

immediate concern is integrity of airway; apply cold intermittently to control hemorrhage and swelling, immediate referral

151
Q

thyroid gland disorder

A

thyroid gland produces thyroxine and triiodothyronine

152
Q

Hyperthyroidism

A

overproduction of thyroxine which impairs glucose metabolisms, and causes increased metabolism, rapid fatigue during exercise, weight loss, hyperthermia during exercise

153
Q

Grave’s disease

A

may lead to weakness, tremors, difficulty swallowing/speaking

154
Q

Hyperthyroidism

A

deficient secretion of thyroid hormone,

causes lowered metabolism, poor circulation, dry skin, low blood pressure, slow pulse, depressed muscular activity, intolerance to cold, increasing obesity, development of goiter

155
Q

thyroid gland disorders management

A

refer to physciant, may need meds or surgery

156
Q

how long can the brain last without oxygen without incurring damage

A

4-6 minutes

BOC (49 decks)

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