Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emed/Surg > Facial Trauma > Flashcards

Facial Trauma Flashcards

1
Q

What’s the first and most important consideration when it comes to facial/neck trauma?

A

airway- low threshold for intubation. you want to protect from hemorrhage and obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

B in facial/neck trauma

A

monitor O2 sats and ABGs if intubated
aggressive suctioning
ID and treat PTX/HTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

C in facial/neck trauma

A

control hemorrhage
-watch for expanding hematoma
-never remove FB until you are in controlled environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

D in facial/neck trauma

A

disability/neuro
-GCS- consider ICH
-suspect SCI until proven otherwise
-maintain C spine immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

E in facial/neck trauma

A

exposure
-avoid hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Upon doing the eye exam, a ___________ indicates a globe injury.

A

teardrop pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the tx for a septal hematoma?

A

I/D to prevent avascular necrosis > saddle nose deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the gold standard treatment for a CSF leak?

A

serum beta 2 tranferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a battle sign?

A

ecchymosis over the mastoid process and its indicative of a basilar skull fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. Etiology for malignant otitis externa
  2. Exam
  3. Tx
A
  1. pseudomonas aurginosa, MRSA (15%) and fungal if immunocompromised, DM
  2. parotitis and trismus
    -CN 7 involvement = bad. can lead to meningitis
  3. IV cipro
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the etiology for mastoidititis ? What is the treatment?

A

strep pneumo, strep pyogenes, pseudomonas.
Tx: IV abx- ceftriaxone
recurrent - vanco/zosyn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Blunt trauma is associated with __________

A

intracranial trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

On exam in patients with frontal bone/sinus injury, otorrhea is ___________ until proven otherwise. To dx these patients a ________ is ordered and you want to consider ______ and ______. For the treatment, you want to give the patient _________ or ___________. Complications include __________ and __________.

A

CSF until proven otherwise.
CT, brain and c spine
1st gen cephs or augmentin
complications: cranial empyema and mucopyocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

On exam, what will a patient with an orbital blow out fracture present with?
2. What diagnostic tool will you use and what is the complication associated with it?
3. What is the tx?

A
  1. diplopia on upward gaze
  2. CT, complication: orbital fissure syndrome
  3. Tx: muscle entrapment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Orbital compartment syndrome is considered an optho emergency. What will you see on exam? What is the treatment?

A

-retrobulbar hematoma (bleeding behind globe, only seen on CT scan)
-exopthalmus
-decreased vision
-resistance when pushing back on globe
-increased IOP
Tx: lateral canthotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A child comes in and presents with foul smelling drainage/discharge. What do you want to make sure to inspect on exam? What diagnostic tool do you want to use and what is the treatment?

A

inspect bilaterally and remove any clot.
foul smell +/- visualized FB
Dx- CT acan
Tx- pain control/afrin
abx for staph coverage
removal of FB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the s/s of a maxillary fracture (LaForte)

A

It is a direct blow, high impact.
S/S
ecchymosis
swelling
possible deformity
instability noted when grasping the hard palate and rocking maxilla
Malocculsion
maxillary tenderness
diplopia
facial emphysema
CSF
MAY REQUIRE INTUBATION
GET A CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In LaForte Type I, the _________ separate from the ________. What will you see on exam? What is the tx?

A

maxillary teeth, face
exam: malocculsion, tenderness, ecchymosis, +hard palate and upper teeth move
Tx: nothing specific, consult with facial trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Laforte Type II involves _________ and _________. What will you see on exam? What is the tx?

A

Laforte I, nasal complex
exam: malocclusion and ecchymosis along nasal dorsum and inferior eyelids. +hard palate/teeth/nose
Tx: trauma consult- pain control, admit vs DC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Laforte Type III is a _______________ and you have ____________ complications. What will you see on exam? What is the tx?

A

craniofacial disjunction, airway
exam: complete instability of the face, check vision, BLINDNESS IS A MAJOR COMPLICATION
Tx: admit
facial trauma c/s
pain control
avoid NGT (nasal gastric tube)
surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the second most common facial fx? What do you want to ensure in a patient with this type of fracture? You want to presume its an open fracture if___________ and __________. What do you want to have the pt do?

A

mandibular fracture. - direct blow
Want to ensure airway is open
intraoral lac + mandible fx
have pt bite down

22
Q

What are the s/s of a patient with a mandibular fracture?

A

pain, malocclusion, trismus, mucosal lacerations, dysphagia, associated dental fractures, sublingual hematoma, evidence of condyle displacement/hemotympanum

23
Q

What is the imaging for a mandibular fracture?

A

panorex- per text study of choice
CT maxillofacial series Is the best choice

24
Q

What is the treatment for a mandibular fracture if open?

A

PCN, clinda, erythromycin. you want to admit if open/displaced

25
Q

When closing facial lacerations, it is important to do a __________ before washout and closure. You want to wash out and close within ____________. You want to update _______________. You want to leave open ________________ unless active bleeding.

