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Emergency Medical Technician > Face & Neck Injuries > Flashcards

Face & Neck Injuries Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

The head is divided into two parts

A
  1. Cranium
  2. Face
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2
Q

The most posterior portion of the cranium is called the ___

A

Occiput

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3
Q

On each side of the cranium, the lateral portions are called the ___

A

Temples or temporal regions

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4
Q

Between the temporal regions and the occiput lie the ___

A

Parietal regions

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5
Q

The forehead is called the ___

A

Frontal region

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6
Q

Just anterior to the ear, in the temporal region, you can feel the pulse of the ___

A

Superficial temporal artery

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7
Q

The face is composed of the ___

A

Eyes, ears, nose, mouth, and cheeks

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8
Q

6 major bones of the face

A
  1. Nasal bone
  2. Two maxillae
  3. Two zygomas
  4. Mandible
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9
Q

Maxillae

A

Upper jaw bones

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10
Q

Zygomas

A

Cheek bones

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11
Q

Mandible

A

Jaw bone

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12
Q

The orbit of the eye is composed of the ___

A

Lower edge of the frontal bone of the skull, the zygoma, the maxilla, and the nasal bone

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13
Q

The ___ protects the eye from injury

A

Bony orbit

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14
Q

Only the proximal third of the nose is formed by ___

A

Bone

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15
Q

The distal two thirds of the nose are composed of ___

A

Cartilage

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16
Q

The exposed portion of the ear is composed entirely of ___

A

Cartilage that is covered by skin

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17
Q

External, visible part of the ear

A

Pinna

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18
Q

Fleshy portions at the bottom of each ear

A

Ear lobes

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19
Q

Small, rounded, fleshy bulge immediately anterior to the ear canal

A

Tragus

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20
Q

The superficial temporal artery can be palpated just ___

A

Anterior to the tragus

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21
Q

About 1” posterior to the external opening of the ear is a prominent bony mass at the base of the skull called the ___

A

Mastoid process

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22
Q

Forms the jaw and chin

A

Mandible

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23
Q

Motion of the mandible occurs at the ___

A

Temporomandibular joint

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24
Q

Lies just in front of the ear on either side of the face

A

Temporomandibular joint

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25
Q

Below the ear and anterior to the mastoid process, the ___ is easily palpated

A

Angle of the mandible

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26
Q

Number of cervical vertebrae

A

7

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27
Q

The spinal cord exits from the ___

A

Foramen magnum

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28
Q

The upper part of the esophagus and trachea lie in the ___

A

Midline of the neck

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29
Q

The carotid arteries are found on ___

A

Either side of the trachea

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30
Q

Firm prominence in the center of the anterior surface of the neck

A

Upper part of the larynx, formed by the thyroid cartilage (Adam’s apple)

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31
Q

The other portion of the larynx is the ___

A

Cricoid cartilage

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32
Q

The only complete circular cartilage structure of the trachea

A

Cricoid cartilage

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33
Q

The cricoid cartilage is located ___

A

Below the thyroid cartilage

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34
Q

Between the cricoid cartilage and the thyroid cartilage is a ___

A

Soft depression called the cricothyroid membrane

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35
Q

The cricothyroid membrane is a ___

A

Thin sheet of connective tissue that joins the two cartilages

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36
Q

Fascia

A

Connective tissue

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37
Q

The cricothyroid membrane is covered only by ___

A

Skin

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38
Q

Below the larynx, ___ are palpable in the anterior midline

A

Several additional firm ridges

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39
Q

The firm ridges palpable below the larynx

A

Cartilage rings of the trachea

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40
Q

Connects the oropharynx and the larynx with the main air passages of the lungs

A

Trachea

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41
Q

Main air passages of the lungs

A

Bronchi

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42
Q

On either side of the lower larynx and the upper trachea lies the ___

A

Thyroid gland

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43
Q

Palpating the thyroid gland

A

Not usually palpable unless it is enlarged

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44
Q

Pulsations in the carotid arteries are easily palpable in ___

A

A groove about .5” lateral to the larynx

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45
Q

Lying immediately adjacent to the carotid arteries, but not palpable, are the ___

A

Internal jugular veins and several important nerves

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46
Q

Lateral to the internal jugular veins and nerves, lie the ___

A

Sternocleidomastoid muscles

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47
Q

These muscles originate from the mastoid process of the cranium and insert into the medial border of each collarbone and the sternum at the base of the neck

A

Sternocleidomastoid muscles

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48
Q

These muscles allow movement of the head

A

Sternocleidomastoid muscles

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49
Q

Series of bony prominences lie posteriorly, in the midline of the neck

A

Spines of the cervical vertebrae

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50
Q

The lower cervical spines are more ___ than the upper ones

A

Prominent

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51
Q

The spines of the cervical vertebrae are more easily palpable when the neck is ___

A

In flexion

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52
Q

At the base of the neck posteriorly, the most prominent spine is the ___

A

Seventh cervical vertebra

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53
Q

Eye diameter

A

About 1”

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54
Q

The eye is located within ___

A

A bony socket in the skull called the orbit

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55
Q

The orbit forms the base of the floor of the ___

A

Cranial cavity

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56
Q

Directly above the eye is the ___ of the brain

A

Frontal lobes

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57
Q

How much of the adult eye is protected in the orbit?

