Facial Trauma

Question 1

Signs and symptoms

Answer 1

Asymmetry, crepitus, dental malocclusion, displacement of nasal septum, ecchymosis, lacerations and bleeding, limited movement of jaw, limited ocular movement, numbness, pain, swelling, visual disturbances

Question 2

Mandibular Fractures

Answer 2

usually through blow to chin
Misaligned bite
Unable to open mouth

Question 3

Mid-Face Fractures

Answer 3

when the face is struck with force from the front the bones collapse

Question 4

Le Fort 1

Answer 4

fracture runs across lower face including hard palate and alveolus

Question 5

Le Fort 2

Answer 5

pyramidal, extending variably upwards in the midline to involve the ethmoids

Question 6

Le Fort 3

Answer 6

more transverse but uniformly higher than le fort 1

separates the face from skull

Question 7

Management of middle face fracture

Answer 7

Mobilise front of face
Marked swelling and bruising
Marked bleeding
Often CSF leak
Normally assoc with spinal injuries
Requires constant suctioning of airways
NPA contraindicated

Question 8

Zygoma (Malar) Fractures

Answer 8

strong bone transmits force to: orbit, zygomaticofrontal suture, may present with subcutaneous emphysema due to fracture of air sinus

Question 9

Nose Fractures signs and symptoms

Answer 9

epistaxis, swelling, deformity, often accompanied by ecchymosis

Question 10

Dental Trauma

Answer 10

assoc with facial and mandibular trauma
Get pt to run tongue around teeth
Broken or jagged teeth may cause excessive bleeding

Question 11

Ear Trauma treatment

Answer 11

direct pressue to control bleeding
cold compress to reduce swelling
irrigate
avulsed pinna can be kept in moistened gauze

Question 12

Orbit Fractures and Blunt Trauma signs and symptoms

Answer 12

contusion injury - black eye
traumatic hyphaema - bleeding
globe or scleral rupture

Question 13

Penetrating Eye injuries signs and symptoms

Answer 13

dispacement of pupil
prolapse of intraocular content
evidence of intraocular foreign body or infection
reduced visual activity 
hyphaema

Question 14

Chemical burns to eye

Answer 14

alkali: reacts with proteins in the eyes to produce destruction of cells and softening of tissue, penetrates eye
acids: immediate and severe pain, destruction of surface tissue

Question 15

Burns to eyes

Answer 15

arc eye from welders or skiers:

may affect both eyes, painful, weeping, red, sensation of foreign body, dye reveals tiny corneal abrasions

Question 16

Retinal Haemorrhage caused by:

Answer 16

hypertension, occluded retinal vein, diabetes, shaken baby syndrome

Question 17

Assessment and treatment of eye injuries

Answer 17

examine with pen torch, look for asymmetry and irregularity, assess eye movement, anterior chamber may contain blood

Question 18

Scalp Lacerations

Answer 18

Skin 
Connective tissue
Aponeurosis - loose muscular layer
Loose connective tissue
Pericranium

Question 19

Nerve Damage

Answer 19

Facial nerve - motor supply to face and scalp,

Trigeminal nerve - cutaneous supply of face and scalp