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CATA 262 > Head and facial Injuries > Flashcards

Head and facial Injuries Flashcards

1
Q

Sports-related facial injuries account for x of all facial soft tissue injuries

A

8%

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2
Q

What are some common types of facial injuries in athletes?

A
  • Soft tissue
  • Eye Injuries
  • Dental/dentoalveolar
  • Zygoma and mandible fractures
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3
Q

Mechanism of injury in facial injuries

A

Blunt force trauma (forces transmitted to the head)

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4
Q

What’s the difference btwn low speed and high speed blunt force trauma for facial injuries

A

Low: soft tissue (laceration, contusion)
High: bone/tooth fractures

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5
Q

What are the soft tissue facial injuries?

A

-Contusions
-Abrasions
-Lacerations
-Avulsions
-Hematomas

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6
Q

What is the MOI of soft tissue injuries in the face?

A

Direct contact with:
- another player
- equipment
- playing surface

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7
Q

What could be another injury when noticing facial contusions?

A

Concussion

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8
Q

In facial contusions there are varying degrees of:

A
  • Tenderness
  • Swelling
  • Ecchymosis
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9
Q

Tx of facial contusions

A
  • Ice for 15-20mins
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10
Q

What is the recovery time for facial contusions

A

days to weeks

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11
Q

What is another way of saying brain freeze?

A

Phenopalatine Ganglioneuralgia

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12
Q

What is phenopalatine ganglioneuralgia?

A
  • Quick change in blood vessel size/flow
  • areas: forehead, behind eyes, btwn skull and brain (meninges)
  • Pains signals through trigeminal n.
  • Pain perception at source AND front of head
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13
Q

What is the MOI of a facial abrasion?

A
  • Sliding: shearing force
  • Head impact?
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14
Q

Tx for facial abrasion

A
  • Stop bleed
  • Inspect and remove gauze
  • Clean (saline solution)
  • Remove foreign material (to avoid “tattooing”)
  • Dressing (non-adherant gauze) + Topical antibiotic ointment
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15
Q

When should you refer to a doctor for a facial abrasion? (infected)

A

Full thickness (tissue loss) or not healed after 14 days

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16
Q

S/S of infection

A
  • Redness
  • Swelling
  • Warmth
  • Pain or tenderness
  • Drainage (yellow, green, brown)
  • Foul odour
  • Inc. body temp
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17
Q

Describe the stages of infection

A

1: intact skin (non-blanchable redness)
2: partial thickness loss of dermis (ulcer w/o slough)
3: full thickness tissue loss (slough may be present)
4: full thickness tissue loss + exposed tendon/muscle (slough or eschar may be present)

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18
Q

How should you monitor an infection

A

Sharpie around injury and see if it spreads

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19
Q

What is Slough?

A

necrotic tissue to be removed for healing (yellow, tan, green, brown)

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20
Q

What is eschar?

A

Dead tissue (tan, brown, black)

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21
Q

What is the most common type of facial injury?

A

Lacerations

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22
Q

What are common areas for facial avulsion?

A

Nose, ear, lip

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23
Q

Tx incomplete facial avulsion

A
  • Stop bleed
  • Clean
  • Approximate + bandage + hospital
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24
Q

Tx complete facial avulsion

A
  • Recover avulsed tissue
  • 2 places to treat
  • wrap in saline-moistened gauze
  • place in bad, on ice (name + time)
  • tetanus immunization (human/animal bite, metal)
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25
Q

MOI + Tx lip laceration

A

MOI: compression of lip on teeth
Tx: stop bleed + clean, vaseline

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26
Q

What’s special about oral mucosa (inside mouth)?

A

Only lacerations that heal well w/o sutures

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27
Q

Tongue laceration:
MOI
S/S
Location
Risk of…

A

MOI: biting down on tongue
S/S: pain, swelling, bleeding
Location: tip/middle section of tongue
Risk of INFECTION

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28
Q

Tx of tongue laceration

A
  • PPE
  • Irrigate, remove foreign bodies (rinsing mouth w/ clean water)
  • non-adherent sterile gauze
  • pressure + tip head fwd
  • stop bleed: reduce swelling/ pain by sucking on ice
  • Monitor for infection
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29
Q

When do tongue lacerations require repair?