A

xray
24 hours
tetanus
bite wounds to face

26
Q

For lip lacerations, you want to align the _________________ first. There is no repair for _________________. The _______________ is a highly vascular area.

A

vermillion border, maxillary frenulum, lingual frenulum

27
Q

For nasal lacerations, you want to avoid ___________ into _________ and you want to ________________.

A

epi into the tip
consider topical

28
Q

When do you want to remove sutures from a face?

A

5 days

29
Q

What are important factors to consider for epistaxis?

A

careful history important- ASA or anticoag. use.
consider pregnancy status- may change Rx

30
Q

When do you want to consider a posterior source for epistaxis?

A

if bilateral nosebleed without clear ant. source or fresh active bleed in post oropharynx

31
Q

What is the treatment for anterior epistaxis?

A

phenylephrine, lidocaine/epi or topical cocaine, cautery using silver nitrate, packing

32
Q

What is the treatment for posterior epistaxis?

A

ARTERIAL SOURCE= DANGER
consider nasostat packing

33
Q

In terms of dental pain, if there is surrounding erythema, swelling, fluctuance > _______________

A

abscess

34
Q

What is one of the main differential dx for dental abscess?

A

acute necrotizing ulcerative gingivitis (ANUG)

35
Q

What is the ellis criteria as it pertains to dental trauma?

A

it is a criteria that exists based on the position of the tooth thats been fractured

36
Q

What is the etiology of viral parotitis (mumps)

A

paramyxovirus
>influenza> parainfluenza > coxasackie> HIV
most common in children <15
spreads airborne

37
Q

What is the etiology for suppurative parotitis?

A

bacterial infection occurs in patients with compromised salivary flow.
s aureus, strep pneumonia, S pyogemes, H flu

38
Q

What is the presentation of a pt with suppurative parotitis?

A

erythema and tender**
pus from stenson duct**
rapid onset
fever
trismus

39
Q

What is sialolithiasis? What presents on the PE?

A

stone in stagnant salivary duct. symptomatic men 20s-60s
80% originate from submandibular or parotid
PE: pain/swelling/tenderness
**unilat
**colicky and worse by eating

40
Q

TM perforation is secondary to a __________ ear infection, ________, and blunt penetrating/noise trauma or lightening strikes. What will you find in the HPI? What do you do for tx?

A

middle, barotrauma
HPI: acute pain and hearing loss, +/- bloody otorrhea, +/- vertigo tinnitus.
Tx: can heal spontaneously, dont allow water to enter the canal. ABX if cause was infection

41
Q

What is the history for a patient with epiglottitis?

A

immunocompromised hx- risk for H influenza
-severe dysphagia
-severe odonophagia
systemic sx(HA, body aches, arthralgias) > think VIRAL

42
Q

What will the PE be for a pt with epiglottitis?

A

drooling, tripod position, difficulty moving air, stridor (late) > upper airway abnormality, high pitched

43
Q

What will the PE be for a pt with epiglottitis?

A

drooling, tripod position, difficulty moving air, stridor (late) > upper airway abnormality, high pitched

44
Q

What are the 3 Ds associated with epiglottitis?

A

drooling, dysphagia, distress

45
Q

How is the Dx for epiglottitis made?

A

lateral neck XR or CT with IV, THUMB PRINT SIGN

46
Q

What is the tx for a patient with epiglottitis?

A

definitive airway, O2, IV hydration, monitor
IV antibiotics and steroids
-rocephin/zosyn or levaquin if PCN allergic

47
Q

Odontogenic abscess (dental abscess) arise from infected tooth or after tooth extraction. The etiology is _____________ and most ___________ infections originate from this source. What presents in the PE? How is it diagnosed and what is the tx?

A

polymicrobial, deep neck

PE: neck mass, trismus, fever, leukocytosis, dysphagia, dyspnea
Dx: bedside U/S + CT neck with IV
Tx: IV abx and surgical drainage

48
Q

Ludwigs angina is an infection of the __________, _________ and ___________ spaces. It progresses rapidly so you want to think ______________. What is the hx, PE, dx and tx for this diagnosis?

A

submental, submandibular, sublingual spaces.
AIRWAY
hx: poor dental hygiene, dysphagia, odynophagia
PE: trismus and edema of upper neck and floor of the mouth
Dx: clinical and CT
Tx: definitive airway

49
Q

__________________ is the most common deep space infection in the throat. What presents on the PE? What diagnostic do you want to order? How about tx?

A

Peritaonsilar abscess. “quincy”
PE: **hot potato voice, **halitosis, trismus, difficulty opening mouth, fever, dysphagia
Want to order a CT with contrast
Tx: I/D
IV abx: PCN/clinda

50
Q

What is a complication in peritonsilar abscess?

A

avoid deep penetration with instrument > carotid nearby

51
Q

HPI/DX/ TX of a patient with retropharyngeal abscess

A

HPI: sore throat, dysphagia, neck pain, muffled voice, cervical nodes, poor intake
DX: CT with IV contrast if stable
TX: ENT, IV hydration, IV abx- staph/strep/ anaerobes as clinda + flagyl

Emed/Surg (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions