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Face and Neck Injuries Flashcards

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1
Q

Function of hyoid bone

A

Supports and stabilizes larynx and serves as a point of attachment for many neck and tongue muslces.

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2
Q

Which nerve carries parasympathetic nerve fibers that cause constriction of pupils?

A

Oculomotor nerve

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3
Q

Which nerve provides the sense of vision?

A

Optic nerve

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4
Q

How does the eyeball keep its global shape?

A

Pressure of fluid contained within anterior and posterior chamber.

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5
Q

Aqueous humor

A

Clear watery fluid filling anterior chamber of eyeball.

Loss of aqueous humor will gradually replenish.

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6
Q

Vitreous humor

A

Jellylike substance in posterior chamber.
Maintains shape of globe.
Loss of vitreous humor will cause blindness as it cannot be replenished.

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7
Q

What is the external ear compose of?

A

Pinna and external auditory canal

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8
Q

What does the middle ear contain?

A

Three bones - malleus, icus, and stapes. Move in response to sound waves hitting the TM.

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9
Q

What is the inner ear composed of?

A

Bony chambers filled with fluid

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10
Q

Injury to major vessels in the neck can cause :

A

Cerebral hypoxia
Infarct
Air embolism
Permanent neurologic impairment

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11
Q

s/s of facial fx

A 
Ecchymosis
Swelling
TTP
Crepitus
Misalignment of the teeth, facial deformities or asymmetry
Instability of facial bones
Impaired ocular movement
Visual disturbances
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12
Q

Nasal fx are characterized by :

A

swelling, tenderness, and crepitus when palpated

Anterior or posterior epistaxis

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13
Q

Deformity of the nose usually appears as ____ displacement.

A

lateral

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14
Q

When should you suspect a mandibular fx?

A

Hx of blunt force trauma to lower third of face
Dental malocculsion
Numbness of the chine
Inability to open mouth

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15
Q

Maxillary fx are most commonly associated with which MOI?

A

Massive blunt force trauma such as MVCs, falls, and assaults

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16
Q

Signs of maxillary fx

A

Facial swelling
Instability of midfacial bones
Malocculsion
Elongated face

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17
Q

Le Fort I fx

A

Horizontal fx of maxilla that separates the hard palate and lower maxilla from skull.

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18
Q

Le Fort II fx

A

Separates nasal bone and lower maxilla from skull and cranial bones.

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19
Q

Le Fort III fx

A

All midfacial bones, separating the entire midface from cranium.

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20
Q

Orbital fx sxs

A

Diplopia
Loss of sensation above the eyebrow or cheek
Paralysis of upward gaze
Massive nasal discharge

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21
Q

Signs of zygomatic fx

A

Side of face appears flattened
Loss of sensation over cheek, nose, and upper lip
Paralysis of upward gaze

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22
Q

When do zygomatic fx commonly result?

A

Blunt trauma in MVCs and assaults

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23
Q

Common MOI for face and neck injuries include :

A

MVCs, sports, falls, penetrating trauma, and blunt trauma

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24
Q

Provide rapid transport for :

A 
Signs of shock
Poor general impression
AMS
Abnormal vital signs
Dyspnea
Severe pain
Isolated injuries to the eye
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25
Q

What should be the focus of your physical exam w/ a responsive patient who has an isolated injury w/ limited MOI?

A

Isolated injury
Pt’s cc
Body region affected

26
Q

Management of chemical burns to eye

A

Flush w/ water or sterile saline irrigation

Irrigate for 20 minutes if alkali or strong acid

27
Q

Management of thermal burns to eye

A

Cover both eyes w/ sterile dressing moistened w/ sterile saline

28
Q

Management of burns from UV rays, sun lamp, reflect light, snow blindness

A

Cover each eye w/ sterile, moist pad and an eye shield

29
Q

Three important guidelines when treating penetrating injuries of the eye :

A

Never exert pressure on or manipulate the injured eye in any way.
Eyeball exposed : apply a moist, sterile dressing to prevent drying
Cover the injured eye w/ a protective metal eye shield, cup, or sterile dressing.

30
Q

Hyphema

A

Bleeding into the anterior chamber of the ye

31
Q

Hyphema may signal what type of injury?