A
  • > 1cm
  • bisect tongue
  • gaping wounds
  • uncontrolled bleeding
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30
Q

What is another term for nosebleed?

A

Epistaxis

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31
Q

What should you check for after nasal trauma?

A

Septal hematoma (very common)

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32
Q

What does a septal hematoma do? and how do you get rid of it?

A

Nasal obstruction, pain, rhinorrhea, fever
(Hospital needs to drain it)

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33
Q

How does septal hematoma look?

A

Purple, grapelike swelling from nasal spetum

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34
Q

Whta is a facial hematoma?

A

Collection of blood within muscle, fascial, and dermal layers

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35
Q

Where are facial hematomas seen?

A

Over zygomatic and periorbital regions

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36
Q

Tx for facial hematoma

A

Ice + compression
Monitor for: expansion, overlying skin necrosis, infection

37
Q

What is cauliflower ear called?

A
  • Auricular hematoma
  • Hematoma auris
  • Perichondrial hematoma
38
Q

In which sports is auricular hematoma common?

A
  • Boxing
  • Judo
  • Wrestling
    (martial arts)
39
Q

What is the MOI of auricular hematoma?

A

MOI: blunt trauma or friction to outer ear

40
Q

Explain how the auricular hematoma works?

A
  • separation of perichondrium
  • ecchymotic collection in ant. ear (obscures auricular architecture)
  • blood/fluids fill space and disrupt normal blood flow
41
Q

What is perichondrium?

A
  • dense irregular connective tissue
  • source of nutrients for cartilage
  • outer skin from cartilage that forms the shape of the ear
42
Q

How do you inspect the ear?

A

Observe for:
- hematoma location(s)
- discolouration
- hematoma size
- ear canal
Palpation: soft/firm?

43
Q

Auricular hematoma symptoms

A
  • Localized swelling
  • redness
  • skin irritation
  • fluid may build up on outer ear
  • damage to cartilage (risk of infection)
44
Q

Auricular hematoma Tx

A
  • Rest
  • proper headgear
  • ice 15-20mins at a time (swelling/pain)
  • doctor: numb ear + remove fluid
45
Q

What is the process of removing an auricular hematoma (doctor)

A
  • draining
  • incision
  • cotton ball in ear + bandage + pressure (compression x 3-5days)
  • ear protectors 4-6 weeks
46
Q

Which bones get fractured in facial fractures?

A
  • nasal (3rd most common in body)
  • maxila
  • mandible
  • zygoma
  • orbital
47
Q

in what age range is the occurrence for facial fractures the highest?

A

13-15

48
Q

What are the MOI for facial fractures?

A
  • Throwing/catching/hitting a ball
  • collision btwn players
49
Q

Laceration on top of nose is a good indication of what?

A

nasal fracture

50
Q

List the types of nasal fractures

A
  • Unilateral
  • Bilateral
  • Open-book (splayed)
  • Impacted
  • Greenstick
  • Comminuted
51
Q

What’s the difference btwn a lateral and frontal blow for nasal fractures?

A

Lateral: more common, less severe damage, better prognosis
Frontal blow: less common, more severe damage (residual deformity), poor prognosis

52
Q

What are nasal fracture symptoms

A
  • Pain
  • Nosebleeds
  • Swelling
  • Bruising
  • Deformity/deviation/asymmetry
  • Inability to breathe thru nose
  • Epiphora (overflow of tears)
  • Edema
  • Skin laceration
  • Septal hematoma
53
Q

What is epiphora?

A

Overflow of tears

54
Q

What should you check when palpating the nose?

A
  • Nasal fracture
  • Mobility
  • Crepitations
  • Septal hematoma
55
Q

S/S: mandibular fracture

A
  • Deformity
  • Change in bite (visible step-offs)
  • Jaw mobility
  • Difficulty opening mouth
  • Teeth unaligned
  • Swelling
  • Bruising
  • Bleeding gums
  • Pain
56
Q

What are the most common mandibular fractures, and how many breaks usually occur?

A

Condyle + Angle
60% of cases the break occurs in 2 places

57
Q

What kind of bandage do you use for mandibular fracture?

A

Barton Bandage + gauze/mouthguard

58
Q

What are the most affected areas for dental injuries?

A
  • upper central
  • lateral incisors
  • enamel fracture
  • enamel-dentin fracture
59
Q

How many dental injures were preventable?