A

80%

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58
Q

Between and below the orbits are the ___

A

Nasal bone and the sinuses, respectively

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59
Q

Eyeball

A

Globe

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60
Q

The eyeball keeps its global shape as a result of the ___

A

Pressure of the fluid contained within its two chambers

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61
Q

Clear, jellylike fluid near the back of the eye

A

Vitreous humor

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62
Q

In front of the lens is a clear fluid called ___

A

The aqueous humor

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63
Q

In penetrating injuries of the eye, ___ can leak out

A

Aqueous humor

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64
Q

The inner surface of the eyelids and the exposed surface of the eye, are covered by ___

A

A delicate membrane, the conjunctiva

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65
Q

The conjunctiva are kept moist by ___

A

Lacrimal glands

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66
Q

Tear glands

A

Lacrimal glands

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67
Q

The tears drain on the ___

A

Inner side of the eye through two lacrimal ducts into the nasal cavity

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68
Q

White of the eye

A

Sclera

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69
Q

Tough fibrous tissue that helps maintain the eye’s globular shape and protects the more delicate inner structures

A

Sclera

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70
Q

On the front of the eye, the sclera is replaced by ___

A

The cornea

71
Q

Clear, transparent membrane on the front of the eye

A

Cornea

72
Q

Allows light to enter the eye

A

Cornea

73
Q

Circular muscle behind the cornea with an opening in the center

A

Iris

74
Q

Adjusts in size to regulate the amount of light that enters the eye

A

Iris

75
Q

The iris is ___

A

Pigmented

76
Q

The opening in the center of the iris

A

Pupil

77
Q

Born with unequal pupil size

A

Anisocoria

78
Q

Unequal pupil size may indicate ___

A

Serious injury or illness of the brain or eye

79
Q

Behind the iris is the ___

A

Lens

80
Q

Focuses images on the light-sensitive area at the back of the globe

A

Lens

81
Q

Light-sensitive area at the back of the globe

A

Retina

82
Q

Within the retina are numerous nerve endings that respond to light by ___

A

Transmitting nerve impulses through the optic nerve to the brain

83
Q

In the brain, impulses from the optic nerve are interpreted as ___

A

Vision

84
Q

The retina is nourished by ___

A

A layer of blood vessels between it and the sclera at the back of the globe

85
Q

Layer of blood vessels between the retina and the sclera at the back of the globe

A

Choroid

86
Q

If the retina detaches from the underlying choroid and sclera, ___

A

Blindness, retinal detachment

87
Q

Direct injuries to the ___ are often a source of significant bleeding and/or respiratory arrest

A

Nose and mouth, the larynx, or the trachea

88
Q

If you are unable to control airway bleeding, you may need to ___

A

Suction the airway

89
Q

The ___ may be affected with the patient’s head is turned to the side

A

Airway

90
Q

If the great vessels in the neck are injured, ___ are common

A

Significant bleeding and pressure on the upper airway

91
Q

If there is significant impact to the face, suspect ___

A

Accompanying cervical spine injury

92
Q

Soft-tissue injuries of the face and neck are common, because the face and neck are extremely ___

A

Vascular

93
Q

Blood collects under the skin

A

Hematoma

94
Q

Mandible fractures are relatively common because of the ___

A

Prominence of the mandible itself

95
Q

Mandible fractures are second only to ___ in frequency

A

Nasal

96
Q

Most mandible and nasal fractures are the result of ___

A

Vehicle collisions and assaults

97
Q

If your patient has a mandibular fracture, then consider ___

A

The major force necessary to cause that fracture, there is a strong possibility of additional facial trauma and/or cervical injuries

98
Q

Signs of mandibular fracture

A
  1. Misalignment of the teeth
  2. Numbness of the chin
  3. Inability to open the mouth
  4. Swelling, bruising, and loosened or missing teeth
99
Q

Maxillary fractures are predominately found after ___

A

Blunt-force trauma, high-energy impacts, a fall, or direct blow from an object

100
Q

Signs of maxillary fractures

A
  1. Massive facial swelling
  2. Instability of the facial bones
  3. Misalignment of the teeth
101
Q

Fractured or avulsed teeth are common following ___

A

Facial trauma

102
Q

Dental injuries may be associated with ___

A

Motor vehicle crashes or an assault

103
Q

Why to always assess the patient’s mouth following a facial injury

A

Teeth fragments can become an airway obstruction and should be removed from the patient’s mouth immediately