A

Spinal injury

32
Q

Management for hyphema

A

Cover the eye
Suspect spinal injury
Elevate head of the backboard 40 degrees to decrease IOP and discourage activities that may increase IOP

33
Q

Retinal detachment

A

Separation of the inner layers of the retina from underlying choroid

34
Q

sxs of retinal detachment

A

Flashing lights, specks, or floaters in visual field

35
Q

Eye findings that would alert you to a possible head injury :

A 
One pupil larger than the other
Deconjugate gaze
Eyes fail to follow movement of your finger
Bleeding under the conjunctiva
Protrusion or bulging of one eye
36
Q

When is the only time you should remove a contact lens in the field?

A

Chemical burn of the eye

37
Q

Suspect an artificial eye when it :

A

Does no respond to light
Does not move in concert w/ opposite eye
Appears different from opposite eye

38
Q

Signs of anterior epistaxis

A

Originate from area of septum
Bleed slowly
Resolve quickly

39
Q

Signs of posterior epistaxis

A

Blood draining into throat causing n/v

40
Q

Management of non-traumatic epistaxis

A

Place in sitting position, leaning forward, and pinch nares together or press on upper gums

41
Q

s/s of perforated TM

A

Loss of hearing

Blood drainage

42
Q

In addition to danger of external hemorrhage from facial fractures, ____ may become lodged in ____ and cause an ____.

A

Blood clots; upper airway; obstruction

43
Q

What are the primary risk associated w/ oral and dental injuries?

A

Airway compromise from oropharyngeal bleeding
Occlusion by displaced dental appliance
Aspiration of avulsed or fx teeth

44
Q

Procedure for severe oropharyngeal bleeding in patients w/ inadequate ventilation?

A

Suction airway for 15 seconds
Provide ventilatory assistance for 2 minutes
Repeat

45
Q

Reimplantation of avulsed tooth is recommended within :

A

20 minutes to 1 hour

46
Q

Avulsed tooth should be placed in what solution?

A

Tooth storage solution
Cold milk
Sterile saline

47
Q

What structures in the neck are vulnerable to blunt trauma?

A 
Upper airway
Esophagus
Carotid arteries and jugular veins
Thyroid cartilage
Cricoid cartilage
Upper part of trachea
48
Q

What can a fracture of the cartilages in the upper airway and larynx lead to?

A

Loss of voice
Difficulty swallowing
Severe and sometime fatal airway obstruction
Subcutaneous emphysema

49
Q

Management of subcutaneous emphysema secondary to blunt force trauma to neck

A

Maintain airway as best as you can and provide immediate transport.

50
Q

A large amount of air in the ___ atrium and ___ ventricle can lead to cardiac arrest.

A

right; right

51
Q

Why should you apply an occlusive dressing on a bleeding wound from the neck?

A

Prevent air embolism from entering vein or artery

52
Q

Impaled objects in the neck present life-threatening condition including :

A

Injury to major blood vessels w/ massive hemorrhage
Damage to the larynx, trachea, or esophagus
Injury to c-spine

53
Q

When is acceptable to remove an impaled object from the neck?

A

Only if it’s obstructing the airway or impeding your ability to effectively manage the airway.

54
Q

s/s of larynx injury

A 
Respiratory distress
Hoarseness
Pain
Dysphagia
Hemoptysis
Cyanosis
Pale
Sputum in wound
Subcutaneous emphysema
Bruising on the neck
Structural irregularity
Hematoma or bleeding
55
Q

Mediastinitis

A

Inflammation of the mediastinum often resulting from gastric contents leaking into the thoracic cavity after esophageal perforation.

56
Q

Management of laryngeal injuries

A

Provide oxygenation and ventilation, preferably two-person BVM
Apply soft c-collar
Ready for suction
ALS rendezvous
IV access
20 mL/kg isotonic crystalloid to maintain adequate perfusion

57
Q

Sprain

A

Stretching or tearing of ligaments

58
Q

Strains

A

Stretching or tearing of muscle or tendon

59
Q

What is the most common form of cervical strain?

A

Whiplash

60
Q

Management of muscular injury to c-spine

A

Focus on preventing further injury by restricting ROM w/ c-collar and immobilization to backboard

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