Head and Face Flashcards
What are the 4 eye movements?
- Up down
- Side to side
- Diagonals
- Focus on near and far away
What are the most important mouth movements? Why?
- smile and frown
- Account for majority of muscles in lower face
Accessory movements of the face include…
- nose, cheek, ears, eyebrows
- Most are activated when people talk to you
What are facial lacerations?
- Cuts to the face
- Bleeds a lot due to all of the blood vessels in the face
- Usually occur when someone is already sweaty, or somewhere it is hard to dress the wound
What are the rules for stitches?
- inch wide
- inch long
- quarter inch deep
- can’t keep edges together
What do we have to keep in mind with facial lacerations?
Cannot have visible bleeding while you are playing sports (exception: boxing)
How do we manage facial lacerations?
- Apply direct pressure
- Dress wound
What is the medical term for nose bleeds?
epitaxis
What is the MOI of nose bleeds?
- due to contact or not
- most commonly from a blow to the nose
What are the signs and symptoms of a broken nose?
- Nose can look deformed
- Racoon eyes
- Blue and purple bruising under their eyes
Why do we need to go to the hospital for a broken nose?
- Need to make sure channel for airway is fairly even so there is no breathing problems
- No floating pieces
How do we manage nose bleeds?
- Pressure
- Ice packs to the forehead or back of the neck
- Pinch at or just below bridge of the nose
- Head down
- Do not blow nose
Why do we not want to tilt head back for nose bleeds?
Blood goes down throat and into the stomach = throwing up
What is considered dangerous bleeding for nose bleeds? What do we do?
- 10 minutes of gushing blood
- Go to hospital
- Don’t need ambulance
What can we do for people who have nose bleeds a lot?
- Cut up peels of citrus fruits and rub it on inside of nose
- Constricts blood vessels away from the surface
What is the timeline for someone with a chip halfway into their tooth to see a dentist? Why?
- within 12 hours
- Seal to avoid bacteria into the tooth
- Continuous with bloodstream, easy way to put bacteria into body
- Try to reattach
How can we transport a chipped tooth?
- Bag of milk
- Bag of ice
- Bag of water
- If it lives in a moist environment, try and keep it in a moist environment
What do we do for the surface of the chipped tooth in the mouth?
gauze
What else do we have to check for if someone has a chipped tooth?
concussion
What is the medical term for black eye?
orbital hematoma
What is the MOI of black eyes?
- Trauma to eye area, orbital bone area
- Can come with nose bleeds
How do we check for fractures that result from black eyes?
- Only way to test is to physically palpate them
- More than pain from contusion
- Chips missing
Fracture to 2 or more sides of the eye orbit means …
- eye will drop
- hospital (not EMS)
What are the signs and symptoms of a black eye?
- Bruising
- Bleeding
- Swelling
How do we manage black eyes?
- Can’t check movement of eye if their eye is swollen
- Need to check if white part of eye is red
- Need ice
- Need to be able to see and move their eye in order to play
What do we do if they can’t see or move eye within 24 hours from getting a black eye? Why?
- go see eye doctor
- Make sure muscles are attached
- Optic nerve isn’t damaged
- Retina isn’t damaged
What are blow out fractures?
- Ball hits eye and comes away from the eye
- Contusion, if not fracture to orbit of eye
- Pulls eyeball out, eyeball hangs down
Describe their vision after a blow out fracture.
- Still able to see out of eye
- Vision will be off
What do we do with the fallen eye of a blow out fracture?
- Keep in moist environment
- Do not push back into socket
- Put moist gauze over the eye that has come out of the socket
- Use dixie cup
People with a blow out fracture generally like …
- for both their eyes to be covered
- Uncomfortable for eyes to be looking in different directions
What is the name of the group that does research on concussions?
Zurich consensus
What is the 2012 Zurich Consensus definition of a concussion?
concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces
What are the 4 types of symptoms that you can get from a concussion?
- physical
- cognitive (mental)
- emotional/behavioural
- symptoms that affect sleep
Give 3 examples of physical symptoms from a concussion.
- Headaches
- Dizziness
- Blurred vision
Give 2 examples of cognitive symptoms from a concussion.
- Difficulty concentrating
- Difficulty remembering
Give 3 examples of emotional symptoms from a concussion.
- Irritability
- Sad
- Anxious
Give 3 examples of sleep related symptoms from a concussion.
- Difficult to fall asleep
- Difficult to stay asleep
- Being very fatigued
What is the MOI of a concussion?
- Direct blow to head
- Brain is floating, not attached to surroundings
- Whipping action of neck, brain will hit sides of skull (indirect blow)
- Neck injury and face injury
Most concussions do not involve ….
loss of consciousness
Can we see a concussion with imaging?
no
What are the 2 types of concussions?
- suspected concussion
- diagnosed concussion
What is a suspected concussion?
- Some sort of MOI that can lead to a concussion
- Haven’t seen medical professional to diagnose
- Most concussions
Describe the SCAT.
- Put out by the Zurich Consensus to diagnose concussions
- Anyone can access it
- Should take about 10 minutes
What do you do after the SCAT?
- If after 10 minutes they have symptoms = concussion
- If they have a concussion, monitor them
- Unconscious when you got to them, or go unconscious later = go to hospital
- Do not need to go to hospital for any other reason
What is the only exception for headaches after the SCAT?
only headache where they got hit = contusion
What is the main component of managing concussions?
rest (physical and cognitive)
What does cognitive rest consist of?
- Decrease mental activity as much as possible
- Ex. classes, tv, texting, computer
Describe the steps for RTP.
- Day 1: 24 hours symptom free
- Day 2: light aerobic exercise for 20 minutes
- Day 3: 30 minutes of aerobic activity with intervals
- Day 4: 50% effort no contact practice
- Day 5: contact practice
- Day 6: RTP
What is second impact syndrome?
- Second impact to the brain while it is still recovering from the first
- Will generally see at least twice the damage
- Will take at least twice as long to recover
Why is second impact syndrome most common in people under 20? Why is this a concern?
- Less medically trained people at sporting events
- Brain is still developing
- Can end up with long term symptoms
Why should we do manual work on the neck for concussions?
may have whiplash, can refer symptoms into head
What are the special tests for head injuries?
- SCAT
- cranial nerve testing
Describe the 12 steps of cranial nerve testing.
- smell
- vision
- eye movement
- eye movement
- face sensation
- eye movement
- facial expression
- hearing
- swallow
- swallow, speech
- swallow
- tongue movement
What is a cranial hematoma?
- Complication to a concussion
- Shine light into eyes
- Will kill you in 3 days if not caught
- Bleeding in the brain
- Nowhere for it to go
What is a epidural hematoma?
- Bleeding in brain within minutes to first couple of hours from when blow was sustained
- Fast bleed
- Happening in epidural meningeal
What are the symptoms of a epidural hematoma?
- Shows with loss of consciousness
- Symptoms will get gradually worse over 3-4 hours
- One of their pupils will be dilated on the side they got hit on
- Will eventually lose consciousness again then die
- will all happen within 5 hours of getting hit
What is a subdural hematoma?
- Happens below meningeal
- whiplash as opposed to hitting head
What are the symptoms of a subdural hematoma?
- Generally not see unconsciousness
- Still will see dilation of pupil to the same side as blow
- Symptoms will get worse
- Generally takes longer
- can take up to 2 days
Which one is more common? Epidural or subdural hematomas?
subdural hematoma