104
Q

Patients who are conscious and supine and have oral or facial bleeding may ___

A

Protect their airway by coughing, projecting blood at you

105
Q

Internal bleeding in face and throat injuries may ___

A

Compromise blood flow to the brain

106
Q

A patient who has a significant MOI but whose condition appears stable should ___

A

Also be transported promptly to the nearest appropriate hospital

107
Q

If a patient has an injury involving the eye it should be considered ___

A

Potentially serious

108
Q

Consider transporting a patient with serious, isolated eye injuries to ___

A

An eye care specialty center

109
Q

During the physical examination, your eyes will be looking for ___

A
  1. Swelling
  2. Contusions
  3. Discoloration
110
Q

During the physical examination, your hands will be ___

A

Gently palpating the face, looking and feeling for any abnormalities such as deformity or tenderness

111
Q

Questions to ask yourself during the physical examination

A
  1. Do the facial bones seem to be in alignment?
  2. Does the nasal bone seem to deviate from the midline?
  3. Note any variations from the normal facial examination; is there any facial drooping
  4. Does one eye appear to be lower than the other?
  5. Does the mandible appear to deviate toward one side or the other?
112
Q

One eye lower than the other is an indication of ___

A

An orbital fracture

113
Q

Assess all underlying systems, including ___

A
  1. Neurologic system
  2. Sensory organs
  3. Respiratory system
  4. Circulatory system
114
Q

When you are evaluating the eyes, start at ___

A

The outer aspect of the eye and work your way in toward the pupils

115
Q

___ is considered the vital sign of the eye

A

Visual acuity

116
Q

How to quickly assess visual acuity

A

Gently cover one eye and holding fingers up at arm’s length in front of the open eye. Test for the ability to see fingers in both the injured and uninjured eyes

117
Q

What to look for in the eye during the physical examination

A
  1. Obvious foreign matter
  2. Visual acuity
  3. Discoloration
  4. Bleeding in the iris or redness
  5. Eye symmetry
  6. Pupils equal size and reactivity
  7. Ability to follow objects with eyes side to side and up and down
  8. Ability to read print, blurry vision, or sensitivity to light
118
Q

___ surgery can cause unequal pupil size

A

Cataract

119
Q

Determine if the unequal pupils are caused by ___

A

Physiologic or pathologic issues

120
Q

When an injury exposes the brain, eye, or other structures, ___

A

Cover the exposed parts with a moist, sterile dressing to protect them from further damage

121
Q

For injuries in which the skin is not broken, ___

A

Apply ice or a cold pack locally to help control the swelling or bruised tissues

122
Q

For soft-tissue injuries around the mouth, always check for ___

A

Bleeding inside the mouth

123
Q

Patients who swallow significant amounts of blood are prone to ___

A

Vomiting

124
Q

If you find a portion of avulsed skin that has become separated, ___

A

Wrap them in a sterile dressing, place them in a plastic bag, and keep them cool. Never place tissue directly on ice. Label the bag with the patient’s name and deliver it to the ED with the patient

125
Q

If the avulsed skin is still attached ___

A

Hold it in place with a dry sterile dressing

126
Q

The conjunctiva becomes inflamed and red

A

Conjunctivitis

127
Q

If a small foreign object is lying on the surface of the patient’s eye, you should ___

A

Use a normal saline solution to gently irrigate the eye

128
Q

If you see the foreign object on the surface of the eyelid, you may be able to remove it with ___

A

A moist, sterile cotton-tipped applicator

129
Q

In the eye, never attempt to remove a foreign body this is stuck to the ___

A

Cornea

130
Q

How to stabilize an object sticking out of the eye

A
  1. Bandage the object in place
  2. Cover the eye with a moist, sterile dressing
  3. Surround the object with an eye shield or doughnut-shaped collar made from roller gauze or a small gauze pack
  4. Bandage both eyes to minimize eye movement
131
Q

After irrigating the eye, apply ___

A

A clean-dry dressing to cover the eye

132
Q

If the eyelids are burned, it is best to ___

A

Provide prompt transport without further examination. Cover both eyes with sterile dressing, moistened with sterile saline

133
Q

Retinal injury caused by exposure to very bright light is generally not ___

A

Painful

134
Q

Superficial burns of the eye from UV rays, welding, or snow blindness may become painful after ___

A

3 to 5 hours later

135
Q

How to treat a patient with corneal burns

A

Cover each eye with a sterile, moist pad and an eye shield. Have them lie down and protect from further exposure to bright light

