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ENT week 2 > ENT trauma > Flashcards

ENT trauma Flashcards

1
Q

What is the common mechanisms of injury for nasal trauma ?

A
  • Fight
  • Sports
  • Falls
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2
Q

What are the signs of nasal trauma ?

A
  • Bruising
  • Swelling
  • Tenderness
  • Deviation of the nasal bone
  • Epistaxis (nose bleed)
  • Facial tenderness
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3
Q

How are nasal fractures diagnosed ?

A
  • On clinical findings
  • They do not warrant investigation
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4
Q

What is the management of nasal fractures ?

A
  • Conservative
  • Unless - narrowing of nasal passage sufficient enough to warrant (MUA - manipulation under anaesthetic)
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5
Q

What are some of the complications of nasal fractures ?

A
  • Epistaxis
  • CSF leak
  • Ansomia (loss of smell)
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6
Q

What is the management of epistaxis ?

A
  • 1st line = anterior nasal septal pressure + vasoconstrictor spray (oxyductazoline)
  • 2nd line = rhino packing
  • 3rd line = nasal cauterisation if bleeding point seen (try avoid in kids)
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7
Q

If there is CSF leak due to nasal trauma what bone is most likely to have been fractured?

A

Cribriform plate - note CSF will contain transferrin

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8
Q

What are the main types of trauma which occur to the ear ?

A
  • Pinna haematomas
  • Lacerations
  • Temporal bone fractures
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9
Q

What is a pinna haematoma ?

A

'’cauliflower ear’’

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10
Q

What is the treatment of pinna haematomas ?

A
  • Say day assessment by ENT
  • 1st line = Incision and drainage
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11
Q

What is the management of laceration injuries to the ear ?

A
  • Debridement and closure by either primary or reconstruction
  • Also give antibiotics
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12
Q

What are the signs of a temporal bone fracture ?

A
  • Brusing - ‘battle sign’ this is post-auricular bruising
  • Bleeding from ear
  • Can involve middle or inner ear structures so can get vertigo, hearing loss, balance problems and facial palsys
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13
Q

What are the 2 main classifications of temporal bone fractures ?

A

Longitudinal or transverse

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14
Q

What are the features of a longitudinal temporal bone fracture ?

A
  • Spares the otic capsule
  • Results in conductive hearing loss due to blood in middle ear or disruption of the ossicles
  • Due to lateral head blows
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15
Q

Describe the typical features of transverse temporal fractures

A
  • Affects the otic capsule
  • Results in sensorineural hearing loss
  • Can damage facial and vestibular nerves
  • Due to frontal head blows
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16
Q

Management of temporal bone fracture complications

A
  • May need facial nerve decompression
  • CSF leak usually settles
  • Hearing - may need hearing aid or ossiculoplasty
17
Q

What are some of the causes of neck trauma ?

A
  • Penetrating injuries e.g. knifes etc
  • Blunt injuries - e.g. motor vehicle accidents, sports injuries (clothsline tackle)
18
Q

Following neck trauma what symptoms do you want to know are present or not ?

A
  • Pain
  • Aerodigestive tract problems - dysponea, hoarseness, dysphonia (difficulty speaking), dyspepsia, haemoptysis
  • CNS problems - weakness, paraesthesia
19
Q

What is the management of neck trauma ?

A
  • 1st ABCDE
  • 2nd urgent exploration e.g. laryngoscopy, bronchoscopy etc
  • 3rd may need to stop bleeding
20
Q

What mechanism of injury usually causes maxillary fractures (Le-fort) ?

A

High-energy blunt force injuries to the facial skeleton

21
Q

Give 2 examples of facial trauma injuries ?

A
  • Orbital blowout fractures
  • Le-fort fractures
22
Q

How do orbital floor fractures occur ?

A

A blunt object large enough to not penetrate the eye socket and small enough to not fracture the orbital rim

23
Q

What is the weak point in the orbit which predisposes to orbital blowout fractures ?

A

Infraorbital groove

24
Q

What are some of the signs of an orbital blowout fracture ?

A
  • Pain
  • decreases visual acuity
  • dipolopia (double vision)
  • Hypoaesthesia in infraorbital region
  • Restricted occular movements
  • Posterior displacement of the eye
25
Q

What investigation is done to assess an orbital blowout fracture ?

A
  • CT sinuses
  • ‘tear drop’ sign seen
26
Q

What is the management of orbital blowout fractures ?

A
  • 1st line - conservative
  • 2nd line - surgical repair of bony walls if entrapment, significant displacment of the eye
27
Q

What are the 3 types of Le-fort fractures ?

A
  • Horizontal - type I
  • Pyramidal - type II
  • Transverse - type III
28
Q

How are injuries/ problems with the front of the face diagnosed?

29
Q

Who is most commonly affected by foreign bodies up the nose ?

A

Young kids

30
Q

How do foreign bodies present when stuck up the nose ?

A
  • Early purulent discharge
  • Can cause epistaxis
31
Q

Treatment of a foreign body stuck up a kids nose ?

A

Grab it with forceps if not more complicated

32
Q

What are some of the causes of septal perforation ?

A
  • Trauma
  • Sniffing salts or cocaine
  • Malignancy

ENT week 2 (10 decks)

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