A

1/3

60
Q

Tx tooth displacement

A

Put affected teeth back into normal position

61
Q

What are dentoalveolar fractures?

A

Fractures, displaced/broken/lost teeth, damage to supporting bone

62
Q

Tx: Ellis Class I

A

Grinding/smoothing rough edges or restoring lost structure

63
Q

Tx: Ellis Class II

A

bonded resin restoration or crowning

64
Q

What is a dental concussion?

A

Injured tooth-supporting structures (doesn’t increase mobility or displace tooth)
- pain to percussion

65
Q

What is dental subluxation?

A
  • inc. mobility w/o displacement
  • gingival sulcus bleeding
  • no tx
  • if too much mobility: splint for 2 weeks
66
Q

What is dental extrusion?

A
  • partial displacement of tooth out of its socket
    Tx: reposition + 2 weeks splinting
67
Q

What is dental intrusion?

A

Displacement of tooth into alveolar bone
Tx: surgical repositioning >7mm intrusion

68
Q

What is dental infraction?

A
  • Enamel cracks
  • Usually asymptomatic
69
Q

What is a dental root fracture?

A

Fracture confined to the root of the tooth involving:
- Cementum
- Dentin
- Pulp

70
Q

How to prevent oral injuries

A

Mouth guards:
- cushion
- redistribute shock
- stabilize mandible

71
Q

Types of mouth guards

A
  1. Stock
  2. Mouth-formed (boil-and-bite)
  3. Custom fit
72
Q

What are the 2 MOI of eye injuries?

A
  • Blunt trauma
  • Penetrating trauma
73
Q

MOI and S/S of eye contusion/periorbital hematoma (black eye)

A

MOI: blow to eye
- discolouration from bleeding under skin
- pain
- swelling
- contusion

74
Q

Tx of eye contusion (including examination)

A
  • Eye: vision, acuity, PERRLA
  • Palpation: bones
  • Head: rule out concussion
    Tx: ice, rest, protection
75
Q

What are the affects to visual acuity from an eye contusion?

A
  • blurred vision
  • peripheral vision
  • flashes = retinal detachment
  • double vision
  • focusing
76
Q

What to look for in an eye injury examination?

A
  • penetrating/foreign object
  • swelling (intra-ocular)
  • inspect structures
  • palpate around
  • PERRLA
  • eye mvmts
77
Q

What do you do for a lid laceration?

A

Need expert care

78
Q

Eye injury: NO RTP if

A
  • blurry vision
  • double vision
  • peripheral vision
  • flashers or floaters
  • light sensitivity
  • abnormal PERRLA
79
Q

What is blepharitis?

A

Inflammation of eyelids (exact cause unknown)

80
Q

Potential causes of blepharitis

A
  • clogging oil glands in eyelids
  • dandruff
  • bacterial infection
  • mites
  • rosacea
  • allergies
81
Q

S/S blepharitis

A
  • eyes watering
  • red eyes
  • gritty/burning/stinging sensation
  • eyelids look greasy
  • itchy, red, swollen eyelids
  • frequent blinking
  • crusted eyelashes when awakening
  • flaking skin
  • sensitivity to light
  • scarring of eyelid margin
  • abnormal direction of growth of eyelashes
  • loss of eyelashes
  • infection/erosions of cornea (ant. layer of eye)
82
Q

Tx: blepharitis

A
  • optometrist
  • self care + eyelid hygiene
83
Q

What is subconjunctival hemorrhage?

A

Breakage of small blood vessel below clear surface of eye

84
Q

Potential causes for subconjunctival hemorrhage?

A
  • violent coughing/sneezing
  • straining
  • vomiting
  • roughly rubbing eye
  • trauma (foreign object)
85
Q

S/S and Tx of subconjunctival hemorrhage

A
  • bright red patch in sclera
  • scratchy feeling on surface of eye
    Tx: none
86
Q

S/S blow-out/orbital fracture

A
  • immediate blindness or delayed loss of vision
  • infraorbital numbness
  • skin/muscle damage
  • diplopia (double vision)
  • Ecchymosis
  • Edema
  • Numbness below eye (infra-orbital n.)
  • Enophthalmos
87
Q

What is diplopia

A

Double vision

88
Q

What is enophthalmos

A

Post. displacement of eyeball within orbit

CATA 262 (10 decks)

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