136
Q

Treat lacerated eyelids

A

Apply gentle, manual pressure

137
Q

If the globe is lacerated ___

A

Apply no pressure to the eye

138
Q

Three guidelines for treating penetrating injuries of the eye

A
  1. Never exert pressure on or manipulate the injured eye in any way
  2. If part of the eyeball is exposed, gently apply a moist, sterile dressing to prevent drying
  3. Cover the injured eye with a protected shield. Apply soft dressings to both eyes, and provide prompt transport to the hospital
139
Q

If the eye is dislocated ___

A

Cover the eye and stabilize it with a moist, sterile dressing. Cover both eyes. Lie the patient supine to prevent further loss of fluid from the eye

140
Q

Bleeding into the anterior chamber of the eye, that obscures part or all of the iris

A

Hyphema

141
Q

25% of hyphemas are associated with ___

A

Underlying globe injuries

142
Q

Treat a hyphema

A

Cover the eye and transport to the hospital

143
Q

The bones of the lower orbit are displaced

A

Blow-out fracture

144
Q

The fragments of fractured bone in a blow-out fracture can ___

A

Entrap some of the muscles that control the eye movement, causing double vision

145
Q

Any patient who reports pain, double vision, or decreased vision following a blunt injury about the eye should be ___

A

Placed on a stretcher and promptly transported to the ED

146
Q

Painless, but produces flashing lights, specks or floaters in the field of vision and a cloud or shade over the patient’s vision

A

Retinal detachment

147
Q

Eye findings that should alert you to a possible head injury

A
  1. One pupil larger than another in an unconscious patient
  2. The eyes not moving together or pointing in different directions
  3. Failure of the eyes to follow the movement of your finger as instructed
  4. Bleeding under the conjunctiva, which obscures the sclera
  5. Protrusion or bulging of one eye
148
Q

If the patient has severe swelling or a hematoma to the eyelid, do not attempt to ___ because ___

A
  1. Force the eyelid open to examine the eye
  2. This increases the pressure already present in the globe
149
Q

The only time contact lenses should be removed in the field

A

In the case of a chemical burn because of trapped chemical making irrigation difficult

150
Q

How to remove hard contact lenses in the field

A

Use a small suction cup, moistened at the end with saline

151
Q

How to remove soft contact lenses in the field

A

Place one or two drops of saline in the eye, gently pinch in your gloved fingers, and lift it off the eye

152
Q

Epistaxis

A

Nosebleeds

153
Q

___ nosebleeds are usually more severe

A

Posterior

154
Q

Layers of bone within each nasal chamber, which are covered with a moist lining

A

Turbinates

155
Q

Humidifies air as it passes through the nose

A

Turbinates

156
Q

Three parts of the ear

A
  1. External ear (outer ear)
  2. Middle ear
  3. Inner ear
157
Q

Parts of the outer ear

A
  1. Pinna (auricle)
  2. External auditory canal
  3. Tympanic membrane
158
Q

Parts of the middle ear

A
  1. Hammer
  2. Anvil
  3. Stirrup
159
Q

Eardrum

A

Tympanic membrane

160
Q

Move in response to soundwaves hitting the tympanic membrane

A

Hammer, anvil, and stirrup

161
Q

The middle ear is connected to the nasopharynx by the ___

A

Eustachian tube

162
Q

The eustachian tube permits ___

A

Equalization of pressure in the middle ear when external atmospheric pressure changes

163
Q

The inner ear is composed of ___

A

Bony chambers filled with fluid

164
Q

Treat an avulsed ear

A

Wrap in a dry sterile dressing and pit it in a plastic bag with the patient’s name. Keep cool and transport with the patient to the ED

165
Q

Patients with a ruptured tympanic membrane will often report ___

A

Severe ear pain, difficulty hearing, or ringing in the affected ear

166
Q

Facial fractures alone are not acute emergencies unless there is ___

A

Serious bleeding

167
Q

Treat an avulsed tooth

A

Handle it by the crown. Place in a special storage solution. Notify the receiving facility.

168
Q

Teeth are best reimplanted within ___ of the trauma

A

1 hour

169
Q

Special storage solutions for teeth

A
  1. Special tooth storage solution
  2. Cold milk
  3. Sterile saline
170
Q

The presence of air in the soft tissues produces ___

A

Subcutaneous emphysema

171
Q

Air sucked into a vein and taken to heart

A

Air embolism

172
Q

Significant injuries to the larynx pose an immediate risk of ___

A

Airway compromise

173
Q

Signs and symptoms of larynx injuries

A
  1. Respiratory distress
  2. Hoarseness
  3. Pain
  4. Dysphagia
  5. Cyanosis
  6. Pale skin
  7. Sputum in the wound
  8. Subcutaneous emphysema
  9. Bruising on the neck
  10. Hematoma
  11. Bleeding
174
Q

Manage a laryngeal injury

A

Secure the patient’s airway and provide oxygenation and ventilation as needed

Emergency Medical Technician (100 decks)

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